Editor’s Note: Today is the last piece in our six-part series of articles discussing drug use in Africa. These articles originally appeared on The Conversation, but we’re republishing them here as well. Today’s article comes from Rebecca Hodes, Director, AIDS and Society Research Unit, University of Cape Town.
Much of what we know about human history comes from studying things that have been discarded. The archaeology of dumpsites and middens has long informed us about societies and their pasts. This has included how people survived and sustained themselves, what they gathered, made, amassed and discarded.
Histories of rubbish have also shown that beliefs about sanitation, and what makes for a clean environment, change. These changes are, in turn, influenced by developments in technology, forms of governance, and consumer norms.
I conducted a study on an archive of medical materials, collected over three years from public waste sites around South Africa’s Eastern Cape. What I refer to as ‘pharmatrash’ serves as a proxy for which medicines were provided or purchased, consumed, and then discarded. Pharmatrash in post-Apartheid South Africa shows the vast proliferation of medical waste, the result of increased access to healthcare products in both the public and private sectors – and on the formal and informal markets.
Symposium and Special issues of Pharmacy in History, The Social History of Alcohol and Drugs, and Canadian Bulletin of Medical History
The aim of this Call for Papers and ensuing special issues is to generate a discussion related to the underexplored social history of pharmacy and pharmaceuticals. This 2-day interdisciplinary symposium will stimulate/connect new scholarship as well as place a spotlight on emerging trends in the studies of pharmaceuticals, drugs, and alcohol more broadly.
Pharmacies are important social, political, and economic spaces. And many of the products sold within pharmacies (or apothecaries) exist at the intersection of legitimacy and illegitimacy, domestic and international markets, and medicine and recreation. Candy and cannabis, alcohol and cigarettes, in addition to multiple lifestyle products, are sold in pharmacies in the U.S. as well as abroad. Of course, these goods are in addition to other prescription and over-the-counter (OTC) drugs.
In the summer of 1955, Disneyland opened its doors to the public for the first time. As tens of thousands of wide-eyed visitors entered the Magic Kingdom on opening day, one of the first sights they saw was a small, unassuming apothecary shop at the corner of Main and Center Streets. This was the Upjohn Pharmacy, a company-sponsored store that told the tale of the drug industry then and now.
The Upjohn Pharmacy came to be through a string of fortuitous circumstances. Jack Gauntlett, The Upjohn Company’s advertising manager, recognized Disneyland’s unprecedented potential for brand promotion, and he approached the director of the company, Donald Gilmore, with the idea for the store. Unbeknownst to Gauntlett, Gilmore was close friends and part-time neighbors with Walt Disney (both men owned homes at the Smoke Tree Ranch in Palm Springs, California). Disney had been seeking corporate sponsorship as a means to help him fund his theme park, and with an existing connection to the head of The Upjohn Company, the groundwork for the Upjohn Pharmacy was laid.
Editor’s Note: You know you’ve always wanted to visit South Africa. Here’s your chance! Check out this CFP for an exciting conference at the University of Johannesburg this December.
Beyond the Medicines/Drugs Dichotomy: Historical Perspectives on Good and Evil in Pharmacy
University of Johannesburg 5-7 December 2019
The dichotomy between pharmacologically-active substances considered legitimate (and therefore worthy of regulation as medicines, and also provided as public goods) and those considered problematic (and therefore deserving of moral and legal opprobrium, prohibition and sanction) has informed global regulatory regimes for decades. (Andy Gray, 2017)
Drug policies and ways of thinking and talking about substances and treatment approaches are changing fast, both at national and international levels. These changes reflect a growing acknowledgement of core contradictions within the legislative regimes Gray described above, crafted respectively for ‘drugs’ and ‘medicines’ from the nineteenth-century onwards. Subversions of this dichotomy have lately become more apparent in the public eye – for example, in widespread addiction to opioid painkillers; in the repurposing of pharmaceuticals for pleasure, sedation or sociability; in the scientific legitimation of previously restricted drug alkaloids for medical application. Increasing criticism of ‘war-on-drugs’ style governance, the liberalisation of cannabis laws, and the advocacy of harm reduction approaches to drug treatment are among the indications of shifting views even within governments themselves.
