What if they made disease illegal, and jailed the sick?

M. Simon’s post about heroin drew an interesting comment from reader Bob Sykes:

In the past, I have often thought you were somewhat of a crank on drug legalization. But your link this morning to Dr. Shavelson is a revelation. I have a brother in-law who is a long-term drug addict and who is suicidal. He has never gotten any meaningful treatment for his problems. And I now see somewhat that his pain must be severe….

As I noted in another comment, at some point it was decided to label opiate drugs as “pain killers” and declare that “real” pain consists only of physical pain. A moral line was therefore drawn between emotional pain and physical pain, and it was deemed “immoral” to medicate emotional pain. This in turn led to treating people who medicated their emotional pain as common criminals.

As to why a society would countenance such cruelty, I speculated it may be that some people have a primitive instinct to hate and persecute those seen as weak, but because this cannot be done rationally, they must first be labeled immoral. But at any rate, the use of once legal drugs like heroin to treat emotional pain became a crime — whether the drugs were provided by doctors or consumed by individuals who medicated themselves.

Anyway, Simon’s post and the comments reminded me of a scientfic article confirming something I long suspected: that addicts have a high incidence of social anxiety.

Yet, despite this, conventional “treatment” methodology forces them into 12 step groups! The authors acknowledge this problem:

As most treatment facilities rely heavily on traditional group therapy and 12-step treatment approaches (such as Narcotics Anonymous or Alcoholics Anonymous) for the treatment of SUDs, individuals with social anxiety may have considerable difficulty engaging and participating in such group-oriented activities.

I have known people who would rather die of an overdose than attend 12 step groups. That sort of “treatment” is not for everyone, and you don’t have to suffer from social anxiety to see it as invasive of dignity to be forced to attend touchy-feely meetings in which you confess your sins while being relentlessly indoctrinated to believe in a collection of answers to everything in what is called “The Big Book.” While no one disputes that this works for some people, those who disagree with the approach are often accused of being “in denial.” One man I knew said that they even had a label for his objections to the group-think philosophy: he was told that he suffered from a condition known as “terminal uniqueness.” 

It reminds me of religious therapy to cure another “immoral disease” — homosexuality. As someone who believes in freedom, however, I have no problem with people voluntary deciding to submit such “treatments,” and it would be tyrannical to stop them. However, unlike Exodus-style religious therapy for homosexuals, the 12 step regime for addiction treatment is often imposed on individuals by court order — which means at gunpoint, under penalty of being sent to prison.

Nor are doctors allowed to manage addicts as they see fit. Giving an addict drugs to help him maintain functionality is not considered within the “legitimate practice of medicine,” and any doctor caught doing this will lose his license and can easily be subjected to a lengthy prison term. 

Almost everyone agrees that addiction is a disease. Why should the DEA get to dictate what should be done with these people — even to the point of regulating the practice of medicine? (Anyone who thinks government control of medicine began with Obamacare should read the history of the regulation of medical narcotics.) The DEA has that power because the medications are illegal to use for emotional pain or addiction treatment, which means that not only is self-medication a crime, but all doctors and patients are possible suspects to be watched and monitored.

The problem is compounded by the fact that very few people are sympathetic to drug addicts, as they have been systematically conditioned over the decades to think of them not as sick people, but as bad. (Or maybe both sick and bad.) That’s because they break the law, and breaking the law is bad, whereas in the old days when heroin was sold over the counter, addicts were not bad people. The old “when heroin is outlawed then only outlaws will use heroin” truism.   

While truisms like that may be true, they are also tired, so I tried to think of a better analogy which might be made to a still-legal activity engaged in by sick people who have not yet been turned into “bad” people by operation of law.

It’s an old issue in this blog, but there’s not much debate over the fact that most schizophrenics smoke to self-medicate. So I thought, “Imagine if tobacco were made illegal and people who self-medicated faced imprisonment for the crime of smoking.”

Except that analogy really doesn’t work.

Society would never be so deliberately cruel to sick people.