The narcotic drug problemBishop, Ernest S. (Ernest Simons)
Science
The narcotic drug problem
Bishop, Ernest S. (Ernest Simons)
Drug addiction
This explains the phenomena of the mathematical exactness with which
the minimum daily need can be estimated under experimental conditions,
and with which doses less than the amount of actual body need relieve
existing withdrawal signs in definite proportion to the amount of
opiate administered. In exact proportion as the drug of addiction is
present in the body to neutralize or oppose some antidotal poison, is
the patient free from withdrawal symptoms and from physical craving for
the narcotic drug.
The development and existence of such mechanism in the body of the
opiate addict is suggested also by the apparent continuance of
tolerance to opiate existing after long periods without drug in
individuals who had previously suffered from addiction-disease, and in
the susceptibility of the former sufferer subsequent to the arrest of
his physical need for opiate, to the re-establishment of that need by
the subsequent administration of the drug.
Illustrative of this phenomenon is a case who, after about two years
of relief from addiction-disease, developed pneumonia and to whom in
delirium and threatened death, opiates were administered as unavoidable
medication. After cessation of his delirium, he was dismayed to
discover addiction-manifestations and body-need for opiate drug had
been re-established. This history is one of a number in my possession,
and has been verified.
The case demonstrating the longest persistence of susceptibility among
my records, is that of a man in the early fifties who underwent an
emergency operation for infected gall-bladder. A day or two following
operation he developed excruciating pain in his right side just under
the ribs. It had been necessary to administer opiates since a day or
two before the operation. I was called in consultation for the purpose
of determining the character and origin of the pain, and diagnosed a
pleurisy, the pain of which subsided on the following day. Opiates were
discontinued with a result of precipitating unmistakable withdrawal
phenomena. To his great anger and surprise, I accused the patient of
being an opiate addict. He indignantly declared that he had never
used opiates in his life. Subsequent investigation with the aid of
older members of his family disclosed a distinct and typical history
of addiction manifestations following opiate administration in the
course of treatment of a complicated fracture of his thigh in early
boyhood. The drug had been withdrawn at that time and the addiction
manifestations finally disappeared, he never having been aware of the
facts. His reawakened addiction-manifestations were easily and quickly
checked.
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