Substance use disorder

“ 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. ”

“ The devastating effects of alcohol and drug addiction have destroyed the lives and families of countless Americans. During National Alcohol and Drug Addiction Recovery Month, we recognize the dangers of substance abuse and renew the hope of overcoming addiction for individuals across our Nation. ”

“ Unfortunately, the injury which alcohol does, and the processes of deterioration which it sets on foot, do not end with the individual. Alcohol poisons and injures the germ cells of both sexes, and the offspring of those addicted to its use may inherit a weakened and injured nervous system. ”

“ Substance addiction affects people of every class, creed, and color. More than 20 million Americans are addicted to alcohol or other drugs, and countless more lives have been touched as a consequence of substance abuse.
Together, however, we can fight drug and alcohol abuse. ”

“ There have been many cases, after the unpoisoning was complete, in which a man or woman has been found to be as seriously ailing mentally as others have been found ailing physically. Drugs and alcohol, especially drugs, have frequently been responsible for extraordinary mental and moral twists. But it must be maintained that the use of drug or liquor is usually the result rather than the cause of such conditions. ”

“ I believe this is exaggerated, but I am acquainted with a number of physicians who are addicts.
Physicians who smoke do not condemn the practice. Those who drink are likely to prescribe beer and wine for their patients. Those who are addicted to drugs use them too liberally in their practice. ”

“ Narcotic drug addiction-disease in the man who is vicious or criminal or defective or degenerate should be treated as narcotic drug addiction-disease, as any other disease is treated in the same individual. ”

“ 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. ”

“ 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. ”

“ Any one acquainted with this ordinary effects of this foolish indulgence in the free use of narcotics, on the nervous system of its victims, will be convinced by a few years close observation, that such persons especially, if they are of sedentary habits, are more subject to fits of despondency, and to a far greater degree, than persons of the same general health and of the same employment, but who have escaped contamination. ”

“ What is commonly spoken of as the “American type,” highly nervous, living under pressure, always going to the full limit, or beyond, is peculiarly liable to disorders that lead to the habitual use of drugs. We are all hypochondriacal by nature, prone to “take something” whenever we feel badly. ”

“ Many people still seem to think that substance abuse is something that happens to other families. There's a wall of denial that must be broken down. The truth is drugs and alcohol are everywhere available and everywhere abused. ”

“ Lack of understanding and appreciation of the disease of narcotic drug addiction and its treatment by a large majority of the medical profession has fostered conditions which make it impossible to determine a rational procedure for treating and curing the addicted by the State at this time. ”

“ The many wrecks of addicts to be seen trying through insufficient supply of narcotic drug, self-poisoned with other drugs which they have purchased, alcohol, bromides, coal tar products, cocaine, and of late hyoscine—their addiction disease unrelieved and undiminished—are sufficient argument against mere reduction of dose, below physical body need. ”

“ But the worst of it all is that through the carelessness of physicians, and sometimes through their criminal pretentions, habits are formed for certain drugs, such as cocaine, opium and its products, chloral and alcohol, which enslave their victims, weaken their vitality, and invite disease. I think I do not exaggerate it when I say that the drug habit, no matter how induced, is a menace to the American people. ”

“ We shall save much public money, and personal effort and time, and shall save the narcotic addict much suffering and discouragement, and shall add much to human health, competency and happiness when we realize these facts as applied to addiction-disease, and proceed upon them in a spirit of broad humanity and of rational clinical study and remedy of obvious disease symptomatology. Narcotic drug addiction-disease is a definite, and in most cases arrestable disease. ”

“ The more moderate the use of these substances, the more remotely is the effect removed from the cause and more difficult of detection. That the ordinary habitual, so-called moderate use of stimulants and narcotics, such as tea, coffee, tobacco, and alcohol, is, in the vast majority of cases, really an abuse, is a proposition that I think should be admitted by all who have given the subject an unbiased study. ”

“ 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. ”

“ It seems strange that a condition of as powerful influence over body function and metabolism as is exerted by the addiction mechanism of narcotic drug-disease should not long ago have received exhaustive and complete clinical and laboratory study along the lines of its manifestations and influences, as well as along the line of reduction and deprivation of the drug of addiction. ”