The organizers of this event argue that precise historical understandings of how this dichotomy has worked in practice, in multiple and very different contexts, are necessary in order to map possible alternatives and futures. To clearly identify who established and maintained classificatory boundaries, what interests lay behind their actions, how they have been challenged, and why it is only now that faith in them seems to be waning are important tasks for historians of health, medicines and modernities, and those working in related fields and disciplines.
This event at the University of Johannesburg aims to draw together those addressing the questions below in their research. We invite submissions from postgraduates, together with emerging and established scholars, and are keen to include studies from around the world, as well as those that look at international or transnational contexts.
What knowledge was generated to justify distinctions between medicines/drugs? By whom? How were decisions made about what evidence could be considered authoritative?
Which groups and/or disciplines were involved in establishing or challenging the emergence of this dichotomy and what determined their success or failure?
How have histories of various substances been created and deployed in justifying or disputing this dichotomy?
What values have driven pharmaceutical technologies and their regulation? How have ideas about ‘good’ and ‘evil’ framed scientific and political discussions?
How long has a shift towards a neuro-chemical society been happening and with what effects? Has it necessarily been a dehumanising process?
Have chronologies of commodification, lawmaking and enforcement followed similar routes in different countries or contexts?
How do historians recover neuro-chemical biographies, and what do these reveal about individual or collective experiences of the medicines/drugs dichotomy in practice?
The event is funded by the Wellcome Trust and is jointly organised by the Department of History at the University of Johannesburg and The Centre for the Social History of Health and Healthcare (CSHHH) Glasgow through the ‘Changing Minds: Psychoactive Substances in African and Asian History’ project.
The event will take place from 5 to 7 December 2019 at the University of Johannesburg.
Call for Papers
Please submit a title, an abstract of no more than 200 words which addresses some of the above questions, along with a narrative biography of 200 words, to Caroline Marley (firstname.lastname@example.org) and Thembisa Waetjen (email@example.com) by 20 September 2019.
Applicants will be informed of the committee’s decision by 4 October 2019.
Funding This event is made possible by the generous support of the Wellcome Trust. Some funding for travel and accommodation is available, and will be prioritised for graduate students, post-doctoral fellows and early career researchers, particularly where they are located at institutions in the Global South.
Drug policy historians, academics and the press more generally often present drug use as though it were a marginal activity. We can fault a lot of this confusion on the arbitrary distinctions that are commonly made, starting with categories like legal and illegal use, which are then further subdivided and sliced into even more granular classifications.
Thomas Hager’s Ten Drugs whose focus is on prescription “medications,” opens the book by highlighting drugs’ ubiquity in American life: “More than half of all Americans take at least one prescription drug on a regular basis, and most of those who fall into that group take more than one (somewhere between four and twelve prescriptions per person per year, depending on which study you look at). One expert estimates that Americans takes an average of ten pills per person per day. Add in nonprescription drugs—over-the-counter vitamins, cold and flu remedies, aspirin, and other supplements—and run the numbers: Let’s say a low-ball estimate of two pills per day per American over an average of seventy-eight plus years of life. The total outcome comes to somewhere more than 50,000 pills, on average, in the average American’s lifetime. And there’s a good chance it’s a lot more. Americans constitute less than 5 percent of the world’s population but spend more than 50 percent of the money that flows into the world’s drug companies. And that’s not even counting illegal drugs.”
Once you throw in recreational and illegal drugs, this leaves no segment of society untouched. These figures could be interpreted as troubling, as our society grows ever reliant on psychological crutches to get through the day. Of course, while that’s partially true, there are also serious issues that have been left unresolved, to say nothing of the precarious state millions wake up to. Setting that aside, the larger point is our discourse is divorced from this underlying reality.
Describe your book in terms your bartender could understand.
