Junk is a generic term for all habit-forming preparations and derivatives of opium including the synthetics. There are also non-habit-forming derivatives and preparations of opium. Papaverene, which is found in raw opium, is non-habit-forming. Apomorphine, which is derived from morphine, is non-habit-forming. Yet both substances are classified as narcotics in America under the Harrison Narcotics Act. Any form of junk can cause addiction. Nor does it make much difference whether it is injected, sniffed or taken orally. The result is always the same - addiction. The addict functions on junk. Like a diver depends on his air-line, the addict depends on his junk line. When his junk is cut off, he suffers agonising withdrawal symptoms: watering, burning eyes, light fever, hot and cold flashes, leg and stomach cramps, diarrhoea, insomnia, prostration, and in some cases death from circulatory collapse and shock. Withdrawal symptoms are distinguished from any syndrome of comparable severity by the fact that they are immediately relieved by administering a sufficient quantity of opiates. The withdrawal symptoms reach their peak on the fourth day, then gradually disappear over a period of three to six weeks. The later stages are marked by profound depression.
The exact mechanisms of addiction are not known. Doctor Isbell of the Public Health Centre at Lexington, Kentucky, has suggested that junk blankets the cell receptors. This cell-blanketing action could account both for the pain-killing and the habit-forming action of junk. The way in which junk relieves pain is habit-forming, and all preparations of junk so far tested have proved habit-forming to the exact extent of their effectiveness as pain-killers. Any preparation of junk that relieves acute pain will afford proportionate relief to withdrawal symptoms. A non-habit-forming morphine would seem to be a latter-day philosopher's stone, yet much of the research at Lexington is currently orientated in this barren direction. When the cell-blanketing agent is removed the body undergoes an agonising period of reconversion to normal metabolism characterised by the withdrawal symptoms already described.
The question as to what sort of persons become addicts has been answered by the Public Health Department: “Anyone who takes any addicting preparation long enough.” The time necessary to establish addiction varies with individual susceptibility and the addictive strength of the preparation used. Normally anyone who receives daily injections totalling one grain of morphine every day for a month will experience considerable discomfort if the injections are discontinued. Four to six months of use is enough to establish full addiction. Addiction is an illness of exposure. By and large, those become addicts who have access to junk. In Iran where opium was sold openly in shops they had three million addicts. There is no more a pre-addict personality than there is a pre-malarial personality despite all the hogwash of Psychiatry to the contrary.
To say it country simple, most folks enjoy junk. Having once experienced this pleasure, the human organism will tend to repeat it and repeat it and repeat it. The addict's illness is junk. Knock on any door. Whatever answers the door give it four and a half grain shots of God's Own Medicine every day for six months and the so called “addict personality” is there ... an old junky selling Christmas seals on North Clark Street the “Priest” they called him, seedy and furtive cold fish eyes that seem to be looking at something other folks can't see. That something he is looking at is junk. The whole addict personality can be summed up in one sentence: the addict needs junk. He will do a lot to get junk just as you would do a lot for water if you were thirsty enough. You see junk is a personality - a seedy grey man couldn't be anything else but junk rooming-house a shabby street room on the top floor these stairs cough the “Priest” there pulling himself up along the banister bathroom yellow wood panels dripping toilet works stacked under the wash basin back in his room now cooking up grey shadow on a distant wall used to be me Mister.
I was on junk for almost 15 years. In that time I took 10 cures. I have taken abrupt withdrawal treatments and prolonged withdrawal treatments, cortisone, tranquillisers, antihistamines and the prolonged sleep cure. In every case I relapsed at the first opportunity. Why do addicts voluntarily take a cure and then relapse? I think on a deep biological level most addicts want to be cured. Junk is death and your body knows it. I relapsed because I was never physiologically cured until I took the apomorphine treatment.
Apomorphine is the only agent I know that evicts the “addict personality”, my old friend Opium Jones. We were mighty close in Tangier 1957 shooting every hour 15 grains of methodone per day, which equals 30 grains of morphine and that's a lot of GOM. I never changed my clothes. Jones likes his clothes to season to stale rooming-house flesh until you can tell by a hat on the table a coat hung over a chair that Jones lives there. I never took a bath. Old Jones don't like the feel of water on his skin. I spent whole days looking at the end of my shoe just communing with Jones. Then one day I saw that Jones was not a real friend that our interests were in fact divergent. So I took a plane to London and found Doctor Dent charcoal fire in the grate Scottish terrier cup of tea. He told me about the treatment and I entered the nursing-home the following day. It was one of those four-storey buildings on Cromwell Road room with rose wallpaper on the third floor. I had a day nurse and a night nurse and received an injection of apomorphine one twentieth grain every two hours day and night. Doctor Dent told me I could have morphine if I needed it but the amount would be small – one-twelfth what I had been using, with quite a cut again the next day.
