Addiction II: Chemical warfare

Last post I laid out a story which illustrated how clumsy our cultural mores are when it comes to understanding and reasonably treating addictions. We class a very wide range of different behavioural, chemical and cultural issues under one label, ‘addict’, and then write off anyone caught in that net. Clearly, the colloquial understanding of addiction is likely to vary from the strictly technical, but the variance in this case is so large that it defies communication. One has to check with any layman who uses the terms ‘addiction’ or ‘addict’ what they understand the terms to mean: even between people who are from different fields, say a psychotherapist talking to a SHO, one needs to check definitions to be sure you’re both talking about the same thing.

I believe there is more to this than just a lazy populace or bad secondary education systems. I believe it is useful to someone; I think that having a society in which the general public are poorly informed about addiction is a hang-over from the social domination techniques of the previous two centuries. If you can demonize the concept of addiction, then you can legitimately screw over, ignore or actively persecute addicts without the mainstream of society caring. This is the Othering process at work.

The only defense the populace has against such mimetic engineering is information; more information, better information, thoroughly disseminated information. We need to talk about the distinction between the technical and the colloquial, so that people are more aware of their assumptions when they use the terms. The colloquial is nebulous and unclear, which is precisely the problem: so let’s start with the technical. What does the medical establishment actually say about addiction?

Well, not a whole lot, these days. They talk about ‘chemical dependencies’ a lot though. They’ve become quite careful about identifying the difference between stuff they can work on (i.e. chemical dependency) and stuff they can’t (e.g. “psychological addiction”, of which more later).

“chemical dependency: n. A physical and psychological habituation to a mood- or mind-altering drug, such as alcohol or cocaine.”
                — The American Medical Dictionary

Which is interesting, because almost nothing is not in one sense or another mood- or mind-altering. Caffeine, nicotine, alcohol. Codeine. The FA Cup Final. A magic trick. A good trance track. The only thing this definition really achieves is to explicitly separate medical addictions, ‘chemical dependencies’, from any form of dependency which is behavioural (shopping, sex, gambling, etc.) And at that task, this definition performs its function very well.

Chemical Dependency

When I was 9 I got the shit kicked out of me at a British primary school for a year. This is a fairly standard childhood trauma. The scale was a bit extreme in my case: I had a yankee accent, the wrong handwriting, was two years younger than everyone in my class and bored because I did the subject work the previous year. The children in my class reacted with predictable solidarity and co-ordinated violence, which resulted in my being committed briefly to psychiatric care and then medicated very heavily for about a year. [1] With a ‘mood- or mind-altering drug’, oh yes. This was the ’80s and they were handing out thermonuclear psychiatry like fruti bon-bons. They turned out to have sedated me vastly too heavily, for much too long, and I had to go through what was effectively a laudanum withdrawal process which lasted nearly 18 months and caused me all kinds of physical and mental adjustment problems.

I have been chemically dependent on a mind-altering drug. It was not by choice, nor was it recreational, but neither of those things should matter. It’s a whole different thing from the predisposition I described in my previous article. It takes over your life. Nothing matters except controlling, and guaranteeing, your supply. You can’t breathe or think or move: chemical dependency means that the monkey you live in can’t function if you don’t get your fix. Your life becomes strictly controlled, in whatever regime is dictated by those who supply your drugs. In my case, these were my parents, which gave me a reasonably high level of trust that they had my best interests at heart. Most are not so lucky.

There are so many ways someone can end up in that state. Medical mistake. Spiked drink. Careless drug use. Willful drug abuse. Medical necessity (there are some situations where becoming dependent on pain-killers and then coming off again is still better than having to live with pain that bad for that long). And yet we do not draw appropriate distinctions: it’s as if there were something about chemical dependencies which our culture fears on a visceral level, the kind of revolted terror which produces cultural taboos like incest and cannibalism.

Which is odd, because such deep cultural taboos tend to be relatively universal and entirely functionalist. We have taboos against eating dead humans because doing it regularly makes you very ill. We have taboos against potentially-fertile incest because doing it makes monsters. We have taboos against eating pork in deserts because before refrigeration it’s a really bad idea. These are not abstract questions of morality, ethics or social justification; the kind of horror taboo we have against addiction is usually only the product of genuine, universal, and inevitable consequences. Or, of superstitions.

* * *

And now we finally come to cui bono. There is a good reason for this bizarre social construct: Puritanism. Before the Puritans got in, mental illness was considered to be demonic possession, and substance abuse was considered to be substance abuse. Substance use, certainly in Northern Europe, was entirely a matter of choice but (for example) in the law codes of Anglo-Saxon kings, to kill someone by accident drew a lower penalty than to kill someone by accident while drunk.

Substance use was endemic, but substance abuse was clearly differentiated. However, the Puritans saw demons under every bed. They described literally anything which they didn’t like: alcohol, sex not for procreation, coffee, male masturbation, homosexuality, asking questions, Christmas, whatever the hell you like, as demonic influences. And whatever else you may say about the Religious Right, they have produced and maintained one of the most staggeringly successful propaganda machines in history.

The reason there is such confusion in the West about addiction is that while what we actually know has progressed out of all recognition since the 1790s, what we propagate to society is still founded on this one, bizarre piece of pre-scientific dogma; that to be chemically dependent is intrinsically and incontrovertibly evidence both of inadequacy, and personal moral inferiority.

The only way to beat it is to keep talking about it. Keep telling people what addiction actually means: keep broadcasting other ways of dealing with it, keep talking about solutions rather than blame, about understanding and safety and quality control rather than prohibition. Until we remove the demonic stigma from natural phenomena, our culture will still drag darkness into Enlightenment.

[1] Also I was allowed to start a Kung Fu class and was transferred to a new school. By this time I’d learned a reasonable British accent, seen some Grange Hill and decided that abject boredom was better than being two years smaller than my classmates, so I got put into an appropriate class for my age. I did much better at this school; if nothing else, the first kid who tried to bully me ending up in hospital did a lot for my reputation with the other kids. Not so much the staff, but again, that’s a longer story.

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