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Is Drug Addiction Really Like ‘Any Other Chronic Illness’?

Who can imagine an organization called Arthritics Anonymous whose members stand up and say “My name is Bill, and I’m an arthritic”?

by
Theodore Dalrymple

Bio

September 17, 2013 - 5:00 pm
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Sometimes a single phrase is enough to expose a tissue of lies, and such a phrase was used in a recent editorial in The Lancet titled “The lethal burden of drug overdose.” It praised the Obama administration’s drug policy for recognizing “the futility of a punitive approach, addressing drug addiction, instead, as any other chronic illness.”  The canary in the coal mine here is “any other chronic illness.”

The punitive approach may or may not be futile. It certainly works in Singapore, if by working we mean a consequent low rate of drug use; but Singapore is a small city state with very few points of entry that can hardly be a model for larger polities. It also seems to work in Sweden, which had the most punitive approach in Europe and the lowest drug use; but the latter may also be for reasons other than the punishment of drug takers. In most countries (unlike Sweden) consumption is not illegal, only possession. That is why there were often a number of patients in my hospital who had swallowed large quantities of heroin or cocaine when arrest by the police seemed imminent or inevitable. Once the drug was safely in their bodies (that is to say, safely in the legal, not the medical, sense), they could not be accused of any drug offense. Therefore, the “punitive approach” has not been tried with determination or consistency in the vast majority of countries; like Christianity according to G. K. Chesterton, it has not been tried and found wanting, it has been found difficult and left untried.

But the tissue of lies is implicit in the phrase “as any other chronic illness.” Addiction is not a chronic illness in the sense that, say, rheumatoid arthritis is a chronic illness. If it were, Mao Tse-Tung’s policy of threatening to shoot addicts who did not give up drugs would not have worked; but it did. Nor would thousands of American servicemen returning from Vietnam where they had addicted themselves to heroin simply have stopped when they returned home; but they did. Nor can one easily imagine an organization called Arthritics Anonymous whose members attend weekly meetings and stand up and say, “My name is Bill, and I’m an arthritic.”

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Top Rated Comments   
I am a huge fan of Dr. Dalrymple's writing and have read his book, Romancing Opiates. This is along the same lines as that book.

I am also a long-term recovering addict with drugs/alcohol (25 years), but have active addictions that continue to bedevil me.

I think "disease" is a metaphor. Addiction is a "disease" in that it responds to "treatment." No, it's not malaria or a cold or any other chronic illness, where the disease will respond to the same treatments regardless of how the patient feels about it. But I think we can call addiction a disease in the sense of a mental illness, if that helps. If it doesn't, don't.

I have been among AAers and listened to arguments about disease or not. I usually don't join in because I'm not sure where I stand. The alcoholism phenomenon that I experienced was ruining my life ... and techniques that have been proven to work in others worked for me. In my case, I could not have stopped on my own.

So something's going on. Addiction has a physical component, a psychological component, a spiritual component, and a moral component. If disease is a term that you think creates confusion and undercuts clear thinking, then we can use a different word. For me, addiction is a psychological phenomenon and I have no trouble sticking the label disease on it. In no way do I believe I caught it like a bug or something.

49 weeks ago
49 weeks ago Link To Comment
Addiction is so difficult for Americans to confront because they shy away from dealing with the moral component. Yes, some people become addicts because of a physical predisposition, but it takes a moral choice to abuse drugs in the first place. Except for babies born with drugs in their systems, nobody is "forced" to take drugs. It is a choice.

Addiction runs rampant in my family--both parents, my only sibling--and yet I have been spared. Why? Because I made a conscious moral choice not to use drugs. Diabetes also runs through my family. Guess what? I made a different choice here--not enough exercise and too much food have helped make me a diabetic. That does not make my fondness for cheeseburgers a chronic disease.

