Editor’s Note: Today’s post comes from contributing editor Jordan Mylet, a doctoral candidate in history at the University of California, San Diego. This is Part 1 in a series on The Addict and Addiction Treatment Before the War on Drugs. The next installment will come in March.
It is common today to think about drug addiction as an illness or disorder, and the opioid epidemic as a public health crisis that deserves a robust medical response. This framework is often paired with an implicit (or not) rebuke of past ways of dealing with addiction as a sin or a crime, something to be shamed and punished. The fact of mass incarceration, which has filled jails with hundreds of thousands of drug offenders, predominantly of color, since the early 1970s, has rightfully precipitated a renewed emphasis on treating addicts as people in need of treatment, not prison time.
However, if one looks closely at the long history of medicalizing drug addiction in the United States, they might conclude that applying a treatment framework to addiction does not necessarily lead to clear-cut or even humane solutions. In fact, the mid-twentieth century architects and enforcers of narcotics control policy—with its street-level raids and mandatory sentences—also espoused a belief in addicts’ sickness and need for medical treatment. When public concern about drug addiction skyrocketed in the postwar years, the dilemma facing policymakers and medical professionals was what was to be done with the addict, given that she was sick. In this way, debates over addiction and rehabilitation were also clashes about the responsibilities of the state to its citizens and the limits of individual liberty.
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Editor’s Note: Today’s post comes from Dr. Kerwin Kaye. Kaye is Associate Professor of Sociology, American Studies, and Feminist, Gender, and Sexuality Studies at Wesleyan University in Connecticut. He is the author of the recent publication, Enforcing Freedom: Drug Courts, Therapeutic Communities, and the Intimacies of the State, from Columbia University Press.
Setting the Scene
Dr. Kerwin Kaye
Most of those who study the history of drug treatment are probably already aware of the troubled story of Synanon, the first therapeutic community (or TC) for the treatment of drug addiction. Initially founded in 1958 in Santa Monica, California, Synanon was led by Chuck Dederich, a charismatic if sometimes abrasive figure by all accounts. While Synanon enjoyed approximately a decade of favorable media coverage (including praise from the California governor, a U.S. Senator, and a made-for-TV movie that valorized its approach), by the 1970s, press coverage turned decidedly negative. Dederich ordered all of the residents within Synanon to change their romantic partners, and decided upon the new pairings himself. Dederich also created an armed wing within Synanon called the Imperial Marines, and ordered those within the unit to prevent any of the residents from leaving. When one woman successfully fled and managed to get a lawyer to aid her legal case against the organization, that lawyer found himself the victim of a rattlesnake that had been placed in his mailbox on Dederich’s orders. Dederich was forced to step down from his leadership position within Synanon, but — as Time Magazine put it in 1977 — the organization was now seen as “a kooky cult.”
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Editor’s Note: Today’s post comes from contributing editor Brooks Hudson, a PhD student in history at Southern Illinois University.
If you’ve followed the opioid issue, you might suspect, based on media reports and statements from policymakers, that we have turned over a new leaf in our attitudes toward drugs and are finally moving in the right direction: today we are “expanding treatment” and abandoning the former “punitive” morality play model. Elite discourse reinforces the perception that we have become more sophisticated, science-based and compassionate to users and those with substance use disorders.
That’s only partially true, but not because powerful institutional actors experienced a change of heart; they had to be dragged kicking and screaming into embracing, if only rhetorically, this new model. If anything, grassroots activists, harm reductionists, health workers and criminal justice advocates on the front lines have waged tireless, and at times seemingly thankless, campaigns to reform our draconian laws, and they have succeeded. (Prime examples of these successes include legalizing cannabis, decriminalizing psilocybin in Denver, and expunging criminal records for marijuana arrests in some states.) Activists also shifted the conversation away from the dehumanizing language used to describe people who use drugs among press and policymakers (“junkie,” “addict,” etc), a language that enabled us to conceive of other people as less than human, making it easy on our collective conscience to confine them to cages. Even now, further incremental baby steps are met with the same hostilities and recitations of the parade of horribles that would be unleashed as they used before.
