Romancing Opiates: Pharmacological Lies and Addiction Bureaucracy by Theodore Dalrymple
If public officials who dole out billions of dollars yearly for drug rehabilitation programs would read Romancing Opiates, it could spark a thorough reexamination of how we deal with addiction. Written by the witty and insightful British psychiatrist and columnist Theodore Dalrymple, this short, powerful book is one of the most important—and certainly one of the most entertaining—policy books of recent years. Dalrymple spent most of his medical career treating addicts, first at a clinic for university students and then for 14 years in a general hospital and adjacent prison in one of Britain's largest slums. He began with the conventional views: that heroin addicts are blameless, having been conned into trying the drug, only to become hopelessly trapped; that withdrawing from heroin is agonizing; that addicts need to be "treated" for long periods of time with replacement narcotics such as methadone to spare them the harsh medical consequences of withdrawal; and that addicts become criminals out of necessity to support their habit.
Dalrymple's experiences taught him otherwise. He watched many prisoners go off heroin with withdrawal symptoms no worse than a mild flu. If heroin is not highly addictive, than why do we need an elaborate network of nurses, social workers, psychiatrists, and other doctors who keep addicts dependent on substitute narcotics? "It is easier to give people a dose of medicine than a reason for living," he concludes. Heroin addiction is at bottom a moral and spiritual problem, but for decades a growing medical bureaucracy has held that patients need virtually lifelong medical maintenance. This misconception perpetuates a vast industry and has done nothing to reduce the scourge of addiction on addicts or on our society.
* * *
This article appeared in the Fall 2006 issue of the Claremont Review of Books