Pain, Addiction & Society
The early 19th-century literary figure Thomas de Quincey was an opium user. “The subtle powers lodged in this mighty drug,” he enthused, “tranquilize all irritations of the nervous system … stimulate the capacities of enjoyment … sustain through twenty-four hours the else drooping animal energies … O just, subtle and all-conquering opium … Thou only givest these gifts to man; and thou hast the keys of Paradise.”
A patient of mine in Vancouver’s infamous Downtown Eastside said it more plainly: “The reason I do drugs is so that I don’t feel the f***ing feelings I feel when I don’t do drugs.” All drug addicts, even (or perhaps especially) the abject and marginalized street user, seek in their habit the same paradise de Quincey rhapsodized: a sense of comfort, vitality, and freedom from pain. It’s a doomed search that puts in peril their health, societal position, dignity, and freedom. “I’m not afraid of death,” another patient told me. “I’m more afraid of life.” What kind of despair could lead someone to value short-term pain relief over life itself? And what might be the source of such despair?
In North America, two assumptions inform social attitudes toward addiction. First is the notion that addiction is a result of individual choice, of personal failure, a view that underlies the legal approach toward substance dependence. If the behavior is a matter of choice, then it makes sense to punish or deter it by means of legal sanctions, including incarceration for mere possession. The second perspective is the medical model that sees addiction as an inherited disease of the brain. This view at least has the virtue of not blaming the afflicted person—after all, people cannot help what genes they inherit—and it also offers the possibility of compassionate treatment.
What the choice and heredity hypotheses share in common is that they take society off the hook. Neither compels us to consider how a person’s experience and social position contribute to a predisposition for addiction. If oppressed or marginalized populations suffer a disproportionate share of addiction’s burden—as they do, here and elsewhere—it must be due to their faulty decision-making or to their flawed genes. The heredity and choice based models also spare us, conveniently, from looking at how our social environment supports, or does not support, the parents of young children, and at how social attitudes and policies burden, stress, and exclude certain segments of the population and thereby increase their propensity for addiction. … (read more)
~ by Brendan Kober on November 23, 2011.