CFP: The Alcohol and Drug History Society’s “Drinking and Drug Policies in History”

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Drinking and Drug Policies in History:

Contextualizing Causes and Consequences

Call for papers: Alcohol and Drugs History Society conference

 22-25 June 2017, Utrecht University, The Netherlands.

The twentieth century dawned with an unparalleled drive to regulate the production, distribution, and consumption of alcohol and other psychoactive substances. Many countries have developed their own specific historical trajectories of substance regulation, consumption, and user cultures. This regulatory drive continued into the 21st century, where today we live once more in a period of decisive regulatory changes and discussion. For instance as can be seen in the submission of national regulations in Europe to EU directives. On the other hand, the ‘war on drugs’ is now more contested than ever before.

Global discussions have intensified concerning the consequences, feasibility, and desirability of drug prohibition. Moreover, the rise of virtual communities of substance use defies regulation within national borders.

To befit the context of this global discussion, and to stimulate comparative transnational research on substance use and regulation, the organizers of the conference would like to invite contributions addressing histories, problems and consequences of substance regulation in their wider contexts – including political, social, and cultural developments, as well as responses by and consequences for civil society, communities, and individuals.

Questions may include but are not restricted to the following:

  • To what extent were regulatory practices shaped and determined by national, local, or international factors?
  • How did user cultures and consumption develop within the context of changing regimes, for instance in specific national or urban settings?
  • How and why did substance use and substance regulation differ between periods and regions?
  • How can we explain similarities and dissimilarities between regulation of different substances (e.g., alcohol, tobacco, ‘drugs’) and their consequences, and other regulatory regimes (e.g., food, medicine, gambling, etc.).
  • How did legal markets and illegal economies, their impact on social, cultural and political life, and trading and trafficking patterns and routes develop in the context of changing regulation?
  • What was the role of media debates and public discourses on changing regulatory regimes and on their impact?
  • Finally, in light of the increasing availability of digitized sources the organizers are particularly interested in methodological contributions: on availability of sources in general, and on the impact of digitization of sources and the possibilities of using advanced text mining tools for transnational comparative research in alcohol and drug history in particular.

Proposals for papers (300 words and a short CV) and sessions can be send to:

Stephen Snelders (s.a.m.snelders@uu.nl) or Lisanne Walma (l.w.b.walma@uu.nl)

before 15 December 2016.

More information is available on https://adhs2017.wordpress.com/

 

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Another Shot: Will dAd5GNE “End” Cocaine Addiction?

Among Facebook friends familiar with my work, dozens of conversations have started by their linking me to relevant pieces on, for example, the racial disparities of marijuana legalization, the therapeutic application of psychedelics, and, perhaps less pressing but no less appreciated, the varieties of ways our ancestors got high.

As much as I try to stay up on my drug news, sometimes people scoop me. This most recently happened last month when I received an article with a fantastically understated title: “Groundbreaking Treatment could be the End of Cocaine Addiction.” It was certainly enough to make a skeptical drug historian smile (and chuckle at the layered humor of Yahoo Finance covering anything related to the stockbroker’s culturally purported substance-of-choice).

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Leonardo DiCaprio’s Jordan Belfort fulfilling every stereotype

Cocaine addiction is probably here to stay for the foreseeable future, but the new treatment, called a cocaine “vaccine,” offers some promise. It’s certainly groundbreaking at least. Dr. Ronald Crystal, principal investigator for currently-enrolling clinical trials at New York-Presbyterian/Weill Cornel Medical Center, correctly notes that, “While there are drugs like methadone designed to treat heroin, there aren’t any therapeutics available to treat cocaine addiction.” Addiction research scientists understand fairly well how our opioid receptors operate but most are perpetually vexed by cocaine’s complex neurotransmitter influence.

