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Romancing Opiates: Pharmacological Lies and the Addiction Bureaucracy Hardcover – April 25, 2006
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About the Author
Theodore Dalrymple is a psychiatrist and prison doctor who believes that everything most people know about opiate addiction.
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Complete garbage says Theodore Dalrymple. A doctor in two hospitals, one in a prison and the other in a slum, he has witnessed hundreds of junkies first-hand and, sick of the inconsistencies between what he hears in popular culture about opiate use and the realities right before his eyes, he opts for plain reality. In ROMANCING OPIATES, Dalrymple explodes the entire mythology of opiate use, root and branch.
Far from being near-instantly addictive, it takes not only time but, indeed, conscious effort and even intent to become hooked on the stuff. As Dalrymple points out, narcotics are regularly used for legitimate pain relief after medical procedures and rarely lead to addiction and the downward spiral into squalor.
Difficult to break? Piffle! The medical literature is clear that coming off heroin is about as bad as a nasty bout of the flu. Dalrymple notes that many junkies without their fix are observed acting more or less appropriately with their cohorts only to shake with pretend agitation around the doctor who can prescribe an additional fix. That many doctors fall for the ruse, or give in to put an end to their own suffering in having to deal with the junkie, serves to cloud the truth even more. Dalrymple compares this to alcohol, the withdrawal of which truly is dangerous but, in a notable twist, is often endured by drunks with a stoicism and degree of self-respect not seen in the opiate user. It seems clear that the difference is not the drug of choice per se, but the type of person attracted to drink versus opiates in the first place.
Despite the attempts of opiate users to portray the drug as the gateway to deeper consciousness, Dalrymple makes the pedestrian comment that, despite years of dealing with the addicted, he has not heard a single original philosophical thought out of a single one while on the drug. Although certain writers have been addicted to opium, they are hardly the ones whose contributions have formed the bedrock of Western ideas and typically have failed to provide even coherent and original challenges to those ideas.
Dalrymple advances some particularly intriguing ideas about the supposed link between opiate use and crime. To start, he points out that the causal connection is usually the other way than the popular myth would have us believe. Most opiate users had extensive criminal backgrounds before taking up the needle and their crimes in furtherance of their use are simply part and parcel of a more general criminal propensity. Dalrymple also makes the argument, jarring when first read, that, with respect to heroin dealers (as opposed to mere users) they are exceptionally violent people to begin with and keeping heroin use illegal has the beneficial effect of directing their violence to those within the heroin community. Legalization would not lessen their propensity for violence, but instead would widen the target of the dealers to the general population.
So what is opiate use? It is not a medical condition, as many would believe. Dalrymple convincingly argues it is a moral weakness. Indeed, many opiate users themselves have stated to him such things as a willingness to quit after a child is born. Yet what other disease could be cured in this way? Not cancer or the residuals of a heart attack. Clearly users themselves realize that their opiate use is a substitute for a deeper meaning in their own lives. Further, many users have given up the junk when presented with a strong enough reason, whether that was returning to a normal life after the Vietnam War in the case of American soldiers or the threat of execution in the case of Chinese civilians under Mao.
So why the disconnect? Dalrymple pulls no punches against those on whom he lays the blame. Opiate addicted authors got the ball rolling with their specious but well-taken accounts of their own drug use. Particular scorn is heaped upon Thomas De Qunicey, whose Confessions of an Opium Eater) was merely the first in a long line of books advancing the myths for reasons more to do with self-interest than anything else. William S. Burroughs also gets taken to the woodshed for his patently dishonest accounts of junkie life. However, these authors would not have gained traction but for the assistance of numerous others, particularly in the medical field, who, either for expediency or to construct their own personas as being part of the compassionate crowd, paved the way for the myths to take hold in the body of public knowledge.
Dalrymple makes a good point that, in the larger scheme of problems that the world faces, opium use is far down the list. He also makes a good point, however, that if we cannot tell the truth on an issue of relatively minimal importance, it is unlikely we can tell the truth on much larger issues of more immediate importance. Well taken.
The book is primarily about the Doctor's frequent contact with Heroin users in the British prison system, but it applies to Methamphetamine users and Crack smokers also. Personally, I always found Heroin users more rational than the others.
I did feel a little uneasy that he presented no opposing thinking to be examined and rejected, and I felt the medical evidence supplied was rather dated. I did like his premise that drug addiction is a positive life choice to start out with, even though perhaps he could have given more attention to why some people make that choice and others, with equally disandvantaged, reject drugs out of hand and live worthwhile meaningful lives.
He seems to have much more sympathy with alcoholics, who in my view create much more harm in society than drug addicts do. Perhaps this is because alcohol is his admitted drug of choice. I felt a little more human warmth would have made his case more convincing, and the latter part of his book drifted back to 19th century literature, which seemed at times to be a conceit too far, but nonetheless, a very interesting book and I look forward now to reading his other works.