Tuesday, October 30, 2012

AA in Addiction Treatment, two articles by Maia Szalavitz

    I like Maia Szalavitz, not only is she a former junkie who consistently advocates against the stigmatization and criminalization of illicit drug users, but she also has an open mind about what constitutes recovery.  Below are two interesting papers along with some choice quotes.

Do the 12 Steps Belong in Addiction Treatment? by Maia Szalavitz

"For no other medical disorder is meeting and praying considered reimbursable treatment: if a doctor recommended these religious or spiritual practices for the primary treatment of cancer or depression, you would be able to sue successfully for malpractice. Similarly, people who have those medical conditions and recover from them may have valuable experience and information to share. But they have not graduated from medical school and would never escape legal scrutiny if they decided to set up a medical practice."

"Nor do I think discussions of spirituality have any more place in professional addiction treatment than they do in psychological counseling for depression or other disorders...in cancer care or in hospices, pastoral care should be an adjunct to treatment for those who want it, not a substitute or requirement."

"The idea that spirituality is the only way to meaning is also troubling."

"Finally, when we emphasize addiction as a uniquely spiritual problem, I think we not only subtly reinforce the idea that it’s not a medical issue, but, in fact, suggest that it is a sin."

Addiction: Medical Disease or Moral Defect? by Maia Szalavitz

"Here’s the problem. Several studies find that teaching people that addiction is a brain disease increases rather than reduces stigma. Why should the “scientific” or “medical” model trigger such a seemingly irrational response? Basically, it's because people see those who are “brain diseased” as permanently damaged and scarily out of control. As a result, they want to lock them up (whether or not they get treatment) even if the problem 'isn’t their fault.'"

"The fewer “aspects of mind” you attribute to someone—like being able to freely make choices, feel pain and pleasure, and form intentions and plans—the more you dehumanize at person, research finds. And the more you dehumanize a certain group of people, the more you support measures like incarceration or treatment that is coercive and infantilizing. After all, the treatment is intended to fix those whose behavior is child- or animal-like in being uncontrollable."

"However way you slice it, it seems, addicts lose. Either we are deliberately making bad choices and must be locked up…or we are mindlessly driven by compulsions and must be locked up. The middle way offers an alternative to this dead end—the idea that it is not your fault that you are at high risk for addiction but you are responsible for dealing appropriately with the issue."

Also see:

Does AA Really Work? A Round-Up of Recent Studies

Monday, October 29, 2012

Police and Nurse Sexually Assault Suspected Drug User on Judge's Order

     This is disgusting series of articles.  The facts of the story are taken from, Man sues law enforcement over "forced catheterization" reported by Fox 16 New in Salt Lake City.

SALT LAKE CITY — A 22-year-old college student has filed an $11 million federal lawsuit against police in central Utah, claiming they forced a catheter in him after he refused to consent to a search for marijuana.

The former Snow College student said he was smoking cigarettes with friends back in 2008 when police approached their car, parked on a roadside in Ephraim. His lawsuit, filed in February in U.S. District Court, claims police searched the young men and their vehicle. The police claimed they could smell marijuana, but could not find any during a search, Cook claims.
After a K-9 still could not find marijuana, an officer popped the trunk and found a glass pipe inside. Cook claims the officers then asked him to drive his friend’s car to the police station.
Cook said he believed that after driving his friend’s car to the police station, he thought he would be free to go. Instead, he was put in a holding cell and officers demanded he take a drug test.
“I asked for an attorney because I didn’t know if this was right what they were doing,” he said. “Once I did that, they said ‘We’re getting a search warrant so we’re going to have your urine by the end of the night.’ “
Police obtained the warrant, his lawsuit claims, and they drove him to Sanpete Valley Hospital. After being told that a catheter would be inserted into his body to obtain urine, Cook said he said he would consent to giving a sample but became “nervous” and could not urinate.
Cook was arrested for marijuana possession and resisting arrest. Jarvis said the resisting arrest charge was for refusing to give a urine sample. She accused police of “bullying” people with forced catheterization.
Forced catheterization is a relatively new issue in the courts. A similar lawsuit was filed by a woman in 2008 against police in neighboring Sevier County. It was dismissed after a federal judge ruled the officers acted without malice and their intent was to “bring her to justice” for the charges she was facing at the time.
Stirba noted that Cook reached a plea in abeyance to a marijuana possession charge. A plea in abeyance means a defendant admits guilt, but if they commit no further violations of the law — the case is dismissed. Cook said he entered into the plea after a search warrant challenge was rejected.

     These seem to be the facts, Steven Cook was in his parked car smoking cigarettes when police approached him.  They claimed they could smell marijuana, although a search with a drug dog didn't find any pot they did find a pipe.  So they took him to jail and demanded he take a drug test.  He asked for a lawyer before consenting and the police got a search warrant for his urine.  When they took him to a hospital he couldn't urinate because he was nervous (wouldn't you be?), the police hold him down while a nurse removes his pants and inserted a catheter into his penis.  Then he is charged with resisting arrest for refusing the drug test.  There is so much fucked up about this story, here are some quotes from Stephan Cook, Cook’s attorney, Lindsay Jarvis, Peter Stirba, defense counsel for the Sanpete County and Cook's mother  Holly Ziegenhorn, who is a fellow police officer for a different city.[1]  
“I don’t think it’s right what they did,” Cook told FOX 13 on Thursday. “I’m pretty sure they’re doing it to other people. They made me feel like an animal.”“The nurse told (an officer) to hold my shoulders, so he held my shoulders and then the nurse undid my pants, wiped me down with iodine and put the tube in me,” Cook told FOX 13. “And then they took me to jail.”“I want them to be accountable for what they did,” Cook said.
"It's kind of a bully tactic.  It's the most intrusive search or seizure that can be performed.  We're talking about taking off somene's pants and inserting something into their body," says criminal defense attorney Lindsay Jarvis.“This is being used as a punishment to try and get them to comply,” she said. “Rather than employ a simple blood test, they’re forcibly catheterizing these people.”
"We have requested medical records from Sanpete County hospital, and the hospital doesn't have a record that my client was ever present, so I don't know what they got right here," says Heideman. Criminal defense attorney Lindsay Jarvis calls the forced catheterization the ultimate violation of her client's civil rights. "I would say anybody who's in that position would feel as though they were sexually assaulted - yes.  You've got a female nurse who is unbuttoning his pants while another invidivual holds him down.  And then, they stick an object into his private parts."
 "This is a story of contemptive cops.  He (Stephan) wouldn't voluntarily pee, and they were gonna do whatever it took to get his urine - period," said Stephan Cook's mother Holly Ziegenhorn. “Whatever happened to him in terms of the catheterization was done pursuant to a warrant,” said Peter Stirba. “A bodily fluids warrant issued by a judge, under the auspices of a court order.”
    Make no mistake this was a sexual assault on a 22-year-old young man at the hands of police,  the criminal justice system and the medical profession.  Because it was done "pursuant to a warrant...issued by a judge under the auspices of a court order" it was therefore completely legal and no one involved in the assault will ever be charged with a crime.  This is what happens to human rights when wars are fought.  The United States of America, land of the free, is in the midst of an inquisition-like persecution of illicit drug users.  Since the drug wars are a case of a very powerful government brutally suppressing a relatively powerless minority (illicit drug users), the issue is never framed in this way.
    After obtaining the warrant they could have given him a few hours to drink fluids and urinate on his own accord (or take a blood sample), but because he was a suspected drug user and demanded that his constitutionally protected rights against unreasonable search and seizure be respected, he was sexually assaulted.  Drug users are so stigmatized that the medical profession, whose maxim is to first do no harm, apparently saw nothing wrong with holding down a young man, removing his clothing and inserting a plastic hose through his penis and into his bladder to collect his urine.  Surely Cook won a lot of money in his lawsuit, right?  Not so fast.
Prior to filing his civil lawsuit, Cook fought the case in criminal court, where he accepted a plea of abeyance.  The agreement allowed him to admit to one count of possession of marijuana and a fine, in exchange for dropping the rest of the charges against him.  According to Cook's legal team, the federal judge dismissed his civil lawsuit partially due to the fact that Cook had previously admitted guilt. However, both Cook and his attorneys say the plea of abeyance was made under duress.   The attorneys, who plan to appeal, say the ruling to dismiss the case on those grounds is just plain wrong. "Irrespective of whether he committed this crime, that's irrelevant to whether they're entitled to forcibly catheterize him," said attorney Justin Heideman. Peter Stirba, defense counsel for the Sanpete County officers issued this statement in response to the dismissal of the lawsuit: "The officers' behavior was fully justified and certainly was not violative of any of Mr. Cook's constitutional rights."  [Bold added -Ed]
Cook wants to keep fighting and move forward with an appeal.  He says he does not want another person to have to go through what he did. "I never wanted this to happen.  I'm willing to stand up for everybody else who can't," said Cook.
I guess the federal judge who dismissed Cook's lawsuit thinks that the Bill of Rights are just some pretty words that only apply to real human beings, the people who don't use illicit drugs.
[1] Quotes culled from these three stories from Fox and ABC  affiliates. 


