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These Drug Addicts Cure One Another
by
Jerome Ellison
A
new approach to a tragic social problem – drug addiction
– has been found by the ex-addicts of Narcotics Anonymous.
Here’s how they help users out of their horrible habit
– as in the case of the mining engineer, the hot musician,
the minister and the movie actor.
Tom,
a young musician just out of a job on a big-name dance band,
was pouring out the story of his heroin addiction to a small
gathering in a New York City Y.M.C.A. He told how he started
three years ago, “fooling around for thrills, never
dreaming to get a habit.” His band went on the road.
One night in Philadelphia he ran out of his drug and became
so shaky he couldn’t play. It was the first time the
band management knew of his habit. He was promptly sent
home.
“Music
business is getting tough with junkies,” Tom said.
His audience was sympathetic. It was composed of former
drug addicts who had found freedom from addiction. They
met twice weekly to make this freedom secure, and worked
to help other addicts achieve it. The New York group, founded
in 1950 and called Narcotics Anonymous, is one of several
which have been piling up evidence that the methods of Alcoholics
Anonymous can help release people from other drugs than
alcohol – drugs such as opium, heroin, morphine and
the barbiturates.
The groups enter a field where patients are many and cures
few. The population addicted to opiates has been placed
by competent but incompatible authorities at 60,000 and
at 180,000. The Federal Bureau of Narcotics estimates that
the traffic in illegal opium derivatives grosses $275,000,000
a year. About 1000 people a month are arrested for violation
of Federal, state or local laws regulating the opiates.
Addiction to the barbiturates, it is believed, involves
more people. There are some 1500 known compounds of barbituric
acid, some of them having pharmaceutical names and others
street names such as yellow jacket, red devil and goofball.
Addicts work up to doses sufficient to kill a non-addicted
person or an addict with a lesser tolerance. In New York
recently, three young addicts met and took equal portions
of heroin. Two felt no unusual reactions; the third went
into convulsions and in a few hours was dead. Many barbiturate
users daily consume quantities, which would be lethal to
a normal person. Others have demonstrated an ability to
use barbiturates for years, under medical supervision, without
raising their consumption to dangerous levels.
The drug addict, like the alcoholic, has long been an enigma
to those who want to help him. Real contact is most likely
to be made, on a principle demonstrated with phenomenal
success by Alcoholics Anonymous, by another addict. Does
the prospect, writhing with shame, confess to pilfering
from his wife’s purse to buy drugs? His sponsor once
took his children’s lunch money. Did he steal the
black bag of a loyal family doctor? As a ruse to flimflam
druggists, his new friend once impersonated a doctor for
several months. The N.A. member first shares his shame with
the newcomer. Then he shares his hope and finally, sometimes,
his recovery.
To date, the A.A. type of group therapy has been an effective
ingredient of “cures” – the word as used
here means no drugs for a year or more and an intent of
permanent abstinence. – in at least 200 cases. Some
of these, including Dan, the founder of the New York group,
had been pronounced medically hopeless. The “Narco”
Group in the United States Public Health Service Hospital
at Lexington, Kentucky, has a transient membership of about
eighty men and women patients. The group mails a monthly
newsletter, The Key, free to those who want it, currently
a list of 500 names. Many of these are interested but nonaddicted
friends. Most are “mail-order members” of the
group-addicts who have left the hospital and been without
drugs for periods ranging from a few weeks to several years.
The H.F.D. (Habit Forming Drug) Group is a loosely affiliated
fellowship of California ex-addicts who keep “clean”
– the addicts term for a state of abstinence- by attending
Alcoholics Anonymous meetings with volunteer A.A. sponsors.
The Federal prison at Lorton, Virginia, has a prisoner group
which attracts thirty men to its weekly meetings. Narcotics
Anonymous in New York is the sole “free world”-outside
of institution-group which conducts its own weekly open-to-the-public
meetings in the A.A. tradition.
