Romancing Opiates: Pharmacological Lies and the Addiction Bureaucracy

Romancing Opiates: Pharmacological Lies and the Addiction Bureaucracy | Theodore Dalrymple | Dr. Dalrymple knows whereof he speaks

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Romancing Opiates:...

	Romancing Opiates: Pharmacological Lies and the Addiction Bureaucracy Theodore Dalrymple Encounter Books, 2006 - 165 pages average customer review:based on 27 reviews view larger image
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Leftists better sit down reading this book.

To those who reject the concept of personal responsibility in life, this book is likely going to make you apoplectic. Those who worship at the altar of government will likely break out the torches and nooses in search of Dr. Dalrymple because of his heresy. To those honest therapists who have a compulsive desire to parent adult-children, you'll probably need therapy yourself after reading it. A bureaucratic ox has been so thoroughly gored with with this book that it deserves mandatory reference in treatment manuals.

Having assessed and treated addicts for many years, I found Dr. Dalrymple's descriptions of addicts and their panoply of using excuses to be stunningly accurate. Except for the very few mentally ill people who abuse substances to assuage their pain, addicts are frightened Peter Pans who resist the maturation process at all cost and that, to themselves or others. To help clarify this, his clear and simple explanation of the existential angst construct illuminates the foundation of the opium-eater's personality.

The willfully ignorant and headless addiction treatment bureaucracy provides both the dysfunctional parents and the chemistry to perpetuate the drug addict's misery. "Romancing Opiates" provides full disclosure of this self-serving and parasitic relationship. An honest and courageous work.

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Dr. Dalrymple knows whereof he speaks

I tend to agree with Dr. Dalrymple...

From the jacket blurb:
"Almost everything you know about heroin addiction is wrong. Not only is it wrong, but it is obviously wrong. Heroin is not highly addictive; withdrawal from it is not medically serious; addicts do not become criminals to feed their habit; addicts do not need any medical assistance to stop taking heroin; and contrary to received wisdom, heroin addiction most certainly IS a moral or spiritual problem."

By "moral" or "spiritual", he doesn't mean what US Americans would take it to be. He's a British psychiatrist. He means it's a personal problem or what we might call a psychological problem. "values" or "God" has nothing to do with his analysis.

Here's from the introduction:
"Romancing Opiates draws the appropriate conclusion from this: that addiction to opiates is a pretend rather than a real illness, treament of which is pretend rather than real treatment. How and why addicts came to lie to doctors, how and why doctors came to return the compliment, and how and why society in general swallowed the lies wholesale, is explored in this book."

Make you want to read it yet? Here's more.

"Romantic claptrap invests intoxication by opiates with a philosophical significance beyond mere self-indulgence. The idea is that an addled brain is capable of insights into the nature of existence deeper than those produced by the clearest mind. It also encourages people to suppose that rebellion against society, in the form of such intoxication, is a good in itself, and is self-justifying, no matter what is being rebelled against or what the consequences might be, personal or social. It elevates feeling and intuition above knowledge and thought in the pantheon of human desiderata. It invests the personal pettiness of addiction with the aura of titanic and tormenting struggles against mighty forces, while at the same time implying that there is a connection between opiates, talent, creativity and genius. It encourages histrionic self-dramatization, to the detriment of real character...

I suppose the self-deception could be defined as untruth that one easily recognizes as such when uttered by another, but unrecognized (though of course not unrecognizable) when uttered by onself."

That latter has a general application that is very powerful. No one is immune.

"Why is there such wide acceptance of it? For many of the reasons that non-addicted writers accept it. In addition, there is very little opposition to it: it has become an almost unassailable dogma. Moreover, the public likes victim groups on which it can expend compassion vicariously, at no real cost to itself. But in order for victim groups to be worthy of compassion, they must be entirely free of blame or responsibility for their misfortunes. It is the blamelessness of victims that confers their high moral standing. That is why the imagery of addiction as enslavement is so popular."

So in conclusion:
"It should be clear by now that the causes of opiate addiction, and the reasons why it is maintained, have nothing to do with medicine as a discipline. The addict has a problem, but it is not a medical one: he does not know how to live. And on this subject the doctor has nothing, qua doctor, to offer. What he ought not do, however, is to mislead the addict, or allow the addict to mislead him, into thinking that the problem is medical and requires, or is susceptible to, a medical solution.

Contrary to our current pieties, therefore, which give those who subscribe to them a comfortable warm glow of generosity of spirit, but which are actually dehumanizing because they reduce addicts to the status of mere physiological specimens or preparations in a laboratory, addiction is a moral weakness par excellence. Moreover, addicts tend to be bad people (if bad people are those who consistently behave badly). They usually impose costs, often very severe costs, on other people without giving anything in return. Their lives are usually selfish and self-centred. Susceptibility arising from their pre-addiction circumstances is at best a mitigation, not a complete excuse. This is not to say that they are necessarily the worst people who exist, or that they are irredeemably bad (it is one of the theses of this book, after all, that they can, and often do, redeem themselves): but bad they are so long as they maintain themselves in their addiction. Addicts should therefore be stigmatized far more than they are. It is perfectly just that they should be and it could be beneficial as well, in the absence of medical 'treatment'."

