Is it a disease, or not?


For a very long time doctors who worked with drug addicts have stated that addiction to illicit drugs like heroin is not stronger than that to legal drugs like cigarettes. But this message has not reached the public and has therefore not prevented the emergence of a huge therapeutic bureaucracy, which ironically – at least according to my experience in Germany – has provided jobs for ex-junkies.

Theodore Dalrymple analyses this therapeutic community in his new book Junk Medicine: Doctors, Lies and the Addiction Bureaucracy, which is dedicated to the war against withdrawal symptoms. He thoroughly debunks the disease model of addiction claiming that we should be really talking about a moral and spiritual problem requiring changes in behaviour. Based on U.S. government survey data among others the book provides plenty of examples contradicting the prevailing wisdom about addiction:

  • Just as with smokers the vast majority of people who try heroin either never use it again, use it just a few times, or only use it intermittently.
  • Even among heroin users, the heroin addict is the exception.
  • Experiments have shown that withdrawal symptoms were eliminated with placebo injections of saline solution.
  • Histrionic addicts…who complain of horrible discomfort in the presence of doctors…to obtain narcotics but act normally both before the visit and after.
  • Patients who repeatedly receive large doses of narcotics for pain... rarely become addicted.

Dalrymple has plenty of experience in this field since he had been working as a prison doctor in northern England. Dalrymple’s book offers some hope and a good opportunity to rethink our hugely expensive, mostly unsuccessful therapeutic addiction regimes.


If you buy Junk Medicine here from our online bookshop, you can get it for just £11 – £4 off the retail price.