The vaccine, named dAd5GNE, combines parts of a common cold virus with a particle molecularly similar to cocaine, triggering an immune response against both. “Once immune cells are educated to regard cocaine as the enemy,” Crystal explains, “it produces antibodies, from that moment on, against cocaine the moment the drug enters the body.” The idea is to neutralize cocaine particles before they pass the blood-brain barrier, blunting their effects. This is a key distinction among addiction medications like methadone, which partially block opioid receptors once drugs like heroin cross over.

Crystal concedes that the process may not reliably pan out for humans. Years ago, his team observed vaccinated rats appearing less hyperactive after cocaine use than non-vaccinated rats, and the isolated antibody absorbing cocaine particles in a test tube, but scaling up is not necessarily linear. “We need to find out if the vaccine will cause enough anti-cocaine antibodies to be produced so that it works in humans, too.”

Crystal’s cautious optimism is not reflected in articles like the one my friend shared (though author Melody Hahm is considerably more measured in the main text). Once Crystal began experimenting on primates after mice, an article from The Fix invited readers to “[i]magine that cocaine addiction could be eradicated, poof, with a simple vaccine. [Crystal] now thinks his team has actually figured out a very clever trick to make that dream a reality.” A recent article in the New York Post calls the treatment a potential “saving grace” for addicts.

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Methadone did little to alleviate the structural inequalities that contributed to drug addiction, as elaborated in this 1966 pamphlet

Poof! The drug historian continues smiling. In the early 1960s, scientists Vincent Dole and Marie Nyswander began using the synthetic opioid methadone to treat heroin addiction. Soon, journalists began proclaiming the drug as the “magic bullet” solution to the nation’s growing heroin problem. (But not without reason; the uniquely favorable conditions of early methadone trials, which featured rigorous screening processes for applicants and included staggered patient cohorts in cumulative retention data, produced impressive results: anywhere from 71 to 94 percent of users ceased criminal activity, found steady employment, and/or enrolled in college.) But heroin addiction was most prevalent in poor, high-stress urban neighborhoods characterized by racial discrimination in housing and employment. Methadone didn’t alter the scene much in places short on opportunity and long on reasons to use and sell dope. For decades, critics have credited the drug with simply perpetuating social conditions that give rise to drug use in the first place.

dAd5GNE may face similar charges. It doesn’t eliminate craving for cocaine, it just reduces the drug’s effect. Research suggests cocaine must occupy at least 47 percent of a dopamine transporter to produce a characteristic high and Crystal’s vaccinated primates never reached levels above 20 percent. But committed human addicts may accidentally overdose trying to bridge the gap, assuming they stick with the vaccination booster regiment at all, while polydrug users have an easier workaround. In any case, neither the setting or consequences of cocaine use on a social or individual level will probably change much. And, like its opioid-blocking counterparts, the cocaine vaccine gets us no closer to answering questions about addiction’s natured and (or?) nurtured etiology.

However, the vaccine has one major advantage over most opioid maintenance therapies: it has virtually no addictive potential. Twelve-step adherents and other abstemious interests liken methadone maintenance to substituting one drug – read: addiction – for another. Opioid replacement drugs can induce a mild euphoria, create physical tolerance, and even be fatal at certain dosage thresholds, which, at least theoretically, are non-issues for vaccine boosters administered weeks apart.

However, this treatment is not for everyone who does cocaine. The vast majority of users enjoy it as a fun or utilitarian stimulant without adverse outcomes. Many have no desire to stop. But even for problem users hoping to quit, the cocaine vaccine may go the way of methadone, Antabuse, and nicotine patches: magic bullets for some, stopgaps for others, nothing for most. (Assuming, of course, that trials confirm dAd5GNE is viable for human use.) But for anyone who earnestly desires to break patterns of destructive behavior, here’s hoping for more poofs in the future than the past.

Announcing the latest episode of Poinstcast!

