The Return of the Crack Baby. Again.

“I think that if you say something three times out loud, people take it as fact. And also, I think there are certain ideas that people want to believe, that really fit in with cultural stereotypes, and it’s hard to get rid of those”– Claire Coles

I want to believe

A friend recently posted a Retro Report video about the crack baby myth on my facebook page with the comment, “you called this, like, a year ago.” Another friend emailed me the link and a note, “always ahead of the game, you are.” While I appreciate my friends’ propers, I should point out that people have been debunking the crack baby myth for over twenty years. The correction just can’t seem to stick. If I called anything, it’s that sad fact: we just can’t let go of the crack baby.

As I argued before, one reason why we can’t let go of this myth is that it has the structure of a conspiracy theory, one in which the conclusion is sacrosanct even if the evidence is not yet identified. We have such agile, creative minds, and we really want the crack baby to be real because it has the ring of truthiness. Just the other day, a friend tried to grok the crack baby that wasn’t and concluded that crack still did something - even if that was just to stand in for all the other awful consequences of using crack and, of course, it’s true: some of those awful consequences can have very damaging effects on a human being. I had to agree: in that way, yes, one could say that there is such a thing as a crack baby.

This is not the first time the New York Times has run a story about what it called (in 2009) “The Epidemic That Wasn’t.” A cynic might wonder if maybe debunking the myth has become almost as good a story as the crack baby him or herself, even if it does require a journalistic mea culpa. Perhaps this is a second reason for the persistence of the crack baby myth: saying there is no crack baby makes for some great copy.

The Epidemic that Wasn't

In an article about how crack babies grew up to be fine, the NYT opted for this photo and this caption: “In a 1988 photo, testing a baby addicted to cocaine.” A person could see this photo and caption and get the wrong idea. Seems the NYT couldn’t completely give up on the crack baby in 2008, either.

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The Authority of What Experience?

In most cases, people gain expertise through direct experience. This is not true when it comes to addiction, where legitimate expertise is derived from a lack of direct experience. There are many reasons for this, including cultural investment in educational prestige, faith in systems of authority, resentment of those who take their pleasure in what Derrida calls “an experience without truth,” and a distrust of addicts, who are “by class the most lying, scheming, dishonest group of patients.”

addiction medicine

That quote about lying drug addicts is from this new report, “Addiction Medicine: Closing the Gap between Science and Practice,” which was released by the National Center on Addiction and Substance Abuse at Columbia University.

So when it comes to talking about addiction with any sort of legitimate authority, we generally turn to those with letters after their name rather than those with addiction in their background. The field of expertise has changed over time, from moral to legal to medical but, with very few exceptions, addicts have not been included in the cohort of experts.

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Reflections on Addicts Who Survived: How to Survive a Farce

Actually, he said: “Hegel remark somewhere that all facts and personages of great importance in world history occur, as it were, twice. He forgot to add: the first time as tragedy, the second as farce,” but as with Hegel, sometimes a paraphrase works better.

Actually, he said: “Hegel remarks somewhere that all facts and personages of great importance in world history occur, as it were, twice. He forgot to add: the first time as tragedy, the second as farce,” but as with Hegel, sometimes a paraphrase works better.

Karl Marx is credited with observing that, “history repeats itself, first as tragedy, second as farce.” It is hard not to remember this insight when reading the brilliant Addicts Who Survived two decades after its initial publication. After all, the year the book was published, 1989, was the same year Bush Sr. announced that the $2400 bag of crack he had in his hand was purchased (gasp!) directly across from the White House. Of course, the dealer – a high school student – had been lured to that spot by DEA agents in order to produce the theatrical prop. In the years preceding this stunt, crack had entered the public consciousness as it burned through poor inner city communities. The government had responded by setting mandatory minimum sentences for drug offenses and creating a legal disparity between crack and cocaine that led to imprisonment of the most vulnerable and stigmatized drug users. Meanwhile, HIV/AIDS rates were ballooning exponentially, and injection drug use was increasingly the mode of transmission. The most popular response to the problems associated with drug use and addiction was Nancy Reagan’s 1984 campaign to “Just Say No.” Her husband remained silent on the subject of AIDS until 1985, when he expressed skepticism about allowing HIV-positive children to attend school. Although early forms of harm reduction were emerging in the UK and junkies were unionizing in the Netherlands, the movement did not take significant form in the US until the mid- to late-1980s.

bush crack cocaine-aacdfdc0955188a5f3889c1fc18791ffda8e7079-s6-c10

The War on Drugs: The Farcical Years. When asked to go to the White House to sell his crack, the dealer said, “Where the fuck is the White House?”

first-ladies-reagan

The War on Drugs; the farcical years. Just Say NO: right-O.

So when I bring Marx’s quote to mind, it is with the painful recognition that every farce is still a tragedy. Continue reading

Of Mugshots and Meth or, the Horror of the REAL

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No artistry or fried eggs now; just the REAL truth. Those eggs look pretty good now, don’t they?

