The Illusion of Addiction?

“Heroin doesn’t hook people; rather, people hook heroin.” Theodore Dalrymple, a psychiatrist and skilled essayist, has written an important article on the illusion of addiction. In “Poppycock,’ published in the May 25, 2006 edition of The Wall Street Journal , Dalrymple traces the development of the idea of addiction, as related to narcotics in this case, to the claims of Thomas De Quincey, who in an 1822 book claimed that his use of opium was due to addiction.

Dalrymple counters:

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.

His conclusion:

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’être 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.

This is a brave argument to make, but Dr. Dalrymple draws from decades of experience with these issues, including time spent working with prisoners and the disadvantaged.