The latest episode of Poinstcast is now available on Soundcloud for your listening pleasure! On this episode, Alex and I introduce a new segment, the Paper Chase, where we unpack the cultural meaning of even silly-sounding news from a not-so-bygone era. We end with a discussion of the “lovable drunk” television trope, particularly on The Bachelor and other reality (“reality”) shows featuring heavy alcohol use. Join us for a meandering conversation about dogs on marijuana, a purported heroin Queenpin in 1940s Chicago, and whether Barney Gumble and Karen Walker are held to a gendered double standard.

As always, feel free to reach out via email at pointscast@gmail.com, post on or message our Facebook page, or find us on Twitter. (#YouVapeBro?)

Submit your questions to Pointscast!

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Most of the time, podcasting is a one-way street. But we at Pointscast, the first, best, and only podcast of the Alcohol and Drugs History Society, want to know what you want to know about the history of drugs (illegal or otherwise). We’re actively soliciting questions for our network of experts to answer on the air. Do you want to know more about alcohol Prohibition, the Opium Wars, why particular drug epidemics come and go, or how authorities got the idea that “Reefer Madness” was onto something? Are you curious about how historians of illegal activity do their research? Would you like to start your own project but you don’t even know where to begin reading? Chances are we know somebody—or know somebody who knows somebody—who can hook you up. Submit your questions on this site, email us at pointscast@gmail.com, post on or message our Facebook page, or find us on Twitter. Also stay tuned to the ADHS Points blog for updates and new episodes. In the meantime, check out our back catalog on Soundcloud; it might inspire a question for our next installment!

 

Introducing Pointscast, our new Podcast!

Points is incredibly excited to announce that our assistant managing editor Kyle Bridge and Alex Tepperman, PhD candidate in history at the University of Florida, have launched a new podcast called, naturally, Pointscast.

Deputing here is the first episode, which discusses drugs and alcohol in the news, and features interviews and some really excellent sound effects.

https://soundcloud.com/pointscast/pointscast-ep-1

You can reach Alex and Kyle at pointscast@gmail.com if you have any questions or comments, or if you want to be featured on a future episode.

And, after you’ve tuned in, let us know what you think! Hopefully we’ll have many more episodes of Pointscast to come.

From “Addiction in American Life” to the Addiction Oral History Project

Every semester the UF Samuel Proctor Oral History Program offers an undergraduate internship for those interested in learning oral history theory and practice, archive management, and so on. SPOHP maintains several ongoing projects but also welcomes the development of new collections and, with the help of some enthusiastic interns, during my tenure as an internship coordinator in spring 2015 I inaugurated a new collection centered on addiction. The Addiction Oral History Project features some life histories of self-professed addicts in recovery, treatment providers, drug court personnel, and addiction researchers (from the humanities and sciences).

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Said enthusiastic interns and coordinators

I wrote about my experience putting together the thematic internship, titled “Addiction in American Life,” in a post last summer. This time around, I’m excited to announce that the interviews and transcripts are now available online! Curious readers should first peruse the podcasts created in spring 2015. (Many, though not all, were created from the relevant interviews.) You can then search for particularly interesting narratives on the Addiction Oral History Project’s web page.

I hope this modest but growing collection can be of use to researchers and of interest to everyone else. For now, the stories mostly involve the onset and maintenance of addiction, law enforcement protocols, changing drug use patterns, and life in Florida cities like Gainesville and Jacksonville since the 1960s. Forthcoming additions will include active user experiences and views on evolving drug scenes, as well as insider perspectives on the policymaking process, among others. I will update Points readers about significant new interviews as they are transcribed and uploaded. In the meantime, like any good oral historian should, I only ask that you talk about it.

“Addictions Old and New” Conference: An Overview

Editor’s Note: In this post, Points Assistant Managing Editor Kyle Bridge offers a textual overview of the “Addictions Old and New” conference, convened October 22-23 at the University of Richmond. Follow the link above to see the professionally-recorded presentations in their entirety. 

