POPPYCOCK

In 1822, Thomas De Quincey published a short book, "The Confessions
of an English Opium Eater." The nature of addiction to opiates has
been misunderstood ever since.

De Quincey took opiates in the form of laudanum, which was tincture
of opium in alcohol.

He claimed that special philosophical insights and emotional states
were available to opium-eaters, as they were then called, that were
not available to abstainers; but he also claimed that the effort to
stop taking opium involved a titanic struggle of almost superhuman misery.

Thus, those who wanted to know the heights had also to plumb the depths.

This romantic nonsense has been accepted wholesale by doctors and
litterateurs for nearly two centuries.

It has given rise to an orthodoxy about opiate addiction, including
heroin addiction, that the general public likewise takes for granted:
To wit, a person takes a little of a drug, and is hooked; the drug
renders him incapable of work, but since withdrawal from the drug is
such a terrible experience, and since the drug is expensive, the
addict is virtually forced into criminal activity to fund his habit.

He cannot abandon the habit except under medical supervision, often
by means of a substitute drug.

In each and every particular, this picture is not only mistaken, but
obviously mistaken.

It actually takes some considerable effort to addict oneself to
opiates: The average heroin addict has been taking it for a year
before he develops an addiction.

Like many people who are able to take opiates intermittently, De
Quincey took opium every week for several years before becoming
habituated to it. William Burroughs, who lied about many things,
admitted truthfully that you may take heroin many times, and for
quite a long period, before becoming addicted.

Heroin doesn't hook people; rather, people hook heroin.

It is quite untrue that withdrawal from heroin or other opiates is a
serious business, so serious that it would justify or at least
mitigate the commission of crimes such as mugging.

Withdrawal effects from opiates are trivial, medically speaking
(unlike those from alcohol, barbiturates or even, on occasion,
benzodiazepines such as valium), and experiment demonstrates that
they are largely, though not entirely, psychological in origin.

Lurid descriptions in books and depictions in films exaggerate them a
la De Quincey (and also Coleridge, who was a chronic self-dramatizer).

I have witnessed thousands of addicts withdraw; and, notwithstanding
the histrionic displays of suffering, provoked by the presence of
someone in a position to prescribe substitute opiates, and which
cease when that person is no longer present, I have never had any
reason to fear for their safety from the effects of withdrawal. It is
well known that addicts present themselves differently according to
whether they are speaking to doctors or fellow addicts.

In front of doctors, they will emphasize their suffering; but among
themselves, they will talk about where to get the best and cheapest heroin.

When, unbeknown to them, I have observed addicts before they entered
my office, they were cheerful; in my office, they doubled up in pain
and claimed never to have experienced suffering like it, threatening
suicide unless I gave them what they wanted.

When refused, they often turned abusive, but a few laughed and
confessed that it had been worth a try. Somehow, doctors -- most of
whom have had similar experiences -- never draw the appropriate
conclusion from all of this. Insofar as there is a causative relation
between criminality and opiate addiction, it is more likely that a
criminal tendency causes addiction than that addiction causes criminality.

Furthermore, I discovered in the prison in which I worked that 67% of
heroin addicts had been imprisoned before they ever took heroin.

Since only one in 20 crimes in Britain leads to a conviction, and
since most first-time prisoners have been convicted 10 times before
they are ever imprisoned, it is safe to assume that most heroin
addicts were confirmed and habitual criminals before they ever took heroin.

In other words, whatever caused them to commit crimes in all
probability caused them also to take heroin: perhaps an adversarial
stance to the world caused by the emotional, spiritual, cultural and
intellectual vacuity of their lives.

It is not true either that addicts cannot give up without the help of
an apparatus of medical and paramedical care. Thousands of American
servicemen returning from Vietnam, where they had addicted themselves
to heroin, gave up on their return home without any assistance
whatsoever. And in China, millions of Chinese addicts gave up with
only minimal help: Mao Tse-Tung's credible offer to shoot them if
they did not. There is thus no question that Mao was the greatest
drug-addiction therapist in history.

Substitution of one drug for another is at best equivocal as a means
of treating drug addicts.

No doubt if you gave every burglar $10 million, each would burgle far
less in the future; but this treatment of the disease of burglary
would scarcely discourage burglary as a social, or rather antisocial,
phenomenon. And the fact that there would be a dose-response
relationship between the amount of money given to burglars and the
number of burglaries they subsequently committed does not establish
burglary as a real disease or money as a real treatment for it.

Why has the orthodox view swept all before it? First, the literary
tradition sustains it: Works that deal with the subject continue to
disregard pharmacological reality, from De Quincey and Coleridge
through Baudelaire, Aleister Crowley, Bulgakov, Cocteau, Nelson
Algren, Burroughs and others. Second, addicts and therapists have a
vested interest in the orthodox view. Addicts want to place the
responsibility for their plight elsewhere, and the orthodox view is
the very raison d'etre of the therapists. Finally, as a society, we
are always on the lookout for a category of victims upon whom to
expend our virtuous, which is to say conspicuous, compassion.
Contrary to the orthodoxy, drug addiction is a matter of morals,
which is why threats such as Mao's, and experiences such as religious
conversion, are so often effective in "curing" addicts.