From: peter@petermc.demon.co.uk (Peter McDermott)
Subject: Re: Addiction and the law (or something)
Date: 1996/11/15
newsgroups: alt.drugs.hard

>> >   So yes there is a "Progression" of the illness. Unless
>> >curtailed,addition doesn't get better,just worse.
>> >                       Jackson
>>
>> Aint' that the way it is.  I've never seen addiction get better
>> either.  Unless the person quit.
>
>First of all, it is patently false to say that addiction never gets
>better. Whatever one might think about addiction itself being "good" or
>"bad" in absolute terms, one has to grant that addiction does get much
>better for a lot of people when they switch from IV street heroin to oral
>methadone. (Even when Jackson talks about his troubles with methadone,
>much of them seem to arise in the context of limited supply rather than
>due to the dependence itself.)

Indeed. In fact, I'd go further than that, and point out that you
don't actually have to give people methadone for them to get better.

There is one very famous study of treatment of heroin addicts
(Vailiant did it and cites it in his 'Natural History of Addiction'
that shows that if you take two groups of heroin addicts and give
one group treatment and the other group no treatment, approximately
one third get better, one third get worse, and the final third stay
the same.

Interestingly enough, the figures are broadly the same for the group
that _had_ treatment.

Secondly, close ethnographic studies of heroin addicts conducted in
the UK show that rather than showing a pattern of uncontrolled
escalating use (ie, addiction is chronic, progressive and fatal as
the old 12 step/Minnesota Method people would have it) if you actually
look at the real lives of people, you see a very different picture, in
which people do things like gradually reduce their intake in order
to get their tolerance down so that they can get stoned again, or
have periods when they quit for a while because they have something
else in their lives, and then go back to using later. I have one
friend who has used this way for some 25 years. He get a habit, uses
for a while. It gets inconvenient. He quits. He's currently living in
London, and uses only when he comes home to Liverpool

But he _isn't_ an exception. As I say, using pretty objective measures,
in any given year, some 30% of heroin addicts do get better without any
help at all.

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