I just did a major update to Websites I Like, now renamed other websites of interest..  Added several links to sites related to addiction and a section linking to blogs by opiate users.  Leave a comment if you know of a good site related to opiates and I'll check it out.


Beware, keep your distance lest ye be infected too!

    I generally like zombie movies, Dawn of the Dead, 28 Days Later, Zombieland, they're all good.  I like The Walking Dead TV show and comic book.  The story of a small group of people surviving in a post-apocalyptic world is a theme used over and over in countless stories.  Pride and Prejudice and Zombies is on my to read list.
   Aside from being entertaining the metaphor is actually applicable to the plight of illicit drug users.  The underlying theme behind every zombie movie is xenophobia, defined by Webster's as "fear and hatred of strangers or foreigners or of anything that is strange or foreign."  Zombies represent the metaphorical "other," a definition that is the first step in stigmatizing and discriminating a group that is perceived as strange and foreign.  Opiate users, especially heroin users, are often portrayed as former humans who have been infected with the "disease" of addiction transforming them into "walking corpses" with a single-minded hunger for drugs (brains).    Because they are less than human and may "infect" otherwise innocent Americans (especially children) by "pushing" drugs extreme measures are necessary.  This includes quarantine of suspected infected persons, search for a medical cure, and of course the murder of those gone to far to be saved.
    In 1962 the US Supreme Court heard the case Robinson v. California, in response to a California law that made it a crime to be a narcotics addict.  In this particular case Robinson was arrested for having track marks on his arm and sentenced to 90 days in jail.  The court ruled in favor of Robinson arguing that addiction is a disease and thus civil commitment was a violation of the 8th amendment protection against cruel and unusual punishment.  One might think that if narcotic addiction is a disease characterized by the consumption of narcotics then addicts should not be incarcerated for possession of narcotics, but the courts have not gone on to this logical conclusion.  Reflecting the schizophrenic nature of criminal justice viewing addiction as alternatively a disease and crime, merely being an addict is not a crime.  However the major behavioral symptom of this disease, the consumption of narcotics, is a crime.
    What is interesting, and telling about the popular conception of a heroin addict, was the statements made by Justice Douglas:

"To be a confirmed drug addict is to be one of the walking dead.... The teeth have rotted out; the appetite is lost and the stomach and intestines don't function properly. The gall bladder becomes inflamed; eyes and skin turn a bilious yellow. In some cases membranes of the nose turn a flaming red; the partition separating the nostrils is eaten away — breathing is difficult. Oxygen in the blood decreases; bronchitis and tuberculosis develop. Good traits of character disappear and bad ones emerge. Sex organs become affected. Veins collapse and livid purplish scars remain.

Boils and abscesses plague the skin; gnawing pain racks the body. Nerves snap; vicious twitching develops. Imaginary and fantastic fears blight the mind and sometimes complete insanity results. Often times, too, death comes much too early in life.... Such is the plague of being one of the walking dead." [1]

    This caricature of a heroin addict is repeated endlessly in the media and in the minds of most Americans.  Heroin is a "plague" and addicts are the "walking dead."  This is especially ironic given that heroin is far less toxic than two of our most popular legal drugs: alcohol and tobacco [2].  It is widely assumed that the "progressive" notion that opiate users are sick and in need of (usually coerced) treatment is an enlightened view of opiate addiction.  The notion that opiate users are in control of their intellectual faculties and making a rational choice to use a drug to improve their lives is not even entertained.

    For those of us who care about drug reform emphasizing that narcotics addiction is a disease based on the "NIDA paradigm" is a double-edged sword.  On the one hand anything that moves away from the criminal justice approach to drug prohibition is welcomed, but we should not be quick to embrace a policy that relies on compulsory treatment and continues the stigmatization of opiate users.  The "hijacked brain" meme implicitly supports drug prohibition and the view of opiate addicts as one of the walking dead.

[1] Quoted from Images of Death and Destruction in Drug Law Cases by Steven Wisotsky [Link]

[2] Dr. Arnold Trebach informs us in The Heroin Solution that "putting aside the problem of addiction, the chemical heroin seems almost a neutral or benign substance. Taken in stable, moderate doses, it does not seem to cause organic injury, as does alcoholism over time."


Desperate Addicts Inject Others’ Blood

It seems to me that the tiny amount of opiate in a sample of blood drawn into a syringe would not be significant.  The effect is probably psychological, although the astute reader will not be surprised by this.  Placebo injects have been shown to help with withdrawal sickness and the psychological makeup of the user, along with the conditions they are detoxing in, has significant effect on the severity of the acute withdrawal.

I like the quote at the end of the article, "What are they thinking?"

I don't presume to know the reasons for "flashblooding," but I think they are thinking along the same lines of opiate users who share syringes, namely get me out of this agony NOW.  Society already labels drug users as worthless, many internalize this mentality and don't care what happens to their health as they pursue heroin.  Many probably simply accept an early grave as an inevitable consequence of opiate addiction.  Sad. 

McCurdy, S. A., Ross, M. W., Williams, M. L., Kilonzo, G. P. and Leshabari, M. T. (2010), Flashblood: blood sharing among female injecting drug users in Tanzania. Addiction, 105: 1062–1070. doi: 10.1111/j.1360-0443.2010.02908.x [Abstract]

Friday, October 26, 2012

Sterilization of People Who Use Drugs

Sterilising junkies may seem harsh, but it does make sense [Link]
The Irish Independent
By Ian O'Doherty Friday February 18 2011

This editorial was published in The Irish Independent, which is Ireland's largest-selling daily newspaper.  Here are a few choice segments (italics added -Ed):
"So, there I am, sitting in a cab on the quays when trouble breaks out between a bunch of junkies on the pavement across the road. Nothing unusual there, of course."
"After all, anyone who spends any time in Dublin's city centre will see these feral, worthless scumbags getting up to mischief all the time -- but this bit of aggro was different."
"Let's get a few things straight -- I hate junkies more than anything else. I hate their greed, their stupidity, their constant sense of self pity, they way they can justify their behaviour, the damage they do to their own family and to others. If every junkie in this country were to die tomorrow I would cheer."
"That might seem a little on the harsh side but anyone who has ever seen a family member become a junkie will understand exactly where I am coming from."
"And, also, there is a distinction between an addict and a junkie.  An addict is someone who has developed a habit that they're trying to shake. A junkie, on the other hand, is the one who breaks into his own brother's house and steals stuff; a junkie is the one who will rob you blind and sell valuables that you have worked and saved for and then sell it for a tenner bag of smack. They are worthless."
"So I was interested to see the initiative by Dublin doctor and addiction expert Dr Patrick Troy who wants to offer junkies €220 to be sterilised. It might seem harsh at first, but when you think about it  the scheme makes perfect sense."
"And, as is often the case, there was more sympathy for them than for the victims of their crimes. But what's often lost in the haze of argument is that the biggest victims of these vermin are the kids themselves."
So in case you didn't get all that the first time, heroin users are junkies, feral worthless scumbags and vermin.  O'Doherty "hates junkies more than anything else" and if they "...were to die tomorrow I would cheer."

