For years, Theodore Dalrymple's writings on all things medical have been enjoyable for their dry wit and keen observations - but when he writes about heroin users he seems to me to loose his normal compassion and humanity. Maybe he has some personal "agenda".... but anyway....
Dalrymple was plugging his new book on Radio 4 this morning (hear the interview here) but some aggrieved methadone patient was shouting him down constantly so I did not hear the full argument and I have not read the book.... but it seems pointless to say that stopping using heroin is no worse than a dose of flu - and that it is all "psychological" (as if psychological distress didn't matter), because quite clearly people seem to have a great deal of difficulty coming off heroin which is disproportionate to a dose of flu...... But in another sense of course he is right - traversing an opiate detox can be achieved within 2 weeks by 80% of our patients at Clouds - rather less I suspect if we did not medicalise the event - but then we medicalise flu with aspirin and going to bed as well..... and I also agree with him that by medicalising addiction we turn clients into patients, tacitly suggesting that as "sufferers", they are not responsible for their "disease" ... and the ongoing daily dosing of methadone petrifies that mindset.
But I am not greatly bothered by Dalrymple's prejudices, because when people like him talk about heroin addicts, they talk about heroin, rather than talk about why people become unhappy and look for chemical relief in the first place. Returning to the unhappiness that the chemicals null out is what is hard, not relinquishing the chemicals themselves. Perversely, I am rather glad that we do have heroin and alcohol sloshing around our streets.... for every society has always had inequality of opportunity brought about by intellectual, social, mental and family dysfunction, and that inequality brings about enormous unhappiness. Whilst others, dealt a decent set of cards, get on with their lives, there is a big section that is left behind. If comforting chemicals had never existed, noone would know these people or their unhappiness - but because they find temporary solace in drugs and alcohol, and the knock on effects of their habits are health and criminal consequences, whole care systems have been invoked to look after them. Yes, some of them Dalrymple will say, are indeed lazy blackguards - but not many - the rest are lost souls behind a smokescreen of chemicals, who we try to help and care for - and by looking no deeper than the smoke, his simplistic arguments disrespect them.
Dalrymple was plugging his new book on Radio 4 this morning (hear the interview here) but some aggrieved methadone patient was shouting him down constantly so I did not hear the full argument and I have not read the book.... but it seems pointless to say that stopping using heroin is no worse than a dose of flu - and that it is all "psychological" (as if psychological distress didn't matter), because quite clearly people seem to have a great deal of difficulty coming off heroin which is disproportionate to a dose of flu...... But in another sense of course he is right - traversing an opiate detox can be achieved within 2 weeks by 80% of our patients at Clouds - rather less I suspect if we did not medicalise the event - but then we medicalise flu with aspirin and going to bed as well..... and I also agree with him that by medicalising addiction we turn clients into patients, tacitly suggesting that as "sufferers", they are not responsible for their "disease" ... and the ongoing daily dosing of methadone petrifies that mindset.
But I am not greatly bothered by Dalrymple's prejudices, because when people like him talk about heroin addicts, they talk about heroin, rather than talk about why people become unhappy and look for chemical relief in the first place. Returning to the unhappiness that the chemicals null out is what is hard, not relinquishing the chemicals themselves. Perversely, I am rather glad that we do have heroin and alcohol sloshing around our streets.... for every society has always had inequality of opportunity brought about by intellectual, social, mental and family dysfunction, and that inequality brings about enormous unhappiness. Whilst others, dealt a decent set of cards, get on with their lives, there is a big section that is left behind. If comforting chemicals had never existed, noone would know these people or their unhappiness - but because they find temporary solace in drugs and alcohol, and the knock on effects of their habits are health and criminal consequences, whole care systems have been invoked to look after them. Yes, some of them Dalrymple will say, are indeed lazy blackguards - but not many - the rest are lost souls behind a smokescreen of chemicals, who we try to help and care for - and by looking no deeper than the smoke, his simplistic arguments disrespect them.
