Drug Policy

House Rehab Update

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If the latest episode of House is sitting on your TiVo, waiting to be watched, you should stop reading this now. I watched it last night and was pleasantly surprised that the writers managed to avoid turning the running plot about Gregory House's Vicodin habit into a hackneyed story of addiction and redemption. For several episodes now, the diagnostic genius with the biting wit played by Hugh Laurie has been hounded by a cop (David Morse) who is convinced he's a dangerous addict. In the last episode before the show's mid-winter hiatus, it looked like House, who all along has insisted that he takes Vicodin to relieve chronic leg pain, finally would be forced to admit he has a Drug Problem. Instead, as I was hoping, he merely pretends to have reached this realization as a way of avoiding jail.

First House apologizes to the cop for treating him dismissively and insultingly as a patient, which was the offense that triggered the investigation into his drug use. He seems utterly sincere when he says he's an irascible son of a bitch partly because he's been living for years with severe chronic pain that is only somewhat mitigated by the Vicodin. The cop, convinced House is an Addict in Denial, does not buy it. Then House announces he is going into rehab at the hospital where he works. After some dramatic vomiting, group therapy, and craft projects, his colleagues remark on how much better (i.e., less obnoxious) he seems. He apologizes to his best friend, an oncologist whose practice was shut down by the drug investigation because he had prescribed painkillers for House, for treating him shabbily. The criminal case against House ultimately falls apart because his boss lies on the stand to cover for him, but he still serves a night in jail for contempt of court after walking out of a hearing to tend to a patient. When his friend the oncologist visits him in jail, it's revealed that an employee in the rehab center has been slipping Vicodin to House all along.

This resolution is both dramatically more interesting and, for critics of the war on drugs, didactically more useful than the usual narrative of hitting rock bottom and climbing back up with the help of a Higher Power. (During group therapy House remarks that he's having trouble with the third step, turning his will and his life over to God, because he's rather attached to the idea of free will.) Although there's some lingering ambiguity, it looks like House really is using the Vicodin to control his leg pain. (The uncharacteristic OxyContin-and-alcohol binge of the previous episode, which looked like evidence to the contrary, could be interpreted as his response to the prospect of simultaneously losing his license, his career, his freedom, and his pain relief.)  In any case, it's clear that the painkillers do not impair his professional performance; even the colleagues who view him as an addict recognize that he performs better with Vicodin than without. So if House is an addict, he's a functional addict whose drug use is not harming anyone. Either way, the plot is a pretty bold departure from prohibitionist propaganda; it would not win Fox any credits from the Office of National Drug Control Policy.

I'm not suggesting that no one ever gets addicted to painkillers, or that such habits never cause problems for the users or others. But as Reason has documented over the years (here, here, and here, for example), the fear of that possibility has so skewed government policy and medical practice in this country that people suffering from chronic pain often have great difficulty getting adequate treatment. If the House plot had ended by vindicating the suspicious, meddling cop, it would have reinforced the idea that doctors should err on the side of undertreatment, presumptively viewing every patient in pain as an addict. So I'm glad the writers went a different way, especially since it's more consistent with House's character. Although his apparently sincere apologies suggest he did indeed Learn Something from his ordeal, which was caused largely by his monumental lack of sensitivity, the idea of House in recovery (for real) is too terrible to contemplate.