At Hit & Run, Reason’s Jacob Sullum takes issue with the first three episodes of season 6 of House. Now some of you probably already know of my unabashed love for House. Well, Jacob also manages to hit on another of my hobby-horses, namely, the stupid way in which Americans stigmatize drug use. (To be clear, I think that it’s pretty stupid to abuse drugs, but I also think that it’s pretty stupid to jump out of non-crashing airplanes. I think, however, that you should be free to do either, if you please.) Unfortunately, in this case, I think that Jacob’s assessment is a bit wide-of-the-mark in this case. Here’s a snippet (warning: spoilers):
In this week’s episode, House, on the advice of his psychiatrist after he’s released from the hospital, quits his job and tries to find a “hobby” to distract himself from the leg pain, which is so severe that it prevents him from sleeping. He and his psychiatrist ultimately conclude that what he really needs is to go back to work, even though the stress and drug-associated surroundings may increase his risk of “using,” because that is the only thing that will engage his mind enough to make the leg pain bearable.
This plot is stupid in several ways. First, unless House plans to diagnose disease 24 hours a day, going back to work is not a solution to the pain that keeps him up at night. Second, if all House needed to relieve his pain was his work, why was he taking the Vicodin to begin with? Third, we never get a clear explanation of why House is forever forbidden to use painkillers, no matter how much he is suffering, especially since he managed to do his job brilliantly while he was taking them.
Jacob’s questions are meant to be rhetorical, but I think that there are actually some pretty decent answers to most of them.
First, the show has pretty much always indicated that House’s use (abuse?) of Vicodin increases when he’s bored. That’s a plot device lifted straight from Sherlock Holmes, on whom, if you didn’t already know, House is very much based. Holmes’ drug of choice is cocaine, which he uses between cases. “Give me problems, give me work, give me the most abstruse cryptogram, or the most intricate analysis,” he tells Watson, “and I am in my own proper atmosphere. I can dispense then with artificial stimulants. But I abhor the dull routine of existence. I crave for mental exaltation. That is why I have chosen my own particular profession, or rather created it, for I am the only one in the world.”
We’ve seen evidence of House having the same issues. In the S2 episode, “Skin Deep,” House begs Cuddy for a spinal injection of morphine to combat his rising leg pain. Cuddy complies reluctantly, and House improves. Or he improves as long as he’s working on his case. She notes later that his pain came back — surprise — just an hour after he completed the case. And, even bigger surprise, his previous injection was saline.
What’s more, House has been Vicodin free once before. In between S2 and S3, House is completely free of the drug. An experimental medical procedure has eliminated House’s pain. S3 begins with a scene of House jogging apparently pain free. The Vicodin begins again not because of physical pain, but because of House’s depression at (apparently) failing to solve a case.
IOW, House’s writers have offered ample evidence that House is psychologically dependent on painkillers. Yes, there is real physical pain. But there is also a far more troubling psychological addiction to the drug, one that transcends it’s palliative properties. And that, of course, is at least part of the answer to Jacob’s second question. House takes the drug even when working because he is dependent on it, even when he doesn’t need it to combat the pain (as, for example, when he’s working).
It’s also the answer to why House’s new psychiatrist calls him an addict and keeps him away from painkillers. Remember, this is the same House who, after a bad day, ends up in a stupor on the floor, covered in his own vomit, having downed the better part of a bottle of oxycodone. House is labeled an addict because he’s an addict. House is not simply a chronic pain-sufferer who responsibly takes pain medication under a doctor’s supervision. He’s a guy who steals his best friend’s prescription pad to get more Vicodin, who hides pills inside Lupus textbooks and sneakers and the like, who pops pills because he’s bored or stressed or just had a bad day.
Now I’ll gladly join with Jacob in saying that we vilify narcotic use badly enough that many who are in chronic pain are unable to get the relief that it is possible to give them. Prosecuting physicians who provide high levels of painkillers to their patients who are actually in high levels of pain is beyond dumb. It’s even dumber when we’re talking about terminally ill patients who are left to suffer needlessly lest they * gasp * end up addicted to morphine. I’m just not at all convinced that Greg House is the ideal posterchild for the Why Are We Taking Their Pills Away? movement.