What’s the Point?

The “point” of an academic group blog has been the subject of a fair amount of discussion, and my colleague and co-Managing Editor Trysh Travis has already had her say about that here.

But what is it about the history of alcohol and drugs that seems worthy of the time and attention that we’re devoting to this particular academic blog?  There’s more to the answer than could fit in a single post, but why not start by considering the “points” featured in the header of the blog?  The image shows a beautifully detailed nineteenth-century syringe case, with marvelous decorative details.  How many doors are opened up when we follow the history of the syringe?  Here are a couple:

Technology, culture, and human behavior—David Courtwright showed us in Forces of Habit how global ebbs and flows of psychoactive substance use emerge from the place where commerce, culture, and politics meet. (1)  So, too, for the technologies of drug administration.  The hypodermic syringe entered medical practice in the third quarter of the nineteenth century.  It diffused into medical practice fairly rapidly (alert: that’s a story yet to be fully told).  On the other hand, the syringe hardly displaced the massive sales of oral opiate preparations sold by patent medicine firms.  Moreover, the recreational consumption of opiates tended to ignore the syringe.  Opium smokers, obviously, had no use for the syringe; after heroin’s introduction in 1898, most users were “sniffers” of the drug, and injection users were largely shunned as the lowest rung on the drug-using ladder.  The injection use that took place was primarily subcutaneous (skin-popping) and not intravenous.   I.V. use of opiates emerged only later, in the 1930s and 1940s, as a dominant mode of use among recreational users—a story told well by John A. O’Donnell and Judith P. Jones back in 1968.  Studying patient records from the Lexington Narcotic Hospital, they found that the percentage of white admissions with I.V. experience rose from 44 percent in 1935 to 67 percent by 1945, while black admissions with I.V. experience went from 40 percent to 94 percent in the same period. (2) What happened?  O’Donnell and Jones explained the change by guessing that there had been changes in the “addict subculture” after about 1925, which rendered the syringe less frightening.  That’s probably true, though the declining potency of the available heroin also helped to open the door to I.V. use.  In any event, there’s a pretty complex story to be told here—and it is one that can be repeated countless times when we consider the embrace (and rejection) of myriad psychoactive substances and their modes and sites of use.

Law and Human Experience–There’s a tendency to tie the history of drugs and alcohol in the modern era to various accountings of the origins of prohibitionist legislation.  There’s nothing wrong with being interested in prohibition, of course.  Despite a seemingly endless profusion of books on alcohol Prohibition in the United States, for example, we’re still getting new and engaging work.(3)  But the intersections of law and the human experience with psychoactive substances go well beyond prohibition and (of course) well beyond law’s enactment.  Once again, the humble syringe shows the way.  Consider the following: On October 31, 1932, Charity Hospital in New Orleans admitted a comatose man, diagnosed with malaria and thought to be a drug addict.(4)  The patient deserted the hospital after being revived, was readmitted two days later, again in a coma.  He died the following day.  Over the course of the next month, five more Charity Hospital patients, all injecting drug users, died of malaria.  Over the course of the following year, a total of 48 injecting drug users were admitted to Charity Hospital with diagnoses of malaria (10 died).  There’s a legal context here.  The New Orleans police had determined, in 1933, to begin interpreting the state laws regarding unauthorized possession of a syringe to include medicine droppers and hypodermic needles.  In response, addicts reported, an “outfit” would be planted in a single safe location, to which users could come to inject.  There’s a larger “policy” context here as well.  The mortality rate for injection drug users here was fifteen times higher than for malaria cases in the state as a whole.  Why?  In part because of the criminalization of the behavior, but also because of the utter lack of a public health infrastructure capable of tracking drug users and their behavior, much less responding with constructive interventions.  The syringe, then, is embedded within fluid legal and policy contexts that matter a great deal to actual people.   There’s a real need to supplement our “big” stories of prohibition with smaller but even scarier stories of law and policy in action.