While these editorials spewing vitriolic attacks against people who use drugs have been less frequent in modern times, the views O'Doherty holds are sadly all too common.  Although few people come out and say it so plainly, many people would happily round up all illicit drug users, sterilize them and take away their children.  The War on (some) Drugs implicitly supports the notion that users of certain drugs are deviants deserving dehumanizing treatment.  Sterilization has long been used as a weapon by campaigns against people scapegoated by those in power.  It has a long history of being used by tyrannical regimes as part of eugenics campaigns and was one of the first laws passed by Hitler after taking control of Germany (Law for the Prevention of Hereditary Diseased Offspring).  Although before Hitler eugenics was popular within the United States resulting in many state laws that permitted the forced sterilization of prostitutes, mental patients, criminals, addicts and other popular targets of scapegoating.  Following World War Two coercion for forced sterilization has been recognized as a crime against humanity by the International Criminal Court.

O'Doherty would argue that since the individual is being paid and the sterilization is not mandatory it is not a crime.  This claim is an obviously transparent attack on people who use drugs while superficially seeming like a viable public health measure.  People who use illicit drugs are some of the most vulnerable segments of society.  It's not hard to imagine our poor junkie brothers and sisters getting desperate enough to undergo sterilization in order to get some money and keep THE SICKNESS at bay at least a little longer.  These programs take advantage of the prohibition-caused price inflation of illicit drugs to achieve a modern campaign of eugenics.

Sadly programs like this are also active within the Unites States.  Project Prevention (formerly called Children Requiring a Caring Kommunity or by the not-so-subtle acronym CRACK) uses winning slogans like “Don’t let a pregnancy ruin your drug habit,” “Get birth control, get ca$h,” and “She has her daddy’s eyes…and her mommy’s heroin addiction" to promote their offer of $300 to women in exchange for implanting long-term birth control or undergoing sterilization.  Super-bitch and Hitler wannabe Barbara Harris, the founder of Project Prevention, claims to care about the children of drug-dependent women but is more interested in continuing the global campaign to dehumanize people who use drugs.  Prior to starting CRACK Harris campaigned to have California jail drug dependent mothers unless they agreed to implants or sterilization.

“We don’t allow dogs to breed...We spay them. We neuter them... We try to keep them from having unwanted puppies, and yet these women are literally having litters of children...It’s the truth—they don’t just have one and two babies, they have litters.” [1]

But wait it gets worse.  Project Prevention hired British psychologist Chris Brand, a racist fuckwad who, according to Barry Yeoman writing in Mother Jones [Link], is a "self-proclaimed 'race realist,' claims that blacks are intellectually inferior to whites, and advocates taking a 'eugenic' approach to 'wanton and criminal females.'"  Prior to joining Project Prevention Brand was fired from his tenured position at Edinburgh University.  Interestingly while Brand thinks women who use drugs should be sterilized, he also believes that sex with children 12 and over should be legal.  These are the thoughts of a man with a deeply perverse sense of morality.  Sex with children? Good.  Women who use drugs? Bad.
"Both the American Civil Liberties Union and Planned Parenthood say...and many bioethicists agree...Rewarding someone for having a surgical procedure, they note, violates a basic principle of medical ethics: Health care decisions should be made by patients, without any form of pressure,”'
“The greatest harm of Project Prevention is that they are a propaganda machine used against pregnant women to take away their civil and human rights.”
Thankfully due to the efforts of people like Stuart Sorenson, a mental health and addiction worker, a campaign in 2010 to shut down Project Prevention in the UK was successful.  Sorenson says, “It’s not up to me to decide who has value. Any organization that thinks it’s OK to decide who has the right to live is arrogant in the extreme.” and  “It’s essentially a form of eugenics dressed up in a thin veneer of compassion.”[1]

This has not stopped Project Prevention from waging its campaign against women who use drugs.  After the outcry in the UK resulting in Project Prevention having to close up shop, they have set their sites on Kenya which is far less likely to organized resistance.  The poverty in Kenya also works to their advantage, where the average per-capita GDP is about $300 the women can be bought off for only $40.

As the War on (some) Drugs becomes more and more untenable, these campaigns to exterminate people who use drugs are being seen for what they are.  They may have been able to play on popular prejudices at the height of the "crack epidemic" but thankfully there are now organizations that call out O'Doherty on his hate-speech and open support of crimes against humanity.

Irish Press Ombudsman upholds complaint from coalition of drug services [Link]
"On 23 May 2011, the Press Ombudsman of Ireland upheld a complaint lodged by a coalition of national and international drug services against the Irish Independent, the country’s largest circulation broadsheet. The complaint was filed by the International Harm Reduction Association, the Irish Needle Exchange Forum and the CityWide Drugs Crisis Campaign, with the support of approximately thirty Irish drugs services and professionals."
"However, the more serious claim was made under Principle 8 on ‘Prejudice’, which states: Newspapers and periodicals shall not publish material intended or likely to cause grave offence or stir up hatred against an individual or group on the basis of their race, religion, nationality, colour, ethnic origin, membership of the travelling community, gender, sexual orientation, marital status, disability, illness or age.  In essence, the complainants were asking that the Press Ombudsman recognise people who use drugs as an identifiable group, entitled to protections against hate-type speech in the press. In particular, the complaints argued that because drug dependency is recognised as a chronic and relapsing disease by many authorities, including the World Health Organization and the United Nations Office on Drugs and Crime, that O’Doherty’s column ‘is not only a hateful attack a vulnerable population with a recognised medical condition, it also ignores the well-established link between drug use and depression, mental illness, alcohol use and homelessness.’"
"The Press Ombudsman upheld the main element of the complaint, finding that the newspaper ‘breached Principle 8 (Prejudice) of the Code of Practice for Newspapers and Magazines because it was likely to cause grave offence to or stir up hatred against individuals or groups addicted to drugs on the basis of their illness.’"
"This was the first time that the Press Ombudsman in Ireland has found people who use drugs to be an identifiable group, entitled to protections against prejudicial reporting in the media.  It may well be the first case of its kind internationally. According to the complainants, ‘We believe this to be the first time that drug users have been identified by a media watchdog as an identifiable group, entitled to protections against hate-type speech in the press. In this sense, we think the decision of the Press Ombudsman has international significance.’"
[1]Quotes from Should Addicts Be Sterilized? by Jed Bickman [Link]

A Few Updates

My Beef with David Nutt has been updated and I added some links to Websites I Like.

Thursday, October 25, 2012

The Wisdom of CJ

CJ is the pseudonym of someone who is an opiophile who leaves rather long and amusing posts on heroinhelper and other drug reform websites.  Not only is his writing style funny (despite his logorrhea, I have edited his comments down some) but there are some real insights behind what he is saying.  CJ is what the drug abuseologists call "treatment resistant," I think he is just a man doing what makes him happy in a society that pathologizes the pursuit of his particular form of happiness.  I don't think he would mind me reproducing some of his statements.

On being true to who you are:

OK YES its true i am a god forsaken junkie, you got me, the secret is out... and fine, yes, because of that my opinions my be diluted with dilaudid, morphed by morphine, etc. etc...and in finally doing so you must therefore regard my words not as the ramblings of a demon drug purveyor but of a modern day jesus christ or charlie sheen

ah, the glorious workmanship of our craft, somewhat patch work doctor, somewhat chemical engineer, somewhat shaman, herbalist and all around happiness

 yes i am a junkie and i am proud and its not kevin sabets god damn place to tell me that i cant shoot heroin that i cant sniff or smoke heroin that i cant chug a bottle of roxis if i freakin want to. its my body its my brain its my freakin desire. thats what i want to do and thats what i will always do prohibition or not ive been a junkie for a very very long time and i have seen it all and done it all trust me. i love my junkie life. i love my fellow junkies.