Strange Trips is about “dangerous drugs and magic bullets,” terms that many of us have heard and used. The book investigates how and why these labels (may) change over time. Drugs and pharmaceuticals are far from fixed entities that exist in hermetically sealed bubbles! So I use a number of substances (such as heroin, LSD, cannabis, and others) to challenge the idea that scientific and medical understandings alone determine perceptions of drugs in the modern era. And I make the case that a complex negotiation is happening between medico-scientific knowledge and culture.
In 2019, I feel like we’re operating in an environment where drug policies and regulations are more fluid than ever before. At least as far as I can remember. Strange Trips offers a background for discussions surrounding medical cannabis or the opioid crisis in the present.
What do you think a bunch of alcohol and drug historians might find particularly interesting about your book?
I don’t narrate a linear history of a single substance. Instead, I spotlight several different drugs and put them in dialogue with each other. I definitely enjoy singular biographies of substances or pharmaceuticals, don’t get me wrong. But I reckon that blended analyses will be of value to the historiography as well.
Now that the hard part is over, what is the thing YOU find most interesting about your book?
The character studies. The subtler moments. The finer details. Also: playing with the content and the form of an academic book. Y’know, we have to take pleasure in the writing process.
Another thing I find intriguing about the book at this moment is the evolution: what was cut and why. Where (and who) I was when I started, versus where (and who) I am now. Silly, but true.
Every research project leaves some stones unturned. What stone are you most curious to see turned over soon?
For sure. There are always more avenues to explore. I look forward to seeing the results of various ongoing projects out there: pharmaceuticals and sexual politics (think LSD and conversion therapy); so-called lifestyle drugs; and stimulant use in Asia. I try and keep my finger on the pulse. This might also be a useful opportunity to invite submissions to Social History of Alcohol and Drugs: An Interdisciplinary Journal, which just moved to the University of Chicago Press.
BONUS QUESTION: In an audio version of the book, who should provide the narration?
That’s a difficult one to answer. For the English language version, I’ll pick two: Dame Judi Dench and Peter Capaldi. I’d have to think more carefully about other languages.
David Herzberg, Nancy Campbell, and Lucas Richert (L-R), the co-editors of the Social History of Alcohol and Drugs journal
Michele Bachman’s implosion on the campaign trail back in late September is now widely accredited to her suggestion that the HPV vaccine causes mental retardation. In an earlier post, I argued that pundits should think twice before dismissing Bachman due to her position on this topic, and while Bachman’s campaign collapsed a lot more quickly than I expected, I continue to think that her arguments about vaccination were potent ones.
"La Vaccine Mort en Avortant de Son Dernier Monstre," ca. 1800
There is a deep distrust of the pharmaceutical industry running through much of American culture – indeed, a Harris Poll last year found that just 11% of Americans consider pharmaceutical companies “honest and trustworthy,” a remarkable finding given that virtually all of us place the products of these companies in our bodies and many of us literally depend upon them for our lives. The idea that the drug companies are deceitful and, perhaps, predatorial is widespread, stretching from the halls of academia to the claims of Scientologists, from right wing populists to the Rainbow Family, from alternative health care practitioners and their allies in the New Age and health food movements, to patient advocacy groups, anti-psychiatrists, and more. Even libertarians, who usually trust just about anyone able to make gobs of money, exhibit a certain skepticism of the pharmaceutical industry when they start talking about legalizing marijuana and other drugs. So what’s going on here? Continue reading →
Joe Spillane recently pointed us to Caroline Rance’s blog, “The Quack Doctor,” and suggested that her posts – filled with advertisements for things such as “Carter’s Little Liver Pills” and “Effervescent Brain Salt” – form a “reasonable platform” for historians to “ask the larger questions about consumer behavior, medical authority, business interests, and the role of each in shaping everything from health cultures to health care policy.” In that spirit, I’d like to suggest that those of us who write about the history of pharmaceuticals might want to reconsider our dismissive attitude toward the patent medicine industry. Rather than derisively laughing at the industry – look at that advertisement for brain salt! I can’t believe people bought that stuff! – perhaps it is time that we try to understand it on its own terms. Continue reading →