Points Interview: David Courtwright

Editor’s note: Points author interviews begin with a set question: Describe your book in terms your bartender could understand. David Courtwright said he preferred conversations with bartenders. He talked to his about The Age of Addiction: How Bad Habits Became Big Business (Belknap Press, 2019). 

Screenshot 2019-07-16 08.40.48Bartender: I hear you have a new book.

Courtwright: Just came out in May. I’ll have the draft IPA.

What’s the book about?

How addictions multiplied throughout human history. Even before civilization people discovered pleasurable drugs and pastimes like alcohol and gambling. They went on finding new ones. They traded, refined, manufactured, and digitized them to the point that we live in an age of addiction. Think about it. When you heard the word “addiction” forty years ago, what came to mind? 

Drugs. Heroin. Junkies. Juicers, only back then we called them alcoholics. 

Google the word now and you’ll find addiction to sugar, video poker, computer games, social media, internet porn, shopping, tanning, you name it.

Could be hype.

Some of it is. And some of it is science. Nora Volkow, the director of the National Institute on Drug Abuse, promotes food-addiction studies.  

What’s food got to do with drugs?  

Our brains—well, some brains—react to food packed with sugar, salt, and fat like it was booze. People can lose control over eating the way they lose control over drinking. They join groups like Food Addicts in Recovery Anonymous

They’re like AA? 

Right down to the lingo. And it goes beyond eating.  When I told friends I was writing a history of addictions, they all said, “You’ve got to include kids glued to their phones.” So I did. Behavioral addictions have become social facts.

What’s history got to do with social facts?

Historians explain their origins and how they changed over time. In The Age of Addiction, it’s a long time.

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Points Bookshelf: “The Age of Addiction” by David Courtwright

Editor’s Note: It’s David Courtwright week on Points! Today we feature a review by contributing editor Brooks Hudson, a PhD student in history at Southern Illinois University, of Courtwright’s most recent book, The Age of Addiction (Harvard University Press, 2019). We’ll follow Hudson’s review with an interview with Courtwright on Thursday. Enjoy!

Screenshot 2019-07-16 08.40.48In Age of Addiction, the acclaimed historian David Courtwright dips his toes into familiar waters, analyzing the history of the brain reward mechanism through its component parts: pleasure, vice, and addiction. The book expands on earlier attempts, such as John Burnham’s Bad Habits, which investigated America’s evolving attitudes on everything from alcohol and drugs to gambling, swearing, and sex. Building off and updating Burnham, Courtwright injects fresh blood into the discussion, mapping the newest additions to our pleasure palettes. Courtwright catalogs sugary sweets formulated by Nestlé and Kraft, delineates digital subcultures such as the frenzied World of Warcraft, and documents young men’s sexual fetishes—with Pornhub substituting as both sex education and a how-to manual—while still leaving room for gambling, an ever-changing issue as states embrace sports betting following last year’s Murphy v. NCAA decision. Courtwright draws our attentions to the vast “pleasure meccas” erected of late, updating parts of his previous book Dark Paradise (Harvard University Press, 1982) as opioids have returned to the headlines too.   

Let me invite the skeptical reader to ask the obvious question: hasn’t this always been the case? Courtwright would agree, but with a caveat. To conclude “more of the same” ignores three critical distinctions. First, the rate “hedonic change” has accelerated, Courtwright likening it to the rapid pace of technological change, following its own “Moore’s Law of brain reward” (164). (Moore’s law, first delineated in 1965, predicted that the speed and capability of computers would double every two years due to advancements in the number of components per integrated circuit; in the past half-century, this has proven to be untrue: computer speed now doubles much more rapidly.)

