A different take on opiates

In an interview at Front Page, Theodore Dalrymple tackles the conventional wisdom about Heroin (how people start, how addicted they actually get, and how bad withdrawal really is). Regarding withdrawal, he has this to say:

With regard to withdrawal, it is grossly exaggerated as a phenomenon. Unlike withdrawal from barbiturates or alcohol, it is not dangerous. There is abundant evidence that a large component of the problem is anxiety, which in turn has been brought about by the uncritical mental absorption of the myth. This myth has been perpetuated in many books and films. In addition, addicts frequently lie about their symptoms in order to obtain drugs from doctors.

At its very worst, withdrawal is like flu, but usually is much less severe than that. We used to withdraw addicts in my hospital, making it clear that we would prescribe for them only when we, the doctors, saw the need, and we would not be influenced at all by anything the addict said concerning his symptoms. After two or three days, the addicts always said, ‘Is that all there is to it?’ They never suffered severely.

In the prison in which I worked, the addicts did not know that I observed them before they came into my room. Among themselves, they were chatting, laughing and joking. When they came into my room, they claimed to be in the deepest agony. This is an observation that has been made many times, and indeed there is experimental evidence showing that addicts change their behaviour and their story depending upon their interlocutors, and whether their interlocutors are in a position to prescribe or do anything else for them.

Dalrymple’s version of withdrawal is very easy for me to believe because of a bit of family lore.  While fighting in the desert in the 1940s, my Dad got very, very sick with something.  I say “something” deliberately, because the doctors had no idea what it was — a disease, a toxin, something else?  The whole thing was a mystery.

What was clear was that Dad was suffering greatly and that he was dying.  In response to the first, the doctors loaded him up with Morphine.  I mean, since he was dying anyway, why make him suffer?  Then, my Dad did the unbelievable — he lived.  At the end of his hospital stay, the doctors released him to my Mom’s custody with the warning that, while he had recovered, he would be an addict forever.  They couldn’t have been more wrong.  My Dad left the hospital and, in the intervening 40 years, never again took opiates until the weeks before his actual death from cancer.