I was also unaware of the deliberate use of cheap alcohol to undermine Native American communities by the early white settlers. For example, the word “addiction” was used for the first time in reference to chocolate. But this book is not a polemic, and one of its pleasures is the succession of historical nuggets it serves up, many of which were unknown to me. Of course, none of these insights will be a surprise to experts in this field – they are established facts. Third, do not “wage war” on drugs, because that instantly becomes a war on drug users, with poor, non-white and disadvantaged people the most likely victims. We know this because of the major contribution of methadone and, more recently, buprenorphine to opioid addiction treatment, though neither of them are yet fully utilised.
Second, abstinence isn’t the only – or even necessarily the safest – goal of treatment. The first key message from Fisher’s book: don’t conflate drug use with addiction or even with harm Punitively extending the tentacles of drug-testing is harmful, because many will fail at some point, become marginalised and be driven from legal work into crime. Those are, first: don’t conflate drug use with addiction or even with harm – heed the research by Lee Robins on Vietnam vets, for example, which showed that most of those who used heroin in that war stopped once they returned to a normal life. Given that they are unlikely to do so, I will try to summarise the key messages from Fisher’s book. The authors of that report should now read this book and realise how wrong most of their ideas are, how their new vision will probably repeat a relentless cycle of failed policy approaches. It was a remarkable document not least because it contained no references to any previous research in this field – as if the last two millennia had taught us nothing. It is made even more emphatic and moving because he is also a psychiatrist who treats such patients.Īt the end of 2021, the British government set out a “once in a lifetime” policy for tackling drug crime and drug use. Carl Erik Fisher takes the reader on a vivid tour over several thousand years of multiple cycles of science, medicine and literature, woven together by the thread of the author’s own alcohol and amphetamine addiction and treatment. For if ever a field should heed the lessons of history it is the making of policy on alcohol and other drugs, and their associated addictions. G eorge Santayana’s aphorism “Those who cannot remember the past are condemned to repeat it” doesn’t make an appearance in this book.
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