Today’s groups of former addicts mark the convergence
of two historic narratives, one having to do with alcohol,
the other with opium. References to the drug of the poppies
go back to 4000 B.C. According to Homer, Helen of Troy used
it in a beverage guaranteed to abolish care. Opium was employed
to quiet noisy children as early as 1552 B.C. De Quincy
and Coleridge are among the famous men to whom it brought
disaster. In its dual role it appears today, through its
derivatives, as the friend of man in surgery and his enemy
in addiction.
The alcoholic strand of the story may be taken up in the
Zurich office of the Swiss psychologist Carl Jung, one day
late in 1933. At that time the eminent doctor was obliged
to impart an unpleasant bit of news to one of his patients,
an American businessman who had come for help with a desperate
drinking problem. After months of effort and repeated relapses,
the doctor admitted that his treatment had been a failure.
“Is
there, then,” the patient asked, “no hope?”
Only if a profound religious experience were undergone,
he was told. How, he wanted to know, could such an experience
be had? It could not be obtained on order, the doctor said,
but if one associated with religious-minded people for a
while _______
Narcotics
Anonymous – A.A.’s Young Brother
The
American interested himself in Frank Buchman’s Oxford
Group, found sobriety, and told an inebriate friend of his
experience. The friend sobered up and took the message to
a former drinking partner, a New York stockbroker named
Bill. Though he was an agnostic who had never had much use
for religion, Bill sobered up. Late in 1935, while on a
business trip to Akron, Ohio, he was struck by the thought
that he wouldn’t be able to keep his sobriety unless
he passed on the message. He sought out a heavy drinking
local surgeon named Bob and told him the story to date.
They sat down and formulated a program for staying sober-a
program featuring twelve Suggested Steps and called Alcoholics
Anonymous. Bill devoted full time to carrying the A.A. message,
and the news spread. The now-famous article by Jack Alexander
in The Saturday Evening Post of March 1, 1941, made it nationally
known, and by 1944 there were A.A. groups in the major cities.
In June of that year an inebriate mining engineer whom we’ll
call Houston “hit bottom” with his drinking
in Montgomery, Alabama, and the local A.A.’s dried
him up. Houston gobbled the A.A. program and began helping
other alcoholics. One of the drunks he worked with-a sales
executive who can be called Harry-was involved not only
with alcohol but also morphine. A.A. took care of the alcoholic
factor, but left Harry’s drug habit unchanged. Interested
and baffled, Houston watched his new friend struggle in
his strange self-constructed trap.
The opiate theme of the narrative now reappears. Harry’s
pattern had been to get roaring drunk, take morphine to
avoid a hang-over, get drunk again and take morphine again.
Thus he became “hooked”-addicted. He drove through
a red light one day and was stopped by a policeman. The
officer found morphine and turned him over to Federal jurisdiction,
with the result that Harry spent twenty-seven months at
Lexington, where both voluntary and involuntary patients
are accommodated, as a prisoner. After his discharge he
met Houston and, through A.A., found relief from the booze
issue. The drug problem continued to plague him.
During this period, Houston, through one of those coincidences
which A.A.’s like to attribute to a Higher Power,
was transferred by his employers to Frankfort, Kentucky,
just a few miles from Lexington. “Harry’s troubles
kept jumping through my brain,” Houston says. “I
was convinced that the twelve Suggested Steps would work
as well for drugs as for alcohol if conscientiously applied.
One day I called on Dr. V.H. Vogel, the medical officer
then in charge at Lexington. I told him of our work with
Harry and offered to assist in starting a group in the hospital.
Doctor Vogel accepted the offer and on Feb. 16, 1947, the
first meeting was held. Weekly meetings have been going
on ever since.”
The
Phenomenon of “Physical Dependence”
Some
months later, in a strangely woven web of coincidence, Harry
reappeared at “Narco” as a voluntary patient
and began attending meetings. He was discharged, relapsed,
and in short time was back again. “This time,”
he says, “it clicked.” He has now been free
from both alcohol and drugs for more than five years. Twice
he has returned to tell his story at meetings, in the A.A.
tradition of passing on the good word.
In the fall of 1948 there arrived at Lexington an addict
named Dan who had been there before. It was, in fact, his
seventh trip; the doctors assumed that he’d continue
his periodic visits until he died. This same Dan later founded
the small but significant Narcotics Anonymous group in New
York. Dan’s personal history is the story of an apparently
incurable addict apparently cured.