“ Women, it should be said, though constitutionally more liable than men to feel the need of medicines, form the lesser portion of the drug-taking class. In the beginning their addiction is due almost exclusively to a physician’s prescription, except in the under-world. ”

“ The ultimate solution of the problem of handling the narcotic addict lies largely in the education of medical men, both in institutions and in private practice, and through them securing lay appreciation of disease facts. ”

“ 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. ”

“ 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. ”

“ Where the patient suffers from an incurable malady, the use of drugs is not only excusable, but commendable; but instances are all too frequent where the malady is not incurable, but only puzzling and beyond the average practitioner’s power of diagnosis, so that he covers up his ignorance by the administration of pain-deadening substances. ”

“ It is to be laid at the door of insufficient medical comprehension of addiction-disease and its mechanism in its material manifestations, and in its functional and organic influences, and at the door of inadequate clinical study into the analysis, estimation and control of these. Like much else that has been for generations generally accepted as true about narcotic drug addiction, the belief is erroneous that the addict is a poor surgical and medical risk because he is an addict. ”

“ 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. ”

“ 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. ”

“ In drug addictions the condition of the patient is not mental, as is generally supposed, but physical. Definite medical treatment to remove the effects of the drug itself is imperative, whether the victim be suffering from the drug habit alone or from that habit in a body otherwise physically disordered. With regard to the cure of the habit, as in the case of the conditions which permit of its being acquired, it may justly be said that the victims have been unfairly treated. ”

“ 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 remedy is plain, and the necessity for immediate activity is obvious. Education—scientific medical and lay, administrative and public health education is the lacking element or factor in the solution of the many sided narcotic drug problem. Appreciation of addiction-disease and what it may mean in the individual should be as widespread and as comprehensive as possible and at the earliest possible moment. ”

“ It is evident therefore, that upon the intelligent and competent estimation, measure and control of physical narcotic drug balance and inhibition of function depend the reaction, well being and therapeutic progress of the man who has narcotic drug addiction-disease. These factors also markedly influence the action of all medication, including the drug of addiction, upon the body of the opiate addict. ”

“ Although some individuals, afflicted with this disease, may require custodial or correctional handling—the fundamental physical disease cannot be properly arrested nor handled successfully by mental, moral, sociological or penological methods only. Any toxic, worried, fear-ridden or suffering sick man may show psychological or even psychiatrical manifestations or complications, but observing and attempting to control complications only will not cure basic disease.
Even if it should some day develop that a serum can be produced against the underlying toxins of addiction-disease ”

“ It seems to be the fact that the narcotic wards of our great charity hospitals and institutions of custody and correction still in great measure proceed with their handling of narcotic addicts on the basis of mental or moral degeneracy or deficiency or weakness of will, or morbid appetite, etc., or apply one or another of the various remedies or combinations of remedies. Their internes and nurses do not seem to graduate with a conception of addiction as a definite physical disease, with clinically significant symptomatology and constant physical reactions and phenomena. ”

“ 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. ”

“ We have tended to regard and handle and treat and legislate concerning narcotic addicts simply as narcotic addicts, instead of appreciating that different individuals and different types and classes of people who may suffer from addiction-disease present entirely different problems, and require entirely different handling. ”

“ While it is true that the popular belief in drugging is due to professional practice, yet it is also true that what the people know of the preservation of health, and of the danger of alcohol and other drugs is largely owing to the medical profession. ”

“ Wide and varied experience, however, hospital and private, with careful analysis of history of development, and consideration of the individual case, demonstrates the fact that a majority of narcotic addicts do not belong to this last described type of individuals. ”

“ A second precedent has been set, as is proved by the fact that within a brief time any case of drug or alcoholic habit that is not complicated by physical disabilities due to other causes can be successfully treated in a few days without heroic methods and without risk. ”

“ Habitual users of drugs or drink are literally human derelicts. The symptoms of their true condition are submerged, and to clear them of [Pg 210] their concealed weaknesses it is necessary to lift them like a barnacle-ridden hulk into the dry-dock for investigation and repair.
I regard as a preferred risk among the victims of the drug habits those who have acquired it through the administration of a narcotic by physicians in time of pain or illness. ”