Heroin: Symptom or Disease?

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Originally published in Contemporary Psychology: APA Review of Books, 1978, Vol 23(10), 767. Reviews the book, Behind the Wall of Respect: Community Experiments in Heroin Addiction Control by Patrick H. Hughes (1977). Viewing heroin addiction as a contagious disease, much like typhus or syphilis, the author set out to find untreated cases in the community and to study the natural course of the illness and the mechanism by which it is spread, in order to plan strategies for treating those already afflicted and preventing new infections. In an area long obscured by irrational wishes and fears and further darkened by manipulative political mythologies, the strength of Hughes's approach is its empiricism. Hughes offers aggressive medical outreach, utilizing indigenous exaddict workers, pushing methadone. It helps some, at least initially, and Hughes seems as enthusiastic about his cure as new users are about theirs. Medical orthodoxy aside, there is reason for skepticism. For novice users, Hughes's medicine seems initially irrelevant; for habitues, it seems ultimately insufficient. (PsycINFO Database Record (c) 2006 APA, all rights reserved)

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