On the Aetiology of Drug-Addiction

There are three main sources of psycho-analytic interest in drug-addiction. In the first place its ætiology is still obscure; consequently the treatment of drug-addiction lags behind that of the psychoneuroses. It is true the psycho-analyst is justified in asserting that the only radical approach to drug habits is through psycho-analytic treatment; but he cannot remain content with such a general recommendation. He ought to be in a position to direct his psycho-analytic energies with more precision. There is a considerable difference between 'analysing' a drug-addict and analysing 'drug-addiction'.

A second source of interest lies in the correlation of drug-addiction with various other psychopathological states. Owing to the close connection on the one hand between drug-addiction and the psychoses, and on the other between drug-addiction and social or sublimatory defence-reactions, it is probable that drug states will prove an essential link in the understanding of such different phenomena as paranoia, obsessional neuroses, open-air cults or even an addiction to scented soap.

The third source of interest is mainly domestic. Study of psycho-analytic views concerning alcoholism and other drug-addictions seems to me to illustrate very clearly the different tendencies which from time to time have dominated psycho-analytical research or doctrine. Those whose interest in psycho-analysis is comparatively recent, dating, say, from the publication of Beyond the Pleasure-principle, might be excused for thinking that sadism and the aggressive instincts are new discoveries. In a sense this view is not entirely without justification. Wider historical reading shows however that whereas in earlier times the importance of sadism was recognized clinically, its ætiological significance was to some extent obscured by a preoccupation with more predominantly libidinal factors. Indeed, there are some grounds for the view that psycho-analysts can be divided into those who, as it w