When he first took opium in 1804 he hailed it as ‘ the secret of happiness which philosophers had disputed , at once discovered ’.
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Bookshelf
Recommended reading – from the drug and alcohol sector …
Guilty Thing – A Life of Thomas De Quincey
by Frances Wilson , published by Bloomsbury . ISBN : 9781782115489 , £ 10.99 Review by Mark Reid .
Thomas De Quincey was the author of the renowned Confessions of an English Opium-Eater , first published in 1821 . Guilty Thing covers De Quincey ’ s many fixations , which also included poets and murderers .
At the time his drug of choice was very much the opium of the masses – used for almost every ache and pain . De Quincey appeared to champion its recreational use . When he first took opium in 1804 he hailed it as ‘ the secret of happiness , which philosophers had disputed , at once discovered ’.
Were De Quincey to walk into a drug service today , there would not be that much a worker would not recognise in his underlying state of mind . What is striking is that he used opium to selfmedicate his neuroses and ease his character defects in its dizzying dreams .
Frances Wilson asserts that ‘ addiction is now believed to be a shield against childhood trauma ’. De Quincey exemplified this . His obsessive mindset was embedded by seeing the body of his nine-year-old sister Elizabeth who died when he was six . That sepulchral image prompted a lifelong search for the infinite and the sublime , which always had an element of terror at its heart . De Quincey later observed that ‘ an adult sympathises with himself as a child because he is the same and he is not the same ’.
De Quincey the drug addict did his own cost-benefit analyses on his habit . He accepted opium was bad ‘ for health and vigour ’ and a ‘ personal appearance tolerably respectable ’. But this changetalk was outweighed by opium ’ s ‘ mastery over anger and fear , capacity for abstract thinking and emancipation from worldly cares ’.
De Quincey did stop using opium sometimes : for 90 hours once . The result was ‘ unspeakable misery of the mind ’ in withdrawal with no substitute .
Another of his addictions was debt . Like opium this was born out of dread of ordinary life , allowing a second personality ; apart and alone . Inevitably fear redoubled , as he was endlessly hunted by creditors .
When he first took opium in 1804 he hailed it as ‘ the secret of happiness which philosophers had disputed , at once discovered ’.
Could modern-day counselling , medication and a programme of recovery have turned the opium-eater around ? Can you imagine being Thomas De Quincey ’ s keyworker ? If so , this many-sided and accomplished biography is for you .
Mark Reid is participation and recovery worker at East London Federation Trust Addictions Services
CliniCal eye
A mutual respect
Ishbel Straker joins us as a regular columnist to give insights on nursing in addiction . This month she asks , why is there tension between doctors and nurses ?
I WANT TO START BY SAYING I LIKE DOCTORS . I like what they do , what they stand for and their practice – in fact , some of my best friends are doctors ! So why am I talking about the occasionally / more often than not strained relationship between a doctor and nurses ?
When I trained a decade ago , I decided psychiatry was the place for me – not only because of the subject matter , but also the relationships between nurses and doctors . During placements on the general ward I would witness nurses who had 30 years experience behind them putting their knowledge to one side in favour of a third-year medical student .
Now , don ' t get me wrong , I absolutely value doctors – their skill is essential . However a mutual respect seemed to be lost in translation within the general and paediatric wards I was placed on . I was drawn to the relationship between the psychiatrist and the psychiatric nurse as it was one of mutual respect , with a clear understanding that both roles were equally important and neither could work as effectively for the patient without the other .
When I moved into addictions , this working relationship continued and progressed . Over the years I experienced some fantastic working relationships with doctors and watched the coordination of skills within the addictions services , which I feel has been the backbone of excellent care for substance misuse clients . However , I am sad to say , I have also witnessed the recent demise of this relationship and I question whether this is due to the rise of the non-medical prescriber ( NMP ).
The field of addiction has become the NMPs ’ stomping ground on which they have thrived . We now have clinical leads who are NMPs , when ten years ago this would have been unfathomable . Services are recruiting prescribers competitively and no longer differentiating between doctors and NMPs , but deciding who has the best skills at interview .
This is a fantastic step for nurses but one that has destabilised our medical colleagues – at times affecting our relationships . I hear of doctors terrifying NMPs with the dangers of what they are doing , highlighting the risks – and I wonder , is this down to a lack understanding of the jurisdiction of an NMP or is it a deeper issue ?
One thing I can conclude is that if we are to provide the best treatment we can for our under-represented client population , then we must work together . We must keep the client at the forefront of our minds and not our own agenda . We must utilise one another ’ s skills and not be fearful of what each other brings to the table .
Ishbel Straker is clinical director for a substance misuse organisation , a registered mental health nurse , independent nurse prescriber ( INP ), and a board member of IntANSA .
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