Some Practical Realities of Opiate Addiction and Its Treatment in the U.S.

Methadone or suboxone maintenance is just the substitution of the state for the street dealer.  Addicts remain addicts, but now they’re strung out on non-natural chemicals that are much more destructive to their bodies than natural or semi-natural opiates, and which are harder to kick.  The implicit assumption behind this policy is “once an addict, always an addict.”  It is a means of socio-political control for the economic benefit of the state at the expense of the addict.  The reasoning which generates such policies is that addicts are criminals, so let’s bag and tag them and keep them on a short lease so we can monitor their location and actions, controlling them through their addiction – which we maintain.  Ignore the fact that they are criminals because we have defined them to be so by having made any opiate use beyond the control of the medical and pharmaceutical gate-keeping communities illegal.  Eventually, of course, they will become criminals by virtue of having been forced into contact with the criminal community which has control of the illegal drug trade; and by having to commit theft, breaking and entering, script forging, prostitution, etc. in order to get the money necessary to maintain their habits because they have to buy exorbitantly expensive, illegal opiates.

Remember that it was not illegal to obtain, possess, or use a variety of opiates in the U.S. before the 1914 Harrison Act.  Anyone, your grandmother, could walk into a pharmacy and request to buy an opiate preparation – laudanum, codeine cough syrup, morphine tablets, or in some areas opium balls – over the counter without a prescription.  Citizens buying these medications were not adversely judged by their peers unless they committed socially inappropriate acts while under their influence – just like alcohol today.  Recall that Bayer manufactured heroin tablets, which could be purchased by mail order and in pharmacies, for headache, cough, bronchitis and other pains, and which were used by both adults and children for 23 years between 1890 and 1913, when they discontinued production after it had been discovered that their claim about heroin being non-addictive was false.

So opiate addiction is as much a socio-culturally and politically defined condition as it is a medical one.  Alcohol can lead to alcoholism, which is now recognized as an addiction; yet it remains legal.  We see and hear the phrase, “Drink responsibly.”  Why can’t there be a broader statement: “Use substances responsibly”?  Like, well, marijuana, for instance?

Addiction is usually first detected through the addict’s behavior.  In fact, most addictions are expressed through behaviors other than substance abuse, as in addiction to gambling, sex, food, dangerous thrill-seeking, the internet, and of course the one addiction that is not only not proscribed in the U.S., but is in fact encouraged: work addiction.  Behavior is secondary; consciousness – in this case, state of mind – is primary.  Addiction begins as a developing psychological, emotional, and possibly spiritual problem that finally demands expression through behavior.  It grows in the personal subconscious from suppressed or forgotten origins and influences the behavior of the addict from there, which explains why in early-stage addiction the addict is the last to recognize that anything is amiss, and why they react strongly against suggestions that they need help.  Claims that behavior results from physiological and biochemical imbalances are therefore, in most cases, a matter of putting the cart before the horse (so to speak).  After addictive behavior has continued for a period of time, of course such imbalances develop; but they cannot explain why the behavior began in the first place.

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