Take these two divergent scenarios. In Scenario A, we have an Hispanic or African-American needle addict, who lives in a cheap flophouse in Los Angeles, and has been addicted to drugs most of his adult life. For brevity sake, we shall call him "Juan." If a carload of college-educated, middle-class white people were to cruise Skid Row, and see Juan crouched in an alley, shooting up heroin, what would they say?
Again, these are educated white people, so they would definitely have an opinion. They might say, "Oh, my God, look at that guy." Or: "Holy Christ! Let's get out of here!" Or: "Why aren't there any police around?" Or, if from the Westside: "Wow, this neighborhood has really deteriorated." But one thing is certain: There's not a chance in hell anyone in that car is going to allude to Juan's existential crisis or "personal demons."
In Scenario B, we have a famous actor, regarded not only as a movie star, but as a movie "artist," who makes lots of money and lives in Manhattan. He has been addicted to drugs most of his adult life. We shall call him "Philip Seymour Hoffman." If people were to see (or hear of) Hoffman injecting himself with heroin, or nodding off in a opiate-induced stupor, they would instantly (and empathetically) speculate about the "personal demons" this man must be fighting.
In short, if you're a rich, successful artist who happens to be a dope fiend, people will invest your addiction with all sorts of existential import, as if the chemistry and addictive capacity of a celebrity's brain were qualitatively different from those of a street person's brain. If you're Philip Hoffman, your addiction comes equipped with its own narrative, and it's a tale of interior anguish and unimaginable demons. But if you're Juan, you have no narrative. You're simply a congenital screw-up who likes to get stoned.
Some years ago, as a labor union rep, I took a class dealing with the basic elements of substance addiction. Although the class wasn't taught by a medical doctor or chemistry professor, the instructor (a clinical psychologist) did discuss the role of dopamine, neurotransmitters, and the brain's "pleasure centers." What really struck me were her observations regarding "individual differences in physiology."
Using alcohol as the potentially addictive substance, she noted that if you took 20 random men and women, and had each of them consume six shots of vodka, you would get two sets of reactions, one "common," and one individually "different." As for the common set, because they are all human beings and alcohol has a "common" effect on human physiology, they would all be legally intoxicated. Some would be "drunker" than others, but they would all be drunk.
But it was the individual differences that were disturbing. Of the 20 people, there would be maybe two or three (she offered no specific percentage) who not only felt intense pleasure at being under the influence of alcohol, but who looked forward to recapture that feeling. And if they seek to recapture it ("chase the high") enough times, they will begin to actually alter their brain chemistry, turning a quest for pleasure into a debilitating physical illness.
There were no personal demons in her presentation. Indeed, the only "demons" that Juan and Philip Hoffman could be said to be fighting were the biological demons of brain chemistry, the demons that, after showing these two wildly disparate men how amazingly good it felt to get high, caused them to want to stay high for the rest of their lives -- Hoffman in the swanky confines of Manhattan, Juan on the mean streets of LA.
I knew a woman, the wife of a friend, who had never taken so much as one drink of alcohol -- not a single beer, not a single glass of wine. Her reason? Because alcoholism ran in her family, she feared that she was already one of those "two or three" people waiting to become addicted and have her life ruined, and didn't want to take that chance.
David Macaray, an LA playwright and author ("It's Never Been Easy: Essays on Modern Labor," Second edition), is a former union rep.