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Addiction and Opiates

Addiction and Opiates


CHAPTER 6 CURE AND RELAPSE includes addicts, drug peddlers, narcotics policemen and informers-that the user learns the folklore of addiction. It is this subculture that makes the drug available to him. His closest associations arc naturally with other users with whom he shares his preoccupation with drugs. Most of his activity and most of his conversations center on the drug habit., which is the organizational basis of the subculture. When an addict who is part of such a subculture attempts to quit his habit voluntarily, or when be is sent to jail or prison, any attempt that he may make to remain free of the drug is obviously jeopardized if be returns to his old environment and old associates. This, however, is usually what he does because he has no other friends and no other place that he wants to go. Returning to his old haunts, he has no difficulty in finding a supply, and in the process of resuming old associations he strongly tends also to resume his habit. If be has been in prison it is probable that his range of acquaintanceship with addicts, peddlers, and criminals has been broadened, and the probability of his encountering prison acquaintances is increased. Such encounters tempt him to relapse, make the drug available to him, and provide opportunities to make money by illegal means to support his habit. It is a mistake, however, to think of relapse exclusively in terms of the external cultural, environment. Both the impulse to quit and the impulse to relapse first manifest themselves in the private thoughts of the addict, and both impulses may be translated into action without any direct influence or pressure from others. Thus, an addict whom I interviewed, a former, physician, 'became addicted through medical treatment and for several years was unacquainted with any other addict. During this period he made five attempts to quit and remained free for a year on one occasion. Such instances are fairly common among addicts within the medical profession where the availability of the drug makes it quite possible for a person to use it or stop using it in secrecy and privacy. The abstainer who wants to relapse often goes out of his way to seek the environment favorable for this project, just as the determined abstainer may deliberately move out of such an environment. This point is illustrated by an addict who was discharged from prison in the spring Of 1937 and went to Chicago with more than a hundred dollars in his pocket. Fearing re-addiction and yet desiring just one shot, he walked the streets for about two weeks looking for some old friend who might help him make the necessary contact. Frustrated on every side, he finally met another addict just released from the same penitentiary. The latter reported the meeting in these words: "He just fell on my neck and asked me for a shot of anything. He said he was sick of booze and blondes and just wanted a shot." From cases such as these it is evident that relapse cannot be explained in terms of the external situation. An Addict's Rationalizations The following account of his own experiences by a nineteenth century American drug user is particularly interesting and significant because of the manner in which it exemplifies the addict's rationalization of his addiction and of his relapses, presented in this case with amazing naivete but with obvious sincerity. Finding then, that a grain of morphine was just the quantity required in my case, I took that amount every day in the evening, while the neuralgia continued, which was for three or four weeks; when this disease left me. Being now free from pain, I ceased taking morphine, as the necessity for it had ceased. This was my first experience with morphine; would to God it bad been my last! And this experience was pleasant, leaving no sting behind. Is it then to be wondered at, that upon my next attack of my hereditary enemy, and in all subsequent attacks, I employed a remedy which had worked so well before, in fact the only remedy I knew for this painful affliction.... But there came a time when matters took a different turn, when my relations with morphine were not of so friendly a nature, and when my reflections became of a more somber hue.... [He tells of becoming ill.] Before I had fully recovered from the effects of the fever, the neuralgia set in, in the chronic form; and I was never free from pain a single day for four months, except when under the influence of morphine. In the meantime I had become an inmate of a water-cure, but had not as yet received any benefit from the treatment. At the end of four months the neuralgia suddenly ceased, and 1 immediately laid aside the morphine, as I had done always before on the subsidence of the pain. Although I had been using the drug in moderation, never exceeding a grain to a grain and a half daily, yet having taken it continuously for four months, I found a difficulty in thus suddenly leaving it off which I had never experienced before. I felt as weak as a child, and as though I was failing to pieces. All the secretions of my system, file:///I|/drugtext/local/library/books/adopiates/chapter6.htm[24-8-2010 14:23:37]