On Insite, the safe-injection site in Vancouver:

PLEASE DONT MISUNDERSTAND ME! If Junkies could laugh and cry, well this probably aids and definitely hep C positive junkie right here would have cried tears of joy at the victory of that vancouver supreme court, like the native in this junkie who, nevertheless is first junkie than native, wishes he could cry and laugh in reflection of the battle of bull run… wouldnt it be nice if the natives were junkies and custard was idk, Kirlikowske or Kevin Sabet? ah maybe there will be a third opium war yet and maybe that battle will be fought, if so i hope the prohibition induced diseases killing me dont take me before i may take the scalp of a prohibitionist.

but the danger is insite is really nothing great in the grand scope of things – is it baby steps? i dont know because i think sometimes things like this, these things that seem like small victories for us reformers may indeed be ways of stagnating our goals by the prohibitionists who are giving us nothing more than a crumb when they are well aware that we want and will inevitably get the entire proverbial cookie but perhaps we are such skinny, starved, stinky, homeless junkies (indeed,) we cannot see beyond that and take our crumbs when we get them and devour them and love them instead of spitting them at their face and saying “HAND OVER THE COOKIE JAR!!” as the prohibitionist says “WHO ME?!” and we declare “YES YOU!!!!!” and they maintain, “COULDN’T BE!!!” then picking up our crumbs we apologetically ask, “THEN WHO?!!!”

So i guess its just as well i mean the bottom line is i prescribe to the theory of the cookie jar. Its crumbs we accept with glee but shouldnt and should toss aside and demand more. We shouldnt be surprised at the fantastic results of an in-site but we know and should demand better. junkie to junkie. forever like a candle in the wind baby. (one that sits wonderfully underneath a beaten stainless steel spoon with a twingle of blackish brown on its underbelly as wonderous juicies snap crackle and pop for the heat, as soon cotton to liquid, liquid to needle, filling the belly, mixing two colors, pinching myself for good luck before fading away!!!!!!!! and in this case, it is better to fade away than burn out, Neil Young, Kurt Cobain and the Kurgan from Highlander 1 fame!)

On Suboxone, Methadone and Naltrexone:

so, these late to the party pieces of crap are on the naltroxone kick. Like we know subs were created by accident not that long ago. NARCAN and naltroxone has been around. What prevented this so called benefit from being discovered? This is gross man. DISPICABLE. HORRIBLE. a terrible set back to the powers that be getting to the inevitable solution that will work, that what was prescribed for the Soldiers Disease - heroin maintenance.

Naltroxone is a freaking scam. Oh I GET SO PISSED!! Whats more recently a research article came out, if you want me to find it for you just say, no problem. It was basically saying that researchers of naltroxone had discovered a "cure for opiate addiction" that would still allow people to be given opiate meds for pain and that would prevent them from becoming addicted. LOL. They said it had to do with naltroxone localizing in a certain place in the brain that re configures the receptors somehow. I swear Im not making this up. I got so pissed.

I hate them. I hate them so much. How dare they deem themselves so superior to us as to demand we not do what we enjoy. How dare they find the suppression of our desires as a profession, as a scientific subject to be studied, explored and experimented on as NOBLE!! HOW FN DARE THEY!
I get so irate. They try to destroy the plants.. As George Carlan has said, mother nature was here before us all and only created us so we could create plastic and soon enough will be rid of us. The AUDACITY with the GLOBAL CROP ERADICATION and WORSE the POISONINGS!!

And this CRAP about blocking, flooding, suppressing our receptors... BUT FOR WHAT REALLY? AS THOUGH we consume this natural thing from the earth that is rare, impossible nearly and more valuable and expensive than fossil fuels and so our consumption of it is some kind of global threat. BUT RATHER its NOT DIFFICULT to cultivate and at 70 cents a bag PRETTY FREAKIN CHEAP by modern US economic standards.

THE AUDACITY man. It gets me at my core. Naltroxone is an offense. What it is and what it does is TRULY no different than methadone, suboxone. Devious, glory hound, nobel prize wanting, materialistic, pretentious, PIECES OF WASTE champion this because they were ignorant to suboxone. What is the POINT of a third device that is no different and perhaps inferior to the first and second of its kind?

It especially pisses me off because as you all know I am a huge proponent of heroin assisted treatment and was hoping that after suboxone was exposed as nothing more than methadone as NEEDED (aka, rare days of no smack due to weather, finance, dried up sources whatever and therefore go in the ole medicine cabinet, grab the 30 or 60 pill filled 3 month old suboxone script and pop one til tomorrow. in other words, like methadone, merely a withdrawal suppressant, however, unlike methadone, for the most part, at a junkies convenience, NOT a clinics [that will drug test you.] The trade off comes in the fact that methadone floods but offers a nearly non existant SOMETHING whereby unless your opiate naive, suboxone offers totally NOTHING) So instead of being able to more quickly realize the futility of suboxone and thus take a step towards Heroin Maintenance, we have this stupid naltroxone to wait for now as well.

the truth is junkies dont want suboxone or methadone and GOD NO we dont want nalaxone (UNLESS were talking O.D.) however if you say to a junkie we’ll give you something, it wont do what you want BUT it will make sure you dont go through the Sickness. HOWEVER the price you pay isnt just financial if you take this drug the other price you pay is your heroins and painkillers will be blocked, the sub will block it and the methadone will flood your receiptors so it wont be able to fit in – it being your D.O.C. Well the junkie will always pick the bottle of suboxones so the junkie can suck one of them down on a day they are ABSOLUTELY CERTAIN they will NOT get the money and their CONNECTS CANNOT SPOT or COME THRU. Thats it. They will always pick subs because subs can and will and do sit in the closet until that horrible kind of day happens again. Methadone you have to pick up everyday, methadone you usually get in a clinic, your usually drug tested, your usually not able to have AS SUCCESSFUL a Junkie existence on the ‘done versus the bupe.

On Codeine:

Yeah, I know - people get f'n fed up. Tired. EXHAUSTED of the hustle, wait, sickness prohibition inflicted syndrome (and wont get into how this is so disgustingly taken advantage of by the dogma of AA and transformed into the concept of 'rock bottom' those sick materialistic cult bastards!!) so you eventually get so tired and beaten that you begin to buy into that rock bottom BS OR just go for whatever is easiest - I.E some kind of codeine concoction gotten OTC or whatever.

I think its just another bastard condition of prohibition that this codeine deal goes on. I feel bad. I feel real bad. bad enough to do what I do everyday to not feel bad anymore. Perhaps even dedicating one of the post action cleaning out squirts back into the aquafina in dedication of the lad/laddie (one for the money, two for the show, third times a charm, one extra for good luck, two extra for drug war victims, a selfish spray for to not OD, not get caught and not get buzz killed and finally any acknowledgemental (i know its not a word) squirts before the train leaves, if you will, heh heh)

CJ apologizes:

im sorry but the whole naltroxone business gets me very mad... I apologize.. I APOLOGIZE APOLOGIZE APOLOGIZE for ranting and raving and being an uncouth person. It is the way of the prohibitionist, not the junkie. :( I am somewhat ashamed for getting so uptight just now and ranting, but I feel a bit better actually and am glad to share this with the people I admire. Thanks for your patience!!

