by Rebecca Bynum (July 2006)
The conviction has gradually grown within me that alcoholics need help – more help than they currently receive from our society. For life is indeed filled with edges rough and hard that jostle and cut the heart in a thousand ways each day and cannabis as a relaxing agent should not be despised as an aid to those who cannot partake of the pleasures of alcohol in the way most men can and most men do. We know that many of the consequences of abusing alcohol are more tragic than that of other drugs, but authorities seem to be more focused on less dangerous drugs than this deadly but very legal one.
After reading Theodore Dalrymple’s important and explosive new book Romancing Opiates, the question most startling to me is why are heroin addicts treated with such overwhelming official solicitude, not expected to endure the slightest discomfort, are prescribed a synthetic substitutes so as to avoid relatively mild symptoms of withdrawal, and by being viewed as passive victims of addiction, are absolved of all moral culpability for their habits and their consequences, while alcoholics, on the other hand, are often forced to endure pain and suffering even unto death with no pharmacological, or sociological aid whatsoever.
I rage at the injustice of it. I rage at the intolerant upholders of virtue that is no virtue, only unreasoning bigotry. That the pious lawful minded cowards of a straight-laced conformity should judge what they do no know strikes me as the heart and soul of totalitarian harshness: a harshness born of ignorance, a harshness born of a flagging, flabby faith whose constant stock in trade is j’accuse!
In our modern world, lies abound and have currency. Social groupings from the family on up become centered on common assent to lies of varying degrees. And when we assent to a lie, then that lie must be defended from the truth and it is this very defense that becomes the source of group cohesion. Those having the audacity to point out the truth thereby endanger the cohesion of the group and are variously ostracized, expelled, or in the case of the Big Lie of Islam, summarily killed.
Theodore Dalrymple has taken the fateful step to point out the simple truth about heroin addiction and in doing so he endangers the entire multi-billion dollar bureaucracy that has grown up around two central lies concerning opiates. The first is that the addict is a passive and unfortunate victim of the drug itself and the second is that withdrawal from heroin is so excruciating and horrible that no human being can be expected to accomplish it without an army of health and social workers to support him. Both are flat out lies, but both serve the symbiotic relationship between addicts and the addiction bureaucracy. The truth, as Dr. Dalrymple says, is “the bureaucracy of drug addiction needs drug addicts far more than drug addicts need the bureaucracy of drug addiction.” So because it is advantageous for both parties to do so, drug addicts pretend illness and their doctors pretend to cure them, but in actuality each only serves to perpetuate and expand the existence of the other. It is quite simply easier to give an addict another drug than to give him a reason to live. And more essentially, if the failure of the addiction bureaucracy becomes exposed, then the reason for living for all those hundreds of thousands of health and social workers (aiding the “victims” of drug addiction) comes into question as well: the saints would be revealed as shysters and we can’t have that. I therefore predict Dalrymple’s book will be completely ignored by his peers.
Heroin withdrawal, as dramatized in The Man with the Golden Arm and countless literary accounts from De Quincey to Burroughs has become assumed to be so exceedingly excruciating as to serve as the great excuse for all manner of immorality and criminality on the part of heroin addicts in a manner mere alcoholism does not. And yet, withdrawal from alcohol is far more dangerous and is often actually lethal whereas heroin withdrawal, as shown convincingly in Dalrymple’s book, is nothing more serious than a bout of the flu, the histrionics of self-serving addicts notwithstanding.
I have personally witnessed a twenty year intravenous methamphetamine addict withdraw “cold turkey” with nothing more serious than excessive sleeping and irritability. My mother, on the other hand, who was an alcoholic before my birth and who eventually died of cirrhosis of the liver and esophageal hemorrhage, experienced delirium tremens many times in my childhood almost to the point of death, but received no care, no solicitude from professionals whatsoever. Hers was a disease of denial, rescue from which had to be sought by the alcoholic herself, otherwise there could be no help, or so the smug, studiously “street-wise” social worker said, as he casually offered me a cigarette when I was thirteen years old. “You’re here for yourself,” he insisted. No, I wasn’t. And by that point, my mother couldn’t help herself and I couldn’t help her. And no one would help us. She was just a contemptible drunk, one of millions. No doctor would waste his time. No one would come.
And yet, it seems undeniable that alcoholism runs in families and is more prevalent in certain populations, namely that of Native Americans, lending at least some credence to the idea of alcoholism being a actual “disease.” Of the seven children in my mother’s family, for example, six died of alcohol related illness or accident.
Insane drunken scenes were a staple of my childhood. I remember an aunt once grabbing the keys from an uncle’s pants pocket, while he was helplessly sitting on the commode. She took the car, tore out of the driveway and ran down a woman who was walking home from the market, killing her. A few years later, she stabbed her husband repeatedly with a butcher knife, hospitalizing him, and still later, purposely burned their house to the ground. I suppose if heroin had been involved, social workers would have descended like General Lee’s cavalry, but as it was alcohol, no one came.
Another aunt, who was a quiet and literate alcoholic, locked herself out of her house while looking for her cat in midwinter, tried to climb in through a window, fell, and froze to death in the snow. We found her body the next morning.
