"The Worst Species of Inebriety": Opiate Addiction in Antebellum New York City (original) (raw)
Related papers
2020
The nature and management of narcotic addiction, and by extension, the nature and management of those who struggle with it, are not recent issues in the United States. Despite the current opioid epidemics and the apparent discovery of prescription-drug addiction, medical treatment of opioid dependence is already more than 100 years old. Is compulsive drug consumption a vice? A disease? A lifestyle? How does it affect the minds and bodies of those who suffer from it? How can they be cured? In the 1870s, physicians were already struggling with such questions when they pioneered what would become known as “addictology” in the 20th century. This article first endeavors to retrace the emergence of the conceptualization and perception of opiate addiction in the late 19th and early 20th centuries. From “imported vice” to “unhealthy lifestyle” and finally “nervous disease”, narcotic dependence became an increasingly important source of concern for turn-of-the-century physicians, precipitati...
Chasing the Dragon: The Cultural Metamorphosis of Opium in the United States, 1825-1935
Medical Anthropology Quarterly, 2000
Many things to many people, opium has played a role in the emergence of several power bases in the United States. In turn, these bases of power have shaped what opium is for the rest of us. Allopathic medicine brought opium and its derivatives under its control around the turn of the century, promulgating "addiction theory" and addiction clinics as part of its rise to preeminence among rival forms of medicine. Opium also played a role in the U.S. 's international economic and imperialistic ascendance. When politicians began to deploy a new discourse on opium early in this century, they were able to appropriate medical rhetoric. As the politics of opium heated up, some doctors were able to exploit the emerging politically inspired discourse to generate a subtly different medical knowledge of opiates and addiction while establishing a new subdiscipline with the political support of lawmakers and state institutions, [opiates (opium, morphine, heroin), medicalization of opiates, addiction theory and treatment, international opium trade and policy]
Looking at the „modern War on Drugs“1 in the USA from the perspective of the history of knowledge, the talk will focus on the „epidemic(s)“ of heroin addiction in the end of the 1960s and the beginning of the 1970s. Drawing on news reports, hearings before congressional committees and scientific publications, I argue that by applying the concept of infectious diseases to heroin dependence, physicians and addiction researchers claimed interpretational sovereignty within the field of drug policy. While the public health approach toward dealing with users of psychoactive substances had been gaining momentum in the decade before,2 I further argue that it was not until about 1969 when public fears of a heroin 'epidemic' were aroused, that the growing influence of the health sector became further institutionalized and the infrastructure of modern treatment programs was expanded significantly. Medical experts framed heroin addiction as an infectious disease, actively demanding a public health approach. In my talk I will illustrate how three developments were connected with physicians' claims that the heroin addiction was a problem that could be handled best by the medical community – and how actors from this community actively shaped the perception of heroin addiction as a problem or threat in the first place: Firstly, alarming media reports stated that heroin use, thus far supposedly restricted to the communities of ethnic minorities in the inner cities, was becoming visible among white, middle-class teenagers in the suburbs. Secondly, some scientists in Washington, D.C explained the rising crime rates in the capital by establishing a direct link to a local heroin 'epidemic'. And thirdly, fears of another heroin „epidemic“ among U.S. soldiers in Vietnam who were about to return home and import heroin addiction, further directed political attention to the field of addiction treatment. While I do not want to assess whether the growing influence of medicine in the field of drug policy is 'good' or 'bad', I show that it is not a natural or self-evident development. Rather, we have to look at it as a contingency that can be explained by focusing on the debates and ambivalences within, among other things, the medical community itself, as well as contemporary political considerations that became invisible over the course of time. In doing so, I try to open this „black box“3 and explain how and why notions of heroin addiction as an infectious disease helped shape the ways heroin users and dependent persons have been dealt with in the United States since the beginning of the modern War on Drugs.
Medical History
DISCIPLINING ADDICTIONS: THE BIO-POLITICS OF METHADONE AND HEROIN IN THE UNITED STATES
Biomedical understanding of methadone as a magic-bullet pharmacological block to the euphoric effects of heroin is inconsistent with epidemiological and clinical data. An ethnographic perspective on the ways street-based heroin addicts experience methadone reveals the quagmire of power relations that shape drug treatment in the United States. The phenomenon of the methadone clinic is an unhappy compromise between competing discourses: A criminalizing morality versus a medicalizing model of addiction-as-a-brain-disease. Treatment in this context becomes a hostile exercise in disciplining the unruly misuses of pleasure and in controlling economically unproductive bodies. Most of the biomedical and epidemiological research literature on methadone obscures these power dynamics by technocratically debating dosage titrations in a social vacuum. A fou-caultian critique of the interplay between power and knowledge might dismiss debates over the Swiss experiments with heroin prescription as merely one more version of biopower disciplining unworthy bodies. Foucault's ill-defined concept of the specific intellectual as someone who confronts power relations on a practical technical level, however, suggests there can be a role for political as well as theoretical engagement with debates in the field of applied substance abuse treatment. Meanwhile, too many heroin addicts who are prescribed methadone in the United States suffer negative side effects that range from an accentuated craving for polydrug abuse to a paralyzing sense of impotence and physical and emotional discomfort. In a halting voice, over the long-distance telephone lines between New York and California, Primo, the manager of the crack house I had lived next to for almost four years in East Harlem admitted that he was taking 80 milligrams of methadone every day. Profoundly embarrassed, Primo asked me not to mention his new methadone addiction in the epilogue to the book that I was preparing at the time of that telephone call (Bourgois 1995). 1 The news that Primo was physically addicted to methadone was counterintuitive to me: By conventional standards, Primo had turned his life around in the year prior to that telephone conversation. He had stopped selling crack; he had found legal employment as a summer replacement porter for the mafia-controlled union 2 that represents service workers in primarily luxury apartment buildings; and he had stopped drinking alcohol and sniffing cocaine. In contrast, during the almost six years I had known
Frontiers in Sociology
Editorial on the Research Topic The outbreak and sequelae of the increase in opioid use in the United States, Canada, and beyond In 2018, there were 67,367 drug overdose deaths in the United States, Unfortunately, by 2021, the latest year for which data are available, the number of deaths had increased to over 107,000 deaths. This increase in overdose mortality was probably driven by a combination of upstream processes, most of which derive from ways in which capitalism and its system of nation-states are creating economic and cultural crises. These crises include the COVID-19 pandemic, economic crises, and a deepening culture of despair (Friedman et al., 2021). Relatedly, the illicit drug markets for stimulants and opioids have changed and have come to include widespread highly-potent synthetic opioids (Baldwin et al., 2021). Articles in this special issue provide insights into existing and potential strategies to prevent risky opioid use and reduce opioid mortality. We briefly discuss each of the articles in this issue and highlight key ideas, constructs, and recommendations for research and intervention. Friedman et al. present evidence that the opioid/overdose epidemic is not only a question of individual behaviors-although those are important-nor only of corporate greed in the over-zealous marketing of dangerous opioids as harmless pain medicines, but that the overdose epidemic is part of a deeper dialectic of one-sided class war, the impacts of economic trends on profits, wages, employment, wealth and housing inequality, and of the associated social, community, ideological and psychological changes these cause. The recent changes in the racial/ethnic distributions of overdose mortality suggest that the processes discussed in the Friedman et al. paper have taken place in a deeply racialized society where economic, political, and ideological changes are shaped by, and in turn shape, patterns of oppression and of struggle (Friedman et al., 2022b).