Wednesday, October 24, 2012


   I have not officially come out on this blog to offer up my opinion on the debate over whether addiction is a disease or not.  I will eventually publish my views on addiction, it is a topic that I have spent a lot of time reading about and musing over.  For the record let me just say that I do NOT think addiction to opiates (or any other addictions) is a disease, although it does have some qualities that are disease-like.  This post is not about adding to the debate of disease or not.  The notion that addiction is a disease that primarily has to do with drugs, the NIDA paradigm of drug addiction, has many problems.  For a critique of the NIDA paradigm, see the article Rise and Fall of the Official View of Addiction by Bruce K. Alexander (Professor Emeritus, Simon Fraser University).
     The following is a discussion of the concept of neurodiversity.   Neurodiversity is the belief that differences in brain function are not due to a disorder or disease but the result of human diversity akin to diversity in sexual orientation or ethnicity.   There are many activities that humans engage in which have been called mental illnesses.  The most glaring example of medicalizing normal human diversity in recent times is homosexuality.  For some heterosexuals, the thought that someone may be sexually attracted to someone of their own sex was unthinkable.  Homosexuality was so obviously "wrong" that no rational person would ever engage in a homosexual act, ergo they must be insane.  Psychiatry in particular has a long and sordid history of labeling all sorts of deviant behavior as mental illness, followed by novel, often brutal "treatments" for these "diseases."  
    Dirk Hanson, the author of the blog Addiction Inbox, has coined the term Metabolic Chauvinism.  Maia Szalavitz, in this Time article, defines metabolic chauvinism, "... is the idea that one’s own experience — of a drug, a condition, a cure or sensation — is the same as that of everyone else. It’s similar to the way male chauvinists assume that the male perspective is the only one that matters."
     When it comes to the use of opiates, outside of physical pain most people cannot understand why people choose to use these substances.  If some people who find some relief from emotional pain by using opiates they are derided as "fleeing reality" and need to be "cured" of their desire to consume opiates.  The notion that the opiate user may be using the drug to make their life better is referred to as "self-medication."  Rather than viewing self-medication as the fundamental human right to be sovereign over their own bodies and medical decisions, it is viewed as a symptom of the disease of narcotic addiction.  It is only considered legitimate medical use when an individual cedes the sovereignty over their own body and mind to the authority of a medical professional.  Self-medication is perversely redefined as "drug abuse."  This language reinforces the notion that opiate users are sick and their drug use is self-abuse.
    Diversity in America has come to mean people of different ethnicity's, religions or cultures that may look or speak differently but think all alike.  I advocate that the concept of diversity be expanded to include neurodiversity to the growing list of diversities in America.  Maia Szalavitz, in her article "Should There Be Such a Thing as Addict Pride?", expands on this theme:

Rather than aiming to “cure” addictive behavior or punish people in order to try to end drug problems, we can seek to understand them and provide what addicts need to function comfortably in a world that isn’t built for brains like theirs. And just as autistic behavior should not be seen as problematic when it is helping people function and not hurting others, the same should be true with addictive actions...we can begin to stop throwing away addicted people who are already here in counterproductive attempts to "save them from themselves" without understanding their perspective.

Stand up for your right to use opiates as you see fit.  Stand up against the pathologizing of opiate use.  Stand up against the prohibitionists and their barbaric tactics of social exclusion and harm maximalization.

Junkie Pride!!!                                   Junkie Power!!!

Should There Be Such a Thing as Addict Pride? By Maia Szalavitz

Tuesday, October 23, 2012

Homicide Rates In Canada, US and Mexico

Gee I wonder what happened in 2006 in Mexico?  Oh I know:

Mexico went to war against their own citizens!

Source: the blog of Diego Valle-Jones

Buprenorphine Dose Response Plots

These two graphs show the differences between a full agonist, partial agonist and an antagonist.  Note that the partial agonist graph begins to level off at higher dosages.  This is the "ceiling effect" where increasing the dose has no additional effect.

Two other things people should know.  Bupe grabs onto the mu opioid receptor (MOR) and doesn't let go easily.  It's harder to overdose (OD) on bupe than other opioids, but if someone is ODing on bupe it will require more narcan to revive them than a heroin OD.  Whereas a single vial of narcan would work for heroin a bupe OD may require several vials.  There is a flip side to this, the partial agonist action of bupe means that it can be used to reverse an OD caused by a full agonist.  I do not recommend this and would follow the advice posted on Heroin Helper regarding ODs.  HOWEVER if you cannot revive the person and either the EMTs or local hospital is too far off, giving a dose of suboxone  may bring them back.   There was a case printed in the Journal Addition.

A case of heroin overdose reversed by sublingually administered buprenorphine/naloxone (Suboxone). 
Addiction. 2008 Jul;103(7):1226-8.

Monday, October 22, 2012

DEA kills some farmers in Honduras.

Well at least they weren't Americans...I guess Honduran citizens are expendable to save Americans from themselves.

Our Men in Honduras: Losing Control of the War on Drugs
Way To Go USA!!   ..............
Some Highlights:

On May 11, 2012, in a joint U.S.-Honduras drug enforcement operation gone terribly awry, four Honduran civilians, including two women, a 14-year-old boy and a young man were killed as they traveled in a fishing boat along Honduras’s Patuca River. Three other passengers were seriously injured. U.S. government officials have minimized the Drug Enforcement Administration’s role in the attack, characterizing its involvement as merely supportive.

In the aftermath of the shootings, witnesses reported that English-speaking men dressed in U.S. military uniforms threatened local community members, contradicting the official U.S. position that its agents were only peripherally involved. Then a report by the Honduran National Commission for Human Rights (CONADEH) revealed that Honduran police agents who participated in the operation said they were following instructions from the DEA and reported only to its agents. Now, after much scrutiny from Congress and human rights groups, U.S. officials have acknowledged—after many initial statements to the contrary—that DEA agents led the May 11 operation because they “did not feel confident in the Hondurans’ abilities to take the lead,” according to The New York Times. Despite the DEA agents’ central role, the U.S. government has downplayed looking into the incident—the DEA is supposedly conducting an internal probe, away from public scrutiny—and has instead promoted an investigation by Honduran authorities.

Sunday, October 21, 2012

My Beef with David Nutt (Updated 10/26)

I like David Nutt (see his old blog and new one), well I've never met him personally but I like his work.  Dr. Nutt was the head of the UK's Advisory Council on the Misuse of Drugs (ACMD) until he criticised the government's arbitrary classification scheme.  The classification scheme in the UK is similar to the one's used in the US and world over, which means it inexcusably leaves out alcohol and tobacco while criminalizing basically everything else.  Dr. Nutt's great sin, for which he lost his job, was to publicly question the relationship between the actual harms of drugs and the law.  His dismissal occurred right after he released this pamphlet.

Nevertheless I do have a bone to pick with David Nutt.  Specifically two articles he co-authored that were published in the medical journal The Lancet.  The first, published in 2007, claims to rank drugs according to the harm they potentially cause the user.  The second, published in 2010, ranks the harms done to users and greater society and then adds the values producing a value supposedly representing the total harm done to society.
   Now this is not an easy task and necessarily simplifies confounding variables.  For example it does not distinguish pharmacokinetics, especially with regard to route of administration.  The article calculates the values based on the way the drugs are usually administered.  For heroin they assume this means by injection. I challenge this assumption but more important than that is this line:

However, direct comparison of the scores for tobacco and alcohol with those of the other drugs is not possible since the fact that they are legal could affect their harms in various ways, especially through easier availability.

