The narcotic drug problem

by Ernest S. Bishop

Let no one thoughtlessly reply that the very fact of my having on each of these occasions reached a point where, according to my own statement, I was able to live without the drug, constitutes proof that I was cured, or that when I started to use it again I was merely yielding weakly.

What has actually happened has been this. Each time that I have succeeded, in one way or another, in reaching a point where I was no longer taking the drug, I have, even while the suffering was still acute, been filled with a sense of happiness and hope that enabled me to stand it thankfully. I have argued with myself that, being then able even to exist without the drug and, for a while finding this existence day by day a little less of torture, I might reasonably hope for continued improvement. I have not expected miracles, but I have felt that each week should be easier, until, after a period of some few months, I should again be normal.

But this has not come about. Always I have reached a point where progress seemed to stop, and beyond this point my system refused to react. Occasionally this standstill has been quickly reached, that is, I could not react beyond a point where I was unable to sleep, where my legs ached atrociously, and where I was so completely unstrung that life was unendurable. At best, progress has continued for a few weeks, after which, though resting well, having a prodigious appetite and not undergoing marked physical suffering, I have actually been far from normal. This was shown, on these special occasions, chiefly by my inability to do satisfactory work, by my tiring altogether too easily and by a general feeling of unrest and disquietude.

I realize the difficulty of so describing my condition during these most favorable occasions as to show at all convincingly that I was not actually cured and that, in consequence, my resuming the taking of the drug was anything but a relapse. This, however, I must not attempt to do, since the main contention which I wish to make is here directly led up to.

And, hard as is the whole task I have set myself in writing this account, this special part of it is peculiarly difficult, involving the risk of appearing to set a false value on certain personal considerations.

My life has been an active and useful one. I have done work which I know to be good and which has brought recognition. Successful work, even in a given line of endeavor, is not always due to the same qualities in different men. My own work has been characterized by the exercise of careful judgment and the power of accurate analysis, qualities which I have always been credited with possessing. Now, after the most favorable of the so-called treatments which I have taken, and after allowing considerable time for complete recovery, I have in no instance regained these most essential requisites for my work, and thus I have been placed in a position where I would either have had to discontinue my work, or else do the only thing which made the resuming of that work possible. And always there has been the absolute conviction that this state of affairs was due to my not having been actually cured. On this point there has not been one iota of doubt.

Perhaps if I had been able at such times to take a complete rest of six months or even a year, I might have been fully restored, but this has not been possible. I have not been able to remain away from work for over five or six weeks after the “cure” proper, and even this has, as may well be understood, been a severe drain, when I have taken some cure or other at as short intervals as I could manage to get together sufficient funds and the opportunity to leave my practice.

Of course it may be argued that, rather than return to the use of the drug and thus again be able to live a life as nearly approaching normal as is possible for an addict, it would be better to refrain from using the drug, even though this involved never again being able to do those things which, to the ambitious man, are essential to make life worth the living. I submit that it is a high motive and not a low one which makes a man willing to pay the price rather than live a vegetative existence when he knows himself capable of better things. To understand this point of view it must be remembered that the addict gets no rosy dreams, no wonderful journeys into a beautiful and unreal world, no artificially enhanced powers beyond those of the non-addict, but at best only such equanimity and energy as are the latter’s happy possessions.

My point, therefore, is that my resorting to the drug after having stopped its use a number of times does not mean that I have many times been cured, and many times relapsed, but that I have not been truly cured. When the latest “cure” which I have taken has left me, even after weeks, still suffering acutely and continuously, and not improving in the slightest so far as I could see, I have taken the drug again for relief from torture no longer bearable. After “cures” which have left me in decidedly better plight but in the intolerable condition last described above, and with progress at a standstill, I have taken the drug only after calmly surveying the situation, and as the lesser of two evils.

I must reiterate my strong desire to find a cure, a real cure, one deserving the name; that is, a cure which will leave me normal, without need of the drug, and able to do the work which I must do in the world unless I am willing to be a slacker. But until I can find such a cure (and, in spite of my unhappy experiences, I will keep up the quest) I would have only contempt for myself as a physician and as a rational being if I failed meanwhile to make the best compromise possible, namely, to take each day, just as I would take thyroid substance were I suffering from hypothyroidism, a sufficient amount of morphine to enable me to attend to life’s duties and to occupy in the world that useful place which my qualifications enable me to occupy.