Drug addiction

“ The idea that narcotic drug addiction should be accorded a basis of weakness of will—neurotic or otherwise, inherent or acquired—and should be classed as a morbid appetite, a vice, a depraved indulgence, a habit, has been generally unquestioned and the prevailing dogma for many years. It is very unfortunate that we have paid so little attention to material facts and have made so little effort to explain constant physical symptomatology on a basis of physical cause, and that there has not been a wider recognition and more general acceptation of scientific work that has been done. ”

“ The addicted judge, or the addicted physician, or the addicted clergyman, or the addicted man of business or other affairs, or the addicted clerk or industrial worker reacts differently to the sufferings and trials of narcotic drug addiction than does the addict of the underworld, or the heroin “sniffer” of idle and curious adolescence, or the addicted defective, degenerate, or criminal. Also he reacts differently to everything else. What is true of one man who has opiate addiction may be absolutely false of another. One narcotic addict is honest, competent, truthful and intelligent. ”

“ I believe we would have saved many people from the hell of narcotic drug addiction. I believe if it had not been for the use of the word “habit” that the medical profession would long ago have recognized and investigated this condition as a disease. A man, physician or layman, believes that he can control a habit when he would fear the development of a disease. ”

“ That the average medical men can remain so hopelessly, I might say criminally, negligent of the true conditions of drug addiction is a cause for wonder as well as condemnation. If the perusal of my paper induces even one conscientious physician to seek more definite information upon this tremendously vital subject, my efforts shall not have been in vain. ”

“ Most physicians have at some time or other made effort to rescue some victim from drug addiction, and as a rule have given over the effort as hopeless, because even when they had succeeded in taking his narcotic away from the patient, usually after an experience trying and exhausting to both, the patient has resumed narcotic administration—according to the patient, because he had to—according to the average observer, because he wanted to. ”

“ It is only here and there that the practitioner of internal medicine has been sufficiently inspired by scientific interest to seriously consider narcotic drug addiction and to make a clinical study of its actual physical manifestations and phenomena. ”

“ All this is based upon the accepted theory that drug addiction is a vicious habit requiring only a little fortitude and strength of will on the part of the wretched victim to rid himself of it, while the saddest feature of it all is that this canker, eating at the very heart of the nation itself, blighting and destroying the lives of many useful men and women, is not being reached. ”

“ The attitude towards addiction is beginning to follow the trend of modern medicine in getting away from special or routine treatments, and the search for specifics and panaceas, and in aiming at and devoting great effort to the searching out, consideration of, and treatment of fundamental cause and underlying condition. When this method of approach is applied widely to addiction-disease, and the facilities of our great hospitals and institutions of research properly directed to its furtherance, there will come a re-arrangement of conception of opiate addiction. ”

“ After addiction-disease is once developed the addict loses whatever euphoric sensation he may possibly have experienced, and all that narcotic administration spells for him is relief from suffering. Without the drug of his addiction he endures intense physical suffering and misery. Without the drug of his addiction he cannot pursue a social, economic, or physically endurable existence. ”

“ Serious consideration of drug addiction as a problem of clinical and internal medicine, and of experimental laboratory research is a comparatively new thing to a majority of the medical profession, and of course also to legislators and administrators. We should all remember that no matter how strong we are in our beliefs and theories, there are many others whose experiences and results have caused them to hold just as strongly to opposite theories and beliefs, and that we are all on trial for the validity and extent of practical application of our beliefs and theories. ”

“ There is a tremendous number of excellent and worthy and even illustrious people in whom addiction is in no way associated with vice, or other morbidity of mental or environmental origin, who are merely, solely and simply sick people suffering from addiction-disease, whose problem is the control of that disease until it can be arrested by competent therapeutic procedure, for which they constantly seek. ”

“ A matter about which there has been a great deal of dispute is that of the prescribing or dispensing by the practitioner of medicine of opiate drugs to the narcotic addict in the handling of narcotic addiction, itself. The adherents of the older theory of addiction being merely habit or vicious indulgence, oppose as illegitimate practice the continued supply of the opiate to an addiction patient, unless in some cases the patient also suffers from some painful and incurable disease. ”

“ One of the most needed achievements in the line of practical remedy is the admission of narcotic drug addiction-disease to its legitimate place as an accepted part of the practice of internal medicine and the stimulating of education concerning it among medical practitioners, medical students and nurses. ”

“ Until the addict can be offered rational treatment, the profession should do what it can in making the lives of addicts less unbearable by removing from the public mind some of the gross misconceptions concerning addiction, seeing to it, especially, that these unfortunates are not stigmatized as “morphine fiends” and that they are given the means of obtaining, without risk and hardship and almost prohibitive cost, the supply of their drug which, until they are cured, is to them as necessary as the air they breathe. ”

“ Over-emphasis on any aspect resulting in premature, narrow, ill-considered and ill-advised action only increases the complexity of the situation and defers final remedy. For as great and complicated a problem as narcotic drug addiction there will be found no special or specific panacea. ”

