GUEST POST: JONATHON ERLEN’S DISSERTATION ABSTRACTS (SPRING 2015)

Editor’s Note: Readers of Social History of Alcohol and Drugs, the Alcohol and Drugs History Society’s journal, are aware of Jonathon Erlen’s ongoing bibliography of recent dissertations related to alcohol, tobacco, and other drugs. Until recently, Dr. Erlen, the History of Medicine Librarian at the University of Pittsburgh, curated and published his dissertation lists in the print edition of the journal. Last August, the Alcohol and Drugs History Society moved the publication of Erlen’s bibliography to the blog. Below, we highlight a few entries that may be of interest to alcohol and drugs historians and provide a link to the complete listing of Erlen’s selections from the ProQuest index. The highlighted entries were harvested from ProQuest’s database in the spring of 2015.

Link to complete bibliographies:

Substance Abuse Dissertation Abstracts

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The Films of Adrian Cowell: Opium stories from the Shan State to Hong Kong to Washington, DC (Guest Post)

EDITOR’S NOTE: Points is thrilled to welcome Hannah Palin (Film Archives Specialist) and Nicolette Bromberg (Visual Materials Curator) from the University of Washington Libraries, Special Collections. The University of Washington has a wonderful collection of materials by the British filmmaker and journalist Adrian Cowell. Beware, alcohol and drugs historians– once you read their descriptions of the Cowell collection, you might be tempted to book your tickets to Seattle!

In January 2015, the University of Washington Libraries, Special Collections, received  6 pallets of materials shipped from London. They were stacked high with boxes of 16mm film, audio and videotape, photographs, newspaper clippings, transcripts and log books—covering three decades of work by British filmmaker and journalist, Adrian Cowell. From the 1960s to the 1990s, Adrian Cowell created television documentaries detailing the complex relationships between minority insurgents in a remote region of Burma and the international opium trade originating in Southeast Asia. The Adrian Cowell Film and Research Collection contains Cowell’s work tracking the opium trade from its production in Burma to the addicts and dealers in Hong Kong to the drug policy makers in Washington, D.C. It includes the most extensive collection of images of the remote Burmese Shan State in the world, gathered during Cowell’s trips documenting opium merchants, opium caravans, militias, insurgents and other activities related to the opium trade. A year and half after its arrival, Special Collections’ staff, students, and volunteers are still slowly working their way through the collection of over 2000 items, most of which have never before been made public.

Adrian Cowell introducing The Warlords, Part Two of The Opium Series

Adrian Cowell introducing The Warlords,
Part Two of The Opium Series

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The Points Interview: Mary Neuburger

EDITOR’S NOTE: Points is delighted to welcome Mary Neuburger, a Professor of History; Chair of the Department of Slavic and Eurasian Studies; and Director of the Center for Russian, East European and Eurasian Studies at the University of Texas at Austin. Below, Neuburger discusses her recent book, Balkan Smoke: Tobacco and the Making of Modern Bulgaria (Cornell, 2012), which chronicles the politics of tobacco production and consumption in Bulgaria from the late Ottoman period through the years of Communist rule. 

Screen Shot 2015-04-27 at 9.16.14 AMDescribe your book in terms your bartender could understand.

Balkan Smoke is a cultural and social history of tobacco in Bulgaria, with focus on the modern period, roughly 1863-1989. It traces the long and transformative process of the introduction and then expansion of largely “Oriental” tobacco production and exchange in this region, in tune with the rise of a global addiction to tobacco. Like most commodity histories, it is a story that inevitably crosses borders, elaborating on the roles of the most critical global and regional players like the Ottoman Empire—from which Bulgaria became autonomous in 1878 and independent in 1908—as well as the United States, Germany, and the Soviet Union.  The tracing of this process is coupled with a history of smoking (and anti-smoking) culture in Bulgaria, again in the context of global shifts in smoking practices. The books looks at the rise of and changes in patterns (particularly of public) smoking in Bulgaria, but also at the varied (though largely unsuccessful) sources of resistance to tobacco on health, social, and moral grounds.  All of these processes take quite different forms in late Ottoman and early post-Ottoman Bulgaria, in times of war, particularly World War II when Bulgaria was aligned with Nazi Germany, and then, perhaps most dramatically under communism. It is this part of the story that is perhaps the most revealing, as the Bulgarian communist tobacco monopoly, with its gargantuan Soviet market, became the top exporter of cigarettes in the world by the mid-1960s. It was attuned to consumers, and willing and able to adopt technologies and aesthetics wholesale from the West, all in the name of “building socialism.” Given the central role of this industry in the Bulgarian economy, state-driven anti-tobacco campaigns, which peaked in the mid-1970s, were always half-hearted and doomed for failure.