Enjoy what’s posted here.  We hope it will be thought provoking, and we welcome any and all responses from our readers.

NOTES

(1) David T. Courtwright, Forces of Habit: Drugs and the Making of the Modern World (Harvard University Press, 2002).

(2) John A. O’Donnell and Judith P. Jones, “Diffusion of the Intravenous Technique Among Narcotic Addicts in the United States,” Journal of Health and Social Behavior 9 (1968): 120-130.

(3) Three favorite recent titles could not be more different from one another (the better to illustrate the breadth of writing on Prohibition in the U.S., I guess).  Jason S. Lantzer, “Prohibition Is Here To Stay: The Reverend Edward S. Shumaker and the Dry Crusade in America (University of Notre Dame Press, 2009); Michael A. Lerner, Dry Manhattan: Prohibition in New York City (Harvard University Press, 2007); and Daniel Okrent, Last Call: The Rise and Fall of Prohibition (Scribner, 2010).

(4)  A good deal of information about his episode in New Orleans can be found in James A. Bradley, “Transmission of Malaria in Drug Addicts by Intravenous Use of Narcotics,” American Journal of Tropical Medicine 14 (1934): 319-324.

8 thoughts on “What’s the Point?

  1. I thought this was a wonderfully written (and reasoned) justification. I’m excited to see where this project goes in the future – I’m agreed on all counts about the need for academics to reach out to larger audiences, especially those who study something as socially relevant as the history of drugs.

    I occasionally post some findings from my (early stages) dissertation on the early modern drug trade on my blog which might be of interest to readers of this one:

    http://resobscura.blogspot.com/2010/11/compleat-history-of-druggs.html

  2. Ben, thanks for the positive feedback. Your site is brilliant, and beautiful to look at; hopefully some of our readers will take a moment to pop in and see what you’re doing. One of the great challenges with having a lot of modernists running this blog is to make sure we don’t lose sight of what’s happening in the early modern world! For our readership, the points of interest in the period may be less hard to discern, so we need to do our best to keep up. Feel free to suggest some points of entry.

  3. Hi Joe, I’m not a statistician and would like some expansion of the meaning here between percentages and actual numbers. Thanks in advance.

    “Studying patient records from the Lexington Narcotic Hospital, they found that the percentage of black admissions with I.V. experience rose from 44 percent in 1935 to 67 percent by 1945, while black admissions with I.V. experience went from 40 percent to 94 percent in the same period.

  4. Dave, not even a statistician could have helped you out, since you caught a typographical error in the original post (which has now been fixed). The first part of that sentence should have read “Studying patient records from the Lexington Narcotic Hospital, they found that the percentage of WHITE admissions with I.V. experience rose from 44 percent in 1935 to 67 percent by 1945…” That correction should, I expect, make the meaning of the sentence a little clearer! So both white and black admissions to Lexington saw substantial increases in the prevalence of I.V. drug use, but that increase was certainly more marked among black patients. Now, there’s further work one could do to explain some of that difference. How were admissions determined? How did the existence of “voluntary” admissions to Lexington influence the percentages of I.V. users found there, and was there a racial discrepancy there. Still, the basic numbers show that something’s happening in this time period. There are other studies that date from the mid-1930s and earlier that seem to confirm a relative dearth of I.V. drug use. One notable example is Bingham Dai’s doctoral research, conducted at the University of Chicago using data from 1928-1934, and published in 1937. His data shows that the syringe was pretty widespread, but not intravenous use (which was the regular mode of administration for only about 2% of his sample; not the same as the Lexington “any experience” measure, of course).

  5. I’m a first year graduate student at UNLV and focus on early modern British cultural history. I’m fascinated by conversation and manner and how alcohol and drugs relate to these concepts throughout social history. I’m so happy to have stumbled onto this site and community of scholars! I can’t wait to read through the archives.

    • It’s good to have you wading through our not-yet-very-large archives! Please keep reading, and post comments and questions any time.

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