Romancing Opiates: Pharmacological Lies and the
Addiction Bureaucracy
By Theodore Dalrymple
(Encounter Books, 165 pages, $21.95)
Theodore Dalrymple has a knack for draining all of the fun and
romance out of drug addiction. This is not a particularly easy
task, considering that some of our finest writers, filmmakers and
Harvard professors have been romanticizing smack, jack, coke and
junk for nearly two centuries. Dalyrmple, pen name of Anthony
Daniels, MD, worked for years as a doctor and psychiatrist in some
of the most underdeveloped parts of Africa, only to return to
Britain to take up practice in a British slum hospital and prison.
His many years of experience with substance abusers has led him to
conclude that drug use is a willful self-indulgence and a conscious
choice that individuals make — like whether to drive drunk or rape
the neighbor’s daughter — and not an illness that like HIV or the
bubonic plague can be treated.
Trouble is most of us have been taught that addiction is a
disease that can be cured (usually by recourse to other opiates)
rather than a moral failing. Dalrymple devotes much of his book to
debunking this notion of addiction as illness, noting that it takes
a lot of energy and effort to become an addict. Nor is it as hard
to kick the habit as presumed: most addicts tire of the criminal
lifestyle and prison as they age. Mao Tse-tung managed to get 20
million Chinese off opium by executing dealers and threatening to
shoot those who continued using. Chairman Mao — “the greatest
drug-addiction therapist in history” — understood that opium use
was a lifestyle choice — not an epidemic like the plague — and
while one may disagree with his methods, one cannot quibble over
the results. If all that is required to cure the disease of
addiction is a threat then we cannot be looking at a very serious
“disease.”
Scott Fitzgerald once noted that the rich are not like you and
me, to which Hemingway responded, “Yes, they have more money.” In
the same way society assumes the addict is not like you and me. But
rather than having a surplus of hard currency, he maintains a
deficit of moral character. As a consequence he is unable to
imagine the results of his actions, therefore society must treat
him like a sick child, and not even like misbehaving sick child.
Just a sick child. Indeed an entire addiction bureaucracy has been
created based on the idea that the addict is a helpless victim. The
“view of heroin addiction that is almost universally accepted by
the general public,” Dalrymple writes…”serves the interests both
of the addicts who wish to continue their habit while placing the
blame elsewhere, and the [addiction] bureaucracy that wishes to
continue in employment, preferably forever and at higher rates of
pay.”
According to the author, our coddling of addicts only worsens
the problem for the addict and society. “Harm reduction as a policy
is inherently infantilizing of the population: it assumes that the
authorities are, and ought to be, responsible for the
ill-consequences of what people insist upon doing,” he writes. The
government in effect tells the addict that antisocial behavior has
few if any consequences. Then provides him with free methadone.
IN HIS review of Romancing Opiates Lee Harris suggests that Dalrymple is too unsympathetic toward the
addict, as if a physician who has dedicated his entire career to
administering to the poor, the crapulous and the insane were some
kind of pitiless cad. What is needed is not tough medicine, says
Harris, but more compassion and sympathy. “There will inevitably be
large groups of human beings who will be unable to control their
own lives,” writes Harris.
Unable or unwilling? Most heroine addicts, Dalrymple notes,
“were confirmed and habitual criminals before they ever took
heroine…[possessed] with an adversarial stance to the world
caused by the emotional, spiritual, cultural and intellectual
vacuity of their lives.” Indeed criminality causes addiction far
more often than addiction causes criminality. And what is more, the
addict had to work damn hard at becoming addicted. Even the adding
machine heiress and beatnik novelist William S. Burroughs said so:
“You don’t wake up one morning and decide to be a drug addict. It
takes at least three months shooting twice a day to get any habit
at all.” Dalrymple writes that it can take up to 12 months to hook
the user.
Which is it then? Are addicts self-indulgent criminals or
morally weak slaves? Dalrymple agrees with Harris that the
potential addict is likely a person of weak character and moral
failings. But he is not so ready to shift blame from the addict’s
misbehavior and choices to the drug, or to some dubious gene, or to
society’s failure to educate its citizenry about personal
responsibility. He makes a convincing case that many addicts do in
fact shake their habits, if they truly desire to do so. Nor is
kicking the habit as onerous as it is often portrayed (particularly
by Hollywood), Dalrymple writes, likening the symptoms of heroine
withdrawal to the flu.
The problem is the addict’s lack of incentive to kick the habit.
Why should he? The addiction bureaucracy will take care of him. The
drunkard may be viewed negatively, but the opium addict has been
romanticized for centuries. The original romancer was Thomas De
Quincey, who, in his Confessions of an English
Opium-Eater, suggested a connection between opiates and
creativity, that drugs could indeed unlock the mysteries of the
universe, and offer rare philosophical insights. De Quincey was
followed by other romantics the likes of Coleridge and Baudelaire
(“first class self-dramatizers”), and in our own day Burroughs, Ken
Kesey, and Dr. Timothy Leary who preached “Drop Out, turn on, leech
off society,” or some similarly vacuous mantra. Finally the addict
suffers little in the way of stigmatization or shame. In fact, he
is pitied. “Addicts should therefore be stigmatized far more than
they are,” Dalrymple writes, a policy that Harris finds “utopian,”
and unsympathetic, and suggests that submitting the opium eater to
Darwinian evolution would be as bad for our collective soul as
letting the AIDs patient die without treatment.
Dalrymple’s favorite quotation comes from Edmund Burke:
Men are qualified for civil liberties in exact
proportion to their disposition to put moral chains upon their
appetites: in proportion as their love of justice is above their
rapacity…Society cannot exist, unless a controlling power upon
will and appetite be placed somewhere; and the less of it there is
within, the more there must be without. It is ordained in the
eternal constitution of things, that men of intemperate minds
cannot be free. Their passions forge their fetters.
Today, rather than encouraging temperance, we embrace the notion of
addict as victim. Ultimately the question becomes what society
should do with the addict? Dalrymple concludes that he should
receive rehabilitation — not treatment. He should be told that his
free ride is over, and that it is his duty to put moral chains on
his appetites. Hard work putting chains on one’s appetites, but it
is also hard work getting up at 5 a.m. every weekday and going to
work in an office building in order to support your family. And
there is not a thing romantic about it.
