Final Dispatch from Buffalo: Licit Drug Wars

Editors’ Note: The following is the final installment in our series of reports on the biennial ADHS conference held in Buffalo.  Our thanks to Michael Durfee, Nancy Campbell, Joe Gabriel, and Michelle McClellan for their earlier posts.  This time, Joe Spillane tries his hand at post-conference reflection.

Licit Drug Wars

Historians of so-called “licit” drugs face a number of challenges in their work.  Where does that term–licit drugs–even take us, and what does it mean?  In general, of course, it means a focus on regulated-but-legal products of the pharmaceutical industry, but the boundaries of the term are pretty fuzzy.  Still more challenging, it seems to me, is the task of navigating a field where contemporary thought is so dominated by two strong, competing narratives.  The first I’d call the “consumer protection” narrative, in which licit drugs are generally viewed with suspicion as products of an exploitative corporate culture that dupes physicians and victimizes consumers.  The liberal drug warriors, in effect.  The second is what I’d call the “social control/moral panic” narrative, in which efforts to control licit drugs reflects an aggrandizing tendency of state bureaucracies to control all aspects of human behavior, and in which licit drugs (like other substances) are subject to panicked reactions by a society viewing them through the distorting lenses of race, gender, and class.  Four intrepid souls made the journey on this panel.

First, Nick Rasmussen discussed the control of the barbiturate drugs in the postwar United States.  In a fascinating paper, Rasmussen made a convincing case that barbiturates were the subject of extensive policy discussion and legislation in the 1940s and 1950s.  He higlighted local (NYC) and state (New York and California) campaigns to limits distribution and access, as well as the move to restrict barbiturates at the federal level (and give FDA greater law enforcement authority).  For me, this paper really re-periodizes postwar drug control, and reminds us that the pot was boiling well before the 1960s.  In the end, Rasmussen sailed pretty close to the “social control/moral panic” shoreline (indeed, he may have landed and planted his flag): the FDA’s efforts with barbiturates are here seen as a convenient wedge by which to expand their regulatory power more generally, and the social reaction is very much of the panicked variety (a hyper-vigilant defense of the social order).  It still isn’t entirely clear how to reconcile the FDA described here with the agency so eager, by the end of the 1960s, to shed the law enforcement responsibilities it had recently been given.  To the second point, the moral panic formulation still needs some work.  There’s the issue of proportionality, which I have previously raised here, here, and here.  Audience member David Courtwright raised another moral panic issue, that of the displacement reaction–in other words, the idea that fears over barbiturates were simply a proxy for other, more fundamental anxieties.  There’s no definitive answer for historians looking to prove a displacement reaction, but I certainly look forward to seeing more of Rasmussen’s important work.

Lucas Richert told the story of phenylpropanolamine (PPA) and the weight-loss drugs in which it was featured.  Specifically, Richert offered up a rich narrative of PPA’s journey (in the United States) from weight loss wonder drug to banned substance–a narrative that largely covers the final quarter of the 20th century.  Richert does not appear to have planted any flags yet–indeed, like the consumers themselves, Richert finds the contentious battle over PPA to be multi-layered and at times confusing, and he’s right to do so.  Audience member Caroline Acker offered one way through the PPA noise with the idea that at the heart of the PPA case is an evolving effort at risk balancing, efforts which are always historically contingent (and within which there is plenty of room for corporate greed and social distortion!).  In any event, Richert is clearly onto a rich case study, that promises to yield some important work.

Nicholas Parsons offered up a study of the “ADD Epidemic” in major league baseball–the sudden rise in the number of pro baseball players receiving medical waivers to take otherwise banned substances following strict new drug-testing policies adopted in 2006, waivers which included many cases of attention deficit disorder (ADD).  One might have thought that Parsons’ paper was much ado about nothing.  After all, one could certainly have imagined that these numbers would have gone up, and the data itself it so limited, that there isn’t really anything more elaborate that one could do.  But the paper wound up to a very important and challenging premise: access to high quality medical care just might allow some consumers to indulge their psychoactive needs in ways that simply aren’t possible for consumers whose relation to the health care system is more marginal.  That’s certainly an idea rich in implications for both historians and contemporary researchers, and well worth further study by Parsons and others–an idea, frankly, that isn’t contemplated by either the consumer protection or social control narratives.

Finally, Daniel Bradburd presented a “rumination” on drugs in the American workplace, particularly the instrumental use of drugs to enhance (or endure!) daily tasks.  He made a strong case that performance-enhancing drugs have a signficant (if not central) place in American work culture, and his roll-call of work-related drugs was impressively long.  A bit too long, sadly, for Bradburd didn’t quite have the time to take the story back to the conceptual basics.  Still, I think he managed to convince the audience that here, too, was another undeservedly under-studied area of drugs history.

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