My mother had four children. The first child, myself, had a low birth weight, the second child a high birth weight, the third child was a “blue baby” and the fourth died after only a few days of life. I attended roughly 18 schools between kindergarten and high school due to my father’s inability, or rather his lack of desire, to hold down a job. He was a perpetual schemer: always waiting for the next big deal to go through, after which all our problems would be solved. His alcoholism allowed him to pretend this, in fact, the main dynamic of our family involved the belief in this central lie. You had to be a “believer” to belong.
I began working at the age of twelve and was in fact our family’s main breadwinner for a time until my father, who naturally took my paycheck, decided to cheat my employer. It was then I lost faith in the lie. It was then I became an outcast in the family and was hated and shunned by my father till the day he died, even though it was me who had cared for him in his later years and me who was by his side at his deathbed.
I had betrayed him by telling the truth. I had betrayed the lie that held our family together. I could not be forgiven and indeed my father never faced the truth of who he was. As he grew older, his lying became ever more extravagant and he created an entirely fictitious past and present with which he regaled the young drug addicts and alcoholics at the treatment center he frequented with wild tales of vast wealth and great adventure. He was known as one of the “old-timers” for having been off the booze many years, even though he was strongly addicted to prescription painkillers by then.
Both my parents sought oblivion and escape from themselves. They sought deliverance from the pain of living and the truth that living brings pain. Opiates serve the same purpose, but seem to also confer the added illusion of Nirvanic insight or even genius upon the taker. Paradise in a little wrapper – who wouldn’t want that? In fact isn’t that what the entire legal drug market is shooting for? Medicate away the blues? No more depression, no more anxiety, no more problems? Every problem, psychic or emotional, has or will have shortly, a nifty little medical solution. As Dalrymple says, it is easier (much easier) to give a man a prescription than to give him a reason for living.
But of course to call this into question, calls into question the raison d’etre of hundreds of thousands of official “caregivers,” apparatchiks of the nanny state, and writes Dalrymple, “there is nothing an official hates more than a person who makes up his own mind.” He continues:
When self-indulgent actions, such as taking heroin, are deprived of some of their worst consequences, it is hardly to be wondered at that they spread like wildfire through a population. If consequences are removed from enough actions, then the very concept of human agency evaporates, life itself becomes meaningless, and is thenceforth a vacuum in which people oscillate between boredom and oblivion. They have nothing to hope for and nothing to fear; they are more likely to seek the intermittent oblivion of opiate addiction.
Harm reduction as a policy is inherently infantilizing of the population: it assumes that the authorities are, and ought to be, responsible, for the ill-consequences of what people insist upon doing. A recent case in a Canadian women’s prison illustrates this. A prisoner, addicted to opiates, was given a dose of methadone to prevent her from suffering; but so slight was the suffering that she anticipated, no doubt from her previous experience, from withdrawal from opiates – the suffering that supposedly justified the prescription in the first place – that she voluntarily vomited up her methadone, to give it, or more likely to sell it, to another prisoner who was not an addict. The latter drank the former’s vomit and died as a consequence.
Who was to blame? The prison authorities, of course. The relatives of the deceased immediately sued them. There is thus no reasonable expectation that people should not drink one another’s vomitus, or that, if they do, they should take the consequences themselves. We are all children and the authorities are our parents.
But as I have said, this policy of authoritarian concern apparently only pertains to heroin addicts. Alcoholics are on their own. Contrasting these two attitudes Dalrymple writes:
Suffice to say that I have seen hundreds of cases both of delirium tremens and withdrawal from opiates…I have never witnessed an opiate addict experience frightening visual hallucinations, but I have witnessed many alcoholics (mostly men) in a state of real terror at their visual hallucinations, which often start as exceptionally vivid dreams or nightmares, imaginary beings and events that are all too real to them. Indeed, I have known such patients dive through windows of the upper stories of my hospital in order, as they supposed, to escape the monsters, or enemies, who pursued or were attacking them. (Interestingly, it has proved difficult to persuade the hospital administration that such patients should be nursed on the ground floor as a precautionary measure, suggesting a subliminal death wish, though not on the part of the patients.)
I watched my mother have long conversations with people who were not there, remark it was snowing in California in July and confidently declare when asked what day it was, the wrong day of the week, date and year. Once after breaking her shoulder, she had a cast there with which she held conversation for months – it was her “turtle.”
But evidently, my mother wasn’t actually ill. She was a mere drunk and therefore medical treatment, beyond the patching of her shoulder, was not required. I remember a doctor raging in the ER where my mother was taken after collapsing before a church official to whom she was pleading for aid, “What is this woman doing here!! I want to know what this woman is doing here! She’s drunk! Get her out of here now! She has no business taking up a bed in the ER!” So we were thrown out of the hospital in shame and of course we were given no aid from the church.
But the question remains, is there a medication that could help alcoholics? In my experience I have seen only one thing help, and that one thing is cannabis: my husband, an alcoholic of the most severe kind, came through a very frightening episode through its use. And I maintain to this day, cannabis was a godsend. And I maintain to this day, my husband would most probably have died without it, not to mention the risk of killing someone else in a car accident. He has had over ten serious car accidents due to alcohol.
