The narcotic drug problemBishop, Ernest S. (Ernest Simons)
Science
The narcotic drug problem
Bishop, Ernest S. (Ernest Simons)
Drug addiction
An antidotal substance would also explain the after effects of and
the so-called “relapses” which occur after most of the cases treated
by whatever method or procedure, without due appreciation and proper
estimation of the clinical manifestations and indications of addiction
symptoms and physical body need, and without due consideration of the
patient’s reactive abilities and physical condition. These patients are
in a condition of restlessness, discomfort, vague pains, mental and
physical depression, lowered physical vitality and weakness. They have
a sense of a physical lack of support. They cannot endure nor react to
over-exertion, worry, strain, etc. This condition may persist for weeks
and months after no opiate has been administered. The above seem to be
mild withdrawal symptoms of an incompletely arrested addiction-disease
mechanism and might be explained by a continued manufacture of small
amounts-of antidotal toxic substance, causing a low grade chronic
poisoning. They can be duplicated in active opiate addiction before
withdrawal by administering an amount of opiate slightly below the
amount of need and so leaving unneutralized a small amount of the
antidotal toxic substance.
If continued production of a toxic antidotal substance, after
discontinuance of the drug which called it into being is to explain
the existence of the condition I have just described, the causation
of this continued production must be accounted for. It is conceivable
that in the development of addiction-disease mechanism a tolerance
of and slowness to eliminate opiate or some product of opiate is
acquired by all the cells of the body, perhaps especially by the
liver, and that these tolerant and atonic cells are extremely slow of
opiate elimination. Under this condition, a residue of opiate or some
product of opiate capable of antidotal substance stimulation might
remain unresponsive, or very slow of response, to ordinary cellular
and other elimination. If this should prove to be the fact, it would
account for a continued production of antidotal toxic substance, and
might, moreover, in any given case, either before or after cessation of
opiate medication, be one of the determining factors in the amount of
antidotal substance produced, or, in other words, in the measure of the
extent of body-need for opiate drug.
_Inhibition of Function_
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