The major problem with their analysis is that they compare illicit drugs with licit ones but fail to acknowledge the harms caused by prohibition.  They correctly note that a legal market may mean easier availability (its hard to see how providing other drugs in a free-market context would not result in increased use given basic economic principles of supply and demand), however the authors do not take into account how a drug's illicit status affects its harms.  Heroin users do not know what dosage a given preparation is, nor do they know what it may be adulterated with.  Furthermore the social effects of a given drug are greatly impacted by its legal status and artificially high price.  This leads to acquisitive crime to fund a habit as well as social costs due to law enforcement.
     The long term health effects of opiate drugs on the human body are very mild.  Aside from being addictive, there are very few long term health consequences from using opiates even over long periods.  The scale lists 'street methadone' as less harmful than heroin.  This is ironic since methadone is far more dangerous than heroin.  Allow me to explain.
  Methadone is more potent than morphine, up to 6X as potent orally.  By itself this means nothing as you would just take a lower dose to compensate.  However methadone also takes a long time to reach peak blood concentration, 2-3 hours.  Because real education about opiates is virtually nonexistant, what happens is people underestimate the strength of methadone and the time needed for it to 'kick in.'   Let's compare methadone to percocet.  Suppose someone assumes they're relatively equal in strength and is used to getting high off 20mg oxycodone (orally) so they take 20mg of methadone.  Oxycodone begins working within 20 minutes so after half an hour this individual isn't feeling anything so they take another 20mg.  After an hour they still aren't feeling anything so they take an additional 20mg.  After 2 and a half to three hours the methadone really begins to work and it totally kicks this individual's ass.  Unfortunately they not only misjudged the strength of the original dose but also took two booster doses.  Can you say overdose?

    In the figure above the various factors that were weighed are represented in different colors and summed to get a total value of harm.  It is important to note two things about heroin, first its total score is below alcohol and second the largest contributors to heroin's harms are crime and drug-related mortality.  Both crime and drug-related mortality are both products of prohibition.  As I have states many times before opiates are actually very gentle to the user's health.  It is very hard to make the case that they are pathogenic at all.  Unlike alcohol or tobacco, it is hard to truthfully say (though the truth never stops people from doing so) that opiate users are "slowly killing themselves," which is in itself a vastly oversimplified analysis of drug use and how it fits into the lifestyle of the user.  For example there are shamans in South America who systematically addict themselves to tobacco, the acquired nicotine tolerance allows them to take massive doses that induce visions.  Even if the use of tobacco reduces their life expectancy how much value do you assign to the role of tobacco use in the religion of the user and in the larger context of the culture?
    The crime aspect of heroin is due entirely to prohibition and its "tax" on black market opiates.  If anything opiates generally have a calming effect on users and so would be expected to reduce crime.  Furthermore alcoholics were often treated with morphine in the 19th century, doctors judging that an addiction to opiates was less harmful to the alcoholic and society at large than an addiction to alcohol.  The largest drawback to an addiction to opiates is their dependence potential, though I can think of no reason why methadone should have less dependence than heroin.  If anything experience indicates that methadone is harder to kick than heroin.
    My point is that it is nearly impossible to make real comparisons of licit and illicit drugs.  While I greatly admire Nutt's work and statements against drug prohibition, the papers in the Lancet are drawing a false equivalency between drugs.  There are two approaches to looking at the true effects of opiates in an age of prohibition.  The first is at opiate maintenance programs, particularly heroin maintenance as used in Europe.  The second is to compare the social situation prior to the criminalization of opiate users to the modern prohibition regime.  In both cases the welfare of the users as well as prohibition-caused crime were greatly reduced.  A completely legal market in narcotics, far from a nightmare, is the answer to the most pressing problems facing society around these drugs.

We saw no clear distinction between socially acceptable and illicit substances. The fact that the two most widely used legal drugs lie in the upper half of the ranking of harm is surely important information that should be taken into account in public debate on illegal drug use. Discussions based on a formal assessment of harm rather than on prejudice and assumptions might help society to engage in a more rational debate about the relative risks and harms of drugs. [1]

[1] Development of a rational scale to assess the harm of drugs of potential misuse
Prof David Nutt FMedSci,Leslie A King PhD,William Saulsbury MA,Prof Colin Blakemore FRS
The Lancet - 24 March 2007 ( Vol. 369, Issue 9566, Pages 1047-1053 ) 
DOI: 10.1016/S0140-6736(07)60464-4
PDF Link

[2] Drug harms in the UK: a multicriteria decision analysis
Prof David J Nutt FMedSci,Leslie A King PhD,Lawrence D Phillips PhD,on behalf of the Independent Scientific Committee on Drugs 
The Lancet - 6 November 2010 ( Vol. 376, Issue 9752, Pages 1558-1565 ) 
DOI: 10.1016/S0140-6736(10)61462-6

PDF Link

Thanks to anonymous commenter for the pdf links.

Saturday, October 20, 2012

Holy Shit Thomas Szasz Died!

How did i not know about this earlier?  An obituary [Link] written by Jeff Schaler, the author of Addiction is a Choice, is on the Szasz website.  Szasz died on September 8th, apparently by (purposely) overdosing on prescription painkillers.  Szasz has long been an advocate of libertarian principles including the right to end own's own life.  Opiophiles are most indebted to Szasz for his defense of the right to use drugs and his book Ceremonial Chemitry.

Friday, October 19, 2012

Writing Junky

I first read this in the Australian Drug User League (AIVL) publication, JunkMail Issue 5.  I have been looking for the article or David Herkt's PhD work but no luck so far.  The article is good so I cut and paste it so others can read it, but check out AIVL too.  All the back issues of JunkMail are available.

This facinating article was first published back in March 1992 as a feature in the original Junkmail magazine. Between 1990 and 1992, AIVL managed to gain funding to establish and publish a new drug users magazine called “Junkmail”. Unfortunately, due to the lack of continued funding, Junkmail ceased to be published for the rest of the decade. When AIVL received government funding to produce a national drug

users policy magazine in late 2000, it seemed obvious that the magazine should be called “Junkmail” and continue in the proud tradition of the first national users magazine all those years before. The limited funding for the original Junkmail also meant that the print run was small and very few people ever got to see, let alone read or collect those amazing first issues. In order to get some of the best articles from the original Junkmail magazines out to a broader readership we have decided to re-print “Writing Junky” in this issue. “Writing Junky” is an amazing analysis of the origins of the terms “addict” and “junky” which are both central to the way we perceive and describe injecting drug users today. This article, which was originally written as part of David Herkt’s PhD thesis, is a must read for anyone who is interested in challenging the way that drug [Original article cuts off here - Ed]

