Big Nicotine, Part II: Addiction and the “Cult of Pharmacology”

Last month, the U.S. Food and Drug Administration announced its intention to lower the nicotine content of cigarettes to, ideally, “minimally or nonaddictive” levels. Public health advocates celebrated the decision; on the other hand, Big Tobacco investors began dumping shares at the prospect of supplying an ever-more-elastic demand.

Cigarette critics and capitalists alike belong to what Richard DeGrandpre calls the “cult of pharmacology,” a system of belief that dominates American drug discourse. Rooted in modernist faith in understanding the world through scientific approach, by the early twentieth century many considered drug experience to be a straightforward process of brain and body chemistry, without regard for concepts we might recognize today as set and setting. Historically contingent forces divide drugs into “angel” and “demon” categories, but their effects are similarly reduced to biological mechanism: “‘soul’ was reinterpreted as ‘mind,’ and ‘spirit’ was reinterpreted as ‘biochemistry.’”

But cults are given to blind faith, so it is worth considering the extent to which substances are to blame for problem use.Read More »

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Interpreting Donald Trump’s “Oxy Electorate”: On the Interaction of Pain and Politics

On January 20 – inauguration day – the HBO news talk show Real Time with Bill Maher aired its fifteenth season premier. Unsurprisingly, Donald Trump was the topic of the hour. After Maher and his panel of pundits concluded their discussion, the host delivered an editorial monologue analyzing Trump’s electoral victory and offered a provocative comparison:

“Here on inauguration day, in the spirit of new beginnings, liberals have to stop calling Trump voters rubes and simpletons and instead reach out and feel their pain, the pain they insist we didn’t see. And there is ample evidence for that pain. Did you know that of the fourteen states with the highest painkiller prescriptions per person, they all went for Trump? Trump won eighty percent of the states that have the biggest heroin problem… So let’s stop calling Trump voters idiots and fools and call them what they are: fucking drug addicts!”Read More »

Anti-Narcotics as Social Critique: Earle Albert Rowell’s Crusade

 

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Earle Albert Rowell

We are introduced to David Dare in Experiences of David Dare in Bible Research, a novel written by Earle Albert Rowell in 1933. Dare, presenting a series of lectures on biblical prophecy to a town of agnostics gradually wins over the Emersons, a local family who become convinced by Dare’s lectures and convert to Christianity. Four years later, Dare and the Emersons reappear as a team of anti-narcotics crusaders, saving a wealthy family, the Marvels, from the perils of addiction in Dope Adventures of David Dare.

Dare’s creator, Earle Albert Rowell had written several short books on religion and drugs through this period. One about the opium habit from 1929 Battling the Worlves of Socitey and another about the new scourge of marijuana in his 1939 book, On The Trail of Marihuana. Described by his publishers as a well traveled anti-narcotics crusader, a member of the White Cross International Anti-Narcotics Society. He and his son Robert, Earle’s opium pipe in hand, had criss-crossed the country educating the public about narcotics and writing about his work.Read More »

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?)

The German Museum of Pharmacy: A Historiographic Time Capsule

Editor’s Note: This post is brought to you by Miriam Kingsberg, an assistant professor in the department of history at the University of Colorado, Boulder. This summer she visited the Deutsches Apotheken-Museum in Munich and has provided us with a review of its collections. All photos are courtesy of her as well. Enjoy!

During a two-month sojourn in Germany this summer, I eagerly anticipated a visit to Munich’s famed Beer and Octoberfest Museum—in the name of “research,” naturally. Less renowned than this hotspot and its many sister institutions, but equally relevant to historians of intoxicants, is the country’s sole attempt to reconstruct its pharmaceutical history: the Deutsches Apotheken-Museum (hereafter referred to as DAM), located since 1958 in the breathtaking Heidelberg Castle.

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The exterior of the Deutsches Apotheken-Museum

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Conference Summary: “I’ve Been to Dwight,” July 14-18, 2016, Dwight, IL

Editor’s Note: This conference summary is brought to you by David Korostyshevsky, a doctoral student in the History of Science, Technology, and Medicine at the University of Minnesota. He traveled to Dwight, Illinois, in mid-July to attend the ADHS off-year “I’ve Been to Dwight” conference, and has provided this account of his time there. Thanks David!

On July 14-18, 2016, a group of international alcohol and drug historians descended upon the village of Dwight, Illinois, for an ADHS off-year conference. Conference organizers selected Dwight because 2016 marks the 50th anniversary of the closing of the Keeley Institute.

Founded by Leslie E. Keeley in 1879 (and operating until 1966), the Keeley Institute offered treatment options to patients with addiction, usually alcoholism, including Keeley’s Gold Cure. “I’ve Been to Dwight,” the conference title, references “a catchphrase” former Keeley Institute patients “used to explain their sobriety.”

Keeley

To make it easier to read, this summary is organized thematically. You can see the full conference program here.

I live-tweeted the conference as @rndmhistorian under the hashtag #IBTD16. Also, Janet Olson, volunteer archivist at the Frances Willard Historical Association wrote a blog post about the conference.

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The State of the Art: The Malcolms’ Examination of Straight, Incorporated, Timeline

Editor’s Note: This is the fifth in a five-part series from Marcus Chatfield, a regular contributor to Points. Here he offers a timeline of key events and news articles in the history of Straight, Inc., the controversial adolescent drug treatment program that existed from 1976 to 1993. Thank you Marcus for bringing this series to Points!

November, 1980 – Opening Day, Sarasota facility.