What do you think a bunch of alcohol and drug historians might find particularly interesting about your book?

Historians of alcohol and drugs undoubtedly share my fascination with historical changes in the acceptability of intoxicants in various contexts. Bulgaria presents a fascinating case because of its place on the “periphery” of Europe, with a complex set of outside influences that shaped its encounter with tobacco. Tobacco was introduced from the New World into the Ottoman Empire in the 17th century, where the plant adapted to the local climatic and soil conditions growing on small mountain plots (as opposed to plantation lowlands as in the US). Its properties altered into various “Turkish” or “Oriental” varieties that were more flavorful, had less nicotine, and eventually became were sought after in Western markets. This was particularly true after the success of the famous Camel brand released by R.J. Reynolds in 1913, and the eventual dominance of the market of American (and European) “blends”. In the Ottoman Empire, smoking was historically a Muslim habit, an accompaniment to coffee, consumed in hookahs and pipes in the largely Muslim coffeehouse—an institution (and beverage) that spread West in the early modern period. By the late nineteenth century, however, Ottoman Christians, including Bulgarians, were becoming smokers and tobacco consumption expanded rapidly in the twentieth century, tied to Bulgaria’s Europeanization following its gaining of autonomy in 1878, to the World Wars and the Cold War.  The local coffeehouse was replaced by the gleaming European-style café, and ties to European, American, and Russian markets played a role in the expanding Bulgarian tobacco economy.  This is just a taste for the kinds of details the books engages, putting the story of the rise of a dominant tobacco economy in Bulgaria into a complicated regional and global context.

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Will I Be A Dope Doctor When I Grow Up?

EDITOR’S NOTE: Points is delighted to welcome Kim Sue, a previous contributor (check out her earlier posts here and here), medical anthropologist, and dual degree MD/PhD candidate at Harvard University. On the heels of Points’ recent posts about the difficulties of reconciling clinical and scholarly perspectives on addiction treatment and the media frenzy about the recent prescription opioid epidemic, Sue offers a historical and ethical reflection on having the power to dispense prescriptions.

I first met Anita in the Boston jail where she was doing time for passing bad checks related to a prescription opioid addiction. She had first been introduced to opioids after giving birth to her first child several years earlier. “I was prescribed percs [percocets] for pain related to the delivery,” Anita explained. “I just remember taking them and being high and cleaning … I took four or five at a time.” Anita’s drug use spiraled out of control, as her physiological tolerance to the opioids increased and she needed to buy more and more pills to get the same effect. One day, Anita’s dealer offered her heroin, and off she went.

Ethnographers and historians of drug use are all too familiar with stories that resemble Anita’s. As an anthropologist who studies prisons and addiction treatment, I find it relatively easy to point the finger at doctors for their professional complicity in “epidemics” of opioid addiction.

But as a medical student in my final year, destined to start residency in July in an internal medicine-primary care program, I also worry I won’t be able to refuse prescriptions for opioids for patients presenting to me in distress and pain.

Historians of medicine and drug use have detailed how physicians—whether they wanted to or not—became central to the distribution and administration of opioids in the United States. In the wake of the Harrison Narcotics Act, addicts had to obtain prescriptions for their drugs, and so-called “dope doctors” would provide them for cash. The alternative to the dope doctor was the street druggist, the so-called “pusher.”

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Laudanum (image via Science & Society Picture Library/Getty Images)

 

Doctors and opiates have a long, complex history. In the era of magical formulations, Dr. Thomas Syndenham compounded laudanum by mixing “two ounces of opium and one ounce of saffron dissolved in a pint of Canary or sherry wine” with a “drachm of cinnamon powder and of cloves powder,” as historian Richard Davenport-Hines noted in his history of the subject. At the time, opiates (plus or minus alcohol) were among the few medicines that were actually effective pain relievers (working at the μ pain receptors in the brain). They were instrumental in bolstering the medical profession’s emerging reputation for dispensing effective interventions rather than simply bearing witness to suffering. Indeed, enterprising pharmacists and doctors alike created their own patented formulations of various narcotics marketed as cure-alls– a mix of magic, profiteering, and chemistry.

