Dispatches from London: “Under Control?” Conference

This past weekend alcohol and drug scholars across the globe descended upon London’s School of Hygiene and Tropical Medicine to learn from each other about what they know best, alcohol and drugs.  The interdisciplinary conference does much to encourage scholarship across lines of disciplinary specializations, but also, the nation-state.  Below please find assorted notes from my time abroad:


Perhaps most noted for his work Andean Cocaine, Paul Gootenberg gave a keynote speech addressing the concept of blowback.  Entitled “Controlling Cocaine?  1900-2000,” Gootenberg began with what might be considered an obvious truth for drug historians—that is, that if read from an historical perspective, the term “drug control” is an oxymoron.  Throughout the 20th century, drug control often perpetuates the antithesis of control.  Drug control efforts by the United States have bred more chaos, more illicit trade, more use, and worst of all, more violence.  In supporting his claim, Gootenberg examined the ways in which United States efforts to control the global supply of cocaine produced various unintended consequences.

Originally an economic historian by trade, Gootenberg makes good use of global commodity chains to explain the story of cocaine and attempts at its control.  In framing the long history of cocaine commodity chains and blowback, Gootenberg broke down the century into several distinct phases, each with specific unintended consequences.  In the first forty years of the 20th century, particularly after 1914, the United States attempted to push anti-cocaine measures onto the international agenda.  During this period, Andean trafficking in cocaine remained relatively benign, marginal, and nonviolent.  Between 1948 and 1973, cocaine came to be increasingly criminalized as illicit networks began to shift outward from the Andean region in response to FBN attempts to crush production in the region.  A pivotal moment in cocaine commodity chain development passed in 1960 when traffickers were exiled under the Cuban Revolution.  These exiled traffickers quickly became a Pan-American Network of traffickers, thereby expanding the commodity network for cocaine traffic.  Still though, Gootenberg carefully noted, the trade remained small and fairly peaceful through 1970. Read More »

David Simon on the War on Drugs and the NSA Revelations

Last week two prominent critics of the War on Drugs independently declared that their years spent witnessing the civil liberties abuses involved in enforcing drug policy left them largely unmoved by the exposure of the National Security Agency’s comprehensive, only secretly and ambiguously legal, telecom monitoring program.

David Simon and John Stossel are the most unlikely of proverbial bedfellows and, when it comes down to their actual positions, they are not really sharing a bed at all. Stossel is a libertarian who has never met a government program he couldn’t mock in the exasperated, contemptuous style he developed on ABC’s 20/20 and now plies for Fox News. He opened his piece in Reason last week with familiar rhetoric about the ways “politicians abuse us.” Simon is a former newspaper reporter and the creator of Homicide, The Corner, and most famously, The Wire. Essentially a voice of the left, in his blog entry Simon made it clear how he feels about “libertarian selfishness,” in which “there’s never an act of communal sacrifice or societal aspiration that rises above the requisite contempt for collective governance and shared responsibility.”

Two different kinds of reporters.
Two different kinds of reporters.

Simon’s post went much deeper than Stossel’s column, which argued mainly that the  dangers of drugs have been exaggerated. Simon blasted through the struggle that some NSA critics have had marrying world-weariness (of course they’ve been spying on us) and anger by diagnosing instead full-blown myopia on the left. The basic legal and practical framework for telecom snooping has been in place for decades, he contends. It was established not in what we knew about the Bush Administration’s War on Terror, but in the wiretaps and home-raids of the war on drugs. Its abuses are not in some imagined future dystopia, but have been in plain sight, affecting real people.

If I sound exasperated with other liberal voices on this issue it’s because their barricades are in the wrong place, facing the wrong way, defending the wrong moral and legal terrain.  Thus far, the sum of liberal argument against the NSA program amounts to a Maginot Line of legal ignorance, borrowed libertarian selfishness and positive proof that those who fear a civil liberties apocalypse and wish to fight against such were decades late to the fields where those battles actually rage.  Shit, they’re still not in the right place.

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“Blacks Declare War on Dope”

When I began researching grassroots responses to crack-cocaine I found myself—albeit naively—both surprised and confused by heavy-handed, aggressive calls for more policing and harsher sentencing from working and middle class black urbanites.  Was this unique to the period?  Did this represent a specific and different response to the marketing invention of crack?  Moreover, I found myself asking: What motivated calls to stigmatize and scapegoat members of their own local communities?  Why would local leaders deliberately attract negative attention to their already beleaguered districts, thereby further perpetuating negative stereotypes regarding the debasement of inner-city culture?  Where were the progressive voices calling for moderate, rational, public health responses?

