The narcotic drug problem

by Ernest S. Bishop

We would, as a matter of fact, be less absurd in the former instance than in the latter; for we could argue the case out with our malarial friend, telling him he could conquer his “habit” by the exercise of will power, and—provided we argued long enough—we might convince ourselves that we were right because he would cease to shake, his fever would subside and until the next crop of parasites was turned loose in his blood stream, he would to all intents and purposes feel a well man, while in the latter case the more we talked of habit—that is, the longer the addict was deprived of his dose—the plainer would become the picture of a disease-racked body and a tormented mind.

I do not, of course, mean to offer the above comparison as either perfect in itself, or as sufficient to establish the claim that addiction is a true disease. The fact that it is a disease has impressed itself on all competent observers of a sufficient number of cases, and must be accepted. Yet it is astonishing to find that many educated physicians do not know this, while an even larger number, though readily admitting that addiction is a disease, nevertheless show, both by their manner of discussing the subject and by their attitude towards addicts seeking their advice, that this is little more than a verbal concession on their part.

If, however, it be argued that the contention as to addiction being a disease is vitiated by the fact that an occasional addict stops taking his drug by “will power,” that is, without taking treatment, we can point to an even larger proportion of mild cases of malarial fever in which spontaneous cure has come about. But this does not prove that the one, any more than the other, is not a disease.

Indeed, there could be no stronger argument in favor of the fact that addiction is an actual disease than the very phenomena presented by the occasional addict who stops taking the drug by “will power.” Neither medical writers nor literary geniuses, whether themselves addicts or mere observers, have yet succeeded in presenting a true picture of the tortures which this involves. There could be no greater error than to regard cure as dating from the time the last dose was taken. When, in these cases, cure comes at all, it is only after weeks, or months, of horrible existence, during which kind nature brings about a more or less complete restoration of body and mind not alone from the disease of addiction, but also from the profound shock of unskilled or unwise withdrawal. Will power has enabled the addict to abstain from taking the drug, while nature cured the disease.

There has been no time during all the years of my addiction that I have not earnestly longed to be free from its clutches. This is sufficiently proved by the many efforts which I have made to find a cure, each time at great personal sacrifice and expense, each time only to have my hopes shattered, after untold suffering and fresh disillusionment.

But a real cure I have thus far been unable to find. I have tried everything that seemed to offer a chance: gradual reduction, self-conducted and at institutions, the Keeley cure several times, and since then all of the vaunted cures, as each appeared in turn, advocated by men of high standing in the medical profession. Concerning this last class, I have each time hoped that such men could not be totally in error as to the practical results of their methods, notwithstanding what has seemed to me the most bizarre pathology on which they have claimed these methods to be based.

I might, perhaps, have been warned by certain palpable danger signs, but I have been too anxious to find the cure. I cared not at all how mistaken their pathology; for I could not believe that men of such standing could be equally mistaken as to the success or failure of what went on under their very eyes.

And right here let me set down what has impressed me as inexcusable neglect of these cases by most of these self same “big” men of the medical profession. One after another I have found physicians who receive and undertake to treat cases of addiction brought to them by the lure of high professional reputation and medical articles in which is painted a glowing picture of some new and wonderful cure. And, one after another, I have found these men of high professional standing giving to their cases not even enough time and attention to enable them to form an intelligent opinion as to their condition and progress, much less what would be needed for the proper study and treatment of one of the most difficult and distressing ailments which afflict mankind.

Moreover, comparing notes with medical men who have been fellow patients under similar circumstances (many of them, I may remark, of the highest type, as men and as physicians), there has been among us a universal sense of shame and indignation that men with such reputation and standing should lay the medical profession open to the justly founded criticism of extortion and neglect of duty, frequently of seemingly rank commercialism, even including the splitting of fees with quacks and charlatans of the worst sort.

In saying that I have found no cure, I do not mean that I have never succeeded in getting to the point where I could get along for shorter or longer periods without the drug. Many times I have succeeded by myself in gradually reducing the dose to a minimum and then making the final plunge and taking none at all for some time. What this has meant I will not undertake to describe. Several times I have managed to keep from using the drug for a while after taking treatment of one kind or another. But have I been cured?