Taking biology seriously: The next task for historians of addiction?

Bulletin of the History of Medicine

Volumn 80, Issue 1, 2006, Pages 115-143

  Kushner, Howard I ^a,b,c  

^a EMORY UNIVERSITY   (United States)

^b Center for Health Culture and Society   (United States)

^c EMORY UNIVERSITY   (United States)

Author keywords

Addiction; Alcoholism; Drug addiction; Governmental policy; History; Smoking

Indexed keywords

ADDICTION; ALCOHOLISM; HISTORY; HUMAN; POLICY; REVIEW; UNITED STATES;

ALCOHOLISM; HISTORY, 19TH CENTURY; HISTORY, 20TH CENTURY; HUMANS; PUBLIC POLICY; SUBSTANCE-RELATED DISORDERS; UNITED STATES;

EID: 33645673433     PISSN: 00075140     EISSN: None     Source Type: Journal    
DOI: 10.1353/bhm.2006.0025     Document Type: Review

References (123)

1. For the same event as experienced from the perspective of my research partner, see Claire E. Sterk, "The 'Substances' in Addiction: Socially Constructed or Scientifically Determined?" The 8th Distinguished Faculty Lecture, Emory University, 27 March 2003, published 18 February 2004 by the University Senate of Emory University, Atlanta, Ga.
2. Harry Gene Levine, "The Discovery of Addiction: Changing Conceptions of Habitual Drunkenness in America," J. Stud. Alcohol, 1978, 39: 143-74.
3. Sarah W. Tracy and Caroline Jean Acker, eds., Altering American Consciousness: The History of Alcohol and Drug Use in the United States, 1800-2000 (Amherst: University of Massachusetts Press, 2004) (henceforth AAC).
4. Jonathon Erlen and Joseph F. Spillane, eds., Federal Drug Control: The Evolution of Policy and Practice (Binghamton, N.Y.: Pharmaceutical Products Press, 2004) (henceforth FDC).
5. Griffith Edwards, Alcohol: The World's Favorite Drug (New York: St. Martin's Press, 2002), esp. pp. 52-57.
6. Alan Brandt, "From Nicotine to Nicotrol: Addiction, Cigarettes, and American Culture," in AAC, pp. 383-402.
7. William L. White, "The Lesson of Language: Historical Perspectives on the Language of Addiction," in AAC, pp. 33-60.
8. Similar arguments have been made by others, including Howard F. Schaffer, "The Most Important Unresolved Problem in the Addictions: Conceptual Chaos," Subst. Use & Abuse, 1997, 32: 1573-80.
9. According to Helen Keane, this is reflected in the conflict between scientific definitions of addiction, which are based on the way substances interact physiologically in animal and human hosts, and medical diagnosis of addiction, which is made on the basis of behavior: "Focusing on the action of drugs in the central nervous system tells us very little about human drug use, which can only be understood as a social and cultural practice." Helen Keane, What's Wrong with Addiction? (New York: New York University Press, 2002), quotation on p. 22, see also pp. 36-63.
10. Eric J. Nestler and Robert C. Malenka, "The Addicted Brain," Sci. Amer., March 2004, 290: 78-85.
11. Not all researchers, including a number of social and behavioral scientists, endorse this view; see, e.g., Phil Dalgarno and David Shewan, "Reducing the Risks of Drug Use: The Case for Set and Setting," Addict. Res. & Theory, 2005, 13: 259-65.
12. E. M. Jellinek, The Disease Concept of Alcoholism (New Haven: Hillhouse Press, 1960).
13. D. L. Davies, "Normal Drinking in Recovered Alcoholics," Quart. J. Alcohol Stud., 1962, 23: 94-104.
14. See Edwards, Alcohol (n. 5), pp. 159-61, for a discussion of his follow-up of Davies's patients.
15. Mark B. Sobell and Linda C. Sobell, "Alcoholics Treated with Individual Behavioral Therapy: One-Year Treatment Trial," Behav. Res. & Therapy, 1973, 11: 599-618;
