Addiction and Opiates

CHAPTER 2 THE EFFECTS OF OPIATES
In the above sense, there is only one authoritative source on how a given addict feels, and that is the addict himself.
The tendency of the outsider who learns about addiction from the mass media is to assume that the drug user who
sacrifices so much and undergoes so many deprivations and miseries for the sake of his habit must obtain an
extraordinary euphoria from it-in other words, that the drug must make him feel very extraordinary indeed. The idea
that addicts experience uncanny psychological pleasures and live a life of ecstasy is false on the face of it and is denied
by them. Their denial must be accepted unless evidence can be produced to discredit it. Available evidence, however,
tends to confirm the user's view.
For example, it is conclusively established that under appropriate circumstances addicts can be deceived into believing
that they are receiving drugs and are under their influence when in fact they are not. They may also be led to believe
that they are not under the influence of drugs when they in fact are. An illustration is provided by a gradual reduction
method of curing addicts that has been practiced in this country and that has also been used elsewhere. These cures
involved gradual reduction of dosage with saline solution substituted gradually for the drug until after a period of time
(such as two weeks) the patient was being given only saline and no drugs at all. In some of these systems the injections
were continued on a regular basis for a -period of time after complete withdrawal of the drug bad been effected. The
addicts, who were not told what the program was, often thought they were still getting drugs after it had been
discontinued and others thought they were off drugs when in fact they were still receiving substantial doses.
I have interviewed ex-patients who sheepishly admitted that such deception had been successfully practiced on them
for as long as ten days. One addict said that he knew of two women who had received water or saline for an entire
month under the impression that it was morphine. It is also reported that addicts who demand drugs for insomnia can
sometimes be put to sleep with a sterile hypodermic if they believe it is morphine. Conversely, when they have been
given a morphine injection and have been told that it was a non-opiate drug, they may continue to complain. Instances
of this kind have been so generally noted in the literature and reported so often by addicts that the possibility of such
deception must be considered an established fact.
Dr. Charles Schultz performed an experiment in which half of a group of subjects were put on a seven-day reduction
treatment, and the other half on a fourteen-day schedule; for the former, the daily dose was reduced by one-seventh,
and for the latter by one fourteenth.(13) As a result, some patients on the fourteen-day schedule thought they were
receiving the seven-day treatment, and after the expiration of seven days began to show great nervousness and
restlessness, one subject even resorting to an apparently simulated convulsion. When it was explained to them that they
had been put on a fourteen-day course, and that they were still getting half of their beginning dosage, all symptoms
disappeared at once. (14) A similar illustration is furnished by a former addict, a soldier who was wounded at the front
and lay unconscious in a hospital for several days. Opiates were freely administered to him, but when he regained
consciousness he did not realize that he was under the influence of drugs until the characteristic and unmistakable
distress of withdrawal appeared.
In a personal communication to me, a physician reported that a woman patient about to undergo a painful operation
had asked him not to administer opiates under any circumstances, explaining that, although an abstainer, she had once
been addicted and that a single injection might cause a relapse. Even if it were a matter of life and death, she begged
that no opiates be given her, The doctor agreed, but after the operation the patient suffered such intense pain that a
narcotic prescription became absolutely necessary, and was administered orally disguised in liquid form. It made the
patient more comfortable and relieved the pain. Since she was not aware that she had received the opiate there was no
relapse into the former habit. Later she thanked the doctor for his support of her program of abstinence.
R. N. Cbopra and his collaborator performed an ingenious experiment along the same lines. They disguised opium by
administering it in oil of citronella as "tonic number X" to patients in a Calcutta hospital who complained of pain and
demanded relief.'(15)" This device revealed the malingering addict, for be always continued to complain after the
opium bad been taken, while nonaddicts admitted that they felt relieved.
The absence of a distinctive or unusual state of mind produced by the drug is clearly revealed by another interesting
phenomenon. The addict's common complaint during a cure of the gradual reduction type, is not that he suffers from
withdrawal, but that be cannot "feel the shots." When such a point is reached many addicts demand that the drug be
discontinued entirely, preferring not to prolong the suspense; since they cannot feel the injections, they may as well not
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