“Chemical Dependence”: A Clinician’s Retrospective on William S Burrough’s Naked Lunch

Nicole Laurino reflects on the history of harm reduction/maintenance treatments for opioid addiction and how these treatments clashed, and continue to clash, with abstinence-only approaches. Nicole encountered this tension during her half decade working in outpatient mental health in Philadelphia facing the opioid epidemic. Medicines such as methadone and buprenorphine, slower-acting opioids that dull cravings, have been integrated into American addiction healthcare amid much pushback.

This clash between a “chemical” model of drug addiction and a “psychological” model is not new. Beat writer William S. Burroughs wrote the banned-everywhere surrealist novel, Naked Lunch to describe the heroin and morphine-addicted underbelly of the 1950s. Burroughs argued that drug addiction is not psychological in nature, and can only be treated by tempering the physical addiction. Nicole reflects back on Naked Lunch and looks to neuropsychoanalysis to attempt to reconcile this longstanding feud and explore the consequences this could hold for public health