In our culture we tend to look at addiction as a moral failing or a character fault, despite the volumes of evidence of profound biological variables. We know that addiction is a physiological response to intoxication. Yes, there are social and psychological factors that are important, but by the time we get to the point of full blown addiction, it’s the physiological dependency that plays the leading roll. We also know that some people are more prone to addiction than others, and some people become more physically dependent upon certain drugs than are others.
Despite this knowledge, we still hold the the archaic social constructs of moral failing with regard to addiction. And the cure for this moral failing is purging (purgatory). To redeem oneself from moral failing one is expect to pass through a trial of purgatory, to cleans oneself. Hence we possess a certain admiration for erstwhile addicts recounting their stalwart determination against the torment of withdrawals only to emerge from this suffering clean and cured. Twelve step programs are designed to lead people through a process of purgatory that is defined as a daily struggle. Purgatory becomes an expected and accepted paradigm for stories of overcoming addiction.
And the approved course of action for dealing with addiction is cold turkey. Even using progressive treatments such as the nicotine patch or gum has the perceived value of quitting cold turkey when, in fact, one is merely diminishing their addiction in stages. We must also remember that, according to prevailing paradigms, once we are addicted, we are always addicts subject to a fall from grace.
So now we are faced with this story from the New York Times about using controlled doses of heroin to treat heroin addiction. A study printed in the New England Journal of Medicine suggests that the use of diacetylmorphine, the active ingredient in heroin, produces better results than methadone for heroin addicts who have already failed other treatments. Heroin addicts were more likely to continue treatment using the diacetylmorphine than the methadone. Of course, methadone has the benefit of mimicking the chemical interactions of heroin without producing the high. Hence, it’s a great “cold turkey” solution that reduces the purgatorial horrors of heroin withdrawal.
Using heroin, on the other hand, offers no such approved means of resocialization in our culture. There’s no purgatory. There’s no cold turkey. There may even still be a “high” involved. And getting high is just not approved (getting drunk is okay, but getting high will not be tolerated in polite company).
The Journal of a Mad Sociologist is dedicated to revealing what I call social schizophrenia. It’s my contention that social schizophrenia results when contemporary knowledge is influenced by outdated social constructs. Our contemporary knowledge of addiction is still mandated by often medieval concepts of personal character and failing, purging and self control. Progress in knowledge, ergo progress toward freedom and justice, occurs when we liberate ourselves from the social constructs, formulate relevant constructs and institutions to put those constructs into action.