The Alcoholic-Narcotic Addict

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Abstract
Among 380 patients remaining in the U. S. Public Health Service Hospital at Lexington, Ky., 29 were identified as alcoholic -narcotic addicts on the basis of their making a definite switch from the habitual excessive oral use of alcohol to the habitual intravenous use of narcotics. Studies by a psychiatric team over a 6 month period and comparison of these patients with matched controls revealed that the psychodynamic process involved in switching from alcohol to intravenous opiates was similar in both northern and southern patients, although the southern patients had started at a higher level of social and psychological integration, and this process was absent in the controls. In general there was a loss of psychic equilibrium due to the loss of a love object on whom they were dependent for "mother love". It is postulated that a continuum exists in addiction from more benign to more noxious substances, with the patient stabilizing with certain substances depending on what is sufficiently noxious to neutralize their oral aggression. The 2 parameters determining the morbidity of any addiction are the self destructive capacity ("noxiousness") of the substance used, and the amount of the patient''s life devoted to maintaining the addictive process.

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