In an attempt to garner publicity for its services, Rehabs.com published an infographic entitled “The Horror of Methamphetamines.” It is, indeed, a horrifying spectacle, a “sobering depiction of REAL individuals who’ve fallen victim to the temptation of drug use.” We know what we are seeing is “REAL” because all the photos are mugshots. The dispassion of the mugshot, the idea that nothing is staged here, no one is posing or even thinking about an audience, is what lends legitimacy to the project.

The face at the top of the infographic serves an explicitly educational purpose, with information boxes explaining how meth can cause acne, tooth decay, and weight loss. The other photos are just sequenced in chronological order. Explanations are not really necessary; the images clearly show that meth turns young people into zombies.

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Sobriety is Boring

Playlist for this post:

walking sober

“Sober” (Pink)
“Sober Song” (Noir Desir)
“Clean” (Depeche Mode)
“Straight Time” (Bruce Springsteen)
“Beautiful World” (Colin Hay)
“Vipassana” (Macklemore & Ryan Lewis)
“I’m Straight” (The Modern Lovers)
“One Day at a Time” (Joe Walsh)
“It’s been While” (Staind)
“Good Day” (Paul Westerberg)
“That’s Why I’m Here” (Kenny Chesney)
“Twist in my Sobriety” (Tanita Tikaram)
“Little Rock” (Colin Raye)
“Double A Daddy” (Wayne Hancock)

If my sober friends are any indication, sobriety is neither boring nor thrilling. As far as I can tell, sobriety involves getting up, maybe eating a little breakfast and drinking a cup of coffee, showering, going to work, having lunch, coming home, eating dinner, maybe socializing or watching a bit of television, and going to bed. Repeat with slight variations.  So when I suggest that sobriety is boring, I’m not really talking about how people live their lives sober. That seems to be a crapshoot, as it is for most of us involved with the living of our lives: sometimes boring, sometimes thrilling – or embarrassing, or scary, or annoying or fulfilling. You know, life. Continue reading

The Crack Baby Incident

guess which one is the crack baby…

A funny thing happened when I started telling people about the crack baby myth: they didn’t believe me. “Myth?” they said, “but the crack baby is real!” My facebook page was consumed in a 25-comment debate before I could convince some of my intelligent, educated friends that, indeed, the crack baby is a fiction. An off-hand comment to a doctor likewise met with amazed surprise – no such thing as a crack baby? Over coffee, friends struggled to let go of the idea of the crack baby because, as one person confessed, it feels so viscerally true. How could something as awful as crack not cause permanent damage to babies? Maybe we don’t yet know how, their resistance implied, but it must be true.

…not this one!

Saying there is no such thing as a crack baby might be a slight exaggeration, but it pales in comparison to the things people were saying in the late 1980s and early 1990s. Despite the fact that infants born to crack-using mothers were not old enough to attend school, moral entrepreneurs (to borrow Becker’s term) were already warning about a “bio-underclass” flooding our communities and schools, unable to suckle or learn or feel human emotions. Even though early studies suffered from methodological shortcomings (small sample sizes, unreliable identification techniques, selection bias, inconsistent measures, high-attrition rates, racial and class bias) and confounding variables (alcohol, tobacco, and other drug exposure, overlap between cocaine exposure and poverty, poor home environment, lack of parental care, poor maternal health, poor nutrition, social disadvantage, maternal depression), politicians used the specter of the crack baby as part of a larger swing towards conservative, victim-blaming, anti-woman, racist, and classist social and legal policies, with terrible consequences for mothers and children.

“Our job is never easy because drug criminals are ingenious. They work everyday to plot a new and better way to steal our children’s lives” – R. Reagan

… but pregnant women often couldn’t access treatment, Mr. President, so who are you calling the criminal now?

Forgive me, then, if I sound glib when I say that there is no such thing as a crack baby. It just seems that if we have to continue to prove this very basic point, then we can’t go on to think about lessons we might learn from the whole crack baby scare.

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What We Talk About When We Talk About Sexual Addiction

I just don’t see how anyone can write about sexual addiction without also writing about masculinity and feminism. But before I do that, let me propose a few caveats:

  1. It is not my place (or ambition) to say whether sexual addiction exists or not.
  2. I am not claiming that there are not also women who identify as sexually addicted.
  3. When I question the ways we conceptualize sexual addiction, I am not doing so to trivialize or disrespect anyone’s experiences.
  4. Despite the possible inclusion of “hypersexual disorder” in the DSM 5, I will use the term “sexual addiction” because it remains the term of choice and because the word ‘addiction’ shapes our understanding of the disorder.
  5. There will be some explicit references in this post.

