Tuesday, July 18, 2006

Myth of addiction

One of the less orthodox views of the effect of drugs like heroin is that the addiction experience is largely a myth.

Stanton Peel is a prominent exponent of this viewpoint. The claim is that the horrors of withdrawal are exaggerated and largely due to drug users seeing themselves as 'victims' who do not wish to take responsibility for their actions. Users have internalised the view, propounded by the medical profession, that they need drugs to function. As a corollary the supposed addict has much greater freedom to choose than is commonly claimed. For example, a life of crime is not forced on an addict by their addiction - more plausibly they were criminals before they began using drugs. Indeed most of the econometric work examining the causal links between drug use and criminality support this view.

Jim Bugden forwarded to me a succinct recent statement of this type of viewpoint by Theodore Dalrymple in the Wall Street Journal. I'd be very interested in comments on it. These types of commentators are either identifying serious flaws in the way we think of addiction issues or have totally lost the plot.


Anonymous said...

If heroin isn't terribly addictive, and if it doesn't cause crime, then consumption of heroin should be just as legal as consumption of alcohol and tobacco.

The illegality of heroin concentrates huge profits in the hands of a small number of people who are prepared to, and do, murder others to keep those profits; consumes vast law enforcement resources in a largely futile attempt to control the heroin trade, and leads inevitably to corruption amongst some police and customs officers.

Anonymous said...

Even if all or most of the effects were psychological (which they are for many drugs), I don't particularily see why this means we should see the process of withdrawal as easy. People's perception is their perception -- and if it happens to be mental states that cause people to find it difficult to give up drugs, I don't see why we shouldn't accept that as a legitamate reason.

FXH said...

My understanding from observation and talking to people is that for many withdrawal from a heavy heroin habit can be a bit like a bad bout of the 'flu. Sweating, aches and pains and vomitting etc but it passes in a week.

I see no reason not to assist people with a bit of symptom reduction and health assistance during this phase, but it's no big deal medically.

However many also say it is no worse, or even easier, than giving up cigarettes or coffee. And you don't accidently get a heroin habit, you have to work at it for a year or so.

Most who are described as "addicts" aren't addicts in any real sense, only shooting up a few times a week when they have the $.

I'd be happy to give people heroin to be administered by health clinics if they were registered. But it is complicated, it's not just a legal or not legal choice. Just as we can all use the roads pretty much anytime we like there are still a myriad of rules and regulations and customs we observe - they have emerged over the years through discussion and experience.

The whole addiction thing has been over worked, however just as there is a small percent of people who will have instant reactions to peanuts or gluten there will be some others who have a strong inherent (perhaps genetic) propensity to have alcohol or heroin inside their bloodstream for most of the day - not just occassionally.

FXH said...

I alway have found Dalrymple entertaining, sometimes enlightening in his word paintings but often not much use with his solutions.

Most illegal drug users have no contact with the police let alone a criminal past or visits to jail. Drugs come and go in fashion and preference and percieved status. (Just like grog - HC I'll bet you don't drink much Yellow Tail anything, but o/s YT can be a statement of taste!)

Three was a time when (to simplify a bit) speed was a truck driver's, bikie drug and heroin was an urban, artists choice. Speed was working class and used for working. No one under 20 would use either.

[slightly off topic but - this was also when it was very common for workplaces to adjourn to the pub most lunch times for enough alcohol to put people easily over .05 - no one seems to remember this]

Now heroin and speed are available (if limited) in every country town and not used for work but considered non classy.

Extasy - of which there appears to be a huge market, (I'm guessing declining from a peak a few years back) does not seem to have it's users associated with crime or "addiction" at all.

hc said...

Uncle Milton, Some good arguments here but I am not convinced the heroin should be legalised even if it is less addictive than thought and even if it is caused by crime rather than causes crime. I think the 2001 heroin drought experience suggests strong enforcement can reduce heroin use and such things as overdoses.