Treating addiction as a chronic disease is ridiculous. Do we treat smoking or promiscuity or gambling as a chronic disease?
49 weeks ago
49 weeks ago Link To Comment
All Comments   (31)
All Comments   (31)
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Addiction is a disease of the mind and the way a persons body metabolized the substances they ingest. The choice theory of if I put a gun to an addicts head and tell them if they drink I will shot them can prevent them from drinking has merit in the fact that yes it will stop the act of drinking but it loses in the fact that the addict still is trying to figure a way to drink without being shot. Can I get the drink down before they pull the trigger maybe the gun wont fire or will they really shot. The act of drinking is not the addiction its the obsession to use and the way after the use the body processes the substance which makes it a disease.
45 weeks ago
45 weeks ago Link To Comment
'Nor can one easily imagine an organization called Arthritics Anonymous whose members attend weekly meetings and stand up and say, “My name is Bill, and I’m an arthritic.”

Actually my own father almost did exactly that. When he was in the end stage of oesophageal cancer he derived a lot of benefit from attending groups with people who we're going through the same thing. It didn't 't make him better but it made him feel better.

Guess he wasn't really 'ill' then which would be a surprise to him as he is now deceased.
48 weeks ago
48 weeks ago Link To Comment
Calling drug addiction a chronic illness simply legitimizes drug use. Communists and progressives cheer, while the children of drug abusers suffer. Communists and progressives want children to suffer.
48 weeks ago
48 weeks ago Link To Comment
Communists and progressives? Should that not be doctors and the pharmaceutical industry or are they one and the same.

The Soviet Union did not use illegal drugs and street corner dealers to control their citizens. They used psychiatrists and perfectly legal neuroleptic drugs.
48 weeks ago
48 weeks ago Link To Comment
"We scientists know that we get more money if we keep telling Congress that we’re solving this terrible problem."

So if addiction is a symptom of a lonely soul as per the NYT article posted by Mr. Martin then the placement of the lonely soul into a highly structured environment with a pre-planned schedule of activities should lead to the lonely soul finding his way forward into a productive and healthy life.

So, we need containment facilities for those of a non-violent nature without the necessary self-control to make positive decisions for themselves...
49 weeks ago
49 weeks ago Link To Comment
The use of drugs has been an ever-darkening shroud covering our society for 60 years and will, in the not so distant future, destroy us. The longer the so-called drug culture has been with us the more acceptable people who should know better find it. It amazes me that even among conservatives there's no longer any outrage over recreational drug use or any effort to curtail it. The list of the negative ways it's impacted our world is so long that I can't compile it here, but drugs make young people sexually promiscuous, drugs incubate criminal behavior, drugs dull the minds of young people who then are almost impossible to educate, drugs create people whose grasp of reality is so tenuous they can only understand what is superficial, etc., etc., etc. I can only assume that people are no longer concerned about drugs because everyone is implicit, everyone is on one drug or another.

I have a great deal of respect for the political writer, pundit and former psychiatrist Charles Krauthammer, but almost fell off my chair when several weeks ago on a Fox News panel he said that drug use is much healthier for people than alcohol because drugs don't make people violent. Has he never heard of crystal meth? My parents, who came of age in the late '20s-early '30s, were part of a generation of heavy drinkers. Most were social drinkers but those who became true alcoholics sought help in AA and stopped. Why? Because of social pressure. Alcoholism wasn't acceptable. If society had condoned alcoholism then as they condone drug use today it probably would have been a different world.
49 weeks ago
49 weeks ago Link To Comment
"This" is as likely to destroy us as overpopulation, Dr. Malthus, but thanks anyway for your "enlightened" opinion.

I often enjoy your comments, artghost, but here you got it really wrong. Conservatives (as you call them) have backed down from the war on drugs, because they recognize the failures of prohibition in ways Progressive statists can't. We understand that free individuals must be free to take bad choices, OR ELSE THEY ARE NOT FREE.

Many of us know plenty of average people living perfectly happy and normal lives who also enjoy pot recreationally. I would agree that Meth, Cocaine, and Heroine are terrible drugs that probably can't be safely enjoyed recreationally, but that can't be my problem. It must be the problem of the individual who takes them anyway.

