Naked Lunch (29 page)

I have undergone ten ‘cures’ in the course of which all these drugs were used. I have taken quick reductions, slow reductions, prolonged sleep, apomorphine, antihistamines, a French system involving a worthless product known as ‘amorphine,’ everything but shock. (I would be interested to hear results of further experiments with shock treatment
on somebody else.) The success of any treatment depends on the degree and duration of addiction, the stage of withdrawal (drugs which are effective in late or light withdrawal can be disastrous in the acute phase), individual symptoms, health, age, etc. A method of treatment might be completely ineffective at one time, but give excellent results at another. Or a treatment that does me no good
may help someone else. I do not presume to pass any final judgements, only to report my own reactions to various drugs and methods of treatment.

Reduction Cures. – This is the commonest form of treatment, and no method yet discovered can entirely replace it in cases of severe addiction. The patient must have some morphine. If there is one rule that applies to all cases of addiction this is it.
But the morphine should be withdrawn as quickly as possible. I have taken slow reduction cures and in every case the result was discouragement and eventual relapse. Imperceptible reduction is likely to be endless reduction. When the addict seeks cure, he has, in most cases, already experienced withdrawal symptoms many times. He expects an unpleasant ordeal and he is prepared to endure it. But if
the pain of withdrawal is spread over two months instead of ten days he may not be able to
endure it. It is not the intensity but the duration of pain that breaks the will to resist. If the addict habitually takes any quantity, however small, of any opiate to alleviate the weakness, insomnia, boredom, restlessness, of late withdrawal, the withdrawal symptoms will be prolonged indefinitely and
complete relapse is almost certain.

Prolonged Sleep. – The theory sounds good. You go to sleep and wake up cured. Industrial doses of chloral hydrate, barbiturates, thorazine, only produced a nightmare state of semi-consciousness. Withdrawal of sedation, after 5 days, occasioned a severe shock. Symptoms of acute morphine deprivation supervened. The end result was a combined syndrome of unparalleled
horror. No cure I ever took was as painful as this allegedly painless method. The cycle of sleep and wakefulness is always deeply disturbed during withdrawal. To further disturb it with massive sedation seems contraindicated to say the least. Withdrawal of morphine is sufficiently traumatic without adding to it withdrawal of barbiturates. After two weeks in the hospital (five days sedation,
ten days ‘rest’) I was still so weak that I fainted when I tried to walk up a slight incline. I consider prolonged sleep the worst possible method of treating withdrawal.

Antihistamines. – The use of antihistamines is based on the allergic theory of withdrawal. Sudden withdrawal of morphine precipitates an overproduction of histamine with consequent allergic symptoms. (In shock resulting from
traumatic injury with acute pain large quantities of histamine are released in the blood. In acute pain as in addiction toxic doses of morphine are readily tolerated. Rabbits, who have a high histamine content in the blood, are extremely resistant to morphine.) My own experience with antihistamines has not been conclusive. I once took a cure in which only antihistamines were used, and the results
were good. But I was lightly addicted at the time, and had been without morphine for 72 hours when the cure started. I have
frequently used antihistamines since then for withdrawal symptoms with disappointing results. In fact they seem to increase my depression and irritability (I do not suffer from typical allergic symptoms)

Apomorphine. – Apomorphine is certainly the best method of treating
withdrawal that I have experienced. It does not completely eliminate the withdrawal symptoms, but reduces them to an endurable level. The acute symptoms such as stomach and leg cramps, convulsive or maniac states are completely controlled. In fact apomorphine treatment involves less discomfort than a reduction cure. Recovery is more rapid and more complete. I feel that I was never completely cured
of the craving for morphine until I took apomorphine treatment. Perhaps the ‘psychological’ craving for morphine that persists after a cure is not psychological at all, but metabolic. More potent variations of the apomorphine formula might prove qualitatively more effective in treating all forms of addiction.

Cortisone. – Cortisone seems to give some relief especially when injected intravenously.

Thorazine. – Provides some relief from withdrawal symptoms, but not much. Side effects of depression, disturbances of vision, indigestion offset dubious benefits.

