Addiction, History and Historians: Samuel Roberts’ Response

Editor’s Note: Today, we present the final set of reflections in our Points symposium on addiction, history and historians.  Last week’s reflections on David Courtwright’s essay included thoughtful posts by Nancy Campbell, Alex Mold, and Daniel Bradburd.  Our final essay comes from Samuel Roberts, Associate Professor of History at Columbia University, and Associate Professor of Sociomedical Sciences at the Mailman School of Public Health.  Prof. Roberts is author of Infectious Fear: Politics, Disease, and the Health Effects of Segregation (University of North Carolina Press, 2009).

“There are Other (Quarrelsome, Social) Scientists”

On Thursday 17 February, 2012, Fox News commentator Eric Bolling, in a mock address to Congresswoman Maxine Waters, advised her, “Congresswoman, you saw what happened to Whitney Houston. Step away from the crack pipe, step away from the Xanax, step away from the Lorazepam, because it’s going to get you in trouble.” These words Bolling had addressed to Waters in response to a speech the congresswoman (D-CA) had made at a rally the previous weekend, In the speech, Waters had labeled the House Republicans (specifically Speaker John Boehner and  Majority Leader Eric Cantor) “demons” from whom she wanted Democrats to take the majority. Singer/actor Whitney Houston had been found dead in the bathtub of a Beverly Hills hotel room, only six days before Bolling’s response. Houston’s battles with drug abuse for years had been grist for late night punch lines, gossip pages, and even, implicitly, a reality show featuring her, her husband (R&B singer Bobby Brown), and their family. Although no official cause of death had been announced at the time of Bolling’s remark, it was widely rumored to have resulted from a combination of alcohol and Xanax, a benzodiazepine. 

Viewers rightfully criticized Bolling for his callousness. On one hand, it was disrespectful to Houston’s family, who at the time had yet even to bury her. Nor for that matter were Bolling’s comments befitting a news anchor’s discussion of a statesperson. Congresswoman Waters, he justly might have remarked, was using perhaps inappropriately hyperbolic language in her description of House Republicans as “demons” (of course, at the Fox News desk, where hyperbolic language is commonplace, the allegation could not have come off anything but disingenuous). Liberal critics decried the implication that Waters had been using mind altering substances as clearly racist and sexist. There never has been any evidence that her use of illicit or licit substances has affected her work performance, or that she ever has used illicit substances or licit substances inappropriately. The only aspect of their lives which Waters and Houston may have had in common was their both being black women.

Such natural guilt by association was one of many things bequeathed to us through the politics of crack cocaine during the Reagan-Bush-Clinton 1980s & 1990s. That inheritance also includes draconian mandatory minimum sentencing established by President Reagan and a Democratic Congress, a condition which helped to produce a spiral of carceral aggrandizement on an unprecedented scale. A cost accounting of the drug war must also consider the massive escalation of law enforcement and the retraction of recovery services for substance abusers. Nobody had sympathy for users. “Crackhead” became the punchline of a joke, synonymous with fool, anyone lacking reason. More insidiously, female users by the late 1980s drew particular fire, popularly labeled “crack whores”, “strawberries”, or worse, combining a lack of sympathy with misogynist loathing, as Fullilove, Lown, and Fullilove argued in 1992. The gendering and racialization of crack cocaine in political discourse extended to reproductive politics and law, especially on the issue of fetal drug exposure, where black and Latino women, and poor women more generally, often have been made to carry the burdens of inequality, as argued by legal scholars Dorothy Roberts and Laura E. Gomez, cultural anthropologist Aline Gubrium, and sociologists Assata Zerai and Rae Banks.