Increased specialization in scientific research has yielded nuance but added little coherence to how we conceptualize addiction. More broadly across disciplines, the study of addictions is fraught with disagreements over methodologies, treatment and policy implications, and even defining what “addiction” actually is. So it was no surprise that last week’s conference, “Addictions Old and New,” which featured a variety of presenters with current and historical perspectives on the phenomenon, was an enlightening and provocative experience.

Psychiatrist Charles O’Brien’s keynote address, “What is Addiction and What do Addictions Have in Common?”, set the tone for the event. Taking the long view of history—meaning from-the-dawn-of-man long—he argued that addiction is a “coincidence of evolution.” Anything that can activate the neurological reward system has addictive potential, though more data is needed before we label new, discrete addictions. As for etiology, it turns out that addiction and memories are formed the same way and one is as hard to “forget” as the other. Though, O’Brien did differentiate “addiction,” characterized by drug seeking despite adverse consequences, from “dependence,” what he called a natural physical adaptation. Furthermore, he claimed, all addictions are influenced in some way by genes. He also addressed what constitutes sound treatment, which may include medicine, talk therapy, and even potentially electrical stimulation of particular parts of the brain.

The keynote covered far more than can be addressed here, but two main points were raised in the subsequent Q&A. The first took issue with the criteria for recognizing iterations of addictions. Fortunately for anyone curious, two of the next day’s presentations made the case for adding some new acts in addiction’s big tent: food and sex. In “Food as a Drug: How Good is the Analogy?”, historian David Courtwright found that the comparison holds because, at a basic level, food addicts look like drug addicts, exhibiting similar patterns of use and co-morbidity with other disorders. They also recover like drug addicts; for example, promising therapeutic medications like naltrexone suggest biological commonalities between addictions. In fact, food addict behavior often fits neatly within the National Institute on Drug Abuse’s disease model of addiction. Thus, it may only be a matter of time before public health reformers and capitalist interests clash over the availability of hyperpalatable foods, for, almost inevitably, “economic rationality begets social irrationality.”

In a similar vein, sex addiction therapist Robert Weiss lamented that the American Psychological Association does not officially recognize the disorder in its Diagnostic and Statistical Manual. His presentation, “Hyperstimulation and Digital Media,” laid out what sex addiction is not, including an excuse for infidelity, a high sex drive, or criminal sexual offenses. Though his presentation was cut short for time, Weiss made a compelling case that sex addiction is not really about the act of sex at all. Instead, it is the thrill of anticipation and underlying intimacy issues which compel sexually addictive behavior. Hopefully historian Virginia Berridge’s talk, “Whatever Happened to Alcoholism?”, which focused on the twentieth-century British concept of alcoholism, gave Courtwright and Weiss some historical optimism. Alcoholism’s time came, passed, and then came again, bolstering the perennial truth that popular ideas about addiction are subject to change.

Later, in “Addiction by Design,” communications scholar Natasha Schull presented on technological gambling addiction, or, more accurately, the efforts of gaming companies from Las Vegas to Silicon Valley to maximize user “time on device” through innovative ergonomics, deceptive wagering patterns, and sensory gratification. Gambling addiction’s long history relative to food or sex certainly makes it a less contentious notion, but Schull’s research introduced a counterintuitive idea about the practice: that chronic gamers are not actually in it to win it. Really, they play to get in what she calls “the zone” and numb themselves to reality. After her thoroughly fascinating discussion of the increasing sophistication of game design, she considered some policies that would mandate occasionally rousing gamblers from “the zone” while allowing them to still use machines and remain profitable for casino companies. But, she concluded, the latter’s interests may stifle or simply work around any legislative interventions.

A user in “the zone”

Market capitalism’s addictive potential was the subject of many talks. Like Schull, public policy professor Mark Kleiman was skeptical of allowing commercial interests free reign over a vice, in his case cannabis consumption. He argued in his presentation, “Science and Policy in the Legalization Debate,” that removing criminal penalties for marijuana sales and sanctioning mass production would likely reduce price with the undesirable side effect of increased availability and use. Comparing a potential legal cannabis market to the extant alcohol trade is reasonable, Kleiman allowed, but the modal drinking occasion consists of one or two drinks while the modal smoking session only concludes when participants get stoned. The public health costs of increased smoking will fall on the disadvantaged minority who currently bear the brunt of harms from other legalized commercial vices. Still, he made clear, this is no reason to continue incarcerating millions for marijuana possession.