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You don't have to be a bird to be an ornithologist, but...

I agree with almost all of the major points that "Dr Dalrymple" presents about opiates: it is not a horrid experience to withdraw from them, it takes some effort to become addicted, a very large many have stopped using them with no professional health care help, and most tellingly that the industry of aid and comfort to addicts (at least in the UK and western Europe) is a self-sustaining one.

Yet there is something lacking in this book, and it is that it does not try to delve further into the sense of craving that many addicts feel, except by recourse to the explanation that it is natural, when returning to one's prior life before (perhaps) forced withdrawal (i.e. prison), to return to that lifestyle. This seems shallow and incomplete to me.

It is true that one can become "addicted" to many things that do not now seem to have a neuro-psychological basis (chocolate, gambling, pedophilia, to go from the moderately innocent through the dangerous to the horrific), Dalrymple condemns from a moral perspective a phenomenon (addiction) that he does not try to understand.

I don't think that Dalrymple has ever been addicted, and has little sympathy for the sensation. As a reformed nicotine addict (among other addictions), I can only cite Mark Twain: "It's easy to stop smoking--I've done it hundreds of times." There are other addictions even more powerful, and I would wish that Dalrymple would turn his mind to these, in a constructive way.

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Dalrymple leaks his interest in alcohol.

Dr. Dalrymple makes an important point about addiction, that it is a moral and spiritual, not a medical, problem.
However, singling out opiate users was a bizarre mistake on his part. Í've worked with alcoholics and drug addicts. Contrary to what Dalrymple says, they both have the same character. They both are irritable when they aren't using and whiny and entitled, and deflect blame all over the place.
The difference between the alcoholic and the drug addict is it's so easy to get alcohol that the alcoholic can APPEAR to be more civilized and "mature". Obviously. His substance is available everywhere in pretty bottles, legally.
I have a feeling that there's a mysterious reason he demonized the drug addict and discussed the alcoholic as if he's just good old Uncle Al with rosy cheeks and a good story to tell.

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Mixed, powerful points obscured.

Dalrymple does a service by pointing out the illogicality of the notion that addiction, and its attendant criminality, are caused by aversion to withdrawal. If the unpleasantness of the Oakland Flu were such a driving factor, why are the less pleasant effects of opiate use (e.g. nausea and constipation) not a deterrent? For that matter, why would anyone drink alcohol in quantities sufficient to cause a real hangover after their first experience?

Simply put, addicts are driven by the compulsion to use, not by fear of withdrawal. After all, no addict has such a perfect supply line that they do not face withdrawal pretty regularly. Many withdraw, at least partially, several times a year. The problem, as the book Alcoholics Anonymous put it 67 years ago, `lies in the mind.' The addict, like the drunk, will use again, no matter how nasty the consequences.

Thus, as Dalrymple notes, most persons who have used opiates long enough to experience withdrawal--Vietnam veterans and hospital patients for example--will not rush to repeat the experience. Neither will the majority of teenagers eagerly repeat the misery of the day after a drunken prom night. But a significant number will. Almost all cigarette smokers become seriously addicted, but only one in ten or twenty drinkers will blossom into alcoholism. Opiates lie in between, but certainly closer to the tobacco end of the spectrum.

From here on Dalrymple's thinking is harder to follow. If, as he insists, addiction is a moral issue, why are Vietnam veterans and the victims of Maoist tyranny more `moral' than the junky jailbirds of Dalrymple's experience? And how many of those veterans only managed to `abandon the habit ... by means of a substitute drug' probably alcohol? If opiate addiction is a problem of morality, is Dalrymple willing to hold alcohol or tobacco to the same standard? If criminality `causes' addiction why don't smokers and drunks commit more crimes? Or is Dalrymple really just imposing another romantic myth onto opiates, endowing them with `special' qualities to explain away the trouble they cause?

Public opinion about drugs and booze, including `expert' opinion, is usually molded by a priori concepts far removed from reality. Opiates have been romanticized into Satan's own, while cocaine was held to be a `harmless recreational chemical' well into the 1980s. Religion, psychotherapy, and death threats have been touted as solutions, with little or no evidence of success.

Bluntly then, the solution to addiction is for addicts to stop using. More important still is that they refrain from starting again. No social engineering scheme has any chance of success unless this condition is met. Thus far the most effective approach is the association of like-minded, non-using, addicts. Unfortunately, no plan yet devised can manufacture the willingness for change in the individual.

Dalrymple is right to deplore the 'special' status of opiates as the Biggest Baddest Drugs, but his anarcho-libertarian world view blunts his perception.

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reviews: 1, 2, 3, page 4, 5, 6

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