Review: Steven Poole’s Non-Fiction Choice

“This book blasts open with baleful force: “Addiction to opiates is a pretend rather than a real illness, treatment of which is pretend rather than real treatment.” From his experience as a prison doctor, and his citations of medical literature, Dalrymple concludes that going cold turkey from heroin is not that big a deal (not as medically dangerous, for instance, as alcohol withdrawal), but that the bureaucracy of “help” for addicts is self-sustaining, since demand (from addicts persuaded that they need such help) increases to meet the professional self-interest of an ever-expanding supply. Interesting if true; but the argument appears also to depend on a tacit assumption that what is mainly or completely psychological cannot be a “real” illness. There is also a marvellously eccentric and angry strain of the book that blames the origin of the heroin “myth” on literature (Coleridge, De Quincey). That’s just talking smack.”