16. Mark B. Sobell and Linda C. Sobell, "Second Year Treatment Outcome of Alcoholics Treated by Individual Behavioral Therapy: Results," Behav. Res. & Therapy, ibid., 1976, 14: 195-215.
17. Mary L. Pendery, Irving M. Maltzman, and L. Jolyon West, "Controlled Drinking by Alcoholics? New Findings and a Re-evaluation of a Major Affirmative Study," Science, 1982, 21: 169-75.
18. Edwards provides a comprehensive discussion of this controversy in a chapter of Akohol (n. 5) entitled "Once an Alcoholic . . ." (pp. 148-64).
19. See Herbert Fingarette, Heavy Drinking: The Myth of Alcoholism as a Disease (Berkeley: University of California Press, 1988);
20. Stanton Peele, The Diseasing of America: How We Allowed Recovery Zealots and the Treatment Industry to Convince Us We Are Out of Control, rev. ed. (New York: Jossey-Bass, 1995), pp. 31-83.
21. One of the best of these studies is Mark Edward Lender and James Kirby Martin, Drinking in America: A History, rev. ed. (1982; New York: Free Press, 1987).
22. Ron Roizen, "How Does the Nation's 'Alcohol Problem' Change from Era to Era?" in AAC, pp. 61-87.
23. Roizen has been particularly vocal in his opposition to what he sees as a new public health campaign to demonize alcohol. See Kaye Middleton Filmore and Ron Roizen, "The New Manichaeism in Alcohol Science" (commentaries on Tim McCreanor, Sally Casswell, and Linda Hill, "ICAP and the Perils of Partnership"), Addiction, 2000, 95: 188-90.
24. John W. Frank, Roland S. Moore, and Genevieve M. Aimes, "Historical and Cultural Roots of Drinking Problems among American Indians," Amer. J. Public Health, 2000, 90: 344-51, quotation from p. 349.
25. John W. Frank, Roland S. Moore, and Genevieve M. Aimes, Historical and Cultural Roots of Drinking Problems among American Indians, Amer. J. Public Health, 2000, 90: 344-51, Ibid.
26. John W. Frank, Roland S. Moore, and Genevieve M. Aimes, Historical and Cultural Roots of Drinking Problems among American Indians, Amer. J. Public Health, 2000, 90, Ibid., p. 350.
27. Peter C. Mancall, "'I Was Addicted to Drinking Rum': Four Centuries of Alcohol Consumption in Indian Country," in AAC, pp. 91-107.
28. For an anthropological study supporting this view, see Stephen J. Kunitz and Jerrold E. Levy, with Tracy Andrews, Chena DuPuy, K. Ruben Gabriel, and Scott Russell, Drinking Careers: A Twenty-Five-Year Study of Three Navajo Populations (New Haven: Yale University Press, 1994).
29. Craig MacAndrew and Robert B. Edgerton, Drunken Comportment: A Social Exploration (Chicago: Aldine, 1969).
30. Edwards, Alcohol (n. 5), pp. 52-57, quotation from p. 56.
31. Edwards, Alcohol (n. 5), pp. 52-57, Ibid.
32. Katherine A. Chavigny, "Reforming Drunkards in Nineteenth-Century America," in AAC, pp. 108-23.
33. Sarah W. Tracy, "Building a Boozatorium: State Medical Reform for Iowa's Inebriates, 1902-1920," in AAC, pp. 124-64.
34. This includes "the rise of 'issue-focused coalitions,' the secular institution of Protestant moral values; the growth of an increasingly regulatory state with a well-articulated, efficiently organized, social reform mission; the maturation of the professions; and the expansion of scientific and medical authority" (ibid., p. 149).
35. Edwards's reading of this history supports Tracy's view: see Alcohol (n. 5), pp. 91-96.
36. Sarah W. Tracy, Alcoholism in America: From Reconstruction to Prohibition (Baltimore: Johns Hopkins University Press, 2005).
