Opium addiction

“ In the worst conceivable cases it is at least a choice between evils; if he abandons opium, he may count upon much suffering of body, many sleepless nights, a disordered nervous system, and at times great prostration of strength. If he continues the habit, there remains, as long as life lasts, the irresolute will, the bodily languor, the ever-present sense of hopeless, helpless ruin. The opium-eater must take his choice between the two. On the one hand is hope, continually brightening in the future—on the other is the inconceivable wretchedness of one from whom hope has forever fled. ”

“ The man is as limp as a dish-rag, and as lifeless. He perspires all over,—feels wet and disagreeable. To take opium now is to brace the man right up; it tightens him up like the closing of a draw-string. Such is the effect in the internal man, and it pervades thence the entire system. ”

“ To the opium-consumer, when deprived of this stimulant, there is nothing that life can bestow, not a blessing that man can receive, which would not come to him unheeded, undesired, and be a curse to him. There is but one all-absorbing want, one engrossing desire—his whole being has but one tongue—that tongue syllables but one word—morphia. And oh! the vain, vain attempt to break this bondage, the labor worse than useless—a minnow struggling to break the toils that bind a Triton! ”

“ I am led to believe that the records of fatal lesion, mechanical childbirth, cancerous affection, the stake itself, contain no greater torture than a confirmed opium-eater experiences in getting free. Popularly this suffering is supposed to be purely intellectual—but nothing can be wider of the truth.
Its intellectual part is bad enough, but the physical symptoms are appalling beyond representation. The look on the face of the opium sufferer is indeed one of such keen mental anguish that outsiders may well be excused for supposing that is all. ”

“ If my father sought more from opium than the mere absence of pain, I feel assured that it was not luxurious sensations or the glowing phantasmagoria of passive dreams, but that the power of the medicine might keep down the agitations of his nervous system, released for a time at least from the tyranny of ailments which by a spell of wretchedness fix the thoughts upon themselves, perpetually throwing them inward as into a stifling gulf. ”

“ For the same reason that no sensible physician would direct the confinement of a patient and the absolute disuse of opium with the certainty that mania would result, so it would be equally ill advised to recommend a diminution so rapid as necessarily to call out the most serious disorder and derangement of all the bodily functions, especially if these could be made more endurable by being spread over a longer period. In one respect the opium-eater has greatly the advantage over those addicted to other bad habits. ”

“ Nobody needs to be told that a habit is formed by the frequent repetition of acts or indulgences, and that some habits are more difficult to break ourselves of than others. The opium habit falls in this category. It is formed, of course, in the same way as other habits, but there are peculiarities connected with it on which those who are ready to condemn opium-eaters as degenerates might well ponder. The physiological effects of opium are such, that the wearing off of the effects of a dose are attended with the keenest mental and physical distress. ”

“ Those who have used distilled or fermented drinks, tobacco, and sometimes coffee and tea in excess, experience for a time a strong and definite craving for the wonted indulgence. This is never the case with the opium-eater; he has no specific desire whatever for the drug. The only difficulty he has to encounter is the agony of pain—for no other word adequately expresses the suffering he endures—conjoined with a general desire for relief. Yet in the very acme of his punishment he will be sensible of no craving for opium at all like the craving of the drunkard for spirits. ”

“ Indulgence in opium is, moreover, supposed to blunt the moral feelings of those who indulge; and to a certain extent this is true. If your servant smokes opium, dismiss him with as little compunction as you would a drunken coachman; for he can no longer be trusted. His wages being probably insufficient to supply him with his pipe and leave a balance for family expenses, he will be driven to squeeze more than usual, and probably to steal. ”

“ Before the victim of opium-eating is prepared for the services of an intelligent physician he requires some stimulus to rouse him to the possibility of recovery. It is not the dicta of the medical man, but the experience of the relieved patient, that the opium-eater, desiring—nobody but he knows how ardently—to enter again into the world of hope, needs, to quicken his paralyzed will in the direction of one tremendous effort for escape from the thick night that blackens around him. The confirmed opium-eater is habitually hopeless. ”

“ The menace of opium is now threatening America, and our first duty is to ourselves. Little by little, surreptitiously, this drug has been creeping in over our borders, and to-day many thousands of our young men and young women are drug addicts, habituated to the use of one of the opium derivatives, morphia or heroin. The recent campaign against drug users, conducted by the New York Department of Health, has uncovered these addicts in great numbers; has brought them before us, made us see, in spite of ourselves, that thousands of them exist and that new ones are being created daily. ”

“ Some Observations on the Opium Habit.
It is now proper that we should ask the question “Is opium the very dreadful thing it is made out to be?” My answer is, yes and no. Anything immoderately indulged in is bad for one. Over-eating, excess in smoking and drinking, are all bad. There is such a thing as too much of even a good thing. I am prepared to admit that excess in opium is worse than most things; but as a choice between opium and drink, I consider drunkenness to be the greater evil. It may be that it is more common, and therefore responsible for more distress in the world than opium ”

“ A patient whom, after habitual use of opium for ten years, I met when he had spent eight years more in reducing his daily dose to half a grain of morphia, with a view to its eventual complete abandonment, once spoke to me in these words:
"God seems to help a man in getting out of every difficulty but opium. There you have to claw your way out over red-hot coals on your hands and knees, and drag yourself by main strength through the burning dungeon-bars."
This statement does not exaggerate the feeling of many another opium-eater whom I have known. ”

