The Travels of ‘The American Disease’ in China

Editor’s Note: We close our symposium, fittingly, with a post from Yong-an Zhang, Director of the David F. Musto Center for Drug Policy Studies and Professor of History at Shanghai University. He was a visiting fellow of the Center for Northeast Asian Policy Studies (CNAPS) at the Brookings Institution and a visiting professor of History of Medicine at Yale University’s School of Medicine. Dr. Zhang’s research interests include the social history of drugs and medicine, international drug control policy, drug diplomacy, and China’s drug control strategy. He is the author of Policy Choice in Changing Society: A Study on American Marijuana Policy (2009); Asia, International Drug Trafficking, and U.S.-China Counternarcotics Cooperation (2012); and co-author of China’s Urban Health Risk and Social Governance (2012).

In the fall of 1999, I was participating in a seminar on Modern Chinese History by Professor Cheng Shuwei in the Department of History at Northeast Normal University. This seminar led me to understand that opium and other drugs had played a very special role in Modern Chinese History. As a graduate student of American history, I became convinced that I needed to understand the role that drugs played in American society, and how the U.S. government, civil society, and the public responded to the world’s first global commodity. When I myself raised these issues, I suddenly realized that I could not find satisfying answers in general texts on American history. On weekends, I started going to the Scholar Bookstore to look for books that would help me. Then one weekend—to my great surprise as the book had not been there when I’d looked the previous weekend—I found a recently published book: Meiguo Jindu Shi (The American Disease: Origin of Narcotic Control).

Meiguo Jindu Shi (1999)

Meiguo Jindu Shi (1999)

The Chinese version was based on the third English edition and had been published by Beijing University Press that very year. After briefly browsing the contents, I knew it was the book I was looking for. I immediately bought it and finished reading it that weekend. To my mind, it is full of novel wisdom in almost every chapter, every section, and even each page. Professor Musto was familiar with all of the relevant archives and primary materials—nothing was recycled, nothing second-hand.

According to my perspective, the Chinese version of The American Disease should have been the first classic manuscript to be translated and published in China. It offers a comprehensive account of drug use and government drug policy from the 1860s to the 1990s; it explores the origins of narcotics control in international and domestic contexts; and it examines the interaction between politics, health, and ideology during the development of American drug policy. It casts the American concern with narcotics as “more than a medical or legal problem—it is in the fullest sense a political problem.” Furthermore, it explains the “energy that has given impetus to drug control and prohibition” as resulting from “profound tensions among socio-economic groups, ethnic minorities, and generations—as well as the psychological attraction of certain drugs.” More importantly, it opened my beginner’s eye to re-thinking the complex dynamics of American history, particularly medical history, social history, and constitutional history, through a new perspective.

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Remembering David Musto

Editor’s note: As has become apparent in this symposium, how individuals read The American Disease depends on when and where they first encountered the book. In today’s post, Caroline Jean Acker, author of Creating the American Junkie: Addiction Research in the Classic Era of Narcotic Control  (2002) reflects on how The American Disease played in the social world of street-level drug education and ethnography in the late 1970s.

On February 1, 1979, I walked into the office of Up Front Drug Information in Miami’s Coconut Grove, my first day on the job as Coordinator of the agency. Smaller and less well known than the Do It Now Foundation or the Student Association for the Study of Hallucinogens (STASH), Up Front shared these groups’ conviction that scare tactics did little to deter drug use once people found even one of their claims false.

Up Front’s desire to establish a street drug testing lab arose in 1978 due to the concerns of American consumers that they might have purchased Mexican marijuana sprayed with the herbicide paraquat. Up Front’s logo (lower left) was a stylized representation of a mescaline molecule designed by Leon Rosenblatt.

Up Front established a street drug testing lab in response to the concerns of American consumers that they might have purchased Mexican marijuana sprayed with the herbicide paraquat. Up Front’s logo (lower left) was a stylized mescaline molecule designed by Leon Rosenblatt.

Founded in 1973 by Tracy Brown, Up Front assumed that if people were going to use psychoactive drugs, they would be less likely to experience undesirable effects if they had accurate information about them. Lacking clear understanding of drug effects, they risked overdose and other untoward outcomes.  The organization maintained a small library (books ranged from Goodman and Gilman to Peter Stafford’s Psychedelics Encyclopedia; periodicals, from The New England Journal of Medicine to High Times), fielded questioners’ phone calls, developed and distributed pamphlets on drug effects and risks, managed a DEA-licensed anonymous street drug testing laboratory, and produced a small monthly magazine called Street Pharmacologist.