An emotionally unsettled childhood is the rule among addicts,
and Dan’s childhood follows the pattern. His mother
died when he was three years old, his father when he was
four. He was adopted by a spinster physician and spent his
boyhood with his foster mother, a resident doctor in a Kansas
City hospital, and with her relatives in Missouri and Illinois.
When he was sixteen he developed an ear ailment and was
given opiates to relieve the pain. During and after an operation
to correct the condition he received frequent morphine injections.
Enjoying the mood of easy, floating forgetfulness they induced,
he malingered.
Living in a large hospital gave Dan opportunities to pilfer
drugs, and for six months he managed keep himself regularly
supplied. An addict at the hospital taught him how to inject
himself, so for a time he was able to recapture the mood
at will. He was embarrassing his foster mother professionally,
however, and though not yet acknowledging the fact to himself,
was becoming known locally as an addict. Sources of drugs
began to close up, and one day there was no morphine to
be had. He went into an uncontrollable panic which grew
worse each hour.
There
followed muscular cramps, diarrhea, a freely running nose,
tears gushing from his eyes, and two sleepless, terror-filled
days and nights. It was Dan’s first experience with
the mysterious withdrawal sickness which is experienced
sooner or later by every addict.
In one of the strangest phenomena known to medicine, the
body adjusts to the invasion of certain drugs, altering
its chemistry in a few weeks to a basis-called “physical
dependence”-on which it can no longer function properly
without the drug. How physical dependence differs from habit
may be illustrated by imagining a habitual gum chewer deprived
of gum. His unease would be due to the denial of habit.
If he were denied gum and also water, on which he is physically
dependent, he’d feel an increasingly painful craving
called thirst. The drug addict’s craving is called
the “abstinence syndrome,” or withdrawal sickness.
In extreme cases it includes everything Dan experienced,
plus hallucinations and convulsions. Withdrawal of opiates
rarely causes the death of a healthy person; sudden cessation
of barbiturates has been known to. The violent phase, which
is usually over in two to three days, may under expert care
be largely avoided. Physical dependence gradually diminishes
and ordinary habit, of the gum-chewing type, asserts itself.
This is the interval of greatest vulner-ability, N.A. members
say, to the addict’s inevitable good resolutions.
He has formed the habit of using his drugs when he feels
low. If he breaks off medical supervision before he is physically
and medically back to par, the temptation to relapse may
be overwhelming. It is in this period, Dan says, that the
addict most needs the kind of understanding he finds in
N.A. If he yields to the call of habit, physical dependence
is quickly reestablished and his body calls for ever greater
doses as the price of peace.
Dan went through the cycle dozens of times. Besides the
half dozen withdrawals at Lexington, there were several
at city and state institutions, and numerous attempts at
self-withdrawal. He tried sudden and complete abstinence,
the “cold-turkey” method. He tried relieving
the withdrawal pangs with alcohol, and found it only cancelled
out his ability to think, so he automatically returned to
drugs. When he attempted withdrawal with barbiturates he
“just about went goofy.”
All this, however, was to come later; in his early twenties
he had no intention of giving up the use of drugs. Having
been spotted as an addict in the Kansas City area, he sought
fresh fields. He found a job as a salesman and traveled
several Midwest states. The demands of his habit and his
scrapes with the law made it hard to hold a job long. Drifting
from one employment to another, he found himself, in the
early 1930’s in Brooklyn.
His attempts at withdrawal resulted in several extended
periods of abstinence, the longest of which was three years.
When off drugs Dan was an able sales executive and a good
provider. He married a Staten Island girl. They had a son.
Dan continued to have short relapses, however. Each new
one put a further strain on the family tie. For a time,
to save money for drugs, he used slugs in the subway turnstiles
going to and from work. He was spotted by a subway detective
and spent two days in jail. A month later he was caught
passing a forged morphine prescription. As a result, he
was among the first prisoner patients at the new United
States Public Health Service Hospital for addicts at Lexington,
when it was opened on May 28, 1935.