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The Silences of Our Work, Part III: Alternate Paths to Recovery

EDITOR’S NOTE: Today, Points brings you the third in a series of posts on silencing and substance use by Heather Sophia Lee, PhD, LCSW, an Assistant Professor of Family Medicine and Community Health at Rutgers’ Robert Wood Johnson Medical School. You can read the first installment here and the second installment here

For my dissertation, I conducted a qualitative study of two harm reduction programs. The purpose was to describe the experiences of participants in harm reduction programs given that “outcomes” of such programs were difficult to measure.

At that time evidence existed for the efficacy of harm reduction practices, like needle exchange programs, in reducing the spread of sexually transmitted diseases like HIV and hepatitis C. Less was known about the impact of harm reduction as a model for addiction treatment. Its broad focus made it unclear which “outcomes” were most important to measure. Coupled with political resistance, many agencies often avoided calling their work “harm reduction” to avoid scrutiny which might interfere with meeting the needs of their clients.

As a novice qualitative researcher, I was intuitively curious about how harm reduction was being integrated into twelve step recovery experiences. I was also interested in the extent to which one might be just as likely to come to abstinence through harm reduction as abstinence-only based treatment. Harm reduction and twelve step models were often cast as mutually exclusive, and I knew there was a deeper story to be known though I wasn’t yet sure what it was.

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The Silences of Our Work, Part II: Trauma

Editor’s Note: Today, Points brings you the second in a series of posts on silencing and substance use by Heather Sophia Lee, PhD, LCSW, an Assistant Professor of Family Medicine and Community Health at Rutgers’ Robert Wood Johnson Medical School. You can read the first installment here.

I chose to focus my time as a guest blogger on Points focusing on the Silences of Our Work because, in the academic spaces in which I exist, I am most frustrated by what goes unsaid. The gold standard of “science” calls for ignoring certain variables, so that other variables may be tightly controlled. Our work is silenced by design.

Trauma figures prominently in the lives of many of our clients and their relationship to substances, but is often silenced in our work. I don’t mean that everyone who struggles with alcohol and other drug use has experienced trauma– but many people I’ve worked with have, yet the existence of trauma is largely unacknowledged in mainstream discourse about substance abuse in the United States. In my qualitative interviews and clinical work with participants of harm reduction programs, trauma frequently plays a role in participants’ narratives about their relationship to alcohol and other drugs. Yet in the discourse about these clients, trauma rarely enters the conversation. The “why behind the what” is absent.

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The Silences of Our Work, Part I: A Preface

Editor’s Note: Points is delighted to welcome Heather Sophia Lee, PhD, LCSW, an Assistant Professor of Family Medicine and Community Health at Rutgers’ Robert Wood Johnson Medical School. Lee is a practicing clinician and qualitative researcher who studies how stigma influences access to health and social services. Today, Lee opens her series on silencing and substance abuse with a reflection on her relationship to this work.

Some months ago, Points co-founder Trysh Travis read an article I published about integrating harm reduction and twelve step approaches to treatment, and asked how I became interested in addiction research. My answer: I began observing addiction and recovery long before I learned to study these processes systematically. I was born into the witnessing of addiction; it began with my father’s struggles and untimely death when I was nine years old.

This experience exposed me to the scripted language of recovery at an early age. But I’d argue that, even for people without this early formative experience, the scripts of addiction treatment and drug policy manage to shape the psyche. I’ve witnessed many contrasting cases in which the dominant response model to drug and alcohol issues (i.e., punitive, abstinence-based, and informed by an explicit set of assumptions) failed to meaningfully reach those in need of help.

Later, as a clinician-scholar, I believed there must be a better way to engage those in need of help and began exploring alternatives. I acknowledged that the dominant model does reach some people– but it fails to reach most people, and that was the population I wanted to engage. As I reflect on my personal and professional experiences, I think my work has been driven by something deeper and less tangible than clinical efficacy: the greatest injustice in treatment practice and scholarship is the silenced voices of those who struggle with addiction. I also believe that by facilitating space to desilence those voices, we will learn about our failings and be better able to help those who struggle with substance use and misuse in this country.

Image via Harm Reduction Coalition (harmreduction.org)

Image via Harm Reduction Coalition (harmreduction.org)

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