37. Michelle McClellan, "Lady Tipplers: Gendering the Modern Alcoholism Paradigm," in AAC, pp. 267-97.
38. Lori E. Rotskoff, "Sober Husbands and Supportive Wives: Marital Dramas of Alcoholism in Post-World War II America," in AAC, pp. 298-326.
39. Also see Rotskoff, Love on the Rocks: Men, Women, and Alcohol in Post-World War II America (Chapel Hill: University of North Carolina Press, 2002).
40. For a recent scientific view of the effects of alcohol on the brain, see Marlene Oscar-Berman and Ksenija Marinkovic, "Alcoholism and the Brain: An Overview," in "Alcoholic Brain Disease," special issue, Alcohol Res. & Health, 2003, 27: 125-33.
41. A more accessible discussion for laypersons is found in Stephen Braun, Buzz: The Science and Lore of Alcohol and Caffeine (New York: Oxford University Press, 1996), pp. 1-60.
42. Edwards, Alcohol (n. 5), p. 57.
43. John C. Burnham, "New Perspectives on the Prohibition 'Experiment' of the 1920s," J. Soc. Hist., 1968, 2: 51-68;
44. Edwards, Alcohol (n. 5), pp. 85-86.
45. David E. Kyvig, Repealing National Prohibition (Chicago: University of Chicago Press, 1979);
46. Ian Tyrrell, "The U.S. Prohibition Experiment: Myths, Histories, and Implications," Addiction, 1997, 92: 1405-9.
47. The most comprehensive study of this topic remains David Musto, The American Disease: Origins of Narcotics Control, 3rd ed. (1973; New York: Oxford University Press, 1999).
48. Caroline Jean Acker, "Portrait of an Addicted Family," in AAC, pp. 165-81.
49. Caroline Jean Acker, Creating the American Junkie: Addiction Research in the Classic Era of Narcotic Control (Baltimore: Johns Hopkins University Press, 2002).
50. David T. Courtwright, Dark Paradise: A History of Opiate Addiction in America (Cambridge: Harvard University Press, 2001), p. 3.
51. Courtwright has a slightly different take. With the decline of medical (iatrogenic) addiction in the late nineteenth century, "opiate addiction . . . began to assume a new form: it ceased to be concentrated in upper-class and middle-class white females and began to appear more frequently in lower-class urban males, often neophyte members of the underworld. By 1914 the trend was unmistakable" (ibid., p. 3). For Courtwright, "the trend toward criminalization . . . was well underway before the basic narcotic statutes were enacted" (ibid.).
52. Timothy Hickman, "The Double Meaning of Addiction: Habitual Narcotic Use and the Logic of Professionalizing Medical Authority in the United States, 1900-1920," in AAC, pp. 182-202, on pp. 185-86.
53. Lawrence Kolb, "Types and Characteristics of Drug Addicts," Ment. Hygiene, 1925, 9: 300-313;
54. Kolb, Drug Addiction: A Medical Problem (Springfield, III.: Thomas, 1962).
55. Courtwright, Dark Paradise (n. 39), pp. 131-41;
56. Sarah W. Tracy and Caroline Jean Acker, "Introduction," in AAC (n. 3), pp. 1-30, on p. 17.
57. Susan L. Speaker, "Demons for the Twentieth Century: The Rhetoric of Drug Reform, 1920-1940," in AAC, pp. 203-24.
58. John P. Swann's essay, which I do not discuss in detail, is a reprint of an article that first appeared in Pharmacy in History more than a decade ago. It traces the emergence of statutes that resulted in two classes of drugs: those prescribed by physicians and filled by pharmacists, and those that became over-the-counter drugs. John P. Swann, "The FDA and the Practice of Pharmacy: Prescription Drug Regulation before 1968," in FDC, pp. 145-74;
59. reprinted from Pharm. Hist., 1994, 36: 55-70.
