Dr Theodore Dalrymple tears into 'Doctors, lies and the addiction bureaucracy':
"For the past 14 years, I have worked as a doctor in a large general hospital in a deprived area of Britain, and in the even larger prison next door.
In that time, I have seen heroin addiction rise from an infrequently encountered problem to a mass phenomenon.
It has now become so widespread that the city council has politely asked residents not to put used needles and syringes in the weekly rubbish collections.
No stairwell in any housing estate is complete without the discarded paraphernalia of drug abuse."
[...]
"I had briefly run a drug-addiction clinic in a famous university town, at a time when I accepted what I now know to be myths about heroin addiction.
But as more addicts came to my attention – I see up to 20 new cases a day in prison – I began to think about it more. The medical perspective, that these people were ill and in need of treatment, seemed less and less convincing.
I discovered that most addicted prisoners stopped taking heroin in jail, even when it was available. They came into the prison starving and miserable, and went out relatively healthy.
But within a few months, many were back in their former condition, and when brought once more before the courts, some would beg to be imprisoned.
When, soon after their return, I asked them whether they intended to give up taking heroin, some would reply: "I'll have to, I've got no choice."
Asked why, they would offer replies such as: "Because my girlfriend's just had a baby and she won't let me see it unless I do."
This answer was a strange one if these addicts truly thought of themselves as ill and in need of treatment. #
Instead, they clearly believed a purpose in life was enough to enable them to abstain. This is not how pneumonia, for instance, is cured.
No one would say: "I must stop having pleuritic pain each time I breathe deeply because I have just had a baby." Yet the medical services allow addicts to focus exclusively on the physiological aspects of addiction, which in practice means the prescription of a drug such as methadone.
There is a strenuous, almost outraged, rejection of the idea that addiction is, at bottom, a moral problem, or even that it raises any moral questions at all.
Of course, addiction to heroin and other opiates has serious medical consequences. I often saw addicts with deep vein thromboses or multiple abscesses; they would have TB; they would be malnourished and infected with Hepatitis B or C, or both, and HIV.
It would be difficult to obtain blood from the veins in their arms or legs because they had injected so often.
But medical consequences do not make a disease. Many mountaineers get frostbite, but mountaineering is not a disease.
To conceive of heroin addiction as such seems to me to miss the fundamental point: it is a moral or spiritual condition that will never yield to medical treatment."
Full article here.
4 comments:
Definitely worth reading the whole article, and probably getting the book too when it comes out.
Peter Hitchens applauds Dalrymple's book on Heroin:
Cold Turkey, 'French Connection II' and another untrue thing that's believed by almost everyone
'People take heroin because they like it, not because they have to. They are selfish pleasure-seekers in need of deterrence and punishment, not sad victims in need of help, rehabilitation and sympathy. An elegant new book ('Junk Medicine, published by Harriman House in Britain and Encounter Books in the USA) by former prison doctor Theodore Dalrymple ought to be causing a huge public controversy, but isn't because the consensus feels safer ignoring it. Dalrymple tears to pieces the idea that heroin addiction is a terrible disease, somehow caught by innocents, and also the fallacy that getting off heroin is a desperate, agonising physical struggle.
I think this wholly false idea is widely believed partly because of the powerful 1975 film 'French Connection II', in which a New York cop played by Gene Hackman is turned into a junkie by the evil drug barons he is trying to bring to justice. In a gruelling scene, Hackman is shown being weaned off the drug, sweating, moaning and writhing like a man in hell (as I recall).
Heroin It isn't true. Dalrymple demonstrates it isn't true. He also shows that it is quite possible to take heroin (or, as a hospital patient in need of painkillers) to be given large doses of morphine, and not to be in any way dependent. Dependency comes only after a lot of deliberate use, and isn't just 'caught' by occasional use. In any case, you have to find heroin. It doesn't come to find you.
And this dependency is purely mental, a matter of wanting a pleasing sensation and preferring not to go without it. It simply isn't true that giving up heroin leaves you wriggling in the floor groaning, wracked by spasms and sweating by the gallon.
Let me quote the good doctor “As it happens, I have seen a large number of withdrawing addicts in the prison in which I work. of the several hundreds I have seen in the last decade, not a single one has ever caused me as a doctor to feel anxiety for his safety on account of his withdrawal (they sometimes have had dangerous illnesses as a result of their injecting habits, and they are often severely malnourished, starving even, but that is another matter) . None has ever had a symptom requiring hospitalization, and all the genuine symptoms, never severe, have been relieved by simple, non-opiate medication."
He adds:” It is true that the majority of them portray themselves to me as being in the grip of terrible suffering - suffering that they say is physical in nature, not mental. They hunch themselves up, they writhe in histrionic agony. They claim that they have experienced nothing as bad in the whole of their lives, that it is quite unendurable, and they make all kinds of threats if I do not prescribe something ( by which they mean an opiate) to alleviate their suffering, threats that range from damaging or setting fire to their cells, to killing themselves, others or even me...and they add that when they do these things the blame will not be theirs, but mine, because if I had done as they demanded, and prescribed what they wanted, they would never have acted ion the threatened way.
"In fact, they very rarely do act in the threatened way."
So a whole popular myth turns out to be a complete phoney. Doctors know this, but the medical establishment, and the government, and the politicians who argue ceaselessly for more 'rehabilitation' for drug users, continue on their way.
As I said, film and TV portrayals certainly have something to do with this. But once more we have a case of the establishment believing in something wholly untrue (see also 'ADHD' and 'dyslexia') which relieves the people involved of responsibility.
And that's the key. The issue right at the heart of all other arguments, debates and controversies is really this. Are we responsible, free human beings entitled to govern ourselves, and able to do so if we observe a moral code? Or are we hopeless victims of circumstance, incapable of strength of will or choice, whose every failure to be good, or active evil deed, can be excused by our past lives, in need of a strong hand to help us with drugs and treatment?
Well, you can see where this is leading, can't you? Those who argue that we are all hopeless creatures of circumstance are also arguing for a strong, interfering, ultimately all-powerful state to supply our deficiencies and keep us in order. Calls for 'communitarianism' and 'social responsibility' and the invention of the 'social conscience' that replaces the individual one, are arguing for ever greater government power.
If we are not to go under, those, who consider themselves socialists or conservatives, or liberals, who are attached to human freedom, must realise that it is this issue, of personal responsibility and the liberty to choose that goes with it that must be resolved. We have gone much, much too far away from personal responsibility, so that words such as 'duty' and 'punishment' now cannot easily be used.'
The outrage of the drug addict debating with Dalrymple is a beautiful thing to hear.
BBC Radio 4
Today Program
14/08/07
0821: Is heroin as addictive as it's always made out to be? We'll hear from the doctor who thinks not and from a recovering addict.
Listen (@ 20'17") | Permalink
Great stuff from the boy Teddy.
It is right to imprison drug addicts
Theodore Dalrymple
March 18, 2008
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