After a year there, he made a supreme effort to be rid of
drugs for good. To keep away from the temptations offered
by New York drug pushers he found a job with a large Midwest
dairy. He worked hard, saved his money and sent for his
family. By this time, however, it was too late; his wife
refused to come, and a divorce action was begun. “Her
rebuff gave me what I thought was a good excuse to go back
on drugs,” Dan reports. After that, his deterioration
accelerated. On his seventh trip to Lexington, in 1948,
he was in a profound depression.
After a month of sullen silence, he began attending the
group meetings, which were a new feature at the hospital
since his last trip. “I still wouldn’t talk,”
he reports, “But I did some listening. I was impressed
by what Houston had to say. Harry came back one time and
told us his story. For the first time, I began to pray.
I was only praying that I would die, but at least it was
a prayer,” He did not die, nor did he recover. Within
six months of his discharge he was found in possession of
drugs and sent back to Lexington for a year-his eighth and,
as it turned out, final trip.
“This
time things were different,” he says. “Everything
Houston and Harry had been saying suddenly made sense. There
was a lawyer from a Southern city there at the time, and
a Midwestern surgeon. They were in the same mood I was-disgusted
with themselves and really ready to change. The three of
us used to have long talks with Houston every Saturday morning,
besides the regular meetings.” All three recently
celebrated the fifth anniversary of their emancipation from
the drug habit.
Dan, conscious of what seemed to him a miraculous change
of attitude, returned to New York full of enthusiasm and
hope. The twelfth of the Suggested Steps was to pass on
the message to others who needed help. He proposed to form
the first outside-of-institution group and call it Narcotics
Anonymous-N.A. He contacted other Lexington alumni and suggested
they start weekly meetings.
There were certain difficulties. Addicts are not outstandingly
gregarious, and when all the excuses were in only three-a
house painter named Charlie, a barber named Henry and a
waiter we’ll call George-were on hand for the first
meeting. There was uncertainty about where this would be;
nobody it seemed wanted the addicts around. Besides, missionary,
or “twelfth step,” work of the new group would
be hampered by the law. When the A.A. member is on an errand
of mercy he can, if occasion warrants, administer appropriate
“medicine” to stave off shakes or delirium long
enough to talk a little sense into the prospect. If the
N.A. member did so, he’d risk a long term in jail.
Drug peddlers were not enthusiastic about the new venture.
Rumors were circulating discrediting the group.
Out of the gloom, however, came unexpected rays of friendliness
and help. The Salvation Army made room for meetings at its
46th Street cafeteria. Later the McBurney Y.M.C.A., on 23rd
Street, offered a meeting room. Two doctors backed their
oral support by sending patients to meetings. Two other
doctors agreed to serve on an advisory board.
There were slips and backslidings. Meetings were sometimes
marred by obstinacy and temper. But three of the original
four remained faithful and the group slowly grew. Difficult
matters of policy were worked out by trial and error. Some
members once thought that a satisfactory withdrawal could
be made at home. Some hard nights were endured and it was
concluded that the doctors were right-for a proper drug
withdrawal institutional care is necessary. Addicts are
not admitted to meetings while using drugs. Newcomers are
advised to make their withdrawal first, then come to N.A.
to learn to live successfully without drugs.
Group statisticians estimate that 5000 inquiries have been
answered, constituting a heavy drain on the group’s
treasury. Some 600 addicts have attended one or more meetings,
90 have attained effective living without drugs. One of
these is a motion picture celebrity, now doing well on his
own. One relapse after the first exposure to N.A. principles
seems to have been about par, though a number have not found
this necessary. “A key fact of which few addicts are
aware,” Dan says, “is that once he’s been
addicted, a person can never again take even one dose of
any habit-forming drug, including alcohol and the barbiturates,
without running into trouble.”
The weekly “open”-to the public-meetings are
attended by ten to thirty persons-addicts, their friends
and families and concerned outsiders. The room is small
and, on Friday evenings when more than twenty-five turn
up, crowded.
There is an interval of chitchat and visiting, and then,
about nine o’clock, the secretary, a Brooklyn housewife,
mother and department -store cashier, opens the meeting.
