Written in 1821, this is an intense and pertinent portrayal of narcotic dependence from the addict's viewpoint. De Quincey addresses the constant conflict between intoxication and abstinence. Similar sentiments are related by our patients today, but rarely with as much eloquence and insight as Thomas De Quincey. This classic work is essential reading for all involved in drug and alcohol studies and who admire beautiful language.
With so many patients now on maintenance programs (mostly methadone), and illicit opioids still ubiquitous, it is timely to re-examine this work, probably the oldest account of its kind in English.
The 'Confessions' presents us with several episodes in the author's life. He recounts privileged public school days, subsequent hostile truancy, still later poverty in London squats and, some years afterward, a comfortable country existence. But this story is not just biographical. The disparate scenes each place his drug-taking into vivid context.
As a 36-year-old addict, the writer states that his drug of choice was laudanum (tincture of opium), a medicine first prescribed him for recurrent dyspepsia aged 28. It was then that he also discovered its pleasurable qualities. He consumed up to 320 grains of opium daily, equal to around 20g of raw opium, a large, but not unbelievable quantity. Though he claims to have given up opium, history tells us that he continued heavy use for another 35 years. He did not live long enough to 'enjoy' the discovery of heroin and the hypodermic needle.
The original 'Confessions' was published as a series of articles in the "London Magazine" in 1821. Some parts had been written previously, and the series may have been pieced together hastily out of financial necessity. The author pleads for patience, explaining that his prose follows his own train of thought so closely that it sometimes may appear wandering or disjointed. The American author, William Burroughs suffered the same 'malady', (and possibly for the same reason) but, far from craving his readers' indulgence, he has capitalized on it and has made it his trade-mark.
De Quincey apologises needlessly for his narrative style. Seemingly embroidered or wordy descriptions are well balanced by other elegantly succinct poetic portraits. "Thou only givest these gifts to man; and thou hast the keys of Paradise, oh, just, subtle, and mighty opium!" Every page of this work contains language of beauty, humanity and frequently, humour. The subject of this book was taboo at the time of writing, and the very title would have shocked its public. It was then widely believed that Europeans could not become addicted to opium.
As well as 'Preliminary Confessions', he writes chapters on the pleasures and the pains of opium. He affirms his belief in the unique healing powers of the drug, and the benefits of doctor's prescriptions which contain opium. De Quincey reveals that he used opium only intermittently for several years, before developing a daily proclivity. He took it regularly before going to the Covent Garden opera. A proportion of today's narcotic users employ the drug to enhance other pleasurable activities.
Based on personal knowledge as well as information from apothecaries he patronized, De Quincey correctly deduces that opium addiction was extremely widespread in Regency England. He expresses some remorse over his addiction, but devotes much space to explaining his extenuating personal circumstances. Unlike simple pleasure seekers, the reader is told, he took it initially for medical reasons. He also compares it with the pernicious effects of alcohol. He identifies some other prominent opium users: first mentioned is the poet laureate and playwright, Thomas Shadwell (1642-92), a confirmed addict. Of his own contemporaries, he identifies Samuel Taylor Coleridge, William Wilberforce, Dr. Abernethy, and several others in public life.
He revised and enlarged the confessions 35 years later, as if to prove opiate addiction and longevity are not mutually exclusive. Most modern editions give some passages from the revisions, but wisely keep the original as a discrete work. The revisions are longer than the entire original work. Although some central issues are clarified in the revisions, other tangential ones are drawn out and examined in excruciating detail. De Quincey remains one of the great wordsmiths, and this well-forged story gives a personal aspect to one of mankind's most ancient activities, the pursuit of pleasure from drugs.
[De Quincey, T. Confessions of an English Opium Eater. Penguin English Library 1972, edited with an introduction by Alethea Hayter. First published in the "London Magazine", 1821]
Dr Andrew Byrne is a third generation GP, specialising in Drug and Alcohol medicine. He practises in Redfern, NSW, Australia.
Dr. Andrew Byrne, General Practitioner, Drug and Alcohol,
75 Redfern Street, Redfern, New South Wales, 2016, Australia
Tel (61 - 2) 9319 5524 Fax 9318 0631 Email firstname.lastname@example.org
author of: "Methadone in the Treatment of Narcotic Addiction" and "Addict in the Family".