Thomas DeQuincey’s Confessions and the Origin of Addiction

Our conception of the addict or junky has its origins in 1820. It can be quite precisely dated. By 30th September 1821, all the conceptions that make up our paradigm of opiate use and dependence, and our idea of the opiate user, the addict or the junky, had been put into general circulation. The remainder of the nineteenth century saw a working-out of this paradigm with regard to both medicine and law. The individual responsible for our conception of the junky or user was Thomas DeQincey. DeQuincy was dependent on laudanum for 52 years. Therefore, with regard to the conception of drug use that he developed, DeQuincy can be considered the first junky. He was a writer and through his writings in his particular book, Confessions of an English Opium-Eater, DeQuincey delineated many of the features of that model of dependence and opiate use that remains current. Most influentially, DeQuincey brought the attention of the medical profession to the idea of opiate dependence for the first time. He documented that syndrome that we now know as withdrawal, and he also brought opiate tolerance and opiate dependence to the notice of the medicine. DeQuincey was also utilised by nineteenth century medicine as their major case study, because of his extensive descriptions of his physical relationship to laudanum. While many historical writers have outlined DeQuincey’s importance, his centrality in any discussion of our conception of opiate dependence and stereotypes of the opiate dependent, has not yet been fully acknowledged. For us, it is as if opiate dependence always existed. Without a beginning, it is as if our conception of opiate use and opiate users
is the only conception there has been and can be no other. The origin of the concept that we refer to as opiate dependence has been very little examined. For medicine, in particular, given the fact that its conception of opiate dependency is strongly connected to a government policy of drug prohibition, this origin might provide certain problems. For if there are other conceptions of use and users that are possible, the basis for the current prohibition is put in doubt, along with the livelihood of those who are employed by its supporting services and its bureaucracy.
The early nineteenth century is critical in any examination of the origin of our concepts of opiate dependence and those who are opiate dependent. Given the fact that we see opiate dependence as a medical and legal matter, it is surprising that those individuals who had the greatest influence on this origin were a poet and a writer. Perhaps this should not surprise us though, for, as can be demonstrated, this origin is an event that occured in ideas and was the success of a certain description of the world.
DeQuincey was substantially influenced both in his writing and his personal life by Samuel Taylor Coleridge. Coleridge is regarded as one of the great poets of the nineteenth century. His poems include The Rime of the Ancient Mariner, and more pertinent to the subject, Kublai Khan. Coleridge, in his preface to Kublai Khan (“In Xanadu did Kublai Khan/ a stately pleasure dome decree...”) states that, in 1797, he had taken a dose of an anodyne into a half-drowse during which he dreamed the poem. When he woke it was with a perfect recollection of the poem and he began writing the lines down. However, he was interrupted by a visitor and when he returned to his page, he discovered that he had forgotten the remainder. The fifty-seven lines he wrote before the interruption are all that survives. Coleridge was dependent on laudanum from approximately 1797 to his death in 1833, for approximately thrity-six years. It seems strange to say, but Coleridge did not know of his physical dependence at all.
Opiates were freely available at that time and were totally unregulated. It wasn’t until the middle of the century that any form of regulation was imposed on sales or use. Opium could be bought from the corner grocer, pharmacist or apothecary, or from door-to-door salesmen or street merchants. It was routinely used as an analgesic, as a calmative and a sleeping draught. It was also used for pleasure in many of the larger factory areas. Grocers and apothecaries put out additional stocks of wrapped opium pellets for Saturday nights as it was cheaper than gin. There were areas of England where use was widespread and constant, particularly the Fens. As a consequence there must have been large numbers of individuals who were opiate dependent, but had never discovered it, having never had to go without it.
Coleridge’s conception of his own use is interesting. He was aware that he had a habit, but to him it was exactly that, a habit or a custom. Coleridge claimed that he began taking it for an illness and then became accustomed to it. He felt some remorse, due to his strong Christian philosophy, that he was succumbing to a luxury and surrendering to a pleasure. Then when dependence set in, and he attempted to stop, he found that this cessation was accompanied by physical illness. However, Coleridge simply considered that this was the return of the underlying illness that opium had served to palliate or to halt.
The model is clear: Coleridge had an illness, he took opium and the illness went away. When he stopped taking opium, the illness returned. Coleridge did not associate his symptoms with anything resembling withdrawal as we know it. It is pertinent to note that Coleridge demanded that his body, after his death, be autopsied to discover this basic illness that had seemingly so bedevilled his existence.
Coleridge was famous in England at that time for his writing and his personality. To us now, some of the descriptions of Coleridge’s shining face and bright eyes and interminable monologues describe some characteristics of opiate use. He was very much respected for his intellect and his personality and was the object of attentions of young writers and “intellectuals” of the time.1
Thomas DeQuincey was born in 1785 in Manchester, the son of a merchant. He had literary ambitions and made serveral attempts to meet Coleridge. However, it was not only an interest in writing, poetry and philosopy that they had in common, for by the time that DeQuincey met Coleridge in 1807, he had already begun his career as an opiate user. The patterns of opiate use, prior to the institution of laws against he use of the drug, must be of interest to us. Neither Coleridge and DeQuincey had restrictions on their consumption and no formal bounds to their usage. There were no social, medical or legal restrictions on use. DeQuincey referred to the years 1804-1812 as his years of “practicing” opiate use. In 1813, an “irritation” of his stomach was responsible for him raising his dose to 340 grains of opium or 8000 drops of laudanum a day (“a formidable figure”, writes A.H.Japp, DeQuincey’s first biographer, though we learn that it is only a little more than half of what Coleridge was taking at the same time.”) It was during this period, in which DeQuincey attempted to control his increasing tolerance, that he constructed, by connecting the effects of opium on his own body, a model of dependence which, in essence, is substantially the same as our present conception. It was the years 1818-1819 that De Quincey found himself customarily using large amounts of laudanum. This period was seminal for his writing of the Confessions. His “dreaming faculty” was dominant and his state of “nodding-off” produced great dreams and fantasies. “When I lay in bed vast processions passed along in mournful pomp; friezes of never-ending stories, that to my feelings were as sad and as solemn as if they were drawn from the times before Oedipus or Priam - before Tyre - before Memphis.” In the Confessions, he writes of this time: “I sometimes seemed to have lived seventy or a hundred years in one night... the splendours of my dreams were chiefly architectural; and I beheld such pomps of cities and palaces as were never yet beheld by the waking eye, unless in clouds... I escaped sometimes and found myself in Chinese houses, with cane tables, etc. All the feet of the tables, sofas, etc, soon becme instinct with life; the abominable head of the crocodile, with his leering eyes looked out at me...” DeQuincey speaks of these years “set as it were, and insulated in the gloom and cloudy melancholy of opium.” His regaining control of his dose and his life resulted in his literary success. DeQuincey was the first of a long line of individuals who utilised their drugtaking experiences as the basis of a career or a successful best-selling book.
Confessions of an English Opium-Eater was serialised in two parts in the London Magazine for September and October 1821. In the nineteenth century these monthly magazines were extemely popular, providing to their subscribers with sophisticated commentary on contemporaneous events, intellectual discussion, reviews, fiction and vivid opinion. Confessions created great interest and it Samuel Taylor Coleridge was reviewed well. As a result DeQuincey began selling other contributions to such magazines and he became a famous figure in London, being sought-out for interviews and dinners. Confessions were reprinted in book-form in 1882. The book is fascinating when viewed from our later perspective.
DeQuincey describes his opiate use in the preface to the book: “If opium-eating be a sensual pleasure, and if I am bound to confess that I have indulged in it to an excess not yet recorded...” DeQuincey’s recording of the event and the manner and content of this recording were crucial to the development of a conception of opiate use. He told of his usage of opiates in sensational detail, but he placed it in the context of his life, as providing the key to him becoming an opium-eater. This connection is important.
Prior to DeQuincey, an opium habit, if it was noticed at all,was a simple behaviour with no more relevance than any other habit. The situation of DeQuincey’s opiate use in his life created the paradigm whereby opiate use has been seen, not as a behaviour, but a a result of a whole process of life. Currently it is this paradigm that has led to opiate use being seen as a result of an individual’s upbringing or character. DeQuincey’s story as told in the first version of the Confessions, tells of his action of running away from school in 1802. He wandered over England, through North Wales and to London. Then aged sixteen, he avoided all contact with his guardians until he ended up on the streets of London. With scarce financial resources and often hungry, he lived where he could find shelter. As someone who was forced to live on the streets, he fell in naturally with those women “technically known as Street-walkers.”
He developed a relationship with one of many Victorian sex-workers he met, a fifteen year old girl, named Ann. She had taken care of him when he collapsed from hunger, and DeQuincey fell in love with her. After he was recognised by a friend of his family, he made arrangements to see her again, but she did not come to their assigned meeting and though DeQuincey searched for her for as long as he could, he could not find her in the maze of London streets. In his later dreams, DeQuincey was often searching hopelessly, with increasing anxiety, for a young woman in great phantom cities with endless streets.
Part two of the book describes his discovery of opium. After an illness consisting of “excruciating rheumatic pains of the head and face”, a friend recommended him opium. It was a wet cheerless Sunday afternoon in 1804 and the sudden transition caused by the drug, as discovered by innummerable other users on their first encounter with opiates, was a wonderous experience. The pleasure of the drug was amazing to the nineteen year old as was the new world that opened up to him. Over the next months he began to repeat the pleasure. He would use it every three weeks, usually on a Tuesday or Saturday night. DeQuincey would take his laudanum and simply wander through the city, exploring the maze of London streets, watching the faces and following the crowds.
The next chapter heading in the Confessions was entitled “Introduction to the Pains of Opium”. In the period between 1804 nd 1812, he had continued to use the drug but at intervals and for short periods. An illness in 1813 caused him to take larger amounts, with more frequency until, taking the drug on a daily basis, he developed his first habit. Living at the time in a small cottage in the Lake District, he began to experience the full effects of constant use, allied with the large doses he was then using. He experienced “a sympathy that seemed to arise between the waking and dreaming states” which we refer to as “nodding off”. Because of the effects of the opium, the strength of his doses and DeQuincey’s constitutional state of being “a dreamer”, DeQuincey experienced long, complex and nightmarish dreams. William Burroughs, the author of Junkie and Naked Lunch, comments upon his own time in Tangier when he could similarly utilise large amounts of opiates daily for a number of years: “One is forcefully reminded of DeQuincey... when he describes the gloom, the oppression and feeling of death, brought on by habitual over-dosage.”
From our modern perspective, DeQuincey was discovering, without any culturally preordained idea of the drug, the opium experience as we know it. It is a dramatic event. To read his words and transfer those descriptions onto our own concepts and experiences is a remarkable process. However, it is in the Appendix to the 1822 book-version of the Confessions that DeQuincey makes his most important discovery, for he describes a syndrome, or a connection or Thomas DeQuincey - he was our first junky. He discovered dependence and wrote opiate usage into our culture. A series of symptoms, that we now know as withdrawal. If people do not know what to expect, their experience of the world will not tell them that opiate use causes physical dependence and cessation of that use cause physical illness.
Opiate dependence is a unique phenomenon. To claim that stopping opiate use ‘causes’ this illness is a discovery that had not been made in any of the medical literature of the early nineteenth century. In fact, medicine was almost ignorant about opiates at that time, except for the fact that they were (and still are) the
most effective analgesic known. No medical materials in 1820 referred to any aspect of ‘addiction’ or ‘withdrawal’, though it was known that some individuals had a habit of using opiates daily. DeQuincey, in the small Appendix to his book, gave his reduction schedule from 24th June 1821 to 27th July 1821, as he attempted to reduce his dose from 130 drops of laudanum to none. He carries out this regimen well, though his relapses (eg: “Monday 8th July: 300 drops”) must be familiar to anyone who has attempted this self-imposed schedule. But simultaneously, DeQuincey notes and describes his symptoms. “Meanwhile the symptoms which attended my case were these: enormous irritability and excitement of the whole system; the stomach in particular restored to full vitality, unceasing restlessness night and day, sleep - I scarcely knew what it was...” He suffered “violent sternutation” (which can be translated as runny nose and sneezing), excessive perspiration and an inability to keep still for more than a minute. Another symptom was what he called internal rheumatism, which affected his shoulders and joints and which any user who has hung out and ‘kicked’ a habit knows only too well. He also notes: “It’s remarkable that the whole period of years through which I had taken opium, I had never once caught a cold,” (a comment which has been echoed by innumarable users from DeQuincey to Keith Richards and William Burroughs), “but now a violent cold attacked me.”
The list of symptoms to his runny nose to his diarrhoea is the first cataloguing of withdrawal symptoms. These symptoms are also connected causally by DeQuincey, to his cessation of opiates. Thus on 20th September 1822, Thomas DeQuincey provided the information that enabled the construction of the opiate experience, much as we know it today. The story of a boy who runs away from school, hitchhikes around the country,
hits the streets of a large city where he becomes a street-kid, hangs around with sex workers, and develops a drug habit is a standard story. It is repeated daily in our media, in some form or another. It has nothing to do with the intrinsic nautre of opiates or the type of individual. Rather it can be seen that DeQuincey wrote a paradigmatic case and so influential was his writing, that all medical descriptions of opiate use in the nineteenth century directly utilised DeQuincey’s model and often quoted his descriptions. However, it was not simply medicine that followed DeQuincey. Such was his success that several individuals were brought to the attention of the medical authorities in the 1820’s, because they overdosed in an attempt to followed
DeQuincey’s example. Thousands of others would have followed his example without overdose.
DeQuincey’s description of himself and his drug adventures created a social construction of use, where any individual using, even for the first time, approached opiate use as already situated in his or her social world, in his or her cultural context. In other words, each of us knowing what to expect from the experience, as a result our experience will follow that path. DeQuincey’s personality, his rebellion, his fascination with dreams and visions, his explorations of the psychic world that opium created for him, were all used to establish a certain type of use and user. This conception of use predominates in our world now, in people who have never heard of DeQuincey. When DeQuincey described himself as “an English opium-eater” he took upon himself an identity as a user, as a ‘junky’. This first proclamation of this identity established a basic pattern for perceiving users for the next two hundred years. It is of interest to ponder how our perception of users might have differed if it had been another dependent individual of the time, such as the aristocratic Lord Erskine, who was the Lord Chancellor of England, William Wilberforce, the politician and philanthropist, or Dr Isaac Milner, the Dean of Carlisle, who had written such a book. Then, instead of seeing users as rebellious and street-wise, perhaps we would have seen users as being upperclass, conservative men, who had integral roles to play in the nation’s power structure.
Thomas DeQuincey and the effects of his Confessions of an English Opium-Eater have had on subsequent history has been immense, but such is the power of discovery and first descriptions, which not only describe, but create.