Second, pleasure and vice are more diverse and ubiquitous, appealing to specific subsets of the population. Third, and most significantly, pleasure and vices are meticulously engineered by companies with billion-dollar marketing and advertising budgets. In effect, this means that Big Pharma, Silicon Valley and the food industry have grown much more efficient at weaponizing our weaknesses against us, and reaping the profitable rewards. This asymmetry means companies are able cater and concoct an ever-widening array of products and pleasures, while conveniently sidestepping externalities and effects on global health. Whereas earlier eras met vice with reluctance, if not with outright resistance, today the tendency is on an opposite trajectory: vice is both normalized and accepted. 

 

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David Courtwright

The Age of Addiction hones in on the brain reward system’s “big bang” moment, tracing it back to the agricultural revolution. What characterized pleasure, vice and addiction then was limited. People dabbled with local food-drugs but had little else at their disposal. Pleasure was in its infancy. Gambling, for instance, consisted of improvised devices: “sticks, shells, fruit pits,” and the occasional animal bone. Questions of accessibility or affordability were not yet part of the vocabulary. From the agricultural revolution on, the story follows a familiar trajectory: the invention of new technology, innovative forms of transportation, and specialized knowledge that built up networks for global trade, transforming rickety ship with a few luxury goods into colossal container ships packed with the inexpensive goodies we all enjoy today. 

The second half of the book deals with changes over the last hundred years or so. In the late nineteenth and early twentieth centuries pleasure, vice and addiction seeped into urban areas, leaving few places or people untouched by their influence. In response, anti-vice reformers rallied and challenged vice’s legitimacy and sought to ban or suppress commodities like narcotics and alcohol and activities like prostitution and gambling. Reformers, as Courtwright sees it, have been unfairly maligned and should be given a second hearing, or at least some credit for enacting regulatory measures that curbed use and resulted in improvements to public health. He argues that we should not separate some reform measures and label them “progressive” (among them, sewage and water infrastructure and vaccination efforts) from their other attempts to eliminate vice. In practice the desires that propelled one propelled the other activities as well, all with the aim of improving public health and safety. Yet the gains made by anti-vice reformers were partial. They failed, as Courtwright documents, for multiple reasons: from internal divisions, corporate resistance and government ambivalence on the one hand, and from their desire to raise revenue on the other. 

Neoliberalism was in its ascendancy by the late twentieth century. It brought with it a new figure, the “vice entrepreneur” who pushed and profited from packaged delights. Courtwright coins the term “limbic capitalism,” described as “a technologically advanced but socially regressive business system in which global industries, often with the help of complicit governments and criminal organizations, encourage excessive consumption and addiction.” Limbic capitalism refined the art of exploiting brain reward and weaponizing it against consumers, perhaps best captured by the Pringles slogan: “Once you pop, the fun don’t stop.” This corporate slogan distills the limbic capitalisms formula: hook customers, encourage them to indulge, rinse and repeat—or, in short, reap the rewards and ignore responsibility for subsequent externalities. Limbic capitalism continues as a force to be reckoned with. It has aided overeating, led to distracted driving, compulsive porn consumption, and other ills. And all of it was intentionally constructed to be this way, causing some of the biggest public health problems globally, according to Courtwright. 

“Limbic capitalism” differs from capitalism through its route of administration: brain reward and its repetition. But is limbic capitalism more predatory or detrimental to public health than the routine behavior of say, Big Pharma or the climate catastrophe wrought by the fossil fuel industry? And does that matter? These are some questions that lingered. One feature that works in limbic capitalism’s favor it is that it is easy to understand, meaning there is less asymmetry of information—risk, for instance—when buying cigarettes or alcohol than in other transactions, like purchasing health insurance, signing financial contracts, or whatever it is we are agreeing to when we hit the “agree” button after every iPhone update. The book’s last line recommends that “we should be against excess,” which, in general, is sensible. But as a concrete matter, policy implications and what limiting excesses means in practice—preference for punitive or health-oriented approaches—also matters but gets less attention. Courtwright offers solutions: government regulation, restrictions on advertising, targeted taxation, and education campaigns. All of these could be good, depending on a lot of other things. 

