Romancing Opiates,  a controversial book on opiate addiction was written by social critic, retired doctor and highly acclaimed author many call the Orwell of our time.  Theodore Dalrymple (pen name) is actually Anthony Daniels.   He has written extensively for the City Journal, Manhattan Institute; a social journal worth viewing.  His 2006 book, Romancing Opiates treats addiction and treatment much in line with his social commentary on failed states and systems.  Most of his writing follows an Orwellian ideology.  Curiously,  in his book about opiate use, he compliments Mao Tse Tung’s totalitarian methods of eradicating  opium and heroin use in China with extreme coercion or death.  He  basically underscores the moral argument of individual manifest destiny and self-control.  Addiction is a social problem and not a disease.  He advocates closing  treatment facilities and letting a sort of Darwinian law of the fittest sort out our current epidemic of drug addiction.  The “romancing” in the title speaks of eras past in which Dalrymple delves into bourgeois literary history to describe the way writers in the last three centuries described opium use, its benefits and its ultimate addiction as “romancing” the use of opium’s power to enhance one inner qualities, further seduced into an enduring relationship with the drug for fear of facing the clutch of addiction.  The “horrors of withdrawal” seals ones fate.  He sees the “horrors of withdrawal” as a systemically and perennial exaggeration becoming a means of preserving the addiction to the romanticized opium and other more powerful opiate drugs.  He calls the treatment industry of today a bureaucracy of addiction using the same rationale to perpetuate their survival.  As such,  treatment providers end up needing the addicts more than the addicts need them; their mission cry a  “new speak”, if you will.

After reading this, it looked like the chasm between the moral and medical arguments of what addiction is, got a lot wider.  Understanding the strengths of each point of view, however,  can’t be a bad thing.  Of course treatment centers need to stay open.  Of course all addicts do not have moral fortitude and off course we are a humane society unlike Mao’s totalitarian China.  Some addicts are legitimately dual diagnosed with deeper more complex  mental problems warranting all we can offer.  Those poor souls really need humane treatment.  I found a great symposium in FRONTPAGE.COM in which Dalrymple, Rutenfrans, a Norwegian criminologist, Fisher, an opiate addict and Menzies a pharmacologist take on the debate of addiction in the symposium:  Romancing Opiates; morality vs medicine.

Dalrymple makes a clear distinction between the reality of addiction and many illusions that have surrounded it.  Addiction is both a moral failing and a disease unlike cancer or diabetes.  It is a modern scourge, affecting many millions on our planet and can be treated both medically and morally.  Debates, like the one that took place in the FRONTPAGE.COM symposium should lead to a more concise protocol for addressing addiction effectively in the medical camp and an understanding of it in the context and capability of human will.  There are many heroin addicts that can in fact quit heroin “cold turkey” in the local detox clinics or in our jails.  Those who can’t, surely will benefit from the wealth of medical pharmacological knowledge that has evolved. The tools are there to handle the problem.  Where, I disagree with Dalrymple, is that the mission to tackle the epidemic of addiction as a social disease is still worthwhile without resorting to all out totalitarianism.  One thing missing from Dalrymple’s book is an explanation of what is behind the sociological failing that is feeding the epidemic of addiction.  A giant vacuum of leadership.   That is  worthy of another book.