- Dominic Lawson; “Addiction is a moral, not a medical, problem”; The Independent; February 6, 2007
- Jacob Sullum; “Talking Smack”; National Review; November 6, 2006
- Jamie Glazov; “Symposium: Romancing Opiates”; FrontPageMagazine.com; October 13, 2006
- Jamie Glazov; “Romancing Opiates” (interview); FrontPageMagazine.com; July 5, 2006
- Dr. Fred Hansen; “Is It a Disease or Not?”; Adam Smith Institute; May 13, 2008
- Roswyn Hakesley-Brown; Nursing Standard; February 2008
- Steven Poole; The Guardian; Saturday September 29, 2007
Theodore Dalrymple has never been one to shy away from the truth, no matter how controversial, and he continues the trend in this book by exposing all the modern myths about opiate addiction. “Almost everything everyone knows about it is wrong,” he says, “and obviously wrong.” He cites medical science, literature and the common experience of doctors (all of which are in plain view but ignored) to back up his central contention that the vast majority of opiate addicts are not innocent victims but are responsible for their own addiction and that opiate addiction is not an irresistible physical craving but a moral failing, the result of a conscious decision that people make, mostly to alleviate their existential woes.
Addicts, he says, do not get addicted easily. They choose to take opiates knowing full well the dangers they pose. They must take them in great quantities for a year or more to become addicted, and even then, sufferers are not helpless. It is not true that addicts are compelled to commit crimes in order to feed their habits. Rather than addiction causing crime, the opposite is true: crime causes addiction. The vast majority of addicts are simply bad people that already live criminal and anti-social lifestyles before they first take heroin, and their existential problems (a lack of purpose in life; no incentive to work, since public welfare provides for them; no cultural interests; no moral foundation from religion or elsewhere) lead to boredom and a desire for escape via the oblivion of drugs. They enjoy the network of acquaintances, the routine and the drama of escaping detection by the police that opiates provide.
Contrary to popular opinion, withdrawal from opiates is not medically serious, much less life-threatening, as portrayed in popular media. At its very worst, it is like the flu and lasts only a few days. During the withdrawal period, addicts can become irritable, but the popular image of near-death experiences are pure fiction and in fact probably contribute psychologically to the discomfort of withdrawal. Patients often fake or exaggerate their symptoms to win sympathy or to convince doctors to prescribe methadone. In the end, addicts can break their habit if they make the decision to do so and go “cold turkey” for a few days. Dalrymple cites patients who broke their habit because their wives (or rather, the “mothers of their children”) demanded they do so, as a precondition for visiting their babies. If heroin addiction is a disease, it is one that is fundamentally different than cancer or AIDS, which cannot be cured by the providing of incentives.
Medical issues may arise out of addiction, but this does not make it a disease any more than sports injuries make football a disease. There is almost nothing that doctors or medical clinics can do to end opiate addiction, and yet a “treatment” bureaucracy has grown up that benefits from and perpetuates the myths in order to justify ever-larger government largesse. These doctors and auxiliary workers have become addicted to addiction, which has simply grown hand-in-hand with supposed attempts to alleviate it. This issue is clearly very personal for Dalrymple, who calls the book his “personal exorcism or catharsis” after years of toiling in an “atmosphere of Kafka” and struggling against the “prevailing and unassailable orthodoxy” of the medical establishment.
Dalrymple locates the source of these myths in literature, especially the “dishonest, exhibitionist and self-dramatizing claptrap of the early nineteenth-century Romantics” like Thomas De Quincey and Samuel Taylor Coleridge, both of whom were “opium eaters” who claimed addiction was a source of profundity. More recently, William Burroughs justified heroin and its related, depraved lifestyle as being more “real” and thus somehow desirable. The general public has been persuaded to accept the myths of addiction as a means to display their compassion and virtue.
As a solution, Dalrymple proposes closing all drug clinics, whose needle exchange and other “harm reduction” programs only serve to infantilize addicts. Methadone substitution programs should be ended, since they are not a cure (despite the flawed studies that purport to prove otherwise) and actually increase rather than decrease addiction. He is against legalization since it is likely to make drug abuse more widespread and not less.
In the end, opiate addiction is a function of ideas, and that is where the battle must be fought. Like so much in the modern world, the facts are available but ignored. Speaking the truth is considered “mean” and deserving of condemnation. Modern beliefs about opiate addiction are yet more evidence that conventional wisdom is not exactly the result of an objective search for truth.