Like any book, Age of Addiction has shortcomings, many of which might be exposed by the authors and thinkers he cites. Critics of the brain disease model will be disappointed there is not a full airing of arguments made against it, such as Marc Lewis’s The Biology of Desire. Stanton Peele, mentioned twice, will likely continue to have his reservations about this book over exposure and accessibility. This same could be said for Bruce Alexander, whose book The Globalization of Addiction disagrees with Courtwright when Courtwright argues that exposure is a driving force for addiction — Alexander’s other writings suggest that exposure is a secondary or tertiary concern.

Courtwright also perhaps missed an opportunity in his exploration of vice, a very elastic category, limiting it only to individuals and excluding corporate persons. Vice is defined as “bad for the individual, bad for other people, bad for the social order, or some combination of the three” (emphasis mine). Vice looked at through the lens of greed would have been an edifying avenue for him to pursue: patients rationing insulin, some dying; the “public health” consequence of things like the EpiPen, a drug that sells for several hundred of dollars while its active ingredients cost pennies. This could have played to Courtwright’s advantage, given that he uses the idea of “nudges.” Everyone can get behind Courtwright’s goal, which ultimately is about improving public health, but if public health continues to be mostly privatized, preventing people from accessing essential services—mental health services, medication, and the rest—many of the issues discussed will unfortunately remain unresolved. 

 

Conference Report – ADHS Shanghai, 12-15 June 2019

Editor’s Note: Today’s post comes from contributing editor Dr. David A. Guba, Jr., of Bard Early College in Baltimore. He presents his conference report from the biennial ADHS conference, held last month in Shanghai. It was the meeting’s first gathering in Asia.

From the 13th through the 15th of June, nearly 100 scholars from 14 countries gathered at Shanghai University in China for the biennial conference of the Alcohol and Drugs History Society, beefily titled “Changing Minds: Societies, States, the Sciences and Psychoactive Substances in History.” Jointly sponsored by the Sir Henry Welcome Trust, the David F. Musto Center for Drug Policy Studies at Shanghai University, and the Centre for the Social History of Health and Healthcare at the University of Strathclyde, the conference marked the first meeting of the ADHS in Asia and an important next step in the organization’s ongoing efforts to globalize drugs and alcohol history. I trust I speak for all in attendance in extending sincerest gratitude to the organizers and sponsors, the staff of the New Lehu Hotel and Conference Center, and the many graduate student volunteers for putting on a great four days of stimulating conversations, fascinating presentations, and productive networking. 

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Points Update: Book Review Editor Wanted, and New Article Available from Lucas Richert and Erika Dyck

Happy 4th of July from your friends at Points! We hope you’re celebrating safely with friends and family if you’re in the United States.

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Two quick notes before we get back to grilling and sparklers:

First, the Social History of Alcohol and Drugs is looking for a book review editor.

As the editors seek to diversify the journal, book review editors from non-Anglo-North American perspectives are wanted for SHAD. The book review editor will help manage the flow of books and reviews, including identifying titles for review, populating a list of books, securing appropriate reviewers, and overseeing the timely completion of reviews.

Inquiries should be received by September 6, 2019. You can see the full request here.

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Points Bookshelf: “The African Roots of Marijuana” by Chris Duvall

Editor’s Note: Today’s book review comes from Nick Johnson. Johnson holds a bachelor’s degree in journalism from Southern Illinois University and a master’s degree in American history from Colorado State University. A former freelance journalist in his home state of Illinois, Johnson now lives in Fort Collins, Colorado, and works as associate editor of the online Colorado Encyclopedia. He is the author of Grass Roots: A History of Cannabis in the American West.

Screenshot 2019-07-02 at 8.52.56 AMDespite a vast and ever-growing scholarly literature on cannabis, the African experience with the plant is too often glossed over or entirely neglected. One gets a sense of this reading some of Chris Duvall’s earlier work, including the global history Cannabis (2015). But in his most recent book, The African Roots of Marijuana (Durham, NC: Duke University Press, 2019), the geographer hammers this point home with an infallible rigor that should convince other cannabis scholars to more closely examine the biases reflected in their own work.

