Romancing Opiates

The title of this post is the title of a recent book by Theodore Dalrymple: Romancing Opiates: Pharmacological Lies and The Addiction Bureaucracy (New York: Encounter Books, 2006). Wikipedia introduces our author: "Anthony (A.M.) Daniels (born 1949) is a British writer and retired physician (prison doctor and psychiatrist), who generally uses the pen name Theodore Dalrymple. He has written extensively on culture, art, politics, education and medicine, drawing upon his experience as a doctor and psychiatrist in Zimbabwe and Tanzania, and more recently at a prison and a public hospital in Birmingham, in central England."

In a brief description of the views that animate his writing, the entry notes that Daniels "contends that the middle class abandonment of traditional cultural and behavioural aspiration has, by example, fostered routine incivility and ignorance among members of the working class. Occasionally accused of being a pessimist and misanthrope, his defenders praise his persistently conservative philosophy, which they describe as being anti-ideological, sceptical, rational and empiricist."

I happen to be an unabashed Marxist in economics (along the lines, in part, of the 'analytical Marxists'), while, at the same time, subscribing to many of the values and principles found in the Liberal tradition of political philosophy. Nevertheless, risking inconsistency and contradiction, I feel free to draw upon, say, classical Greek thought, the natural law tradition, and even anarchist political philosophy if it suits my fancy. And this is only the political and economic parts of my worldview: the broadly philosophical and spiritual parts are principally of Asian provenance. In short, my own worldview is a hodgepodge, a motley, in the words of the late Ninian Smart: "Our values and beliefs are more like a collage than a Canaletto. They do not even have consistency of perspective" (From Religion and the Western Mind, 1987, p. 17). All of this by way of accounting for the fact that while Daniels is clearly a consistent conservative, that does not preclude me from finding this particular book persuasive on many counts, a reminder that, at least on what are sometimes confusingly called "cultural matters," I too am fairly conservative.

For some inscrutable and unjustifiable reason, the book lacks notes of any kind, which is inexcusable, especially with regard to the extensive quoted material of others, nor is there a bibliography, and the index is far from complete. As I was digesting the argument it called to mind Herbert Fingarette's controversial but equally provocative and, by my lights, well-argued book, Heavy Drinking: The Myth of Alcoholism as a Disease (1988). It turns out that Dalrymple/Daniels thought so too, for near the end of his work we learn that "What Fingarette said of alcoholism can be applied with equal force to opiate addiction," as he quotes a passage from Heavy Drinking that supports his contention that "the addict has a problem, but it is not a medical one: he does not know how to live. And on this subject the doctor has nothing, qua doctor, to offer."

According to Daniels, "The temptation to take opiates, and to continue to take them..., arises from two main sources: first, man's eternal existential anxieties, to which there is no wholly satisfactory solution, at least for those who are not unselfconsciously religious; and second, the particular predicament in which people find themselves. Modern societies have created, or at least resulted in, a substantial class of persons peculiarly susceptible to what De Quincy calls 'the pleasures of opium.'" Now it is the second source that Daniels elaborates upon in the following:

"...[I]n most western societies, there is now a class in which tedium vitae is very common, almost normal. This is the class from which the great majority of heroin addicts now comes....

The young of this class are disaffected, and have good reason to be so. They are for the most part poor, though not of course in the absolute sense. On the contrary, they are healthier, better fed, dressed, and sheltered than the great majority of the world's population, past and present, and dispose of appurtenances whose sophistication would have astonished our forefathers. But they are poor in the context of their own societies (which is what counts psychologically [such 'relative poverty' counts in other ways too, as Amartya Sen has recently argued]) and they are so badly educated (this time in the absolute sense) that any historical or geographical comparison, by means of which they might put their poverty in some kind of perspective, is completely beyond them.

They have no interests, intellectual or cultural. The consolations of religion are closed to them. As for their family lives, loosely so-called, it is usually of an utterly chaotic nature.... Their sexual relationships are a kaleidoscope of ephemeral couplings, often with abandoned offspring as a result, motivated by an immediate need for sexual release and often complicated by primitive egotistical possessiveness leading to violence and conflict. Their emotional life is intense but shallow, and their interactions with others governed by power rather than any kind of principle. Life is a matter of doing what you can get away with.

Their economic prospects are poor. They are unskilled in countries in which the demand for unskilled labour is limited. [....] Any work that they do will be repetitive and dull; and while a man might once have derived satisfaction from performing a menial task well, from leading a life of modest usefulness to others, this is not an age when such humility is very common. In large part, this is because people live to a quite unprecedented degree in the virtual world of so-called popular culture. From the very earliest age, their lives are saturated with images of celebrities, whose attainments are often modest but who have been whisked by good fortune into a world of immense and glamorous luxury. This comparison with their own surroundings, squalid if not poor in the literal sense, is not only stark but painful, and is experienced as an open wound into which salt is continually rubbed. It is also experienced as an injustice, for why should people with tastes and accomplishments not so very different from their own lead a life of fairy-tale abundance? The injustice of which they feel themselves to be the victim reduces any lingering inhibitions against causing harm to society, which means in practice individual members of society. Crime ceases to be crime, but is rather restitution or justified revenge. And the fact that the abundance they so desire is itself empty and leads to dissatisfaction and boredom entirely escapes them.

The end result is that, while profoundly dissatisfied with their present lot, they do not have ambitions towards which they might actually work in a constructive fashion, but daydreams, in which every thing is solved at once in a magical way, daydreams from which the emergence into reality is always painful. Any aid to the perpetuation of the state of daydreaming (or reverie, as Coleridge and De Quincy call it) is therefore greatly appreciated."

Highly recommended.

[Cross-Posted at the Medical Humanities Blog]