I feel the need to begin with these caveats because I have already learned that to speak about sexual addiction with any sort of doubting curiosity is to invite angry assertions of its existence. The invocation of addiction implies the absolute certainty of the recovery movement. It demarcates a clear trajectory into abjection as well as the redemptive potential of recovery. Cohering (as in: bringing together and making coherent) sexual excess under this term leaves little room for nuance. Yet, as I have argued earlier, sexual addiction remains an aporia that helps shape notions of sexuality, morality, and even addiction itself. If we do not pay close attention to what we mean when we say that certain destructive sexual behaviors are “addictions,” we risk losing sight of what we might learn about gender roles and entitlements.

The other response to any doubting curiosity is the seemingly inevitable reference to men who feel compelled to masturbate until they bleed.  Continue reading

A Sex Addict By Any Other Name

The problem, in a nutshell; check the ad in the lower right corner.

It seems the DSM-V might revive (and rename) a contentious old diagnosis: hypersexual disorder is proposed to take up the spot previously occupied by “sexual addiction” and, on occasion, “sexual compulsion.” Over the past century, we have seen this shifting set of symptoms in many other guises, including hyperesthesia sexual, satyriasis, nymphomania, Don Juanism, paraphilia, sexual deviance, hypereroticism, hyperlibido, hyperphilia, and perversion. It has been categorized as a form of obsession, a compulsion, an impulse-control disorder, an addiction, and, in more private conversations, perhaps, bad behavior, tom-foolery, men-being-men, she’s-gotta-have-it, no-good-two-timing, misogyny, macking, swinging, or just dating.

This newest diagnosis describes “recurrent and intense” sexual fantasies, urges, and behaviors that emerge in response to “dysphoric mood states.” People who suffer from this disorder engage in non violent sexual activity “while disregarding the risk for physical or emotional harm to self or others.” The last time we saw a similar diagnosis was in the 1987 DSM IIIR. That entry, on “sexual addiction,” described “distress about a pattern of repeated sexual conquests or other forms of nonparaphilic sexual addiction, involving a succession of people who exist only as things to be used.” In the DSM-IV, the entry was removed due to a lack of data. All that remained was an unnamed reference to “[d]istress about a pattern of repeated sexual relationships involving a succession of lovers who are experienced by the individual as only things to be used.” It is bookended by distress about inability to conform to gender roles and distress about sexual orientation.

for the wanna-be sex addict?

The revision (and renaming) of this set of shifting symptoms marks some significant changes in thinking. The term “addiction,” after all, carries with it notions of powerlessness, consumption, dependence, withdrawal, and escalating need. It also implicitly proposes a mode of self-treatment through a modified twelve-step recovery program, individual therapy, or pharmacological intervention. Hypersexuality (literally: over/above/excessive + sexuality), on the other hand, only amplifies what is normal human activity. When it comes to sexuality, this term might imply, too much is not never enough. The term shifts attention from the more complex emotional qualities of addiction to the biological. Finally, the notion of harm to self and others has replaced the more judgmental assumption that a sexual addict (or player, or swinger, or casual dater) only uses people without actually recognizing their humanity. Being a cold-hearted snake no longer means you’re a sex addict; harmful excess might.

Before “sexual addiction” was removed from the DSM, there was some question about whether it named and described behavior that we might otherwise consider thoughtless, cruel, selfish, or sexist. After all, this diagnosis coincided with the third wave of feminism as well as the so-called sex wars.  How could it not be informed by debates about pleasure and danger, porn and sex work, BDSM and other “non-normative” sexual and romantic activities? So, I imagine, people probably wondered: Does a cheating husband really have a mental disorder, or is he just a jerk? Is a man who thinks he’s entitled to look at porn, go to strip clubs, and purchase sex a male chauvinist pig, or is he suffering from a compulsion? Is a woman who sleeps around a slut or a sex addict? Is a serial monogamist just looking for love in all the wrong places, or is that person addicted to love?  Continue reading

Michael Jackson’s Addiction Problem

Murder weapon?

Murder Weapon?

On 25 June, 2009, Michael Jackson died of a propofol (and possibly lorazepam and midazolam) overdose. Soon after, his personal doctor, Conrad Murray, was charged in the singer’s death. Although Murray claimed his job was to “keep surveillance” on the health of Jackson and his children and to make sure that everyone “washed [their] hands” and ate right, it was clear that his most important job was to enable the singer to sleep with the help of a pharmacopeia of drugs. On 7 November, 2011, Murray was found guilty of involuntary manslaughter.

Portrait of the Addict as a Young Man

Murray chose not to testify at his trial, but in the media circus that accompanied the proceedings, he more than made up for his silence on the stand. In particular, he participated in a BBC documentary (The Man who Killed Michael Jackson – a name I’m sure he did not choose), which was eventually sold to MSNBC and renamed Michael Jackson and the Doctor: A Fatal Friendship. The film covered the months leading up to the trial and a small portion of the trial itself. A few days before the verdict, Murray granted an interview to the Today show. His arguments in the court of public opinion hinge on what strikes me as an interesting red herring: was Michael Jackson an addict? Continue reading