Duvall’s most pervasive and important argument in the book is that Europeans’ historic preference for hemp over drug cannabis was rooted in racist interpretations of cultural ecologies, and those interpretations became the foundation for much of what is known (or assumed) about the plant today. In Europe, where ecological conditions favored hemp, cannabis was known as the fiber-yielding plant of productive industrialists; in South Asia and Africa, where ecological conditions favored drug-producing cannabis, “the plant was valued principally to supply psychoactive drugs” (103). When nineteenth-century Europeans began traveling Africa under the oppressive shadow of colonialism, they saw the use of cannabis drugs as an unnatural corruption of the plant itself as well as an indicator of Africans’ supposed backwardness and inferiority (10-11). This perspective then became embedded in Western understandings of cannabis and remains lodged there today, despite a robust academic literature on the role of racism and colonialism in the development of scientific thought.

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Reefer Madness in France: Part II

Editor’s Note: Today’s post comes from contributing editor Dr. David A. Guba, Jr., of Bard Early College in Baltimore. 

One of the earliest cases of “arab aliené: folie hasishique” I’ve found thus far in my research is from Algiers in the summer of 1857. On August 22 of that year, a twenty-year-old Muslim man called Soliman-ben-Mohammed attacked a crowd of Jewish Algerians gathered in the city’s central market for the Sabbath, wounding seven and killing one. Eyewitnesses described the killer as being “crazed by a fury” and “prey to unspeakable exasperations” as he wildly clubbed the fleeing crowd of men, women, and children. It was only when a group of nearby Frenchmen, “hearing the cries of the victims, seized the madman and disarmed him,” bringing the violent scene to a close.[1]

Screenshot 2019-06-27 09.13.57The most comprehensive record of the event and trial is found in a series of articles published in the Medical Gazette of Algeria in September of 1857 by Dr.’s Alphonse Bertherand and Noël-Eugène Latour, both with the French army and Civil Hospital in Algiers.[2] During his interrogation Soliman stated that he neither remembered the attack nor recognized his victims. He recalled leaving work earlier that day, smoking kif and drinking wine and anisette for several hours at a café in Algiers. He even recalled getting into a small altercation with several Jewish patrons at that café.  But, “visibly regretful and shedding tears,” Soliman again and again claimed he never intended to kill anyone and remembered nothing of the fatal attack.[3] 

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From Taboo to Veneration: Marijuana, Canada, and the New Social Construct

Editor’s Note: Today’s post comes from Dr. Stefano Tijerina, a lecturer in management and the Chris Kobrack Research Fellow in Canandian Business History at the University’s of Maine’s Business School. 

In January 1968 the Winnipeg Free Press reported that marijuana was “the biggest mass floating of the law since prohibition.”[1]  Back then the urban myth said Lebanese cannabis was the most potent, but Canada, like the U.S. market, was limited to Mexican cannabis; “Acapulco Gold” was the common preference among “local users.”[2]  This new generation of consumers was juxtaposed against the anti-marijuana initiatives on both sides of the border that had, by that point, constructed the idea among sectors of civil society and policy makers that the drug led to mental disorders, violence, degeneration, addiction, and that it served as a gateway to other more dangerous narcotics.  It was from the late 1960s onward that a pro-marijuana movement across both sides of the border was spearheaded by young rebellious Baby Boomers in order to clarify the facts and debunk the old myths. Fifty years later the construct of the “thin, sunken-eyed individual slowly starving himself to death” has been replaced by the image of the radiant millennial stoner.[3] Within that transformation of the constructs of marijuana, Canada’s Federal and Provincial governments were able to build a government-business partnership that positioned the nation and its private sector as the pioneers of a new global business that might even surpass the global market for coffee.  A half century ago possession in Canada could cost you seven years in prison; today it represents an entrepreneurial opportunity.

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Director, Louis J. Gosnier. “Tell Your Children,” 1936.

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