“I proclaim it as my sincere belief that any one afflicted with neurotic disease of marked severity, and who has in his possession a hypodermic syringe and morphia solution, is bound to become, sooner or later, if he tampers at all with the potent and fascinating alleviative, an opium habitué. The first dose is taken, and mark the transformation. This overmastering palliative creates such a confident, serene, and devil-may-care assurance, that one does not for once think of the final result. The sweetness of such harmony can never give way to monotony. Volition is suspended. You may not think of it when the pain for which it was taken subsides. But when distress supervenes you go at once for the only balm that abounds in Gilead, and every additional dose is but another thread, however invisible, of which the web is made that binds us fast as fate.”
If this be true—and it is true—what justice is there in the charge that these unfortunates continue the use of opium from an innate propensity to evil, or a merely vicious desire? What right have we to set ourselves up in judgment to note the beam in our brother’s eye, when the only reason it is not in our own—when the only reason you and I are not opium habitués—is because a kind Creator has so conditioned us that this physical necessity, and consequent opiate need, does not, with us, obtain?
Having thus touched upon the etiology of this disorder, let us reason together regarding the special ethical point involved, and note the reason—if reason there be—for the commonly accepted idea that all men who use opium are liars. While admitting that the habitual need and use of this drug does, in many cases, warrant such assertion, I hold that the leading factor in this moral obliquity is the principle of self protection—the habitué’s desire to shield himself from that censure which the prevalent opinion—uncharitable and untrue—that he is simply the victim of his own vicious indulgence, involves.
There are various proofs that this holding is correct, and, too, without resorting to the opinion held by Lahr, Fiedler, and some others, that opium habitués are the subjects of a mental alienation, both in the creation and continuance of their addiction, and therefore absolved from culpable wrong—an opinion in which I do not share. Nor do I believe, for reasons given, with another German observer, that “the morbid craving for morphia ranks among the category of other human passions, such as smoking, gambling, greediness for profit, etc.,” for if this were true, the impulse to protect one’s self would not so largely prevail.
The opium habitué realizing that he is looked upon as one who has given himself up to a vicious habit, a habit in which he persists from mere desire to enjoy the pleasures of opium—pleasures which, be it ever remembered, soon give place to its pains—and so liable to the censure which a vicious indulging involves, is impelled—by a feeling common to us all of guarding our good repute—to yield to the protective temptation to untruth.
But to this there are numerous exceptions, for many a captive to this drug, though well nigh crushed by his captivity, and that “cruelty of ignorance,” which the unjust reproaches of should-be friends entails, still refuses to seek refuge behind such subterfuge, and scorns to tell a lie.
And do we not note this same impulse to deceit in most non-habitués who, lapsing from the right, make effort to avoid the sequence of their sin? Does the swindler always confess his swindling? Do the thieves, the forgers, the rascals of any degree, never deny their wrong doing? And while, in these cases, such double wrong may be the outcome of a general depravity, that, of itself, tends to prove that if the pernicious effect of opium in this regard were due solely to its baneful effect upon the morale in general, we should note the same tendency to lying along the various lines of life, whereas, it is a fact that on any question other than one involving his opiate taking, and consequent accountability, the habitué may be, and often is, a very prototype of truth.
What is the bearing of this question on the medico-legal status of these cases? If they be held culpable for the inception and furtherance of their condition, whatever outcome there may be affecting the jurisprudence of their action, must, from such erroneous view of the situation, fail of that legal justice which a correct appreciation of their case demands.
The writer was recently called upon to testify in the case of a physician who had been under his care for treatment of narcotic inebriety. This gentleman was the subject of delusions and hallucinations, so marked, that, in my opinion, he was not accountable for his conduct. Suit for separation was brought against him, and the referee’s remarks during the trial, and his final decision, were in keeping with the belief that the defendant was responsible for the consequences of his alienation.
Again, a right appreciation of the status of such patients will lessen the labors of the doctor and the lawyer in their legal aspect, and remove the risk of failure to determine the true physical condition of the habitué where the question of narcotic taking is the leading issue in the case. To illustrate. Granting a general acceptance of my assertion that the class to which this paper pertains are the subjects of a disturbed organism, beyond their control, and for which they are blameless; and granting an appreciation of this belief by the patients themselves, then their main motive for concealment will be removed, and no more reason for untruth exist than if they were the victims of any other functional disease.