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Editor’s Note: Today’s post comes from contributing editor Jordan Mylet. Mylet is a doctoral candidate in history at the University of California, San Diego.
When Bill Wilson had the “spiritual awakening” at the upscale Charles B. Towns Hospital in New York City that would inspire the founding and program of Alcoholics Anonymous, he probably didn’t know the strange, at times sinister, history of the treatment that made his transcendent experience possible.
What he received was the Towns Hospital’s version of the belladonna treatment, which had emerged as a cutting-edge addiction treatment in 1900 and became the dominant method in public and private hospitals by the 1920s. Per its name, the treatment was derived from alkaloids of the belladonna and henbane plants in the nightshade family, which had been used for millennia as poison, cosmetic enhancement, and hallucinogen. They were known to be potent, psychoactive, and potentially fatal. As the belladonna treatment (or “hyoscine cure”) spread in American medical practice, physicians and medical researchers engaged in an unwieldy process of trial and error to control the volatile qualities of the drug mixture. In practice, this meant that poor addicts and alcoholics during the first decades of the twentieth century encountered a far more dangerous version of the belladonna treatment. The course of the hyoscine cure reveals the long history of the United States’ two-tiered addiction treatment (and healthcare) system, and the at times wildly experimental character of medicine and pharmacology in the early twentieth century, the same era in which the nation’s narcotics control laws were developed.
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Editor’s Note: Welcome to the first installment of the Points Bookshelf, in which we review books about drugs, alcohol, history–and maybe even a combination of all three. We open with a review of Judith Grisel’s new book “Never Enough: The Neuroscience and Experience of Addiction,” which was released last month.
If you’re interested in reviewing a book for Points, get in touch! You can reach editor Emily Dufton at emily.dufton (a) gmail.com
Sometimes it’s nice to consult an expert.
I first heard Judith Grisel on Fresh Air. Her interview with Terry Gross was fascinating. She has a PhD in behavioral neuroscience and psychology from the University of Colorado, Boulder, and she spent a good part of her early life addicted to numerous substances, including alcohol, marijuana, cocaine, heroin, and more. Now drug-free for over thirty years, she is a professor of psychology at Bucknell University, in Lewisburg, Pennsylvania.
Her approach to the difficult subject of addiction is thus colored by all of her experiences. Because of her years as someone who had an unhealthy romance with numerous intoxicants (the title comes from a statement a friend made to her in a seedy hotel room in Miami as they snorted up as much cocaine as they physically could; there would “never be enough cocaine” for Grisel, her friend said, and when she realized the truth in this statement, it was a turning point in her life and career), she’s aware of the havoc addiction can wreak in individuals’, families’ and communities’ lives. As a neuroscientist and psychologist who has spent decades studying how the brain reacts to, and adapts to, intoxicant use, she’s also adept at explaining the biological and neurological underpinnings of this issue.
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Editor’s Note: Today’s post comes from guest blogger Nicole Allen. Nicole is a freelance writer and educator based in the Michigan and believes that her writing is an extension of her career as a tutor since they both encourage learning and discussing new things. When she isn’t writing, you might find Nicole running, hiking, or swimming. She’s participated in several 10K races and hopes to compete in a marathon one day.
It seems to be these days that whenever there’s money involved, there’s always a sure case of fraud. Although fraud is not new in business transactions, it can be surprising that some people are finding devious ways to trick insurance companies into paying for the rehabilitation process. Much like watching crime and investigation documentaries about insurance fraud, individuals can also “fake” their way into claiming a benefit from a company, without using it for the actual cause.
As seen in a Roman epigram: A case of fraud?
Surprisingly, insurance fraud is not a new thing–in fact, it may even be as old as the stone statues built by the previous civilization. As seen in an epigram by the Roman poet Martial, there is a clear evidence that insurance fraud dates back to the old ages of the Roman Empire:
“Tongilianus, you paid two hundred for your house;
An accident too common in this city destroyed it.
You collected ten times more. Doesn’t it seem, I pray,
That you set fire to your own house, Tongilianus?”
Source: Book III, No. 52, Martial
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