Circling back, the second major flashpoint following O’Brien’s keynote was the boundary between “addiction” and “dependence.” Clinician-researcher Andrew Kolodny addressed this most directly in his presentation, “The Prescription Opioid Epidemic and the Heroin Revival.” The “bright line” separating the two concepts was in large part contrived by pharmaceutical interests looking to change the culture of opioid prescribing. He dated the current opioid addiction epidemic to 1996, when Purdue Pharma introduced Oxycontin and rolled out an extensive marketing campaign to convince doctors that long-term use of addictive drugs was safe under medical supervision. They reinforced their message through sponsoring mandated continuing education classes for physicians and propping up “grassroots” (or “astroturf”) patient advocacy groups that called for considering pain the “fifth vital sign.” The takeaway was that the current crisis is almost entirely rooted in medical practice. Overdose deaths are highest among older folks with easy access to prescriptions. And the media narrative of a mass migration to heroin following police crackdowns on “pill mills” is wrong on two counts: first, the “migration” has actually been a gradual, consistent process over the last two decades among young, healthy people with sporadic access to legitimate prescriptions or expensive black market versions; and second, there is no evidence of a substantial “crackdown” at all.

Kolodny concluded that to address the epidemic we must prevent new cases of opioid addiction with more cautious prescribing and expand access to treatment for people who are already addicted. And at one point, during another Q&A, even a self-described “drug warrior” conceded that the hardline drug war is lost. Most attendees and presenters seemed sympathetic to or enthusiastic about the goals of harm reduction, or mitigating the negative outcomes of drug use as opposed to simply imposing abstinence. Though this principle is usually applied to illegal drugs, given that their consequences are generally exacerbated by prohibition, in an innovative presentation titled, “Old Drug in a New Container?”, pharmacologist Robert Balster applied it to tobacco and e-cigarettes. Abstinence campaigns have been hugely successful in reducing the prevalence and incidence of smoking, but they may suffer diminishing returns and implicitly accept the harms accrued by the minority that continues to light up. Alternatively, a harm reduction approach of encouraging e-cigarette or other electronic nicotine delivery system (ENDS) use, might maintain or even increase nicotine consumption but at a much lower public health cost. No matter the ethos going forward, he urged for more research into ENDS, which are severely under-regulated by state authorities.

Better than the alternative, but worth the risk?

In “Uppers and Downers,” an historical evaluation of under-regulated pharmaceuticals, historian David Herzberg offered that the mid-twentieth-century’s narrow definition of addiction “shielded sedatives and stimulants from regulation.” Laws passed in the decades after the 1914 Harrison Act targeted “dangerous,” not “addictive” drugs. They imposed few if any manufacturing limits, little required record-keeping, and mild penalties for offending pharmacists. Even as barbiturate overdoses mounted by the 1950s—perhaps as high as over 7 per 100,000 in 1953—public concern did not translate to punitive laws. Harms from prescription drugs were widely viewed as accidental poisonings. It took the 1960s culmination of the civil rights movement and experimental white hippies to overturn mainstream American ideas about who actually used drugs. Meanwhile, a series of public scandals within the pharmaceutical industry made it an easier legislative target. Of course, New York’s Rockefeller drug laws and the crack epidemic reoriented public discourse toward illegal drugs once again, allowing for new pharmaceuticals like Valium and, ultimately, Oxycontin to establish relative legitimacy.

In real, tangible ways, we continue to grapple with the historical and more contemporary issues broached by the presenters, and this report did not even address every issue discussed (see the videos linked above). I can only hope that this conference serves as a model for more interdisciplinary gatherings in the future.