Who Is an Addict?

According to the basic text of Narcotics Anonymous, a person is an addict when their life is controlled by drugs: “Our whole life and thinking was centered in drugs in one form or another—the getting and using and finding ways and means to get more. We lived to use and used to live. We are people in the grip of a continuing and progressive illness whose ends are always the same: jails, institutions, and death”. In the paragraph cited, the scientific-medical status of Narcotics Anonymous is not very clear.

These first considerations raise the question: From what scientific platform do the authors claim that addiction is a disease? Or, to put it another way, if we knew someone who found it difficult to wake up early to go to work, could we state right away, due to the recurrence of fatigue, that this situation was symptomatic of a disease? In terms of the World Health Organization (WHO), a chronic disease is “one of long duration, whose end or cure cannot be foreseen or will never occur.” After noting that there is no consensus on when a disease becomes chronic, the WHO nevertheless breaks down those conditions that, even considered as such, do not carry major risks for the organism, such as asthma, rhinitis, certain kidney failures, etc., and those that can be fatal such as heart disease, cerebrovascular diseases, diabetes, cancer. This brief terminological presentation brings the following conclusion: the ability of a disease to be chronic refers to a certain degree of its evolution, that is, the temporal criterion is defined according to which a disease, by its persistence, reveals at a given moment either that it is incurable or, in any case, that science may or may not cure it, according to its own advances in technology and research.

Narcotics Anonymous is clear about this: “We are people in the grip of a continuing and progressive illness whose ends are always the same: jails, institutions, and death.” With what has been said so far, we do not intend to refute the validity of this principle, namely, that drug addiction is a disease. We have seen how Narcotics Anonymous declared its corporate purpose: “NA is a nonprofit fellowship or society of men and women for whom drugs had become a major problem”. The WHO, on the other hand, tells us nothing about the severity of chronic diseases, for which it only considers in its definition this quality of being prolonged, of being endemic. For its part, in order to successfully delimit the field of drug addiction in the context of its meetings, Narcotics Anonymous must go further, pointing out the point from which a person who has entered into a relationship with substances that have this property of making addicts (a separate topic) can be classified as sick. And then instances appear which, like jail, hospital, and death, already express what we must understand by “a major problem.” The scientific status of Narcotics Anonymous and the epistemological foundations of its basic assumption: addiction = disease, remain outside our object of research. It is evident that the book of Narcotics Anonymous, although it contains a claim to validity, even truthfulness (submission to this principle guarantees the permanent affiliation of men and women to the fellowship, taking into account the undefinable nature of the cure), does not offer itself, however, as a treatise on etiology, but rather as a simple manual for those who willingly welcome its principles.

Much more interesting, to address the theoretical problem of “drug addiction,” are the questions that Peter Sloterdijk, from a philosophical point of view, proposes to future researchers. After speculating about how addiction could be the response to three circumstances in historical subjectivity: 1. The silencing of the gods, 2. The deritualization of subjection, 3. The explicit formation of the will to non-being, each of which would cover a period of millennia for itself, Sloterdijk poses the decisive questions: “How was it possible that addiction met the drug? By what means do psychotropic substances acquire the reputation of being “drugs” and making addicts? How could the objective certification be born that there are substances which, as such, enslave the mind and produce addiction? How could the psychological certification be generalized that, by nature, there are individuals prone to addiction?”. Sloterdijk is not deceived; he knows perfectly well that his formulations exceed in magnitude and scope the competencies of historians and philosophers at the current stage of the academy. But, for the moment, the professor has achieved the important thing: denaturalizing the frequent association, so spontaneous in appearance, between substances and addiction. At the end of a savory, though necessarily rhapsodic, review, after enumerating the very varied relationships that men have always maintained with drugs, relationships that include the magical, ritual, and religious, medicinal and curative use common to indigenous people, but also the obsessions and practices of heroin addicts in the contemporary city, Sloterdijk places us once again before the only question: When did we begin to speak among ourselves of “addiction”?