Reprinted courtesy Spectrum of Homeopathy 01/17
“What is addiction, really? It is a sign, a signal, a symptom of distress.
It is a language that tells us about a plight that must be understood.”
– Alice Miller 
Addiction is rife in all parts of society. Some of these addictions are more socially acceptable than others. Every culture has its prejudices for and against certain substances and behaviours. Addicts everywhere are condemned for their refusal (or inability) to give up something deemed to be damaging to their own or other’s health while society as a whole shares the same blindness and rationalisations.
Us and Them – Hard Lives, Hard Drugs
In 1998 I was invited to join the team at the recently established Addiction Response Crumlin (ARC) – a community-based organisation set up in response to the growing epidemic of heroin abuse in inner-city Dublin . Many of the founding members of ARC were prompted by the tragic death of a family member through drug addiction and decided to take action. In Crumlin, a small borough of Dublin (approx. population 22,000), it was estimated that there were probably 1,200 heroin addicts (mostly aged 18 – 30). Heroin was so prevalent in the area that one of my patients John* commented: “You could get heroin delivered to your door quicker than a pizza!” On average, 90 – 100 patients were involved in ARC’s programme at any one time. The primary drug taken on admission to the programme was heroin but most were poly-drug users; alcohol, cannabis, cocaine, ecstasy, solvents and amphetamine also featured. The core aim of the service was to reduce the harm caused by the over-use of these drugs. Patients were prescribed methadone in order to stabilise their drug use and then supported and challenged to begin a process of detoxification and rehabilitation.
Homeopathy (alongside acupuncture and counseling) was used to support this process with many patients benefitting from the results. Cravings were reduced; side-effects of detoxification from methadone were minimised; sleep problems improved; anxiety and anger issues were dealt with. Many other health issues, concomitant to addiction, also required treatment to support recovery. Malnutrition and poor immunity were common; many patients had Hepatitis C and/or H.I.V.; abscesses were rife; as was septicaemia and chronic constipation. All of which responded well to homeopathy.
The prescribed methadone however was a major problem – more addictive than heroin, it also carried many side-effects and was so difficult to wean off that many patients (and their doctors) considered themselves “drug-free” when they only used this. It also didn’t provide a “buzz” for the patients and often left them with insomnia and anxiety problems. Alcohol and Benzodiazepine abuse filled the vacuum and these often had to be prescribed for as side-issues. Having been down the methadone road before before relapsing to heroin use, many patients chose “cold turkey” – a complete detox of the drug using homeopathic remedies and diet. After a very challenging three/four days with intense vomiting, sweating and diarrhoea, they could begin a drug-free life. However it quickly became clear to me that coming off drugs was one thing – the easy part of the work, staying off was the hard part in a community that was awash with drugs and addiction.
When I got to know my patients better, certain patterns began to emerge. Most of them had been brought up in families which seemed to have significant problems. Almost two-thirds experienced frequent conflicts or violence in the home and more than half experienced alcohol abuse by parents. Child physical and/or sexual abuse was also experienced by about a third of all ARC patients while an even larger proportion experienced the loss of a parent through separation, imprisonment or death. A disturbing feature in the lives of many of my patients – most of whom still lived at home with their parents – was that many continued to experience problems, such as frequent conflicts/violence in the home and ongoing alcohol abuse by parents. More than half had siblings who were also addicted to drugs – most of whom were also still taking drugs while their siblings attended ARC. Almost all the patients knew somebody in the neighborhood who had died from drugs and almost a fifth of these had lost siblings through drug use.
Crumlin itself had a serious unemployment problem and an even more serious problem of educational under-achievement. Poor levels of educational achievement almost inevitably led to unemployment. In turn, parents who experienced educational underachievement and unemployment were often instrumental in handing on these disadvantages to their children.
The illegal nature of drug use in Ireland and some of the methods used to finance it (robbing, occasional dealing and prostitution) typically brought many drug users into conflict with the law. Almost two-thirds of all patients had been arrested prior to coming to ARC and nearly a third had been in prison. In each of these instances, men were far more likely to have come into contact with the law than women. The differences between men and women was most pronounced in terms of the amount of time spent in prison: men spent an average of 4.2 years there compared to 9 months in prison for women.
During my time in ARC, I learned a lot about the stigma associated with drug addiction and the extraordinary prejudices that most heroin addicts meet. Although ARC’s Mission Statement recognised that: “the causes of heroin addiction are linked to social injustice and inequality in our society” and “addiction is an issue for the whole community”, the experience of those involved in setting up the project is that many people in the community were hostile towards drug users and to the establishment of any treatment and rehabilitation services for them within their neighbourhood.
I had many conversations with both local people and medical colleagues about the work we did, often over copious cups of tea, cigarettes and pints of beer, where strong opinions about the “addicts” would be expressed. It seemed to be that addiction was what happened to someone else, The ‘addict’ was someone who used different drugs than those socially acceptable; was the ‘other’ , somebody strange who was to be excluded from ‘normal’ society.