“ I will not again refer to the mournful effects produced on your own health from this indulgence in opium, by which you have undermined your strong constitution; but I must notice the injurious consequences which this passion for the narcotic drug has on your literary efforts. What you have already done, excellent as it is, is considered by your friends and the world as the bloom, the mere promise of the harvest. Will you suffer the fatal draught, which is ever accompanied by sloth, to rob you of your fame, and, what to you is a higher motive, of your power of doing good ”

“ One is often weighed and found wanting, called upon and not at home, mentally. Great shame and mortification attend this consequence, as one in this nerveless, enfeebled state is morbidly sensitive. Opium usurps the function of nerve, and is nerve in the victim. Without it he is a ship without sails, an engine without steam,—loose, unscrewed, unjointed, powerless. As the effect of opium passes off, a deep feeling of gloom settles upon the heart, such as might follow suddenly and unexpectedly hearing the death-knell of a dear friend. ”

“ But medical men must very well know that a certain state of the liver, mechanically and without any co-operation of the will, expresses itself in sighs. I was much too firm-minded and too reasonable to murmur or complain. I certainly suffered deeply, as one who finds himself a banished man from all that he loves, and who had not the consolations of hope, but feared too profoundly that all my efforts—efforts poisoned so sadly by opium—might be unavailing for the end. ”

“ In the first stages, opium commits its ravages on the human system by expansion and explosion; in the after stages, it does its work by contraction and compression; the weary victim totters beneath a heavy load.
In the first stages he has occasional periods of enjoyment; in the latter he has none; he is so benumbed by opium as to be incapable of enjoyment. Temporary manumission from positive pain or distress only brings out into stronger relief his miserable situation. He sees and feels that he is not happy; cannot be at his best ”

“ It is a very different thing to cure a man of acute from curing him of chronic opium-poisoning; and my own large experience, together with that of all the most experienced, the soundest and most skillful men that I have ever known as successful practitioners among these cases, points to the unanimous conclusion that it is not safe, either to mind or body, to make the abrupt transition required of an old opium-eater who must give up his drug in toto and at once, especially after such an acute attack as that just described. ”

“ The more you compare smoking and drinking and drugging, the more resemblances you see. Opium, like tobacco and alcohol, ceases to stimulate the moment the effect of it is felt: it then becomes a narcotic. The history of the three [Pg 158] as a resort in an emergency is precisely the same. At the time when the average man feels that he needs his faculties most, he will, if addicted to any of the three, deliberately seek stimulation from it. He does not intend to go on long enough to get the narcotic effect, since that would be clearly defeating his own aims ”

“ The opium habit must be classed with the taste for alcohol, gambling, avarice, and lust as among human passions. That nervous subjects, invalids, and individuals wanting in moral and physical tone are specially prone to it is obvious. It constitutes in these cases, however, an expression of the morbid constitution rather than a substantive affection in itself. In the same manner, the opium habit in insane persons must be looked upon as an epiphenomenon of the morbid mental condition. ”

“ It is true, much of their morbid power might be ascribed to the use of opium. But before you blame too harshly this use, or rather abuse, try a hopeless life, with daily cravings of the body for food. Try, not alone being without hope yourself, but seeing all around you reduced to the same despair, arising from the same circumstances; all around you telling (though they use no words or language) , by their looks and feeble actions, that they are suffering and sinking under the pressure of want. Would you not be glad to forget life, and its burdens? And opium gives forgetfulness for a time. ”

“ If to these discomforts be added a prevailing tendency to a febrile condition of body, together with permanent disorder in portions of the secretory system, the catalogue of annoyances with which the long-reformed opium-eater may have to contend is completed. This statement is not made to exaggerate the suffering consequent upon the disuse of opium, but is made on the ground that a full apprehension of what the patient may be called upon to go through will best enable him to make up his mind to one resolute, unflinching effort for the redemption of himself from his bad habits. ”

“ All the effects produced after that by the opium, are to keep the body at that level of sensation in which one feels positively alive and capable to act, without being impeded or weighed down by physical languor and impotence. Such languor and impotence one feels from abstaining merely a few hours beyond the wonted time of taking the dose. It is not pleasure, then, that drives onward the confirmed opium-eater, but a necessity scarce less resistible than that Fate to which the pagan mythology subjected gods not less than men. ”

“ The effects of opium and the strength of the habit, as is the case with other stimulants, vary with the temperament and constitution of the victims. A few can use it with comparative moderation and with no great detriment for a long time, especially if they allow considerable intervals to elapse between the periods of indulgence, but they eventually sink into as horrible a thraldom as that which degrades the least cautious. Upon far more the drug promptly fastens its deathly grip, and too often when they awaken to their danger they find themselves almost powerless. ”

“ In the United States the opium-smoker is invariably unworthy. Not long ago the New York police raided the apartment of a physician where were found thirty or forty opium-pipes and more than a hundred pounds of opium, either crude or prepared for smoking. I have known fewer than half a dozen physicians whose drug vice was purely social, however. The victims of drag habit who achieved it through a tendency toward dissipation are almost invariably denizens of the under-world ”

“ In their more fluent and exuberant way, when pressed for a reason, they tell us in effect that indulgence in opium is “Against our religious tenets, and it is very bad in every way.” It is time reformers recognised that opium is not such a dreadful thing after all, and confined their attention, and devoted some of their ample leisure, to winning back those who have gone over the limit of moderation, instead of anathematizing them. ”