In this ceremony all repeat the well-known prayer: “God
grant me the serenity to accept the things I cannot change,
the courage to change the things I can, and the wisdom to
know the difference." The secretary then introduces
a leader-a member who presents the speakers and renders
interlocutor’s comments from his own experience with
a drugless life. The speakers-traditionally two in an evening-describe
their adventures with drugs and with N.A. In two months
of meetings I heard a score of these case histories. I also
charted the progress of a newcomer, the young musician named
Tom, whose first N.A. meeting coincided with my own first
reportorial visit.
Within the undeviating certainties of addiction, individual
histories reveal a wide assortment of personal variations.
Harold, an optometrist, is a “medical” addict;
he got his habit from the prescription pad of a doctor who
was treating him for osteomyelitis. An outspoken advocate
of psychotherapy for all, Harold absorbs a certain amount
of ribbing as the groups “psychiatric salesman.”
Florence, the housewife-cashier-secretary, recently celebrated
her first anniversary of freedom from morphine, which she
first received twenty-five years ago in a prescription for
the relief of menstrual cramps. Carl, an electrician, became
interested in the effects of opium smoke thirty years ago,
and reached a point where he could not function without
his daily pipe. He eventually switched to heroin and his
troubles multiplied.
Manny, an executive in a high-pressure advertising agency,
and Marian, a registered nurse with heavy administrative
responsibilities began using morphine to relieve fatigue.
Don, Marian’s husband, regards alcohol as his main
addictive drug, but had a bad brush with self-prescribed
barbiturates before he came to A.A. and then, with Marian,
to N.A. Pat, another young advertising man, nearly died
of poisoning from the barbiturates to which he had become
heavily addicted. Harold and Carl have now been four years
without drugs; Manny, three; Marian, Don and Pat, one.
Perhaps a third of the membership are graduates of the teen-age
heroin fad which swept our larger cities a few years ago,
and which still enjoys as much of a vogue as dope peddlers
can promote among the present teen-age population. Rita,
an attractive daughter of Spanish-American Harlem, was one
of the group’s first members. Along with a number
of her classmates, she began by smoking marihuana cigarettes-a
typical introduction to drugs-then took heroin “for
thrills.” She used the drug four years, became desperately
ill, went to Lexington and has now been free of the habit
four years. Fred, a war hero, became a heroin addict because
he wanted friends. In the teen-age gang to which he aspired,
being hooked was a badge of distinction. He sought out the
pusher who frequented the vicinity of his high school and
got hooked. There followed seven miserable and dangerous
years, two of them in combat and one in a veteran’s
hospital. In December of 1953 he came to N.A. and, he says,
“really found friends.”
Lawrence’s story is the happiest of all. He came to
N.A. early in his first addiction, just out of high school,
just married, thoroughly alarmed at discovering he was addicted,
and desperately seeking a way out. N.A. friends recommended
that he get “blue-grassed,” an arrangement by
which a patient may commit himself under a local statute
to remain at Lexington 135 days for what the doctors consider
a really adequate treatment. He attended meetings in the
hospital and more meetings when he got home. Now happy and
grateful, he thanks N.A. His boss recently presented him
with a promotion; his wife recently presented him with a
son.
Besides the Friday open meeting there is a Tuesday closed
meeting at the Y for addicts only. As a special dispensation
I was permitted to attend a closed meeting, the purpose
of which is to discuss the daily application of the twelve
steps.
The step under discussion the night I was there was No.4:”Make
a searching and fearless moral inventory of ourselves.”
The point was raised as to whether this step might degenerate
into self-recrimination and do more harm than good. Old-timers
asserted that this was not the proper application. A life
of drug addiction, they said, often built up an abnormal
load of guilt and fear, which could become so oppressive
as to threaten a relapse unless dealt with. When the addict
used step 4 honestly to face up to his past, guilt and fear
diminished and he could make constructive plans for his
future.
The Narco meetings at Lexington have borne other fruit.
