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Addiction and Opiates

Addiction and Opiates

CHAPTER 6 CURE AND

CHAPTER 6 CURE AND RELAPSE Side: Perspectives on Deviance (New York: Free Press, 1964), P. 172. 17. Ibid., p. 173. 18. James C. Layard, "Morphine," Atlantic Monthly (1874), 33: 68-99. 19. Ibid., PP. 700-7o6. 20. Ibid., P. 707. file:///I|/drugtext/local/library/books/adopiates/chapter6.htm[24-8-2010 14:23:37]

CHAPTER 7 A CRITIQUE OF CURRENT VIEWS OF ADDICTION file:///I|/drugtext/local/library/books/adopiates/chapter7.htm[24-8-2010 14:23:37] PART I The Nature of the Opiate Habit CHAPTER 7 A CRITIQUE OF CURRENT VIEWS OF ADDICTION The views of addiction most commonly expressed in both the popular and the scientific literature have not changed significantly for many decades. The main substantial change has been in the vocabularies employed to express them. This is made evident by listing terms that have been used to describe addicts or types of addicts, usually with the assumptions that what is being described is an addiction-prone personality type and that the named attribute has etiological significance. All of the terms that follow are taken from only two studies: that of Terry and Pellens (1) in 1928, which presents older terms taken in some cases from literature of the nineteenth century, and that of Ausubel, (2) published thirty years later: "alienated," "frustrated," "passive psychopath," "aggressive psychopath," "emotionally unstable," "nomadic," "inebriate," "narcissistic," "dependent," "sociopath ... .. hedonistic," "childlike," "paranoid," "rebellious," "hostile," "infantile," "neurotic," 11 over-attached to the mother," "retreatist," "cyclothymic ... .. constitutionally immoral," "hysterical," "neurasthenic," "hereditarily neuropathic ... .. weak character and will," "lack of moral sense," self-indulgent," "introspective," "extraverted," "self-conscious," motivational immaturity," "pseudopsychopathic delinquent," and finally, "essentially normal." Views or theories of addiction advanced by different writers can, as a rule, be reliably predicted from knowledge of the investigator's professional and intellectual training and commitments. Orthodox Freudians find, in addiction behavior, a confirmation of Freud's ideas; Adlerians propound Adlerian theories; behavioristic psychologists who are followers of Skinner find that drug addiction fits neatly into the framework of operant conditioning. sociologists who are followers of Merton emphasize alienation, anomie, and the double-failure hypothesis; statisticians tend to -e the methodological blunders, connected with sampling e of controls, that are committed by the nonstatisticians; trained researchers suggest biological theories and by the subjectivism and lack of precision of behavioral gical studies. is is true, it implies that theories of addiction are 'ling other than the facts. If the data serve only existing ideological positions of the investigate controversies are likely to be noisy and futile conducive to the formulation and progressive thereof theory which is characteristic of genuine science on the assumption that the controversy between competing positions stems in large part from the fact that different investigators proceed from different and usually unstated methodological presuppositions, I have tried to state my own fairly explicitly and fully in the foregoing chapters. The comments in this chapter on views which I do not share and which seem mistaken to me are implied by my own methodological assumptions. Thus, I must state that most of the views examined in this chapter are not genuine theories at all from my standpoint, either because they do not purport to be generally applicable to all opiate-type addiction or because they are so formulated that no conceivable evidence to negate them is possible or conceivable. Persons who think of scientific theories in other terms than these will naturally not agree with my evaluations. When a theorist or a critic makes his assumptions explicit, those who disagree are in the position of knowing whether they should discuss the evidence or concern themselves rather with questions of scientific method and logical inference. Psychopathy and Addiction Thirty years ago, in a discussion of drug addiction, E. W. Adams, a well known British writer on this subject, stated: It is almost universally agreed now, that running beneath all other causes is an inherent mental or nervous instability of a greater or less degree. That statement may be said to rest upon evidence as convincing as that upon which most of the canons of medicine are based. Addiction can, as will later be seen, be brought about in persons mentally normal Jo all appearances, if deliberate attempts are made with this object or if their medical advisers unwisely subject them to unduly prolonged narcotic treatment, but such persons will not become addicts of their own accord. Ordinarily, then, addiction is a sign of a mental makeup which is not entirely normal.... We shall not go wrong, then, in accepting as a fact the existence of this psychopathic basis in the large majority of the victims of drug addiction. (3) Numerous other authorities who agree with this conclusion are cited by Adams, and essentially the same views have been expressed by countless writers since that time.

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