From Freud to Winehouse: The ‘Anatomy of Addiction’

GUEST AUTHOR BLOG: Two Addicts Who Changed the World by Howard Markel author of "An Anatomy of Addiction: Sigmund Freud, William Halsted and the Miracle Drug Cocaine."

1 out of 4 Americans will have either a substance abuse or addiction problem at some point in their lives. Tragedies, such as Amy Winehouseaside, we all confront the reality of addiction every day even if we don’t always know or acknowledge it.

Some of these addicts have even managed to change the world.

Sigmund Freud
Max Halberstadt | LIFE Photo Archive
Sigmund Freud

Take for example, Sigmund Freud (1856-1939) and William Halsted (1852-1922).

Freud, of course, became the father of psychoanalysis and changed the way we think about the way we think. Dr. Halsted was the greatest surgeon of the 20th century. As he invented dozens of surgical techniques, including the rubber glove, Halsted changed the way we heal.

And yet for years, both these men were raging cocaine addicts!

When Freud and Halsted first became acquainted with their chemical bête noire, cocaine was heralded as the wonder drug of the day, a substance reported to cure everything from tuberculosis to flatulence.

Neither they nor their colleagues had any idea of its potential to dominate and endanger their lives. Addiction as a bona fide diagnosis was not yet in the doctor’s lexicon, let alone his textbooks.

As young doctors, Freud and Halsted studied the effects of cocaine by experimenting on themselves, consumed great quantities of it, and eventually encountered serious problems doing so.

As a result, each man actively participated in the birth of the modern addict, and their clinical histories prefigure the ever-challenging spectrum of addiction and recovery. After more than a decade of abuse, Freud somehow abandoned cocaine but was plagued by periods of sexual turmoil, increased alcohol consumption, and depression. In the years after Halsted restricted his cocaine abuse to occasional binges, he still availed himself of daily morphine injections to quell his addictive urges, often with negative results.


For many people, the use of mind-altering drugs provides a brief, occasional reprieve from life’s psychic battles.

But, predictably, 5 to 10% of humankind will develop serious abuse problems after discovering their substance of choice.

As with many clichés, there are some elements of truth to the notion of an “addictive personality”; the claim that certain types of people are more likely to become addicts than others, such as those who enjoy taking risks, are hard-driving, perfectionists, or who have emotional difficulties enduring painful stimuli and delaying gratification.

But it is also important to note that more than half of all adults diagnosed with substance abuse problems simultaneously suffer from one or more mental health problems such as depression, mood disorders, or attention deficit disorder.

Furthermore, evidence is being uncovered each day demonstrating the genetic basis of addiction as well as a host of other mental illnesses. Imagine this susceptibility as four wheels of misfortune and risk: genetics; environment; mode of administration; and emotional or physical trauma. The addict’s luck runs out when spinning most or all four wheels.

In years past, historians have eagerly discounted Sigmund Freud and William Halsted’s “cocaine episodes” because they occurred accidentally, as if anyone becomes an addict on purpose. Such conclusions are only bolstered by their remarkable success in transforming modern psychology and medicine.

Yet, cocaine failed to make either man more productive, happier or smarter.

These two men often practiced medicine while under the influence and their most fallow professional years coincided with their most prodigious substance abuse. Each man confessed regret over the physical and emotional tolls cocaine exerted, the valuable time it consumed, and the harm its abuse inflicted on others.

Indeed, Freud’s and Halsted’s brilliance, social position, specialized knowledge, determination, and highly developed calls to duty hardly immunized them against addiction’s indiscriminate ravages. Their vulnerability to this disease testifies that the two intellectual giants were all too human.

Dr. Markel, a professor of medical history at the University of Michigan, is the author of "An Anatomy of Addiction: Sigmund Freud, William Halsted and the Miracle Drug Cocaine", which was just published by Pantheon Books.

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