Conrad, I think psychological factors are important but if metabolic addiction is low this suggests strategies for encouraging people to quit. For example changing environmrents and putting the emphasis on achieving self-control.

fxh, Sounds like you endorse the radical theory. I am not so sure. One thing that does seem to be clear is that actual withdrawal can be achieved at low cost. Preventing long-term relapse is difficult and that is something primarily psychological. I have a few friends who quit heroin after using for several years without great discomfit. But dangerous to generalise from limited experience.

Anonymous said...

Harry, the arguments for making heroin illegal are that it causes uncontrollable harm to the user (it is addictive, so users aren't making a free-willed choice and that it causes harm to others (the users commit crimes because of their heroin use.)

None of which means that heroin use is a good thing. It is clearly harmful, whether the users are addicted or not. But so is the tobacco consumption. The 2001 heroin drought proves only that when there is less heroin around, there is less harm caused by heroin.

Anonymous said...


Do you have some of the treatment plans offered for addictive drugs used in Australia? I was under the possibly incorrect impression that psychosocial factors were already a big target, even for addictive drugs, as a large part of the problem is that people just start using them again some time after they have "quit" (or not bother to quit because they know that they will), and this is well recognized.

Anonymous said...

I've read the Dalrymple article and can't for the life of me see where he says that heroin is not addictive. The opening words of the article are "Pretending that heroin addiction is a disease is perverse. THERE ARE many heroin addicts in prison." and the article goes on to talk in detail about addicts. The title of your post, "Myth of addiction", implies you are the one who has "lost the plot".

hc said...

Anonymous, the myth here is that addiction is very difficult to overcome so that it is something insurmountable. D is claiming it is no big deal.

You will note if you read carefully that I have not endorsed this view nor that of Stanton Peele.

Could you do me a favour and tone down the language?

Anonymous said...

Again, I can’t see where Dalrymple claims addiction is ‘no big deal’. Ceasing to blog would not have any physical withdrawal symptoms, but it doesn’t mean that you cannot be addicted to blogging, or that it can’t be a serious problem or that it is easy to give up.

For what it worth, I think Dalrymple is saying that only the addict can choose to give up heroin and that the standard approach to addiction makes it more difficult for the addict to do so (as it implies others must cure him). See in particular his closing paragraph:
“the existence of drug clinics sends a message to addicts that they are ill and in need of treatment rather than they have chosen a disastrous path in life. It conceals from people their responsibility for their own lives”

He never says that it is easy to give up heroin.

The language you object to was a quote from your post.

Anonymous said...

And I am not saying that you endorse his view, just that you misrepresent it.

Actually, your post implied to me that you opposed it (hence your 'have they totally lost the plot' comment).

Anonymous said...

Sorry Harry. I should follow links before jumping to conclusions. I thought that you had linked to this recent Dalrymple article, http://www.timesonline.co.uk/article/0,,6-2277523,00.html (sorry, i can't get the html tags to work) which is similar to the one you link to, but has a different emphasis. Having now read your Dalrymple, I can see why you concluded Dalrymple was saying addiction is no big deal. I apologise.

That also explains why my Dalrymple quotes weren’t in your article.

It is worth reading both articles.

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Anonymous said...

a real quick, off-the-cuff reply, as i just saw your blog while searching "myth of addiction" as keywords.

Are all familiar at all with Tom Szasz's demystification of addiction? see www.szasz.com (his general deconstructions of such currents may inspire) How about John B. Davies' _The Myth of Addiction_?

My own view is that the *conception* of addiction is largely (if not fully) tooled by both a lack of *context* of knowing why people use it (i.e. to try to fill a void left in a largely empty, yet "normal" life), and also in those who use such ideas not knowing the way that such words tool them.

For instance, we automatically give away our power to a big hefty mystified word/value assumption like "addiction"; we don't see ourselves being *able/capable* anymore; suddenly, it's these jargon words which tell us "chemicals in our brains" have us, and we're powerless.

Really, such words and the propaganda that has to prop them up, are a kind of voodoo, and people not seeing the enormity of how we're under attack systematically (by, i would argue, intensely alienated persons who *know not what they do*) accept such things because such word smiths are "the experts".

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