by David Herkt

(When this article was written David Herkt was the Editor of Junkmail. This material
forms part of David Herkt’s PhD thesis: “Writing Junky: The Creation of Addiction”.)

Drug User Enslavement Pt 1

When you take a group of people, label them as different based on their choice of intoxicant, and then round them up and lock them in facilities where they work for little or no money, is called justice in the United States.  I call it slavery.

It is now widely recognized that labeling a group of people based on some arbitrary metric such as skin color, and then using that metric to stigmatize and discriminate that group is morally wrong.  The institution of racially based slavery in the United States is rightly viewed as a great travesty in history.  However most people are blind to this travesty being played out again, only with choice of intoxicant replacing skin color as the arbitrary metric used to stigmatize and enslave a certain group of people.  At least its good to know that the US isn't the only country that enslaves drug users.  Check out this article in the Atlantic.  Drug users in the US, who do no harm to anyone but themselves (and even then less so than tobacco or alcohol), are regularly incarcerated where they work for between 30 to 70 cents per hour.


At any given time, over 300,000 people are locked up in mandatory drug detention in China like the one where Lixin was held. Police often pick people up off the streets and take them immediately into custody, keeping them in "treatment" for years at a time. Although it's difficult to track down standard practices -- many of the centers allow neither rights monitors nor press -- it's believed that these programs offer no clinical care and don't conduct patient evaluations.

"All drug detention is, is work. We get up at five in the morning to make shoes. We work all day and into the night. That's all it is," a former Chinese drug detainee told Human Rights Watch (HRW) in 2009. Du, another patient of a Chinese treatment program, echoed the complaint, saying, "The detox center is a factory. We work every day, until late in the night, even if we are sick, even if we have AIDS."

...as drug abuse in China isn't considered a criminal offense, drug users are usually sent to detention centers without any formal trial, never seeing the inside of a courtroom. 

What is even worse is that researchers at NIDA are using these prisoners (slaves) as participants in research trials.

The authors state that the participants gave informed consent, gaining approval from the Peking University Health Center review board, but Mr. Amon questions the validity of the claim, noting that the Beijing Ankang Hospital and the Tian-Tang-He Drug Rehabilitation center have historically been compulsory programs staffed with more police officers than doctors. Amon began to question the researchers' description of detained drug users as "patients" and the detention centers as "hospitals." It's difficult, Amon says, to determine if "informed consent" in such a setting can be truly voluntary.

"NIDA seems to be saying that they are willing to ignore human rights abuses and support misleading and even unethical research to fulfill a mission of advancing knowledge on drug addiction." He continued, "Is there really nowhere NIDA won't go, no type of research they won't support? Individuals in these centers are being held illegally, abused, and denied care."