60. James Harvey Young, Pure Food: Securing the Federal Food and Drug Act of 1906 (Princeton: Princeton University Press, 1989).
61. Joseph F. Spillane, "The Road to the Harrison Narcotics Act: Drugs and Their Control, 1875-1918," in FDC, pp. 1-24, quotation from p. 15.
62. Joseph F. Spillane, "Building a Drug Control Regime, 1919-1930," in FDC, pp. 25-59, quotation from p. 52.
63. Jim Baumohl, "Maintaining Orthodoxy: The Depression Era Struggles over Morphine Maintenance in California," in AAC, pp. 225-66, quotation from p. 228.
64. Rebecca Carroll, "Under the Influence: Harry Anslinger's Role in Shaping America's Drug Policy," in FDC, pp. 61-99;
65. Carroll, "The Narcotic Control Act Triggers the Great Nondebate: Treatment Loses to Punishment," FDC, ibid., pp. 101-44.
66. Also see Nathan Toby, "A History of the Killer Weed: The Violence Myth, Federal Bureaucracy, and American Society, 1914-1951" (M.A. thesis, Emory University, 2005).
67. William B. McAllister, "Habitual Problems: The United States and International Drug Control," in FDC, pp. 175-207.
68. In a recent book, Richard Davenport-Hines argues that the criminalization and prohibition of drugs has resulted in an epidemic of use and an exacerbation of fatal encounters. The almost paranoid response of puritanical American policymakers has, according to Davenport-Hines, led to a black market and growth in all types of criminal activity: Richard Davenport-Hines, The Pursuit of Oblivion: A Global History of Narcotics, 1500-2000 (New York: Norton, 2002), pp. 420-74.
69. In an interesting review essay that appeared recently in the Bulletin, David Courtwright finds this argument unpersuasive: "What is unique about The Pursuit of Oblivion is that it combines the simplification inherent to world history with the simplification peculiar to polemical exertion. The result is a book that, for all its length and erudition, is almost startlingly reductive: the story of a bad idea imposed upon a doubtful world by aggressive fools" (David T. Courtwright, "Essay Review: Drug Wars: Policy Hots and Historical Cools," Bull. Hist. Med., 2004, 78: 440-50, quotation from p. 445).
70. Steven Novak, "LSD before Leary: Sidney Cohen's Critique of 1950s Psychedelic Drug Research," in AAC, pp. 352-83.
71. Also see Robert F. Ulrich and Bernard M. Patten, "The Rise, Decline, and Fall of LSD," Penpect. Biol. & Med., 1991, 34: 563-75.
72. Peter Kramer, Listening to Prozac (New York: Penguin Books, 1993).
73. Nicholas Weiss, "No One Listened to Imipramine," in AAC, pp. 329-52, quotation from p. 329.
74. Warnings about the hazards associated with SSRIs first appeared in Peter Breggin, with Ginger Ross Breggin, Talking Back to Prozac: What Doctors Aren 't Telling You about Today's Most Controversial Drug (New York: St. Martin's Press, 1994).
75. Also see David Healy, The Anti-Depressant Era (Cambridge: Harvard University Press, 1997;
76. Joseph Glenmullen, Prozac Backlash: Overcoming the Dangers of Prozac, Zoloft, Paxil, and Other Antidepressants with Safe, Effective Alternatives (New York: Diane, 2000).
77. U.S. Department of Health and Human Services, The Health Consequences of Smoking: Nicotine Addiction: A Report of the Surgeon General (Washington, D.C.: GPO, 1988).
78. U.S. Public Health Service, Smoking and Health: Report of the Advisory Committee to the Surgeon General of the Public Health Service (Washington, D.C.: GPO, 1964), pp. 350-51,
79. quoted in Brandt, "From Nicotine to Nicotrol" (n. 6), p. 389.