1981

1/4/1981 – Sarasota Herald-Tribune begins series on Straight, featuring Dr. Robert DuPont (White House Drug Policy Advisor for Presidents Nixon and Ford, and former Director of NIDA), and his sense of urgency about preventing marijuana use.

1/4/81 – “Former Drug Abusers Share The Holidays At Straight-South Inc. – Straight: Hurt Into Help” – Sarasota Herald-Tribune

1/5/81 – “Community Concern Gave Straight Its Start” –  Sarasota Herald-Tribune

“Doctor Discusses The Dangers Of Pot Use” – Sarasota Herald-Tribune

“‘Facts’ Change Doctor’s Views On Pot Use” – Sarasota Herald-Tribune

1/20/81 – Reagan/Bush Inauguration Day

2/6/81 – Press conference at Sarasota Straight, Dr. Robert DuPont announces Straight’s national expansion: 26 new branches that will cost $18,212,000.00 over 5 years (1982-1986).

2/9/81 – “Straight Inc. Urged To Expand Nationwide” – Sarasota Herald-Tribune

2/10/81 –  “Straight Inc. Directors Mull Nationwide Expansion” – Sarasota Journal

7/6/81 –  “Growing Straight Inc Remains Controversial” – St. Petersburg Times

7/7/81 –  “Tough Love Makes Straight Successful, 2 Graduates Say…Another Youth    Tells of Threats and Intimidation” – St. Petersburg Times

7/30/81 –  “Drug Rehabilitation Center Will Help Users Go Straight” – Atlanta Constitution

8/2/81 – “Straight, Inc Coming to Cobb to Help Free Teens From Drugs”– Marietta Daily Journal

8/5/81 – Betty Sembler (wife of Straight’s founding president, Mel Sembler) letter to Carlton Turner (White House Drug Policy Advisor), confirming his future participation in the “Awareness Program” and inviting him for dinner with Dr. DuPont in Washington, D.C. (p. 1).

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The State of the Art: The Malcolms’ Examination of Straight, Incorporated, Part 4

Editor’s Note: This is the fourth in a five-part series from Marcus Chatfield, a regular contributor to Points. Here he continues his examination of Straight, Inc., the controversial adolescent drug treatment program that existed from 1976 to 1993. 

Carlton Turner visited (p. 7) the Saint Petersburg facility, two months after Andrew and Barbara Malcolm. He attended a Friday night “Open Meeting” on October 16, 1981 and soon after that visit, Straight’s National Director, James Hartz, asked Turner to write an endorsement letter for their Solicitation Presentation:

As you know from our telephone conversation, STRAIGHT, INC. is developing strategies for expanding our base in the search for funding. At the moment we are preparing an informative brochure to submit to those foundations, corporations, and individuals from whom we are requesting financial support. Enclosed is an outline illustrative of the type of information to be included. As soon as the brochure is completed, we will forward a copy to you. One of the most important facets of our presentation will be letters of support. We have already obtained permission from Dr. DuPont and Dr. Malcolm, who are forwarding their letters to us. The impact of a package such as ours is perceptibly enhanced by this type of verification. We are, of course, well-known in the areas in which we are located but a communication from you would substantially strengthen our credibility with those unfamiliar with our program and accomplishments (p. 15).

As the lawsuits and bad press accumulated during the years of expansion, this “perceptual enhancement” would become more and more important to Straight’s directors. As the ACLU was investigating the Atlanta program, within 6 months of its opening there, Robert DuPont (p. 1399) and Carlton Turner (p. 22) arranged for Nancy Reagan to visit the Saint Petersburg program, apparently in a show of solidarity. When Straight was (briefly) “cleared” of wrongdoing in Ohio and Georgia, James Hartz, wrote to Turner thanking him for his endorsement at the Florida fundraiser and “the efforts of your good offices in helping us over some rough spots during the past few months” (p. 24).

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Nancy Reagan and Lady Diana visit a Straight facility in Springfield, Va.

That was just the beginning; as Straight expanded it was repeatedly sued – Vice President George Bush made a promotional visit in 1987 and a TV commercial for Straight. In 1988, As President-elect, he agreed to appear on a Straight Inc. fundraising telethon. As rumors about brainwashing spread, Nancy Reagan made highly publicized visits to Straight, one of them with Lady Diana. After multiple lawsuits and state investigations found evidence of widespread abuses, Ronald Reagan wrote a blurb for a Straight brochure.

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The State of the Art: The Malcolms’ Examination of Straight, Incorporated, Part 3

Editor’s Note: This is the third in a five-part series from Marcus Chatfield, a regular contributor to Points. Here he continues his examination of Straight, Inc., the controversial adolescent drug treatment program that existed from 1976 to 1993. 

Beginning in 1976, the original design of Straight’s milieu was a slightly modified version of The Seed Inc., a program whose methods were also compared to “brainwashing” in the Congressional report, Individual Rights and the Federal Role in Behavior Modification (1974). Specific details about the origins of the actual design of The Seed program are elusive; it was one of many programs initiated in the late 1960s that implemented an array of group methods attributed to those developed by adult members of the therapeutic community, Synanon, founded in 1957 for the treatment of heroin addiction.

But the controversy over “brainwashing” in adolescent reform programs is older than any of the programs that grew out of Synanon; it seems to have started in 1962, over concerns about the Provo Experiment in Delinquency Rehabilitation at the Pinehills Center in Utah County, Utah. According to authors LaMar Empey and Maynard Erickson in their book, The Provo Experiment (1972), in November, 1962, at least one county commissioner had voiced concerns about public funding for the program because it seemed similar to “communist brainwashing.”

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