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self medication hypothesis

Psychiatrist and psychoanalyst Edward Khantzian* first hypothesized that individuals with substance use disorders may suffer more distress than others and may choose the drugs they use in order to modify their distress.

It is the way of John Barleycorn. When good fortune comes, they drink. When they have no fortune they drink to the hope of good fortune. If fortune be ill, they drink to forget it. If they meet a friend, they drink. If they quarrel with a friend and lose him, they drink. If their lovemaking be crowned with success, they are so happy they needs must drink. If they be jilted, they drink for the contrary reason. And if they haven't anything to do at all, why they take a drink, secure in the knowledge that when they have taken a sufficient number of drinks the maggots will start crawling in their brain and they will have their hands full with things to do. When they are sober they want to drink; and when they have drunk they want to drink more.* -- Jack London

A madman who takes hashish contracts a new madness that puts the other to flight; but once the intoxication has run its course, true madness, which is the madman's norm, resumes dominion, just as health and reason do in us. -- Charles Baudelaire

*Khantzian, E J. The self-medication hypothesis of addictive disorders: focus on heroin and cocaine dependence Am J Psychiatry 1985 142(11):1259-1264