My first published writing appeared in this venue where, as editor, I accepted my own submissions. When I was hired, I knew little about psychoactive drugs, and Tracy set about educating me before he went off to law school.

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A Tribute to Patient Historical Diagnosis: The Doctor in ‘The American Disease’

Editor’s note: Like the other contributors to this symposium, Nancy D. Campbell celebrates the 40th anniversary of David F. Musto’s The American Disease by noting the book’s landmark status in her own intellectual journey. She is author of Using Women: Gender, Drug Policy and Social Justice (2000); Discovering Addiction: The Politics of Substance Abuse Research (2007); co-author with JP Olsen and Luke Walden of The Narcotic Farm: The Rise and Fall of America’s First Prison for Drug Addicts (2008); and co-author with Elizabeth Ettorre of Gendering Addiction: The Politics of Drug Treatment in a Neurochemical World (2011).

“We are, however, an impatient people.” Thus ended the Expanded Edition of The American Disease, which opened my eyes to the underlying history of the War on Drugs that was unfolding in the late 1980s. Musing about returning to graduate school from a vantage point high in the Coast Range in Mendocino County, California, I was riveted by the contradictions of the historical moment. On rare occasions when there was network reception at my remote outpost, the War on Drugs appeared to target pregnant, African-American women using crack-cocaine. Yet in the Emerald Triangle realities, there was paramilitary action against pot-growers. What was the War on Drugs, I wondered, if it meant so many things to so many people?

Scales fell from my eyes as I read The American Disease. So this was what historians did! They enabled ordinary people to make sense of the contradictions they inhabit. This was what drug policy was about—cycles of alternating tolerance and intolerance, fear and loathing, learning and unlearning. Through David Musto’s book, I thought I understood what all this demonization and marginalization was about. What more was there to say? Little did I foresee a career spent reading between the lines of a book that came out when I was 10 years old, announcing to my father’s med-school buddies that I would grow up to write a “history of the pill in America.”

David F. Musto hosts drug policy historians, young and experienced, at Yale in 1996.

David F. Musto (bottom left) hosts drug policy historians, young and experienced, at Yale in 1996. 1st row: David Musto, Stephen Kandall, Caroline Acker, Nancy Campbell, Mara Keire; 2d row: Tim Hickman, Rebecca Carroll, Sarah Tracy, Jennifer Gold, Susan Speaker, Peter Bourne; 3rd row: William White, Pamela Korsmeyer, Ann Blanken, Ruth Engs, David Courtwright; 4th row: Joseph Spillane, Jill Jonnes, John Burnham, –.

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Confessions of an Historian of Secrecy, Science, and the Self

Editor’s note: We continue our celebration of the 40th anniversary of the publication of David F. Musto’s book with a contribution from cultural historian and American Studies scholar Timothy A. Hickman, whose first book, The Secret Leprosy of Modern Days, reconstructs (and deconstructs) the entrepreneurial therapeutics of the late 19th century historical world inhabited by Dr. Leslie Keeley, proponent of the famous “Gold Cure” for inebriety. Hickman recounts grappling with Musto’s capacious framework in the context of a post-Foucauldian intellectual moment.

Most historians of drugs and alcohol get used to the question, “So how did you get interested in THAT topic,” usually punctuated by a cocked eyebrow and an arch chuckle. My interest arose during the popular recovery movement of the late 1980s, when I read “As Sick as Our Secrets,” a Summer 1990 LA Weekly article by writer Helen Knode, who detailed her family’s troubles with substance dependence over the years. I was particularly taken by her claim that, if one were to multiply the number of “addicts” by the number of “co-dependents” asserted by recovery writers, the product would exceed the entire US population!

The fonts were just a symptom.

Bad fonts were a symptom.

What fundamental beliefs might underwrite the diagnosis of the entire American population as “dysfunctional”? Whose interests were met in defining a whole population as a target for therapy? What institutions benefited? What did this state of affairs suggest about American society, and why did millions of people ‘Just Say Yes’ to the recovery movement’s call?  Still more pressingly, what kind of a “disease” required confession as the first step to cure?