At first blush, this has little to do with the subject matter of David Courtwright’s “Addiction and the science of history,” a robust call to historians for historians to abandon, or at least stay, their oppositional stance in favor of the pursuit of an understanding of the (more empirically objective) neuroscience of drug action.  Failure to do so jeopardizes the little bit of dialogue which we historians have enjoyed with our bench science colleagues on the other end of campus. “While we have not yet reached such an impasse,” Courtwright warns, “I worry that mutual distrust and incomprehension will end the tenuous cross-fertilization between scientists and historians concerned with addiction.” There are good reasons for this call for at least two reasons. First, while I have come to regard claims of “objectivity” with great suspicion (as someone exposed to History of Science methods in the mid-1990s, I share this distrust with many of a similar training and cohort), I do – as do most scholars, I would hope – prefer studies whose arguments rely on well-measured evidence collected through transparent methods. I find it difficult to understand a historian – or most social scientists – who claims true objectivity, simply because outcomes may be different depending on the evidence collected, the manner in which it is collected, and the methods by which it may be analyzed. However, when a scholar is rigorous and honest about the data sets employed, an argument may be, as they say, “true within its method and approach.” This is not objectivity – which implies to me a third person omniscience – but it is good enough for me in that it maintains a standard of research at least largely insulated from bias. What also makes Courtwright’s advice worthwhile is similarly simple: any facility one group of scholars may develop through or for the purpose of interlocution with another group of scholars probably will produce positive results.

These are two worthy points. However, I am uncomfortable with what seems to me a conflation of the two: neuroscience with objectivity. If I may take one telling passage: “To avoid appearing foolish, scientists need to understand that history is the fruit of disciplined research, not something cobbled together from memory, oral tradition and prefaces from old journal articles. Historians, for their part, will gain credibility and insight by adding the new language of addiction neuroscience to the familiar languages of paradigms past. Historians, who are interested in the diachronic development of multiple scientific approaches, are multi-lingual in the classical languages of addiction; laboratory researchers, who are interested mainly in the synchronic elaboration of the current paradigm, are monolingual in their modern language—and blissfully unaware that it, too, will pass into the classics under the pressure of revision. Even so, historians should do their best to understand the latest dispensation.” (p3, italics mine). While I agree that there are valuable insights to be garnered from a facility with “the new language of addiction neuroscience,” I am not convinced that the “credibility” to be gained would be universal, even among neuroscientists. For one reason, a deep familiarity of the current science in brain-drug interactions, for example, would afford the ability to write an informed history of the development of the field. However, this knowledge on its own would not be sufficient to write a real history or to earn one the credibility of one’s peers. Unless one were to write a simple and whiggish “milestones” history, such a work necessarily would have to bring into relief the junctures – in past and present – at which consensus has not been assured, even at which actors are in determined disagreement with one another. A historian could be thoroughly versed in the language of neuroscience and still find that there would be historians and neuroscientists  alike (and for similar or different reasons) who might question the conclusions. This is simply because the field (at least in my understanding) is not entirely unified. Many advances have come as a result of research on drug action on the brain over the past fifteen or more years, but there still remains disagreement over some not-so-fine points.

One of these points, to take an example, regards how environmental elements may trigger drug seeking behavior. Neuroscience alone cannot explain entirely why many individuals are able to cease their destructive behavior without pharmacological assistance, nor why some who may have ceased for several years, even decades, might suddenly relapse after prolonged period of stress or depression. There is also, for that matter, the issue of how drug seeking behavior may spread through social networks. On an even broader scale, there exist (and there are more to come) many very good analyses of how drug politics performs the work of stigmatization (or glorification), social differentiation (marginalization, privilege, etc.), or social mobilization (electoral gains, etc.). None of them need rely particularly on neuroscience to be considered credible. On each of these points we return back to social analyses: social psychology, epidemiology, ethnography, sociology, etc. To those seriously interested in the histories of most of these dynamics, it would be more appropriate to issue a call for historians to master the language of social science.