Despite the extraordinary work of the ARC team and the courage of its many of its patients over the years, heroin and poly-drug use in Crumlin has continued to grow, along with all its concomitant crime and social problems. More money has been poured into community projects in Dublin and around the country and vast amounts of police and judicial resources have being used in an apparently unending spiral to combat drug addiction in Ireland. More people have been arrested, imprisoned; many more have been marginalised, disenfranchised – all of which continue to feed the rising addiction rates.
Challenging the Programme – What Causes Drug Addiction?
If I had been asked when I started work at ARC, what caused drug addiction, the answer would have been self-evident for me: drugs, addictive substances cause addiction. I knew that drugs like heroin and cocaine have strong chemical hooks, that after repeated administration the body will developed a need, a craving for the substance – an addiction. One of the ways that this theory was first established was through rat experiments – especially ones that were popularised in the advert shown in the 1980’s during the Reagan Administration by the Partnership for a Drug-Free America. A rat was placed alone in a cage with two water bottles. One was water and the other was water containing heroin or cocaine. Every time the experiment was run, the rat became obsessed with the drugged water, kept coming back for more until it finally killed itself. The advert explained: “Only one drug is so addictive, nine out of ten laboratory rats will use it. And use it. And use it. Until dead. It’s called cocaine. And it can do the same thing to you.” But a Vancouver professor of Psychology, Bruce Alexander  noticed something odd about the experiments. The rat was alone in its cage with nothing to do except take drugs. What would happen if this experiment were done differently, he wondered. So he built Rat Park – effectively a rat paradise. He filled this cage with lots of space, tunnels, coloured balls, plenty of food and female rats and the two water bottles. What he found surprised him, all the rats in this cage tried both of the water bottles. However none of the rats with good lives liked the drugged water, consuming only a fraction of what the isolated rats used. None of them died. Meanwhile all of the isolated rats became heavy drug users and ultimately died.
At the same time, Professor Alexander was conducting his lab experiments, a large-scale, real-life experiment was also taking place – the Vietnam war. Heroin use was endemic among American soldiers, estimates suggested that over twenty percent of soldiers had become addicted to heroin while there. When the war ended, there was widespread concern that a huge number of addicts would end up back in the homeland. But this never happened; research published in the Archives of General Psychiatry  showed that neatly 95 percent of soldiers simply stopped using as soon as they returned home. Only a very small minority needed rehab. They came back home to their families from a terrifying war zone and simply didn’t need the drug any more.
Reading this research confounded my prejudices. Conventional wisdom would consider addiction, either in a moralistic light – a weakness in the addict’s personality, or in a medical one – the chemically hooked brain. Professor Alexander concluded that addiction is a kind of adaptation, it’s not you, it’s your cage. People every day continue to repeat this experiment. Morphine and heroin are routinely used in hospitals for pain-relief – in a much higher purity and potency than available on the street. But when patients return they almost never seek out opiates on the street to continue their use. This makes no sense in terms of chemical hooks but makes total sense in terms of Professor Alexander’s research. My patients in ARC were caught in the first cage, isolated, alone with their drug. The hospital medical patients returned home to their human version of the Rat Park. The drug is the same but the environment is different.
“The opposite of addiction is not sobriety. It is human connection.”
– Johann Hari 
Current recovery rates from heroin addiction through conventional (12-Step Programmes) treatment in Ireland show an eighty to ninety percent relapse rate. This of type addiction is mostly associated with living in the most deprived sections of society, where the options available for creating a home and community environment to support recovery can be limited. Recovery, where it does happen, requires a strong will and compassionate support.
Harry* – 43Yrs. Presenting with Hepatitis C and “Addictions”
Harry presented with advanced symptoms of Hepatitis C. He had been an intravenous heroin user for many years and had contracted the illness from sharing needles. He was confused, angry and very concerned about the future, especially for his family. He is married with three young children. He is terrified of the pain he may suffer (“I can’t cope with pain”). He complains of continual “acid” digestion: constant tiredness and gets flare-ups” from his hepatitis whenever he feels stress (“I am always under stress – it goes straight to my gut”). All his worries and upset are felt in his digestive system; feeling constant nausea and frequent bitter reflux. He is presently on Zantac for his digestive problems and Interferon injections for his hepatitis. He describes himself as somebody “who has to succeed, no matter what comes in my way”. “I’m a trouble-shooter, the one they call when everything is in shit. I get a real buzz out of solving problems”. “If anyone gets in my way it’s ‘FOR F***** SAKE, GET OUT OF MY FACE’. I’m often shocked how the anger can just burst out”. “I get so ANNOYED when things don’t go my way, I’ll snap out or explode, do whatever it takes…..” “In the past I was involved in lots of life-threatening activities. I drove cars, bikes flat out; climbed onto the roofs of trains at high speed…. anything that nobody else was crazy enough to do! I’d do anything, take anything, rip the balls off life.” “Of course there were loads of drugs too. I was an IV drug user for 10 years (heroin), then methadone. I got clean from this, then became a cocaine user. I got bored with this and then binge drank for a while. I took everything I could get my hands on, must have been stoned continuously for at least 20 years. I came off everything 2 years ago – even coffee and cigarettes and have been ‘clean’ ever since. I work out now in the gym, five, sometimes six times a week – I need the high energy ‘buzz’.”