There was Charlie, the young GI from Washington, D.C., who
once looted first-aid kits in the gun tubs of a Navy transport
en route to the Philippines and took his first morphine
out of sheer curiosity. After his Army discharge his curiosity
led him to heroin and several bad years; then to Lexington,
where the Narco Group struck a spark. He heard about Dan’s
work, went to New York to see him, and on his return to
Washington looked around to see what he could do. He discovered
that there was a concentration of addicts in the Federal
penitentiary at Lorton, Virginia. Working with Alcoholics
Anonymous, which already had meetings in the prison, he
obtained permission to start a group like the one at Lexington.
Now a year old, these meetings, called the Notrol Group-
Lorton backward-attract the regular attendance of about
thirty addicts. Washington has no free-world group, but
Charlie helps a lot of addicts on an individual basis, steering
them to A.A. meetings for doctrine.
Friendliness of ex-drug addicts with former devotees of
alcohol sometimes occurs, though Bill, the same who figured
so prominently in A.A.’s founding, says a fraternal
attitude cannot be depended upon. The average A.A., he says,
would merely look blank if asked about drug addiction, and
rightly reply that this specialty is outside his understanding.
There are, however, a few A.A.’s who have been addicted
both to alcohol and drugs, and these sometimes function
as “bridge members.”
“If
the addict substitutes the word ‘drugs’ whenever
he hears ‘alcohol’ in the A.A. program, he’ll
be helped,” Houston says. Many ex-addicts, in the
larger population centers where meetings run to attendances
of hundreds, attend A.A. meetings. The H.F.D. (Habit-Forming
Drug) Group, which is activated by an energetic ex-addict
and ex-alcoholic of the Los Angeles area named Betty, has
dozens of members, but no meeting of its own. Individual
ex-addicts who are “making it” the A.A. way
include a minister in a South-eastern state, a politician
in the deep South, a motion-picture mogul in California
and an eminent surgeon of an Eastern city. The role call
of ex-addict groups is small. There is the parent Narco
Group, Addicts Anonymous, P.O. Box 2000, Lexington, KY;
Narcotics Anonymous, P.O. Box 3, Village Station, New York
14, N.Y.; Notrol Group, c/o U.S. Penitentiary, Lorton, Va.;
H.D.F. Group, c/o Secretary, Bay Area Rehabilitation Center,
1458 26th St., Santa Monica, Calif.
A frequent and relevant question asked by the casually interested
is, “But I thought habit-forming drugs were illegal-where
do they get the stuff?” The answer involves an interesting
bit of history explaining how opiates come to be illegal.
In the early 1800’s doctors used them freely to treat
the innumerable ills then lumped under the heading, “nervousness.”
Hypodermic injection of morphine was introduced in 1856.
By 1880, opium and morphine preparations were common drugstore
items. An 1882 survey estimated that 1 per cent of the population
was addicted, and the public became alarmed. A wave of legislation
swept the country, beginning in 1885 with an Ohio statute
and culminating in the Federal Harrison Narcotic Law of
1914. Immediately after the passage of this prohibitory
law, prices of opium, morphine and heroin soared. A fantastically
profitable black market developed. Today, $3000 worth of
heroin purchased abroad brings $300,000 when finally cut,
packaged and sold in America.
Among the judges, social workers and doctors with whom I
talked there is a growing feeling that the Harrison Act
needs to be re-examined. Dr. Hubert S. Howe, a former Columbia
professor of neurology and authority on narcotics, says
the statute, like the Volstead Act, “removed the traffic
in narcotic drugs from lawful hands and gave it to criminals.”
In an address before the New York State Medical Society
he asserted that the financial props could be knocked from
the illegal industry by minor revisions of present laws
and rulings, with no risk of addiction becoming more widespread.
Doctor Howe proposes a system of regulation similar to that
of the United Kingdom, which reports only 364 addicts.
Meanwhile the lot of those who become involved with what
our British cousins rightly call “dangerous drugs”
is grim. It is just slightly less grim than it might have
been five years ago. Since then a few addicts have found
a way back from the nightmare alleys of addiction to a normal
life which may seem humdrum enough at times, but which when
lost, then regained, is found to be a glory.
(Source:
The Saturday Evening Post, August 7, 1954)
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