Now every addict has his special symptom, the one that hits him hardest when his junk is cut off. With me its feeling the slow painful death of Mr Jones. Listen to the old-timers in Lexington talking about their symptom:
“Now with me it's puking is the worst.”
“I never puke. It's this cold burn on my skin drives me up the wall.” “My trouble is sneezing.”
“I feel myself encased in the old grey corpse of Mr Jones. Not another person in this world I want to see. Not a thing I want to do except revise Mr Jones.”
Third day cup of tea at dawn calm miracle of apomorphine I was learning to live without Jones, reading newspapers writing letters, most cases I can't write a letter for month and here I was writing a letter on the third day and looking forward to a talk with Doctor Dent who isn't Jones at all. Apomorphine had taken care of my special symptom. Seven days after entering the nursing-home I got my last eighth-grain shot. Three days later I left the hospital. I went back to Tangier where junk was readily available at that time. I didn't have to use will power whatever that is. I just didn't want any junk. The apomorphine treatment had given me a long calm look at all the grey junk yesterdays, a long calm look at Mr Jones standing there in his shabby black suit and grey felt hat stale rooming-house flesh cold undersea eyes. So I boiled him in hydrochloric acid. Only way to get him clean you understand layers and layers of that grey junk rooming-house smell.
Apomorphine is made from morphine by boiling with hydrochloric acid but its physiological action is quite different. Morphine sedates the front brain. Apomorphine stimulates the back brain and the vomiting centres. One-twelfth grain of apomorphine injected will produce vomiting in a few minutes and for many years the only use made of this drug was as an emetic in cases of poisoning.
When Doctor Dent started using the apomorphine treatment, 40 years ago, all his patients were alcoholics. He would put a bottle of whisky by the bed and invite the patient to drink all he wanted. But with each drink the patient received an injection of apomorphine. After a few days the patient conceived such a distaste for alcohol that he would ask to have the bottle removed from the room. Doctor Dent thought at first that this was due to a conditioned aversion, since the spirit was associated with a dose of apomorphine that often produced vomiting. However, he found that some of his patients were not in the least nauseated by the dose of apomorphine received. There is considerable individual variation. Nonetheless these patients experienced the same distaste for alcohol and voluntarily stopped drinking after a few days of treatment. He concluded that his patients conceived a distaste for alcohol because they no longer needed it and that apomorphine acts on the back brain to regulate metabolism so that the body no longer needs a sedative to which it had become accustomed. From that time he stressed the fact that apomorphine is not an aversion treatment. Apomorphine is a metabolic regulator and it is the only drug known that acts in this way to normalise a disturbed metabolism.
The treatment is fully described with dosage in Doctor Dent's book, Anxiety and its Treatment. Anyone undertaking to administer the apomorphine treatment should consult this book. It is essential to the success of the treatment to give a sufficient quantity of apomorphine over a sufficient period of time. Vomiting should be avoided whenever possible. If the method of administration is sublingual as much as a tenth of a grain can be given even hour. With sublingual administration it is quite easy to control or eliminate nausea and the entire treatment can be carried out successfully without a single instance of vomiting. The concentration of apomorphine in the system must reach a certain level for the treatment to be successful. I have known doctors in America who gave two injections of apomorphine per day. This is quite worthless. It is important to remember that any opiate or any sedative reverses the action of apomorphine. As regards sedatives, tranquillisers and sleeping pills, absolutely none should be given.
Like a good policeman, apomorphine does its work and goes. The fact that it is not an addictive substitute drug is crucial. In any reduction cure the addict knows that he is still receiving narcotics and he dreads the time when the last dose is withdrawn. In the apomorphine treatment the addict knows he is getting better without morphine.
When you take apomorphine for a severe emotional state you have faced the problem, not avoided it. The apomorphine has normalised your metabolism, always disturbed in any emotional upset, so that you can face the problem with calmness and sanity. Apomorphine is the anti-anxiety drug. I have witnessed in others, and experienced myself, dramatic relief from anxiety caused by mescalin after a dose of apomorphine where tranquillisers were quite ineffective.
I feel that any form of so called psychotherapy is strongly contradicted for addicts. Addicts should not be led to dwell on or relive the addict experience since this conduces to relapse. The question “Why did you start using narcotics in the first place?” should never be asked. It is quite as irrelevant to treatment as it would be to ask a malarial patient why he went to a malarial area.