80. American Cancer Society, Smoke Signals: The Smoking Control Media Handbook (publication developed on the recommendation of the September 1985 International Summit of Smoking Control Leaders. Sponsored by the American Cancer Society, in cooperation with the International Union Against Cancer), p. 25.
81. Smoke Signals: The Smoking Control Media Handbook, Ibid., pp. 13-14;
82. U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, Media Strategies for Smoking Control, from a Consensus Workshop Conducted by the Advocacy Institute for the National Cancer Institute, Washington, D.C., 14-15 January 1988.
83. NIH, Media Strategies (n. 62), p. 36.
84. American Cancer Society, Smoke Signals (n. 61), p. 23.
85. Smoke Signals (n. 61), p. 23., Ibid.
86. Courtwright, writing in the Bulletin, warns against conflating drug policy with drug use: "When doing drug policy history, it pays to zoom in on details: What was the mix of regulations, taxes, and penalties governing access to this drug in this society at this time? When doing drug use history, it pays to zoom out, looking for broader connections among drugs and across cultures. Opium smoking would not have taken root in China had it not been for the introduction and spread of tobacco, with which opium was first smoked. Marijuana smoking would not have taken such hold among Western youth had it not been for the antecedent cigarette revolution. Fewer alcoholics would have meant fewer narcotic addicts, the relief of hangover often inspiring the use of opiates. 'Licit' and 'illicit' categories obscure the indivisibility of drug history" (Courtwright, "Drug Wars" [n. 53], pp. 449-50, emphasis in original).
87. Colin Talley, Howard I. Kushner, and Claire E. Sterk, "Lung Cancer, Chronic Disease Epidemiology, and Medicine, 1948-1964," J. Hist. Med., 2004, 59: 329-74, esp. pp. 372-74.
88. For a representative, accessible, and up-to-date discussion of the brain's reward system and addiction, see Wilkie A. Wilson and Cynthia M. Kuhn, "How Addiction Hijacks Our Reward System," Cerebrum, 2005, 7: 53-66.
89. Patrick Zickler, "Nicotine's Multiple Effects on the Brain's Reward System Drive Addiction," NIDA Notes (National Institute of Drug Abuse), 2003, 17 (6): 1-3.
90. http://www.philipmorrisusa.com/en/health_issues/addiction.asp, last accessed 13 July 2005.
91. For a fuller discussion, see Howard I. Kushner, "Beyond Social Construction: Toward New Histories of Psychiatry," J. Hist. Neurosci., 1998, 7: 141-49, esp. p. 148.
92. There is a persistent view held by a number of historians and sociologists of psychiatry that psychiatric disorders themselves are culturally constructed. For a discussion and critical analysis of these claims, see Howard I. Kushner, Beyond Social Construction: Toward New Histories of Psychiatry, J. Hist. Neurosci., 1998, 7, ibid., pp. 141-49.
93. Edwards, Alcohol (n. 5), p. 162.
94. Also see Edwards, Alcohol (n. 5), ibid., pp. 68-72.
95. Howard I. Kushner, Christena H. Turner, John F. Bastian, and Jane C. Burns, "The Narratives of Kawasaki Disease," Bull. Hist. Med., 2004, 78: 410-39, on pp. 415-17;
96. Morely C. Sutter, "Assigning Causation in Disease: Beyond Koch's Postulates," Perspect. Biol. & Med., 1996, 39: 581-92, on pp. 584-85.
97. Howard I. Kushner, A Cursing Brain? The Histories of Tourette Syndrome (Cambridge: Harvard University Press, 1999), pp. 4-6;
98. Ian Hacking, Rewriting the Soul: Multiple Personality and the Sciences of Memory (Princeton: Princeton University Press, 1995), pp. 8-38.