Reserpine. – I never noticed any effect whatever from this drug except a slight depression.

Tolserol. – Negligible results.

Barbiturates. – It is common practice to prescribe barbiturates for the insomnia of withdrawal. Actually the
use of barbiturates delays the return of normal sleep, prolongs the whole period of withdrawal, and may lead to relapse. (The addict is tempted to take a little codeine or paregoric with his nembutal. Very small quantities of opiates, that would be quite innocuous for a normal person, immediately re-establish addiction in a cured addict.) My experience certainly confirms Dr. Dent’s statement that
barbiturates are contraindicated.

Chloral and paraldehyde. – Probably preferable to barbiturates if a sedative is necessary, but most addicts will vomit up paraldehyde at once. I have also tried, on my own initiative, the following drugs during withdrawal:

Alcohol – Absolutely contraindicated at any stage of withdrawal. The use of alcohol invariably exacerbates the withdrawal symptoms and leads
to relapse. Alcohol can only be tolerated after metabolism returns to normal. This usually takes one month in cases of severe addiction.

Benzedrine. – May relieve temporarily the depression of late withdrawal, disastrous during acute withdrawal, contraindicated at any stage because it produces a state of nervousness for which morphine is the physiological answer.

Cocaine. – The above goes double
for cocaine.

Cannabis indica
(marijuana). – In late or light withdrawal relieves depression and increases the appetite, in acute withdrawal an unmitigated disaster. (I once smoked marijuana during early withdrawal with nightmarish results.) Cannabis is a sensitizer. If you feel bad already it will make you feel worse. Contraindicated.

Peyote,
Bannisteria caapi.
– I have not ventured to experiment.
The thought of Bannisteria intoxication superimposed on acute withdrawal makes the brain reel. I know of a man who substituted peyote during late withdrawal, claimed to lose all desire for morphine, ultimately died of peyote poisoning.

In cases of severe addiction, definite, physical, withdrawal symptoms persist for one month at least.

I have never seen or heard of a psychotic morphine addict,
I mean anyone who showed psychotic symptoms while addicted to an opiate. In fact addicts are drearily sane. Perhaps there is a metabolic incompatibility between schizophrenia and opiate addiction. On the other hand the withdrawal of morphine often precipitates psychotic reactions – usually mild paranoia. Interesting that drugs and
methods of treatment that give results in schizophrenia are also
of some use in withdrawal: antihistamines, tranquillizers, apomorphine, shock.

Sir Charles Sherington defines pain as ‘the psychic adjunct of an imperative protective reflex.’

The vegetative nervous system expands and contracts in response to visceral rhythms and external stimuli, expanding to stimuli which are experienced as pleasurable – sex, food, agreeable social contacts, etc. – contracting
from pain, anxiety, fear, discomfort, boredom. Morphine alters the whole cycle of expansion and contraction, release and tension. The sexual function is deactivated, peristalsis inhibited, the pupils cease to react in response to light and darkness. The organism neither contracts from pain nor expands to normal sources of pleasure. It adjusts to a morphine cycle. The addict is immune to boredom.
He can look at his shoe for hours or simply stay in bed. He needs no sexual outlet, no social contacts, no work, no diversion, no exercise, nothing but morphine. Morphine may relieve pain by imparting to the organism some of the qualities of a plant. (Pain could have no function for plants which are, for the most part, stationary, incapable of protective reflexes.)

Scientists look for a non-habit
forming morphine that will kill pain without giving pleasure, addicts want – or think they want – euphoria without addiction. I do not see how the functions of morphine can be separated, I think that any effective pain killer will depress the sexual function, induce euphoria and cause addiction. The perfect pain killer would probably be immediately habit forming. (If anyone is interested to develop
such a drug, dehydrooxy-heroin might be a good place to start.)

The addict exists in a painless, sexless, timeless state. Transition back to the rhythms of animal life involves the withdrawal syndrome. I doubt if this transition can ever be made in comfort. Painless withdrawal can only be approached.

