How to Treat the "Bottomless Arm"
By William Burroughs
Consider the economics of junk: a billion dollars a year to enforcement agencies and who knows how many billions to pushers and wholesalers; economic loss through thefts by addicts, with the attendant expense of police, courts, and custody. It seems reasonable to legalize junk, tax it like liquor, and sell it in drug stores. Owing to legislation pushed through by the American Narcotics Department, even the manufacture of heroin is illegal in America -- so this drug, a much more effective painkiller than morphine, is not available to the medical profession for the excruciating pain of terminal cancer and such conditions as leprosy of the eye, which morphine cannot alleviate.
so we legalize the manufacture and sale of heroin, and with a small fraction of the money now poured into this bottomless arm, treatment centers could be set up throughout the country where any addict who wanted to be cured could go and get cured. And if an addict doesn't want to be cured, you can't cure him. Doctor John Dent of London, who introduced the apomorphine treatment for addiction and cured me of a thirty-grain-a-day morphine habit in ten days, always said that he would not have addicts dumped on him by relatives or confined against their will, and he consistently opposed any program of compulsory treatment; the addict had to come to him and say "I want to be cured." It's simply a waste of time and money otherwise.
Now what are the objections to legalizing junk? Of course, thousands of addicts. Well, we have thousands of addicts right now, who would then be able to buy the drugs they need for a few dollars a day -- they wouldn't have to steal.
They would know how much they were shooting, which would cut down ODs to the vanishing point. ODs result from the fact that all street heroin is cut and some pushers cut heavier than others. You are shooting ten percent junk, then along comes a competitor with twenty percent and that can be it. Or the addict hasn't been able to score for a few days, then shoots his usual dose, forgetting that his tolerance is now down. A steady supply of standard junk would eliminate both factors. And ten addicts wouldn't have to be using one dirty needle and passing around serum hepatitis.
The advocates of continued enforcement of what amounts to an unenforceable law say there would be thousands of new addicts. How many addicts were there before the Harrison Narcotics Act, when you could buy morphine, cocaine, or heroin in any drugstore? No one knows. In some cases, the addict himself didn't know. He knew that if he didn't take a teaspoonful of Doc Jones' cough medicine three times a day, he just didn't feel right. And since he could buy it for fifty cents a bottle he never found out how unright he would feel if he didn't have any Doc Jones or its equivalent. And, of course, some people would become addicted owing to various chronic illnesses for which doctors are now reluctant to prescribe opiates: asthma, arthritis, suicidal depressions. So what -- they'll live longer and be happier. De Quincey, who wrote Confessions of an English Opium-Eater, started taking opium for tuberculosis at the age of thirty and lived to be 75. Without it, he would have died in a few years. I think that surprisingly few new addicts would result from legalization. I was in Tangier before Independence when you could buy morphine across the counter, and there were not more than five addicts in Tangier. I was buying it across the counter then, so I knew every drugstore and every druggist in Tangier. Now that morphine is on prescription and hippies are bringing in heroin from England and France, they have quite an addict colony.
If full legalization seems too drastic a step, consider the results of partial legalization: heroin is made available on prescription to addicts. When I first went to England in 1956 this system was in operation. At that time there were only four hundred addicts in the whole United Kingdom and no black market since the addicts could get it free on National Health. And there were only two narcotics agents for metropolitan London, where most of the addicts were located. Then the American Narcotics department starting putting on the pressure to stop prescribing for addicts. It's known as missionary work. New legislation was passed, making it increasingly difficult for doctors to prescribe and treatment centers were closed. Now there is a big black market in Chinese heroin -- brown sugar, it's called -- with thousands of addicts OD'ing in subway toilets, more and more narcotics agents; in short, exactly the same dreary picture that we have in America.
So, we have liberated a billion dollars, at least, for treatment. There is no doubt that intelligent research and treatment centers could come up with a relatively painless cure. The idea that a cure should be as unpleasant as possible is all wrong, from basic Pavlovian principles. If an addict is cut off cold, or subjected to a rapid and painful reduction cure, this simply implants an overwhelming desire for the relief which the drug would afford, and he will relapse much more quickly than an addict who has not suffered such a severe withdrawal.
What immediate methods could be used? Apomorphine: I can say from personal experience that this is a relatively painless and highly effective cure. However, it requires injections of apomorphine every two hours, day and night, for three to four days, which poses a problem. And regulation of the dosage to avoid nausea is another problem. If the drug were synthesized, and variations on the formula developed, no doubt drugs with a much more potent regulatory action could be devised. When quinine was synthesized in World War II, drugs with ten to twenty times the efficacy of quinine emerged.
There are other methods of treatment. Acupuncture has been used in England and is now being used here. I quote from an English newspaper: "Acupuncture has proved remarkably effective in completely removing withdrawal symptoms. Of 15 addicts, 11 on opium, 3 on heroin, and one on morphine, all experienced relief of their withdrawal symptoms with acupuncture treatment," the doctors report in Drugs and Society. "Ages of the subjects ranged from 27 to 72 years, with dependencies spanning 3 to 51 years. It is a simple, quick, economical process and has no side effects. Moreover, there is no danger of secondary dependence."
There is a non-addictive drug called Lomotil that greatly reduces the need for opiates so that the addict can get by on a much smaller dosage. This drug has been used with good results in treating addicts in England. Cortisone and antihistamine drugs are useful in alleviating some withdrawal symptoms. A combination of all these methods could be applied, and certainly, with further research, a standard cure could be established that would be easy enough, perhaps even completely painless.