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‘The American Disease’ Turns Forty

Editor’s Note: This spring marks 40 years since the first publication of The American Disease: Origins of Narcotic Control, the groundbreaking book by David F. Musto (1936-2010). In honor of this anniversary, Nancy D. Campbell has organized an online symposium at Points this week on Musto’s book and its impact, featuring leading drug historians. The symposium begins today with a reflection by David T. Courtwright, Presidential Professor of History at the University of North Florida. Courtwright discusses the origins and publishing history of The American Disease, and the role it played in his own career as a drug historian, which has produced such similarly lauded works as Addicts Who Survived: An Oral History of Narcotic Use in America, Dark Paradise: A History of Opiate Addiction in America, and Forces of Habit: Drugs and the Making of the Modern World.

In 1968 Dr. Stanley Yolles, the Director of the National Institute of Mental Health, assigned a young physician named David Musto the task of investigating the history of the narcotic issue. Yolles was particularly interested in the narcotic clinics that briefly flourished in the early 1920s. Musto, then attached to the U.S. Public Health Service, dutifully began reading documents in the National Archives and the Library of Congress. He made two discoveries. The first was that almost no one before him had bothered to use archival sources. The second was that these sources did not line up with either the medical-reformist or police-enforcement versions of the past. “These ‘histories,’” Musto wrote, “appeared to be more in the nature of political party platforms than accurate descriptions of the process of narcotic control in the United States.”

This defect Musto corrected in The American Disease (1973), whose fortieth anniversary falls this year. What his book conveyed was the contingency and complexity of narcotic control. It untangled American drug policy’s serpentine roots, showing how narcotic abuse and addiction, diplomatic maneuvering, muckraking journalism, racial anxieties, pharmaceutical and medical lobbying, and moral entrepreneurship all affected early laws and treaties. Federalism further complicated the story. In the early twentieth century many Americans questioned whether and to what extent the federal government had jurisdiction over drug control. The matter ended up in the Supreme Court, which in 1919 narrowly upheld both the constitutionality of the Harrison Narcotic Act and federal prosecutions of individual physicians who wrote large numbers of prescriptions to maintain addicts’ habits.

Yale University Press ad for the 1973 edition of 'The American Disease'.

Yale University Press ad for the 1973 edition of ‘The American Disease’.

It was the constitutional questions that first led me to the book. In 1975 I was a Rice University graduate student in Harold Hyman’s legal history seminar. I was struggling to understand the ban on addict maintenance, which had only recently and grudgingly retreated before the methadone revolution. My first thought, as I thumbed through The American Disease, was one of disappointment. Someone had already published a big book—with Yale University Press, no less—on my intended subject. Continue reading →

Desperate Mothers, Only Sons: The ‘Moral Reformation’ of China’s Internet Addicted Youth

Points Desp Mothers 1

Chinese gamer Sky takes an oath of good sportsmanship during the opening ceremony of the World Cyber Games in Kunshan, China

I am writing this blog post from the 2012 World Cyber Games in Kunshan, China. This international competition for professional digital gaming, also known as e-sports, is an interesting setting from which to contemplate Chinese government efforts to draw strict divisions between nationally sanctioned e-sports and “unhealthy” and “addictive” Internet games.  Indeed, during the press conference prior to the start of the competition, one of the members of China’s General Administration of Sport shared a story about a conversation she had with the Vice Mayor of Kunshan city.  The Vice Mayor had noted that she originally intended to bring her son to the event, but her husband had forbidden it for fear that exposure to digital games would negatively impact his studies.  The Sport Administration official used this as an example of the image work still needed to train Chinese citizens to have the “proper” perspective on e-sports.  If only parents could understand the positive (the actual phrase she used was “sunny” or yangguang) impact of this particular form of gaming…. Compare this attitude to the concerned mothers depicted in these images drawn from the Chinese news media.

Points Desp Mothers 3

Points Desp Motheres 2

A mother wrestles her son to keep him from the Internet cafe

In the photograph above, drawn from the Chinese news media, a woman cries in the face of her despondent son,  despondent son responsive only to the stimulus of a game on a computer screen. In the photo to the right, a mother pins her son to the street to keep him away from an Internet café.  A third story in the news relates the tale of a mother who stabbed her own son in the leg with a knife because she could not stop him from running off to an Internet café to play games.  Rather than frame this incident as child abuse, the news anchor noted, “We can sympathize with the feelings of the parents, but we should not use disciplinary measures that are too violent.”  The frequency with which such acts of desperation appear in the press makes them seem almost natural, as the nonchalant response to this otherwise shocking incident of parental violence indicates.

