I don’t know if it is really true that nicotine is more addictive than heroin. I was never addicted to heroin. But for years I smoked 2-1/2 packs of unfiltered cigarettes a day – a pretty serious nicotine habit. I never had to go through the kind of agonizing withdrawal associated with hard drugs, nor did I risk sudden death from an overdose. The agony with nicotine comes from the long-term health effects, notably cancer and heart disease, often ending in premature death. I am reasonably persuaded if I had not quit when I did, when I was still young, I would not be here to talk about it today. I mention all this so you will know that when I speak of addiction, I am no mere casual observer.
The word “addiction” comes from the Latin root dicere, meaning to say or to declare; in this case, to give one’s assent to. (The word “dictator” comes from the same root.) When you are addicted to nicotine or alcohol or heroin, whatever your drug of choice, you are giving your assent to it, often against your better judgment -- indeed, often against your will. It goes without saying the stuff is bad for you – or at least bad for you in the quantities you are consuming. One of the hallmarks of addictive substances is that we must keep taking more of them to get the same kick. I suppose you can always argue we are addicted to breathing. However, we don’t usually go around hyperventilating because we feel a compulsion to do so.
Addiction -- in the sense of a "compulsion and need to take a drug as a result of prior use of it" -- is of a relatively recent vintage, dating from 1906. It was first employed in reference to opium. But long before this meaning had been applied, there was a well-developed literature of addiction.
Start with Thomas De Quincey’s Confessions of an English Opium-Eater, first serialized in London Magazine in 1821 and later published in book form. Hounded by creditors and plagued by poor health for most of his life, De Quincey had the equivalent of a 2-1/2-pack-a-day nicotine habit – except his drug of choice was not nicotine but laudanum, an opium derivative commonly used as an analgesic when such remedies were still sold over the counter. The self-described pope of the “true church on the subject of opium” created a sensation with his unvarnished account of both the pleasures and pains of his laudanum habit. No less an authority than William Burroughs, himself a longtime heroin user, proclaimed the Confessions "the first, and still the best, book about drug addiction.”
De Quincey came from a well-to-do family but quickly squandered his inheritance on rare books, drugs and ill-advised loans to friends like the visionary poet Samuel Taylor Coleridge, who borrowed and never repaid a loan of £300. Coleridge, as it turned out, was an even more prodigious abuser of laudanum. And although drugs were never his explicit subject, they certainly bore evidence in his works. One need look no further than the fevered intensity of his poem, “Kubla Kahn,” which Coleridge himself described as “a sort of Reverie brought on by two grains of Opium, taken to check a dysentery.” Xanadu, the “stately pleasure-dome” featured in Coleridge’s opium-fueled phantasmagoria, was “a savage place! as holy and enchanted / As e’er beneath a waning moon was haunted / By woman wailing for her demon-lover!” Coleridge famously awoke with these verses already in mind. But although he scribbled furiously, struggling to retain the hundreds of lines that he claimed had come to him in the dream, only 54 lines survived, a mere fragment that many regard as a masterpiece.
Another fever-dream-turned-masterpiece was Robert Louis Stevenson’s The Strange Case of Dr. Jekyll and Mr. Hyde. But whereas Coleridge took opium to combat dysentery, the tubercular Stevenson used cocaine to treat his hemorrhages. By the late 19th century, when Stevenson wrote, opium had fallen into disrepute as an all-purpose remedy, but cocaine was still being hailed as something of a miracle drug for treating a wide variety of bodily ailments, from asthma to syphilis. Even a young Viennese physician named Sigmund Freud recommended cocaine as a cure for alcoholism and morphine addiction. Whatever cocaine’s therapeutic value, it is evident that Stevenson’s interest in the drug was not strictly medicinal. Jekyll and Hyde was the product of a drug-induced nightmare, and the elixir Dr. Jekyll took to transform himself into the murderous Mr. Hyde had properties that bore a strong resemblance to cocaine.
Upon awakening from his dream, Stevenson began writing furiously and turned out a first draft of his 30,000-word tale in just three days. By this own account and that of his wife Franny, his first draft was terrible, so he started over. His experience -- and Coleridge’s abortive effort to capture the whole of “Kubla Kahn” in one go – points up the pitfall of relying on drugs as a source of inspiration. It is tough enough to capture lightning in a bottle under the best of circumstances but especially so when you are addled.
This was not an issue with Arthur Conan Doyle, whose creation, the “consulting detective” Sherlock Holmes, remains the most famous addict in all of literature. Doyle was not himself an addict but, as a trained physician, was familiar enough with the subject to render it convincingly. His fictional detective’s cocaine habit was mentioned in the earliest Sherlock Holmes mystery, The Sign of Four, published in 1890. Unlike Dr. Freud, Holmes had no illusions that cocaine was a cure for anything other than his own chronic boredom when he was not otherwise engaged with a case. As he explained to his friend Dr. Watson, the drug may have been bad for him but it was “transcendentally stimulating and clarifying to the mind.” Dr. Watson did not approve. In a later adventure, The Adventure of the Missing Three-Quarter, Watson was able to report that he had successfully weaned Holmes from his “drug mania.”
Doyle -- himself the child of an alcoholic father who eventually had to be institutionalized -- clearly regarded Holmes’ cocaine habit as a moral weakness. This was in keeping with the prevailing social attitudes of the time, which dominated treatment regimes for much of the following century – and which often resulted in the criminalization of drug possession. If addiction was a moral failing, then recovery was a matter of will power. The main problem with this approach, of course, is that it didn’t work, something the 12-step programs recognized early on. Indeed, their entire approach was predicated on the recognition that addicts were powerless to overcome their dependency on their own. Will power, as far as they were concerned, was just another dodge, part of a complex pattern of denial (“I can quit any time I want to”).
Alcoholics Anonymous, the first of the 12-step programs, borrowed many of its precepts from an evangelical Christian organization known as the Oxford Group (not to be confused with the Anglo-Catholic Oxford Movement in the Church of England in the 19th century). However, unlike the Oxford Group, AA and other 12-step programs regarded addiction as a disease, not as a sin. Medical research has since established that addictions produce physical changes in the brain, overwriting circuitry affecting self-control. This, as much as anything, explains why addicts who try to end their substance abuse through will power alone are setting themselves up for failure.
The distinction between disease and sin has important implications for Christianity, which insists upon the primacy of free will in determining personal behavior. The issue of compulsive behavior goes far beyond substance abuse. “I can will what is right, but I cannot do it,” St. Paul complained long ago. “For I do not do the good I want, but the evil I do not want is what I do.” If I can’t do the good I want but wind up doing the evil I do not want, what room is left for free will?
The 12-step programs walk a fine line. While rejecting will power as a means of fighting addiction, they insist upon taking personal responsibility for one’s addictive behavior. You may be powerless against alcohol (or your drug of choice), but you are still expected to clean up the mess you have made of your life – and to make amends to those you have harmed in the process. At AA meetings, you introduce yourself by acknowledging, “I am an alcoholic.” You might as well be saying, “I am a sinner.” Only then can you begin the process of becoming sober.
When I quit smoking nearly 50 years ago, I thought I did it by will power alone. But looking back, I realize this was not true. My wife and I quit together. She did not have nearly the habit I did, but she was there to provide moral support – and vice versa. This, of course, is the essential element of the 12-step model. Bill W., the founder of AA, found that the key to him staying sober was to help others to do the same. It turns out that even if you can’t save yourself, you can still help save someone else.
Romans 7: 18-19
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