Cocaine.
– Cocaine is the most exhilarating drug I have
ever used. The euphoria centres in the
head. Perhaps the drug activates pleasure connections directly in the brain. I suspect that an electric current in the right place would produce the same effect. The full exhilaration of cocaine can only be realised by an intravenous injection. The pleasurable effects do not last more than five or ten minutes. If the drug is injected in the skin, rapid elimination vitiates the effects. This goes
doubly for sniffing.

It is standard practice for cocaine users to sit up all night shooting cocaine at one minute intervals, alternating with shots of heroin mixed in the same injection to form a ‘speed ball.’ (I have never known an habitual cocaine user who was not a morphine addict.)

The desire for cocaine can be intense. I have spent whole days walking from one drug store to another to fill
a cocaine prescription. You may want cocaine intensely, but you don’t have any metabolic need for it. If you can’t get cocaine you eat, you go to sleep and forget it. I have talked with people who used cocaine for years, then were suddenly cut off from their supply. None of them experienced any withdrawal symptoms. Indeed it is difficult to see how a front brain stimulant could be addicting. Addiction
seems to be a monopoly of sedatives.

Continued use of cocaine leads to nervousness, depression, sometimes drug psychosis with paranoid hallucinations. The nervousness and depression resulting from cocaine use are not alleviated by more cocaine. They are effectively relieved by morphine. The use of cocaine by a morphine addict always leads to larger and more frequent injections of morphine.

Cannabis Indica
(hashish, marijuana). – The effects of this drug have been frequently and luridly described: disturbance of space-time perception, acute sensitivity to impressions, flight of ideas, laughing jags, silliness. Marijuana is a sensitiser, and the results are not always pleasant. It
makes a bad situation worse. Depression becomes despair, anxiety panic. I have already mentioned my horrible
experience with marijuana during acute morphine withdrawal. I once gave marijuana to a guest who was mildly anxious about something (‘On bum kicks’ as he put it). After smoking half a cigarette he suddenly leapt to his feet screaming ‘I got the fear!’ and rushed out of the house.

An especially unnerving feature of marijuana intoxication is a disturbance of the affective orientation. You do not
know whether you like something or not, whether a sensation is pleasant or unpleasant.

The use of marijuana varies greatly with the individual. Some smoke it constantly, some occasionally, not a few dislike it intensely. It seems to be especially unpopular with confirmed morphine addicts, many of whom take a puritanical view of marijuana smoking.

The ill effects of marijuana have been grossly
exaggerated in the U.S. Our national drug is alcohol. We tend to regard the use of any other drug with special horror. Anyone given over to these alien vices deserves the complete ruin of his mind and body. People believe what they want to believe without regard for the facts. Marijuana is not habit forming. I have never seen evidence of any ill effects from moderate use. Drug psychosis may result
from prolonged and excessive use.

Barbiturates. – The barbiturates are definitely addicting if taken in large quantities over any period of time (about a gramme a day will cause addiction). Withdrawal syndrome is more dangerous than morphine withdrawal, consisting of hallucinations with epilepsy type convulsions. Addicts often injure themselves flopping about on concrete floors (concrete floors
being a usual corollary of abrupt withdrawal). Morphine addicts often take barbiturates to potentiate inadequate morphine rations. Some of them become barbiturate addicts as well.

I once took two nembutal capsules (one and a half grains each) every night for four months and suffered no withdrawal symptoms. Barbiturate addiction is a question of quantity. It is probably not a metabolic addiction
like morphine, but a mechanical reaction from excessive front brain sedation.

The barbiturate addict presents a shocking spectacle. He can not coordinate, he staggers, falls off bar stools, goes to sleep in the middle of a sentence, drops food out of his mouth. He is confused, quarrelsome and stupid. And he almost always uses other drugs, anything he can lay hands on: alcohol, benzedrene, opiates,
marijuana. Barbiturate users are looked down on in addict society: ‘Goof ball bums. They got no class to them.’ The next step down is coal gas and milk, or sniffing ammonia in a bucket – ‘The scrub woman’s kick.’