A final portrait of maternal desperation that I would like to share with you is depicted in the 2007 film Net Mother.  This film, reportedly based upon true events, chronicles the valiant efforts of a handicapped mother who strives to connect with Internet addicted teens via instant messaging.  Having sustained terrible burns on her hands as a child, this mother overcomes her handicap and uses her story of struggle to convince young people to strive to overcome their own struggles with addiction.

Net Mother opens with a montage of scenes from China’s countryside: a farmer working the fields on his tractor, families and children enjoying an outdoor performance of classical Chinese opera, and women practicing traditional fan dancing in a park.  But the serene music that accompanies these opening shots takes a sudden dark and sinister turn as the scene switches to the dimly lit interior of an Internet café.  A young boy stands up woozily from his computer and stumbles out of the café, walking only a few feet before collapsing from exhaustion and, improbably, falling asleep directly on a set of train tracks in front of an oncoming train.  As unbelievable as this incident might seem, this is in fact yet another scene ripped straight from the Chinese media’s sensationalistic headlines about Internet addiction.

Sensationalism aside, what is most striking about this opening sequence is its vision of two competing Chinese cultures: there is, on one hand, the vibrant culture of Chinese tradition, and, on the other, the dangerous and foreign culture of the Internet café.  In the face of this threat, the figure of the desperate mother becomes a symbol of national moral crisis.  She can be seen as reaching out to her child, usually a son, in a frantic effort to restore tradition and protect the future of the nation in the face of corrupting foreign influences.

While the mother as symbol of the nation is not restricted to China, the image of the suffering and desperate mother has a particular resonance within Chinese history. Hsiung Ping Chen (1994) has noted that mothers in late imperial China often used their suffering as a device by which to manipulate and guilt their sons into achieving excellence.  The mother of opium commissioner Lin Tse-hsü (Lin Zexu) famously admonished her son that, “Only if you study hard and honor your parents by your success will my pains not be suffered in vain” (p. 39).  Today, the desperation of mothers in China may be compounded by the fact couples are restricted to one child, making that child what anthropologist Vanessa Fong (2004) has called the family’s “only hope.”  Fong notes that mothers thus invest everything in their child’s future, hoping that their children will grow up to be filial and successful enough to provide for them in their old age.

With reports that Internet addiction centers are using extreme measures such as shock therapy to treat addicts, mothers have also become the face of a different kind of treatment: moral reformation (ganhua).  Rather than framing addiction as a mental illness that brings shame to families by suggesting an internal or hereditary defect, moral reformation frames Internet addiction as an issue having to do with external forces such as proper education.  Young people are portrayed as having lost their moral compass and sense of duty to their families.  Notably, this kind of treatment was also used to address the problem of opium addiction. Dikotter, Laamann, and Zhou (2004) have called attention to the portrayal of “addicts as misguided human beings in need of help,” noting that “moral reformation” involved lectures, formal education and “wholesome leisure.”  Addicts were strictly disciplined in hope of  “correcting wrong ideas” and creating “morally good citizens.”

Today, as I watch the pomp and circumstance surrounding the opening ceremony of the World Cyber Games in China, it is clear that e-sports is being promoted as a form of “wholesome leisure” that can lead to the creation of “morally good citizens.”  The question left in my mind, as I scan the audience, is where are all the proud mothers?

— Marcella Szablewicz

Reflections on Red Ribbon Week

When my daughter came home from kindergarten talking about Red Ribbon Week, I was delighted. I proudly showed her my collection of red ribbons, proud that a consciousness-raising symbol signifying AIDS awareness had made its way into public school classrooms. No, she explained, this Red Ribbon Week was different. She had never heard of AIDS. This Red Ribbon Week was about drugs. “But,” she said, “We don’t really learn about them. We just get told “DON’T DO DRUGS!”

When she showed me her Red Ribbon Week handouts, I was bemused by the big red X’s over coloring-book line drawings of wine bottles and beer cans, syringes, pill bottles, and cigarettes. I was mildly amused at her ferocious response to my very occasional glass of wine with dinner in the post-Red Ribbon Week weeks. My own parents were tee-totalers, so I hold on to my increasingly rare social drinking as a form of no-longer-precocious resistance to authority. But as a drug policy historian, I began tugging at the thread of the Red Ribbon. Continue reading →