Addiction and Withdrawal Phenomena

Narcotic addiction is not as great a public health hazard as is the abuse of the barbiturates and alcohol. However, to the addict and his family, narcotic addiction is a tragedy. When the Harrison Narcotic Act was passed in 1914, there were around 200,000 narcotic addicts, mostly women, in the United States. At the end of 1948 there were approximately 48,000, mostly men. This reduction in addiction was largely due to the vigorous enforcement of the Harrison Narcotic Act (6). 

In World War I the Army rejected 1 man in 1,500 as an addict and in World War II 1 in 10,000. The current rate for the adult population is estimated at 1 in 3,000 or a total of 50,000. Another 10,000 adolescent addicts bring the national total to 60,000. They spend in the neighborhood of a quarter of a billion dollars a year for illicit narcotics (51). This represents an unbelievable average of 4,000 a year and suggests that to cover income tax (probably not paid) and other liabilities, an addict requires an income of 10,000 a year (47a). 

The most important factor which predisposes to addiction is a -personality defect. Drug addiction is not a separate disease but usually represents a symptom of a number of psychiatric difficulties. Many addicts suffer from psychoneuroses or have character defects (6, 50). While personality defects are easily diagnosed in addicts, and while it can be established that these defects were present before the addiction, an equally intense study of the majority of individuals would disclose equivalent problems. All in- 

Contact with a narcotic drug as a result of deliberate experimentation to experience the pleasurable effects is currently a more potent cause of addiction than is contact as a result of administration for legitimate medical purposes (6, 50). Yet prior to the Harrison Narcotic Act a significant number of addicts developed from the indiscriminate medical use of narcotics. 

Addiction to one drug predisposes to addiction to another. Cocaine and marihuana users very often change to opiates. Alcoholics gravitate to the use of barbiturates and morphine. 

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