5 years ago

Addiction and Opiates

Addiction and Opiates


CHAPTER 2 THE EFFECTS OF OPIATES and the heavy demands it makes upon him. In addition, he experiences more than his share of tragedy, frustration, and misfortune and is affected by them much as other people are except that there is superimposed on his reactions the artificial cyclic rhythm of addiction. Without the drug, life may seem intolerable; with it the user feels that he is in control and that be can face his problems. Misfortunes that occur when a user is suffering from drug deprivation seem to depress him more than they should. When be has an adequate supply, the addict feels that his reactions to misfortune are more nearly what they should be, more like those of the average, normal non-addict. It is well known that many addicts have led useful and productive lives, relatively unaffected by their habit Lawrence Kob. in a study of 119 person addicted through medical practice.. -)und that go had good industrial records and only 29 had poor ones. He comments: Judged by the output of labor and their own statements, none of the normal persons had their efficiency reduced by opium. Twenty-two of them worked regularly while taking opium for twenty-five years or more; one of them, a woman aged 81 and still alert mentally, had taken 3 grains of morphine daily for 65 years. She gave birth to and raised six children, and managed her household affairs with more than average efficiency. A widow, aged 66, had taken 17 grains of morphine daily for most Of 37 years. She is alert mentally but is bent with age and rheumatism. However, she does physical labor every day and makes her own living.(20) After three years of observation and tests upon 453 addicts in India, Chopra found changes in personality and social behavior in only one third of the cases, and in only 3.6 per cent were these described as major changes .(21) The most usual were the acquisition of a sad expression, vacant look, bad memory, or tendency toward slow cerebration. About 6o per cent of his subjects had a healthy and normal appearance and were mentally unaffected by the habit. A notable case was that of a British army officer who, at the alleged age of 111 was said to have used opium or morphine in huge quantities for the preceding seventy years. His army career had been brilliant, and at his advanced age he was described as unusually active and alert.(22) Cbopra asked 1,070 addicts whether they regarded the habit as beneficial or harmful. Grouping the cases according to the size of the daily dosage, his investigation yielded the following principal findings: (23) Grouping the same cases according to the reason given for the original use of opium, he obtained the following results: file:///I|/drugtext/local/library/books/adopiates/chapter2.htm[24-8-2010 14:23:33]

CHAPTER 2 THE EFFECTS OF OPIATES These data suggest that, disregarding social consequences, the effects are considered beneficial in inverse proportion to the size of the dose, and depending upon whether the drug is used to alleviate such conditions as old age, worry, fatigue, and disease, or for other reasons. This conclusion harmonizes with medical opinion. Although it may strike the reader as a paradox, the morphine habit may actually benefit particular individuals, such as the chronic alcoholic or the psychoneurotic. Drug addiction and drunkenness are incompatible vices for liquor causes the addict's withdrawal symptoms to appear sooner than usual and morphine tends to make an intoxicated man sober. Neurotic symptoms may sometimes be suppressed by the regular use of opiates. Roger Dupouy describes a woman who took morphine for hysterical Symptoms.(24) She used it for thirty years without any further seizures until the drug was removed, whereupon the paroxysms immediately returned. The obvious deleterious effects which the drug habit usually has on the American addict's social life and personality, and even some of physical discomforts and disturbances associated with it, cannot be regarded as direct and necessary consequences of the pharmacological action of the drug. Addicts who are well-to-do or who have an assured supply of drugs often avoid these consequences. Serious "character deterioration" often makes its appearance only when the user is apprehended by the police and processed in the courts. There are vast differences between the behavior of most American addicts and those of other countries that handle the problem in different ways. The social behavior of the addict everywhere depends upon the legal and social context in which it occurs, not on the biochemistry of the drug. Ostromislensky has appropriately remarked that "the phenomenon of morphinism seems from the outside to be a chaotic mixture of strange and apparently illogical facts, seeming nonsense and various paradoxes."(25);, If the user only succeeds in feeling normal, one is compelled to wonder why he should go on spending twenty to fifty dollars a day for this non-effect. Why, when he has been extricated from this trap, is he so strongly impelled to resume his habit? In view of his intense craving and his extravagant appraisal of the drug's effects, how can it be possible to deceive him about whether he is under its influence? In view of the catastrophic personal consequences of addiction of which the user is more keenly aware than anyone else, why does the user not feel "normal" when he is withdrawn from the drug? These paradoxical aspects of the addict's behavior make it easy to understand the popular impression that there is something sinister, mysterious, or uncanny in a drug which has such devastating effects and is at the same time such a great boon in medical practice. Conclusion Three major points emerge from this discussion. First, that the initial effects of opiates are not comparable to their effects upon an addict and are indeed, in many respects, the opposite of them. Second, the psychological effects of the drug upon the regular user, apart from the impact effects, are not sufficiently marked to provide any clue for an understanding of the power of the habit. During addiction the drug seems to function to keep the user in a psychological and physical state which is so close to what may be called normality that it is often extremely difficult or impossible to determine by simple external observation whether a given person is or is not actively using drugs. Third, the personal and social characteristics of the American addict are not directly determined by the file:///I|/drugtext/local/library/books/adopiates/chapter2.htm[24-8-2010 14:23:33]

Opioid Addiction