CHAPTER 6 CURE AND RELAPSE which under the influence of morphine had been locked up, were now poured forth abundantly. Perspiration was profuse. Yet it was a cold and clammy sweat, and I was compelled to go to bed and cover up with blankets in order to keep warm in the middle of a July day. I had a gnawing sensation in my stomach which demanded for its satisfaction mustard, pepper, and other hot and stimulating condiments. And for eight days and nights I never closed an eye in sleep. But in a little over a week the system had fully reacted, and I began to feel pretty comfortable. I had not yet become a confirmed opiumeater, but I bad made a narrow escape. I had been standing on dangerous ground.... The neuralgia returned before I had been free from it a month. Being still at the water-cure, I brought to my aid all the resources of hydropathy. I tried cold baths and warm baths, and a most rigid diet, all to no purpose; and after suffering as none but a neuralgic invalid can stiffer, I again resorted to the old remedy, and the only remedy for this protean malady. It may be that I resumed the use of the drug without proper reflection; but when does a man in severe and agonizing pain ever reflect? Although I suffered, suffered severely, when last I abandoned the use of morphine, still I did not suffer as much from that cause as I was now suffering from neuralgic pain. I thought I was choosing the lesser of two evils.... I now struggled both against the disease and against the remedy. I tried bard not to become an opium-eater. I tried hard to sever the links of the chain rapidly forging about me, links which were every day becoming more adamantine. And at one time, and that within four months of the date of my last resumption, taking advantage of a temporary cessation of pain, I almost succeeded. Yet I did not succeed. After this period my pains increased, calling for increased doses of morphine. I had now become a conformed opium-eater. I had been taking morphine every day continuously for several months.(18) He then goes on to describe his relapses after temporary abstinence: My health had now become pretty well established. But it was for a brief period indeed. About the beginning of July of this year symptoms of my old malady began to make themselves felt. I took every precaution to ward off the attack. I tried all the resources of allopathy, homeopathy, and hydropathy, together with a most rigid regimen; for above all things I did not wish again to become an opium-eater. But what was to be done? Although my condition before when taking morphine habitually was a truly deplorable one, still it was more tolerable than my condition was now, without it. While using it moderately I could give some attention to business; I had still some enjoyment to life, especially intellectual pursuits, for it seemed to stimulate the intellectual faculties to increased activity. And barring all considerations of this kind, I was free from pain while under its influence. Now I was wholly incapacitated for business of any kind, and enjoyment was out of the question. I had no pleasure in existence, life was a burden. I fought the enemy long and desperately; I fought him with the energy of despair, until, overcome with suffering, I finally succumbed. Then I took morphine for a single day, making a truce with the enemy, as it were, for that short period, only to renew the battle the day following. Then on the third day I took morphine again. In this way I kept the enemy at bay for several weeks, making it a rule never to take morphine two days in succession, thus giving the system time fully to recover from the effects of one dose before taking another. I thought that in this way I incurred less danger of falling back again into my old habits. But the time came when this rule could no longer be observed, and I took morphine every day, but once a day for a while, and, by the time winter had set in, twice a day, or oftener, as required. Thus in about a year from the time I had gone through the tremendous crisis described a little further back, I was again in the gall of bitterness. Indeed, I had come to that condition in which I cared but little whether I lived or died. I had become, in short, perfectly reckless of consequences.... [Relapse No. 2] It was about six weeks since I had taken the last morphine. My health in the meantime had not improved to that degree which I thought I had a right to expect. I was free from neuralgic pain it was true, but I was still nervous and irritable, and exceedingly uncomfortable in every way. That cold and clammy perspiration still continued. It seemed to be more profuse than it bad been three weeks before. Other symptoms there were too, which along with this, indicated a state of great relaxation of the general system. I saw that tonic remedies were called for, and I took quinine, but without any effect whatever. Mine is one of those constitutions upon which quinine never file:///I|/drugtext/local/library/books/adopiates/chapter6.htm[24-8-2010 14:23:37]

Opioid Addiction