What treatment facilities exist now? Almost none. Methadone maintenance of course has nothing to do with care. Getting someone off whiskey by giving him rotgut wine is what it amounts to. The long-range physical effects of methadone are worse than those of morphine. People get fat and funky on methadone, and methadone is a terrible habit to kick. I have been contacted by a number of people on methadone maintenance asking about the apomorphine treatment, people who want to get off. But there simply isn't any treatment offered to them. Lexington [ the State-run detox center in Kentucky] takes only a few addicts and you have to fill out forms and go on a waiting list. How long can an addict wait? You also have to stay at least four months. The treatment offered is simply a reduction cure with methadone. After all these years of research and spending God knows how much of the taxpayer's money, that's all they have come up with. They should be broken down to veterinarians. They have run thousands of animal experiments. Not content with addicting rats, rabbits, dogs, hogs, and monkeys, they have even conducted experiments on "decorticated canine preparations" as they call them -- dogs with their brains cut out. So what do you know? Even a dog with its brains cut out can be addicted. Big deal. And none of these interminable animal experiments have the slightest interest. Have they tried addicting cold-blooded animals and birds? Not that I know of. Certainly a spitting cobra in acute withdrawal would be a powerful sight. And could chimpanzees be trained to give themselves injections? The chimp fumbles with the syringe and finally manages to give himself a fix. The doctor points dramatically:
"The creation of Adam!"... the first motivated use of an artifact.
A number of experiments, funded by the CIA, have also been carried out on volunteer patients during the 1950's. I quote from the Paris Herald Tribune, Nov. 9th, 1975: "The experiments at the Federal Addiction Center involved the administration of various drugs, including hallucinogens, to prisoner volunteers, according to a statement prepared by the CIA. The Lexington experiments were part of a broad CIA drug experimentation program that involved more than 30 universities and private and public agencies." So an addict can't get treatment. All he can get is heroin or methadone maintenance. He is in a dead-end situation. All the money is poured into perpetuating this multi-billion dollar industry. So of course any program of legalization or partial legalization encounters a very powerful lobby right there: billions of dollars of vested interest. All these pushers and wholesalers and narcotics agents would have to get out and work for a living like everybody else, and they sure don't want to do that.
So what can be done? Well, anybody can take the apomorphine cure if he can find a doctor to administer it. Apomorphine is made from morphine by boiling it with hydrochloric acid. But its action on the body is quite different from morphines. It is not a painkiller. It is not addicting. No case of addiction to apomorphine has ever been recorded. There is no kick, no lift, no rush. What it does is stimulate the back brain to re-regulate a disturbed metabolism. Apomorphine is a metabolic regulator. Now I've had doctors tell me that apomorphine is addictive. They were talking not from experience but from something they heard or read somewhere and believed. It's known as "informed medical opinion." A hundred years ago doctors were saying that masturbation results in paralysis, brain damage, and hopeless insanity. And that was "informed medical opinion." Of course you can hardly have an outpatient clinic giving shots to patients every two hours day and night. But you can get around this by giving oral tablets to be dissolved under the tongue. Doctor Xavier Corre of Paris, who studied with Doctor Dent, has gotten good results with oral administration, and an advantage is that the factor of nausea can be more readily controlled. If the patient starts to feel sick he can spit out the tablet and establish his own threshold dose. There is no point in the patient being sick; this is not an aversion treatment.
Acupuncture as a method of treatment certainly makes sense. I have seen on television major surgery performed with no other anesthetic than acupuncture, and anything that relieves or eliminates intense pain will also relieve withdrawal symptoms. I know of a practitioner here in New York City who has obtained good results treating addicts with acupuncture and who is willing to accept addict patients. The treatment lasts about 30 minutes, and six to eight treatments usually suffice.
Lotomil was developed at Lexington to relieve the diarrhea of withdrawal and finally released to the medical profession when exhaustive tests showed that Lotomil is non-addicting. I have talked with English doctors who reported good results in getting patients off drugs with Lotomil. But in this country, it seems to be unknown as an adjunct to therapy. In fact, it says on the bottle here "not to be given in conjunction with narcotics." Whose idea was that, I wonder.
A sensation discovery may supersede all existing methods of treatment. I quote from the New York Times, June 22nd, 1975: "Evidence has been found suggesting that the body spontaneously manufactures substances whose narcotic effect is similar to that of morphine. It is suggested that their role may be to mitigate the effects of severe pain and stress. Some researchers hope that such knowledge will be applicable to the treatment of drug addiction." With proper training under a guru, you could metabolize your own. A Doctor Goldstein has isolated a substance he calls Pituitary Opioid Peptide; POP. And a follow-up article states that this substance possesses fifty times the pain-killing power of morphine and is non-addicting. Anything with that power could completely relieve withdrawal symptoms. This may be the final solution to the drug problem: POP.
William S. Burroughs' experience of heroin, along with his vivid perceptions of every other area of contemporary life, is woven throughout the extraordinary "mosaic" of his many novels, including the famous Naked Lunch, The Soft Machine, The Nova Express, etc. This essay is the March installment of his monthly column, "Time of the Assassins," which appears regularly in Crawdaddy Magazine (with whose permission it is reprinted here) (c) 1976, Crawdaddy Publishing Co.