I agree with our colleague on the point that there is much to be gained from at least some familiarity with the current dispositions of neuroscience. However, I am uneasy with the implication that such knowledge automatically brings one closer to objectivity, in contradistinction to “oppositional” (read biased) scholarship which, as Courtwright notes, most dramatically has targeted illicit drug policy, specifically the ongoing war on drugs. One may believe, deeply, in the explanatory power of neuroscience, and, similarly so, in the necessity of removing bad drug policy. This is the case, for example, with many of the signatories to the Vienna Declaration. One may spend decades in epidemiological research and still be very critical of the Prison Industrial Complex and its effects on the public health in certain communities (see, for example, Ernie Drucker’s A Plague of Prisons: The Epidemiology of Mass Incarceration in America, New York, 2011). In “Addiction and the science of history,” Courtwright begins with “At the bar of addiction knowledge, historians make for excellent companions—until they turn quarrelsome.” However, this comes, ironically, at a time when more and more scholars, from a broadening spectrum of disciplines (even history) have weighed in on the multiple and disastrous effects of the modern drug war. They may be considered “oppositional” in their recognition and scholarly of these effects, and even quarrelsome in their insistence on the failure of current policy means to meet stated policy objectives. However, given the weight of the historical, economic, epidemiological, ethnographic, demographic, and (yes) neuroscientific evidence which they collectively have amassed, “oppositional” should not be read as “biased” or “unobjective.” These are perspectives which we historians should embrace as readily as we would those of the bench scientist. We even may hope that there might emerge even more real dialogue and cooperation between them.

 

 
 

3 thoughts on “Addiction, History and Historians: Samuel Roberts’ Response

  1. Great conversation! I especially appreciate the points raised in this and other responses about the multiplicity and complexity of science and “the latest dispensation.” Historians like to interpret things like the “NIDA paradigm” as cultural processes rather than achieved endpoints: they are the most visible manifestations of complex, conflicted cultural campaigns by various social groups working to accomplish something–to persuade others about what is self-evidently true or “common sense.” The intensity and visibility of these campaigns is not a sign that they have succeeded; we don’t have fierce cultural debates over things everyone agrees on. This one is still intense, so it’s a good bet that it’s not settled. But what are we debating? Courtwright implies, I think, that at least some oppositional historians are debating issues of fact: that they simply refuse to accept that researchers can produce useful new facts about addiction. But I don’t think the facts are the main question, or at least, not in a straightforward way. Science is a wide, rich affair that is producing many different kinds of fascinating “nondiscomfirmable” information about brains and neurochemistry, much of which has relevance for the changing cultural category we call addiction. But historians are right to raise two kinds of questions about it: first, which of the multitudinous new facts will (or have) become part of the “latest dispensation”; and second, and how do those new facts become *relevant* by being translated into cultural narratives–narratives about people, communities, and interactions rather than neurons? Neither of these is a given, and both have enormous political ramifications, not always visible at the outset.** Here, I think, is where historians and humanists are crucial to the conversation: attuned to the social and political salience of battles to establish “common sense,” they can offer insight into the way new nondisconfirmable information becomes a culturally powerful “paradigm” through selecting preferred pieces of information and narrating them together so as to be socially, culturally, politically meaningful–i.e., valuable, for example to someone trying to make policy, or to respond to a sibling in trouble, etc. If it is scientifically naive for historians to ignore that researchers can produce valuable information about drugs and addiction, it would be humanistically naive to assume that the process of turning this information into a “paradigm”–into a way of thinking, rather than isolated points of particular data–can be accomplished without politics. So I also think Courtwright is right, we need dialogue, because I’d hate to see this momentous political and cultural work undertaken without having super-smart historians like Courwright and his POINTS responders be part of the conversation. And I bet that many addiction researchers would agree–if not now, in hindsight, fifty years from now!

    **Check out, for example, this fun pop science piece on memory and forgetting with unexpected bonus thoughts on addiction, http://www.wired.com/magazine/2012/02/ff_forgettingpill/all/1; “true” or not, they certainly spin a different yarn than a singular focus on addiction-specific neural pathways, and highlight how cultural and context can be central to a fundamentally biological paradigm. Or see Elizabeth Wilson’s Psychosomatic (http://www.dukeupress.edu/Catalog/ViewProduct.php?productid=8751) for a different way to make biological knowledge relevant to debates about gender.

  2. This is a superb synthesis of the many points of view elided in the original Courtwright piece.

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