NCPA - National Center for Policy Analysis


May 8, 2008

Addiction is a moral and spiritual problem demanding deliberate changes in behavior, not an illness demanding treatment, says Theodore Dalrymple, who has encountered many heroin addicts in his work as a psychiatrist and prison doctor. 

In his latest book, "Junk Medicine: Doctors, Lies and the Addiction Bureaucracy," Dalrymple debunks the disease model of addiction.  According to the conventional view, people who try heroin are quickly "hooked," compelled to continue taking it by the unbearable agony of withdrawal.  Dalrymple offers one example after another that contradicts the official account.  For example:

  • He describes histrionic addicts, writhing in apparent pain, who complain of horrible discomfort in the presence of doctors from whom they hope to obtain narcotics but act normally both before the visit and after.
  • He notes experiments in which withdrawal symptoms were eliminated with placebo injections of saline solution.
  • He cites the experiences of patients who repeatedly receive large doses of narcotics for pain yet rarely become addicted.

Medical texts agree that the physical symptoms caused by abrupt withdrawal of opiates are not life-threatening and at their worst resemble the flu.  Just as the difficulty of giving up a heroin habit is routinely exaggerated, so is the ease of acquiring one. You have to work quite hard to become a bona fide heroin addict, says Dalrymple:

  • In fact, to judge by the U.S. government's own survey data, the vast majority of people who try heroin either never use it again, use it just a few times, or only use it intermittently.
  • Even among heroin users, the heroin addict is the exception.
  • Heroin is a minority taste even among users of illegal drugs, who prefer marijuana by a factor of about 50 to 1.

Source: Jacob Sullum, "Junk Medicine: Doctors, Lies and the Addiction Bureaucracy," Economic Affairs, March 2008; based upon: Theodore Dalrymple, "Junk Medicine: Doctors, Lies and the Addiction Bureaucracy," Harriman House Publishing, August 27, 2008.


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