99. Terra Ziporyn, Nameless Diseases (New Brunswick, N.J.: Rutgers University Press, 1992), pp. 1-2.
100. Wilson and Kuhn, "How Addiction Hijacks" (n. 68).
101. See also Oscar-Berman and Marinkovic, "Alcoholism and the Brain" (n. 32);
102. Braun, Buzz (n. 32), pp. 1-60.
103. Nestler and Malenka, "Addicted Brain" (n. 8), pp. 78-80;
104. Alex Blaszczynski and Lia Nower, "A Pathways Model of Problem and Pathological Gambling," Addiction, 2002, 97: 487-99;
105. Wilson and Kuhn, "How Addiction Hijacks" (n. 68), pp. 58-64.
106. Edwards, Alcohol (n. 5), pp. 163-64.
107. For an interesting discussion of the variety of smokers, see Helen Keane, "Smoking, Addiction, and Time," in Keane, What's Wrong with Addiction? (n. 7), pp. 89-109.
108. David D. Courtwright, Forces of Habit: Drugs and the Making of the Modern World (Cambridge: Harvard University Press, 2002).
109. Davenport-Hines goes further, asserting that "intoxication is not unnatural or deviant. Absolute sobriety is not a natural or primary human state" (Davenport-Hines, Pursuit of Oblivion [n. 53], p. 12).
110. Tammy Saah, "The Evolutionary Origins and Significance of Drug Addiction," Harm Reduct. J., 2005, 2: 1-8, quotation from p. 8.
111. Tammy Saah, The Evolutionary Origins and Significance of Drug Addiction, Harm Reduct. J., 2005, 2, Ibid., p. 1.
112. Also see David M. Buss, "The Evolution of Happiness," Amer. Psychol., 2000, 55: 15-23.
113. Courtwright, Forces of Habit (n. 81), pp. 91-111.
114. As Courtwright demonstrates, Western economies were built on the production and sale of mind-altering drugs - including alcohol, tobacco, coffee, cocoa, tea, and sugar - and the consumption of these substances was no doubt exacerbated by increasingly sophisticated marketing practices. This complements Courtwright's argument in Dark Paradise, that addiction is exacerbated and enabled by the availability of and exposure to mind-altering substances: Courtwright, Dark Paradise (n. 39), p. 6.
115. Volumes have been written attempting to define human consciousness, and its meaning remains an issue of intense philosophical and neurobiological debate. Although there is no definition that seems to satisfy everyone, most philosophers and neuroscientists seem to agree that what they label "higher" consciousness is an emergent property of the human brain that is connected to, if not synonymous with, self-awareness. Perhaps the clearest discussion appears in neuroscientist Gerald Edelman's Bright Air, Brilliant Fire: On the Matter of the Mind (New York: Basic Books, 1992).
116. Also see John R. Searle, Consciousness and Language (New York: Cambridge University Press, 2002).
117. Edwards, Alcohol (n. 5), pp. 165-76, esp. p. 166.
118. Also see T. J. Allen, F. G. Moeller, H. M. Rhoades, and D. R. Cherek, "Impulsivity and History of Drug Dependence," Drug & Alc. Depend., 1998, 50: 137-45;
119. J. M. Murphy, N. J. Horton, R. R. Monson, N. M. Laird, A. M. Sobol, and A. H. Leighton, "Cigarette Smoking in Relation to Depression: Historical Trends from the Stirling County Study," Amer. J. Psychiatry, 2003, 160: 1663-69;
120. Vincent J. Felitti, "Ursprünge des Suchtverhaltens - Evidenzen aus einer Studie zu belastenden Kindheitserfahrungen" (The origins of addiction: Evidence from the adverse childhood experiences study), Praxis der Kinderpsychologie und Kinderpsychiatrie, 2003, 52: 547-59.
121. Ian McEwan, Saturday (New York: Doubleday, 2005), p. 281.
122. Ian McEwan, Saturday, 2005, p. 281., Ibid.
123. Ian McEwan, Saturday, 2005, Ibid., p. 282.