Harry and I worked together for about a year. He required increasing doses of Nux vomica, Carduus marianus tincture and intercurrent doses of Syphilinum. His liver recovered completely; his temperament cooled off sufficiently for him to understand what he had been running from all his life and allowed him to finally enjoy his family and all he had worked for.
Losing My Religion – Addiction in Gilded Cages
After nearly three years of working within the ARC programme, I found it increasingly hard to hear about the “jobs” (robbing, prostitution, etc.) my patients did and the harsh violent lives they lived, without judgment. The work took its toll on me and I retired to my private practice to continue my work with addiction in a different context. In the suburbs, I also found heroin/methadone addiction but I also found cocaine addiction among young, upwardly mobile professionals; teenage boys’ cannabis addictions; eating addictions in young adults; porn addiction in young men; addiction to (doctor-prescribed) pain medication; teenage girls addicted to electronic devices (phones, tablets etc.); adult sport/gym addictions. And it being Ireland, the drug that everyone seemed to use to excess – alcohol, brought addiction to all ages.
And then there was the question of my own addiction to work. Did I really have to work seventy plus hours a week teaching and seeing patients?
At the core of all these addictions I have usually found a place of emptiness and fear – fear of real or potential pain; fear of the future; fear of feeling. Under the influence of the chosen drug or behaviour, these become briefly suspended, only to return stronger. It seemed that increased affluence alone was not sufficient to create the “Rat Park” in which the suburban Soul could thrive.
Brian* – 30Yrs. Substance Abuse
Brian is a highly educated academic who has dropped out of college. He describes himself as “imprisoned” in himself, in his body; feels a sense of absolute freedom and beauty inside but can’t connect with others. He has taken refuge in his mind and has become a recluse. He has felt a “profound sense of abandonment and loss” for as long as he can remember; feels and finds himself “unable to express or feel deep emotions” and feels “numb.” Substance abuse (cannabis, alcohol, food) keeps him “in prison”. After homeopathic doses of Peregrine Falcon, Brian realised that “I was the jailer and I always have been;” “I can be the witness to all this drama, not the jailer or the prisoner.” He found “a great sense of peace and aliveness”; experiences the “stillness underlying everything” and has developed a healthy, balance appetite toward food, alcohol etc.
Compassion for Addiction
“Not all addictions are rooted in abuse or trauma, but I do believe they can all be traced to painful experience. A hurt is at the centre of all addictive behaviours. It is present in the gambler, the Internet addict, the compulsive shopper and the workaholic. The wound may not be as deep and
the ache not as excruciating, and it may even be entirely hidden – but it’s there…. the effects of early stress or adverse experiences directly shape
both the psychology and the neurobiology of addiction in the brain.”
– Gabor Maté 
Dr. Gabor Maté, a renowned speaker, best-selling author and co-founder of Compassion for Addiction  has a different take on how we understand addiction. “Society, by and large, sees addiction as a bad choice that people make,” he says, “while other people see it as a brain disease. My definition of addiction is: any behaviour in which the individual finds temporary relief or pleasure in – and craves for that reason, despite negative consequences.”
Looking at the process of addiction from the inside out allows Dr. Maté’s definition to be applied universally. “That behaviour could be consuming heroin or cocaine or alcohol, but it could also be work or sex, or shopping, or any number of human activities. So it is not the external activity or substance but the internal relationship to it. Does it provide temporary relief? Is there craving? Is there short term pleasure at the expense of negative consequences and an inability to give it up?” ” Addiction is pretty simple. It’s what happens when people don’t get what they need and end up soothing themselves.”
Back to Basics – Indigenous Cultures and the Soul
“Many of us resemble the drug addict in our ineffectual efforts to fill in the
spiritual black hole, the void at the center, where we have lost touch with our souls,
our spirit – with those sources of meaning and value that are not contingent or fleeting. Our consumerist, acquisition-, action-, and image-mad culture only serves to
deepen the hole, leaving us emptier than before.”
Gabor Maté 
In recent years, I have travelled extensively and have had the great privilege of working with indigenous healers from many traditions, from Amazonia to North and Central America to West Africa and India. While the healing practices and medicines differed among these traditions, all shared the belief that health and disease were matters of spirit/soul and that the gravest forms of disease were due to “Soul Loss” – a loss of some part of a patient’s essence.