This standard or received view conceives opiate addiction as an illness and therefore implies that there is a bona fide medical solution to it. When all the proposed "cures" fail to work, as they usually do, and when the extension of quasi-medical services to addicts is accompanied not by a decline in the prevalence of the problem but, on the contrary, by an increase, who can blame addicts if, in continuing their habit, they blame not themselves but the incompetence of those who have set themselves up as their medical saviours and offered them solutions that do not work?
But where bureaucracies are concerned, nothing succeeds like failure. For example, the budget of the US National Institute on Drug Abuse increased by 16.2 per cent between 2001 and 2002, which would be quite a creditable performance if it had been a purely commercial enterprise. In the period, $US126,394,000 was added to its budget, but it would be foolhardy to suggest that a single drug addict stopped, or will stop, taking drugs because of this extra funding
[...] The addict has a problem, but it is not a medical one: he does not know how to live. And on this subject the doctor has nothing, qua doctor, to offer. What he ought not do, however, is to mislead the addict, or allow the addict to mislead him, into thinking that the problem is medical and requires, or is susceptible to, a medical solution.