Our history of addiction “(opinion)

Hearing to mention that someone is “performance intervention”, “bottom-up” or “recidivism”, few people who read this will have to look for consequences. Thoughts and idioms about addiction and healing are fully integrated into a common culture, a shared message through which we understand and navigate our daily lives.

That’s so weird overall. It wasn’t always like that. And this was accompanied by inflation in the very concept of “addiction”. Originally limited to dependence on a very narrow range of substances, it now covers almost any compulsive behavior considered undesirable. (As usual, OnionThe satirists soon described this trend with the headline: “I’m like anything, but for booze.”)

Such an accidental mention of addiction could reflect an overall increase in public awareness of the problem, which includes approximately 14.5 million people with alcohol dependence in the United States, as well as three million opioid addicts. But acknowledging the reality of addiction and directing rational attention to it are very different issues and Carl Erik Fisher Urgency: Our history of addiction (Penguin Press) underline this difference with an engaging story full of promising development and missed opportunities.

The author is an Assistant Professor of Clinical Psychiatry at Columbia University and is also an addict. He acknowledges this from the beginning and adds details along the way, leaving the memoiristic aspect second to his project. Urge is a narrative history of ideas, policies, and practices that have emerged over the centuries. The book focuses largely on substance dependence, but quotes “The Lament of the Player” from Rigveda, an ancient Indian script, as a recognizable evocation of the drug addict’s experience: then slap the winner again, soaked in honey, by force … He rolls down, then he jumps up quickly and forces a man with his hands to serve them. ”The same words can apply to a syringe or a pipe.

This struggle to gain control after losing it (again and again) is accompanied by Fisher’s account of being a young psychiatrist at a prestigious university hospital when he was captured by various substances to alleviate stress. He has not ruined his career or himself, thanks in large part to the measures of the medical community that has taken care of himself: there are special treatment programs to deal with addicts. “For rehab,” Fisher writes, “he met with doctors who had been there for the second or even third time and who had relapsed, exactly as planned, after their own five-year monitoring contracts had expired.” (Status has its privileges.) The book repeatedly emphasizes social inequality wrapped in a stigma associated with certain drugs – such as 18th-century gin or crack cocaine in recent times – and repression overthrown by their users. while others have a good reputation when they are supported by established industries such as in heroin?

Yes, heroin. “First widely produced on a commercial scale in 1898 by Bayer,” Fisher notes, it was “initially praised as a safe, modern alternative to morphine” until it merged with “[the] a poor teenager, often an immigrant parent, unintelligent, greedy and rude, and increasingly united with others like him, in a new urban phenomenon of menacing ‘gangs.’ to smaller, informal markets in shabby neighborhoods – poorer, racially mixed neighborhoods, where authorities have segregated gambling, prostitution, salons and other disapproved businesses. ”The drug becomes dangerous when people consider it dangerous, and so the vicious circle spins.

Close what is undoubtedly too short article Urge justice, I should note that its layering of literary, social, medical, and political narratives poses a challenge to any understanding of addiction that reduces it to one-dimensional causes or promotes a single therapeutic approach or outcome. “It is not that addiction is or is not a brain disease, a social disease or a universal response to suffering,” Fisher writes. “It’s all these things and none of them at the same time, because each level has something to add, but it can’t tell the whole story.” He found “no dominant cause of addiction, or even a set of causes that reliably explain why some people develop addiction.”

That doesn’t mean there’s nothing you can do about it. Chapter after chapter is a description of what was a useful treatment in many cases. But the other side of the story is an attempt to enforce one approach or ban another for various political, economic and moralistic reasons. “The best we can say,” Fisher concludes, is that “diverse influences intersect in a complex and dynamic matrix, drastically change from person to person, and even change over the course of an individual’s life.” that one size does not fit all.

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