As we have seen, heroin addicts are liberally prescribed methadone to help them withdraw from heroin, so what is methadone? According to Dalrymple:
[Methadone] is a synthetic opiate first developed in Germany just before the beginning of the Second World War. The most commonly accepted, though not necessarily true, version of its invention is that the Nazis, fearing that their supply of natural opiates would be cut off during hostilities, and aware that the Reichsmarschall Hermann Goering was a morphine addict liable to withdrawal symptoms if his supply of heroin was interrupted, asked the German pharmaceutical industry to develop a synthetic opiate that freed Germany from the need to import, and Goering from his fears…It has often been asserted also that one of the American brand names for methadone, Dolophine, is in honor of the political leader in whose regime its discovery was made. This is strenuously denied by defenders of methadone, who claim that the drug, the patent for which passed to the allies as a spoil of war, was so called by combining two French words, douleur, pain, and fin, end, that is to say, the end of pain. If so, it was a remarkably insensitive play on words, since the drug in Nazi Germany had been named in honor of Adolph Hitler, and the word is at least as likely to conjure up Adolph as a fin de douleur.
Methadone, unlike cannabis, is an extremely dangerous drug. Again we turn to Dalrymple:
Substantial numbers of people are killed by methadone. The exact numbers are difficult to ascertain, and it is impossible to be dogmatic about whether more people proportionately die as a consequence of taking methadone than taking heroin. The fact that it is impossible to be sure in either direction, however, suggests that methadone is not very effective, even if the harm-reduction philosophy is accepted….
Whatever the finer points of the question, it is not difficult to find evidence of a considerable toll caused by methadone…In Scotland alone in 1998, there were 114 deaths in which heroin was directly implicated. There were 64 deaths in which methadone was directly implicated. Since at most a third of the number of heroin addicts receive a prescription for methadone, these figures could be taken to suggest that methadone is more dangerous than heroin, though in fact figures do not permit a straightforward conclusion, since some of the deaths were probably caused by the diversion of methadone to people who had never been prescribed it…
According to the coroner for the City of Dublin, there were 255 drug-related deaths in the years 1998-2000. Of these 157 were associated with heroin and 144 with methadone…
In Manchester, none of the deaths by overdose in 1985 was associated with methadone. By 1994, 30.6 percent of them were. (Interestingly, the same paper in the British Medical Journal shows that despite a fifteen-fold increase in the number of people prescribed methadone in Manchester between 1985 and 1994, the number of opiate addicts increased slightly more than three-fold. Addiction specialists are the new Canutes, bidding the tide recede, but without Canute’s awareness that the tide did not obey him.) In England and Wales as a whole, there were 9 deaths associated with methadone in 1985; by 1992 there were 115.
There has been an upsurge recently in the United States in deaths associated with methadone, so that in states such as Florida and North Carolina they are more numerous than deaths associated with heroin…
According to the U.S. National Institute on Drug Abuse, Bureau of Mortality Statistics, annual deaths caused by alcohol stand at 100,00 (presumably this doesn't include deaths from automobile accidents), all legal drugs 20,000, illegal drugs, 15,000, aspirin 100, and marijuana, none. The truth of the matter is, in all recorded medical history, no one has ever died as a result of smoking too much marijuana, though the smoker may run an increased risk for developing lung cancer.
New research in THC shows the substance actually slows the advance of atherosclerosis and stimulates neurogenesis, the process by which the brain gives birth to new nerve cells, in addition to its well-known properties of reducing nausea and relieving pain. But, to my knowledge, there has been only one study involving one patient specifically using marijuana as a treatment to alcoholism. Dr. Tod H. Mukuriya ends this study with these words:
"It would appear that for selected alcoholics, the substitution of smoked cannabis for alcohol may be of marked rehabilitative value. The drug effect of cannabis, as compared to alcohol, while having the sense of euphoria and detachment in common, lacks any other similarity except the intent for which it is taken. Ecessive alcohol use creates a predictatble weakening and dissolution of various superego and ego functions, whereas cannabis does not seem to have this attribute, providing if anything, an increase in ego strength. Because cannabis deos not facilitate ego alien behavior as seen with alcoholic excess, a great burden os guilt is removed , thus freeing the individual for more constructive pursuits.
"The fact that cannabis did not produce symptoms of irritability upon withdrawal, nor effects on the gastrointestinal tract, as compared with alcohol, also assists in the rehabilitation of the individual. Since he is not physically sick anymore, he is thus free to begin resocialization and to perceive the subtleties of the world beyond his needs for immediate gratification or succor. Certainly cannabis is not a panacea, but it warrants further clinical trial in selected cases of alcoholism."
The nanny state in which I live conceives it a serious crime to grow or to use marijuana, though I need hardly state, marijuana was created by God, rather than the Nazis as in the case of legally prescribed methadone, and the absurdity of the attempt to "outlaw" one of God's creatures is apparent. But we are children, remember, and unable to decide these matters for ourselves.
Big Brother knows best. Only he may decide who is deserving of what relief and when.
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