Drug addiction

Drug addiction in the book is neither a simple label nor a problem confined to life outside the hospital. It emerges through a relapse on the PAAZ, arguments over responsibility and stigma, and Michiel’s eventual admission that he is dependent on the intoxicated state he seeks. His story gives addiction a double setting: the ward is meant to offer safety from relapse, while the treatment clinic he describes is itself saturated with drug talk, temptation, and access to dealers.

Addiction and the PAAZ

The clearest crisis begins with a new patient who had reportedly been clean for two years and came to the PAAZ for a time-out unrelated to drugs. Linda says the woman had used the previous evening and arrived back at the ward intoxicated. The relapse immediately unsettles the ward: a place meant to protect recovery has become the place where a patient returns to substance use.

Iefke attributes the relapse to Michiel. She says he had spent two hours talking with the woman about drugs while staff passed by without intervening. Her anger is directed not only at him but at what she sees as the ward’s failure to care: the woman came there to avoid falling back into use, yet nobody stopped a conversation that Iefke believed might contribute to it. She also emphasizes the woman’s two years of abstinence and the consequences of the relapse, including having to leave the ward.

Linda resists treating the causal claim as established. She points out that the woman could have relapsed elsewhere, that she participated in the conversation, and that Michiel had not used drugs himself. The dispute therefore distinguishes a confirmed event from competing interpretations of responsibility: the patient relapsed, but the evidence presented does not establish that Michiel caused it. The scene also refuses to make responsibility an easy either-or. The woman’s choice matters, while the ward’s purpose and its failure to intervene remain part of the argument.

Michiel and the accusation of relapse

The accusation exposes the tension between Michiel’s identity as a person with addiction and the way others interpret his behavior. Iefke sees the two-hour conversation as a harmful influence and condemns him for acting as though his actions have no consequences. Michiel replies that the woman initiated the subject and that, if she has stopped using before, she can stop again. His response sounds dismissive to Iefke, who answers that the woman previously got clean because she had a child.

Emma’s understanding of Michiel shifts during this confrontation. She remembers seeing him with the woman in the garden and has to reconsider the image she had formed of him: a person who had described keeping dealers away from the PAAZ and who had shown tenderness toward a dog. The conflict does not resolve whether Michiel behaved responsibly in that conversation. Instead, it makes visible the gap between his capacity to protect others from drugs and the suspicion attached to his own history of dependence.

Later, Michiel describes the clinic where he previously sought treatment as an environment in which drugs dominate conversation and fantasy. He says dealers wait outside the front door, seek opportunities to get substances inside, or try to draw former customers back. His account makes treatment itself an ambivalent setting: a clinic can offer help, but its patients remain surrounded by reminders and opportunities to use. He further claims that he could have supplied the whole PAAZ if he had wanted to, while insisting that he supplied only people who chose to use and believed they could handle it. That distinction is his own defense of his past conduct, not an independent confirmation that his dealing was harmless.

Dependence, intoxication, and self-recognition

Michiel initially answers Emma’s question about addiction with a bleakly playful reference to being addicted to life. He then clarifies that he is addicted to the intoxicated state and to living within that rush. The admission changes the meaning of his earlier certainty that the relapsed patient could simply stop again: he recognizes that he, too, is dependent, even if he has been able to separate his own use from the conversation that led to the accusation.

The exchange is rendered through concrete gestures rather than a clean confession scene. After describing how a person might go to a dealer for a pill or a shot to escape the misery of the moment, Michiel lights a small tea light and sits watching its flame. Emma is hurt by what he has said and turns away toward the garden, struggling to hide her anger. The small flame does not resolve the conflict; it leaves his stated wish for escape beside the quieter possibility of choosing a different course.

His eventual acknowledgment also distinguishes addiction from a single episode of intoxication. The book presents use as tied to relief from distress and to the appeal of a state that can temporarily lift someone out of a painful situation. Michiel does not claim that recognizing this dependence makes recovery straightforward. Instead, he identifies the dependence and connects that recognition to a concrete next step: going to a clinic.

Treatment, stigma, and the choice to seek help

The book places these events within a PAAZ where patients are expected to manage themselves but also need sustained attention. Elsewhere, Emma describes staff reductions and argues that ward nurses’ value lies in the time they spend with patients, beyond the few hours of therapy and limited contact with a therapist. This wider account of understaffing does not prove that reduced staffing caused the relapse, but it sharpens the significance of Iefke’s complaint that staff walked past while the conversation continued. The institution’s promise of care sits uneasily beside the limits of its everyday presence.

Stigma appears in the language used to sort patients into those worthy of concern and those dismissed as addicts. Iefke fears that the ward has treated the relapse as though it did not matter because the patient was a drug user. Linda, by contrast, tries to keep the discussion from collapsing into blame, reminding the group that Michiel is also addicted. Neither response erases the harm of the relapse. Together they show how a label can generate both condemnation and a reason to overlook a person’s vulnerability.

Michiel’s decision to seek treatment is expressed as a choice made in the presence of doubt, not as a cure or a settled happy ending. When Emma asks whether there is hope for him, he names his dependence on the intoxicated state and says that this is why he is going to the clinic. He considers first going to his parents, while describing the prospect of treatment with a faint, uncertain smile. The ending therefore connects recognition to action without claiming that recognition has already overcome addiction. His trajectory remains open: he has named the problem and chosen help, but the clinic’s own drug-saturated environment and his history make the path ahead uncertain.