“ The financial possibilities of commercial exploitation of the sufferings of addiction-disease, combined with general ignorance of the true nature of the addiction condition, are responsible for the tremendous increase of late of narcotic addiction, of non-medical or non-therapeutic origin, among the youth. ”

“ The constant use of narcotics produces a condition in the human body that many physicians of medical authority now recognize as a definite disease, which diseased condition absolutely requires a continued administration of narcotics to keep the body in normal function unless proper treatment and cure is provided.
“Withdrawal of the drug of addiction induces such fundamental physical disorganization and unbearable pain that addicts are driven to any extreme to obtain narcotic drugs and allay their suffering by self-administration. ”

“ They should be classed as innocent or [Pg 28] accidental addicts—normal and worthy sick people. They earnestly desire treatment and help, and once their addiction process is completely arrested do not tend to return to narcotic drug use. ”

“ It has yet to be demonstrated that there is any warm-blooded animal, which following sufficiently prolonged and constant administration of opiate drug, is immune to the development of the symptomatology and constant physical phenomena of addiction-disease.
Color, nationality, social or economic position, age, mental and moral attributes of whatever sort are no bar to the development of the condition. These may influence, of course, the conduct and incidental manifestations of the individual addicted, just as they do in any other condition. ”

“ The routine and unintelligent use of the products of these groups of drugs in the treatment of narcotic addiction—under the mistaken impression that they somehow or other have direct curative action upon the disease condition—has been the cause of a considerable mortality and an easily understood opposition among intelligent addicts. ”

“ Addicted for years, they have tried one after another of the various and diverse treatments and so-called cures without success or benefit. Is the blame theirs for lack of success and cure, or has there been something wrong in our treatment and handling of them? Did we know enough about addiction-disease to treat them intelligently and to exercise upon their cases the same professional skill and technical ability that we have been educated and trained to apply to other diseases? ”

“ Later I realized the fact that the blame rested almost entirely upon the shoulders of my medical inefficiency and my lack of understanding and ability to observe and interpret. The narcotic addict as a rule will co-operate and will suffer if necessary to the limit of his endurance. Demanding co-operation of a [Pg 7] completely developed case of opiate addiction during and following incompetent withdrawal of the drug is asking a man to co-operate for an indefinite period in his own torture. There is a well-defined limit to every one’s power of endurance of suffering. ”

“ They are the inherently irresponsible, vicious or defective. They demand care and restraint irrespective of their addiction. The mass of addicts, however, need something done for them. They are clinical problems of internal medicine, victims of a definite disease, characteristic in its symptomatology, reactions and phenomena, a disease which will before long come to be known as clinically and therapeutically controllable and arrestable. ”

“ The great numbers of innocent and worthy unsuspected sufferers from this disease, who could not by any stretch of wildest imagination, be regarded as mentally or morally abnormal or subnormal have therefore been placed in a position where they could not afford to demand their rights or state their case. Their problems are only recently beginning to receive general consideration. Their cases have compelled us to revise our conception of the narcotic addict, and to question ourselves as to the necessity for their continued addiction over the years of their addiction. ”

“ The control of auto and intestinal intoxication in narcotic [Pg 79] addiction is as a rule of easy accomplishment if the patient is uninhibited and in functional balance and is not over-supplied or under-supplied with the drug of his addiction. The narcotic addict who is non-toxic and in drug balance and is not harassed by worry or fear needs practically no more drastic methods of elimination than his non-addicted brother. If he is over-dosed his elimination is inhibited; if he is under-dosed his eliminative powers are not capable of response. ”

“ Intelligent addicts well know that, other factors being equal, the less number of times in a day they take their drug, the less inhibited, the less constipated and more normal they are, and the smaller amount of narcotic drug they require to maintain them physically and mentally competent. It is unfortunate that this therapeutic principle so widely recognized among intelligent addicts has not received full recognition and therapeutic employment by all of those who handle and treat addiction-disease. ”

“ One of the great hardships under which every addict suffers is the constant dread lest his affliction become known and he be branded a “morphine fiend,” a term which should be prohibited, or at least never used by an intelligent physician. What this exposure would mean to a man of standing in his community I need not explain. This risk he must always run, but it would be robbed of some of its terror if the nature of addiction were better understood. ”

“ The fact that it is a disease has impressed itself on all competent observers of a sufficient number of cases, and must be accepted. Yet it is astonishing to find that many educated physicians do not know this, while an even larger number, though readily admitting that addiction is a disease, nevertheless show, both by their manner of discussing the subject and by their attitude towards addicts seeking their advice, that this is little more than a verbal concession on their part. ”

“ Indeed, there could be no stronger argument in favor of the fact that addiction is an actual disease than the very phenomena presented by the occasional addict who stops taking the drug by “will power.” ”

“ But neither this combination of drugs nor any other combination known to man can prevent persons, after they are free from their addiction—be it alcohol or morphin—from going out and repoisoning themselves by taking again the drug which has poisoned them and led them on to their habitual intoxication. ”