I do agree with you that if society frowned upon drug use, you'd see it decline. That is the best way to deal with the problem.
48 weeks ago
48 weeks ago Link To Comment
Everything's an "illness" with the Left, even pregnancy.

Excuses are the stock in trade.

Ariel Castro got with some apologists and "explainers" and then proceeded to get out there on the airwaves and pronounce himself not a bad guy, just a person suffering an uncontrollable sex addiction.
49 weeks ago
49 weeks ago Link To Comment
Doc writes: "Nor would thousands of American servicemen returning from Vietnam where they had addicted themselves to heroin simply have stopped when they returned home; but they did."

It would be helpful to have a reliable source for this claim of thousands. I wouldn't accept John Kerry, the film "Apocalypse Now," nor any film by the aptly named Oliver Stone as being reliable.
To me it is akin to the claim that returning Vietnam vets were spat upon and vilified. A few were to be sure, there are photos of a mob engaged in that activity. But try to imagine what would happen if some individual Lefty nitwit would go up to a Staff Sergeant in the Army or Gunny in the Marine Corps in an airport and spit on him.
49 weeks ago
49 weeks ago Link To Comment
Google the history of the war on drugs. Back in 1971 Congressmen Robert Steele (R-CT) and Morgan Murphy (D-IL) came back from Vietnam claiming that up to 15% of the troops were using heroin.

When soldiers were forced to take drug tests prior to going home it was around 20% of servicemen.
48 weeks ago
48 weeks ago Link To Comment
Drug and alcohol use and abuse. The only disease that can be a lot of fun and, oddly enough, very few immediately seek medical help for when they suspect the diagnosis. Heh.
49 weeks ago
49 weeks ago Link To Comment
Dr. Dalrymple is at it again.

Mocking with unpleasant and therefore ignored or dismissed facts and true statistics as part of a what? - conspiracy against the good will of the "best and brightest of Anglo-Saxon elites.

The "medicalisation" of virtually all social indisciplines harmful to individual and community, as "sickness". Medical Doctors and counselors of whatever persuasion the new priesthood of today's Church of Compassionate Liberalism.

That Church for which their Messiah has arrived. Even with special as far as is known, birth place. Places? To follow in the footsteps of the forerunner as their New Kennedy. All out of Chicago the birthplace of liberty for the common man.

EXCEPT or course for "caring". "compassionate" "liberals" so evil lthat no quarter can be given.. SMOKERS. Not only dangerous to themselves but to innocents at distance from them. Their emanations wot !

No "addiction" for their beyond the pale evil . Therefore no compassion. The Law serves to "educate" all.

Throw the book at them, and exit lauging stage left.

Don't you just love democracy as practiced by new age liberals, democrats and friends? ALL of course "for the good of the People" and "the common good".
49 weeks ago
49 weeks ago Link To Comment
1. Find some remote island or corner of the earth and seal it off.
2. Any adult can enter. Once in the police will not pursue, for any offense. A sanctuary for criminals, or self imprisonment, either way works.
3. Upon entering spaying or neutering is manditory, (must detox first)
4. There are no laws but their own. They can have anything they can buy (Certified, guarded product entry gates, cash and carry provided)
5. Money can be from friends, relatives or what the create themselves.
6. No help from outside. Illegal ENTRY will be shot on sight
7. Exit is free and easy. Report to check out center, detox, and get 24 hour head start before police notified.

All the cheap, untaxed drugs ya want. Weird sex, sure. Go for it. We leave you alone you leave us alone.
49 weeks ago
49 weeks ago Link To Comment
You might want to add clean bill of health to entry and exit requirements. We don't need people spreading HIV and drug resistant Gonorrhea around.
48 weeks ago
48 weeks ago Link To Comment
There is of course the "town" of Christiania in Copenhagen. Which may be a start down that path.
49 weeks ago
49 weeks ago Link To Comment
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