In earlier posts, I have begun to explain this reaction through the lens of black-lash.  Much like working class white ethnics before them, working and middle-class blacks responded to what they deemed destructive and dangerous changes to their neighborhood and organized Imagein efforts for reform to “take back their streets”.  Steeped in the language of victimhood and citizenship, these local activists made battles over crime and drugs battles of good versus evil.  The war against pushers, panhandlers, pimps and hoodlums would be about protecting the decent, innocent citizens held captive in their own neighborhoods.  Finally, black-lash—much like white backlash—came to be motivated in part by a perceived threat to group progress.  Working and middle class blacks viewed youth and street culture manifested by the drug trade as a clear threat to gains made under the Civil Rights Movement.

Recently, the use of the term black-lash has given me some pause for two reasons.  First, black-lash is less clearly and directly motivated by race.  The increasing significance of class in the post civil rights era makes such a term less useful.  More significantly, black-lash is not unique to the Crack Era.  The new work of Michael Javen Fortner clearly suggests that such sentiment existed in the 1970s as Harlemites fought vociferously against the increasing presence of heroin and crime in their neighborhoods.  This suggests that black-lash existed less as a reactionary impulse, and more as an enduring, but understudied class fissure within the black community.  With that said, let’s take a closer look at the roots of black-lash in the late 1960s and early 1970s to better assess the utility of the term “black-lash” as an explanatory tool. Read More »

Does “Public Health” Really Want To Own Addiction?

Editor’s Note: Guest blogger and medical anthropologist Kim Sue returned from a recent conference entitled “From Punishment to Wellness: A Public Health Approach to Women and the War on Drugs” with some questions about the coherence of the public health paradigm.

To celebrate the release of a joint report published by the New York Academy of Medicine (NYAM) and the Drug Policy Alliance (DPA) entitled a Blueprint for a Public Health and Safety Approach to Drug Policy, WORTH (Women on The Rise Telling Herstory) organized a conference focusing on women and the War on Drugs. The conference brought together formerly incarcerated women, direct service providers, researchers, policy analysts, and advocates and activists to discuss how to move from a criminalization model of drug use to a public health model. “The war on drugs is more than a failure,” the organizers announced. “It has swollen the prison system, left millions of people with criminal records and damaged communities.” The one-day event was aimed at exploring “practical examples of public health alternatives,” through discussions around four main themes: prevention, treatment, harm reduction, and safety.

Thinking through public health at the New York Academy of Medicine.
Thinking through public health at the New York Academy of Medicine.

What was interesting to me during the panel sessions and the break-out groups was the relative absence of public health professionals and clinicians in these discussions (one notable exception was Professor Lynn Roberts of Hunter College’s Department of Community Health). While “public health” was one of the buzzwords of the day, it seemed to stand in for other things that the conference attendees were actually more interested in talking about: structural violence, poverty, racism, patriarchy—often referred to as the “structural determinants of health.” One possibility is that “public health” was being used rhetorically as a means to talk publicly and politically about race, class, gender and various axes of social inequality under “public health’s” cloak of respectability.

There was some discussion of specific legislation and public-health oriented programming by several of the speakers—for example, Good Samaritan Acts, needle exchange programs, the decriminalization of sex work, and bills against the criminalization of HIV status—but the conference neglected how the massive apparatus of the War on Drugs endeavor will be “public health-ified” on a large scale. What will be the unintended consequences of doing so?

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The Points Interview — Kathleen J. Frydl

Editor’s Note: Kathleen Frydl’s new book, The Drug Wars in America, 1940-1973, is just out from Cambridge University Press. Points welcomes her timely and enlightening interview.

Frydl-book-cover 1.  Describe your book in terms your bartender could understand.

I tell the story of how and why the US government became “addicted” to the modern drug war, choosing prohibition and punishment over treatment and regulation. I argue that the logic behind the particular shape and targets of the drug war (including that which was not targeted) had less to do with crime or addiction, and more to do with the management of state power.

2.  What do you think a bunch of drug and alcohol historians might find particularly interesting about your book?

To be honest, probably not that much. At several points, I rely on that scholarship, but I can’t say that I actually contribute to it. For readers of this blog, it might be interesting — maybe even troubling, but hopefully stimulating — to hear the story of the drug war narrated through a different voice.  I hope it is viewed as a complement to the literature.

That said, there are some parts of the book that may be of interest. In chapter 5, I argue that methadone clinics lost support for a variety of reasons. Proponents of punishment, recovery movements, and various groups on the left imposed standard medical — as opposed to public health — criteria on maintenance: built around “a crisis followed by a cure” paradigm. This is somewhat different from the goals of harm reduction. Under this more demanding paradigm, the fact that every recovery victory could be celebrated  compensated believers for so much failure. In the public health lens, on the other hand, successful maintenance meant only less to be dismayed about. The outcomes were not so heroic and the narrative not so redemptive. Whether it was the Black Panthers or traditional recovery movements, certain advocates criticized maintenance precisely because it staved off the “crisis” which they felt was needed in order to proceed to the “cure,” whether that cure was sobriety or revolution in the inner city.

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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?”
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.Read More »

Setting the Record Straight, Part 5: A Disease They Didn’t Have

Editor’s note: Today marks the final installment of guest blogger Marcus Chatfield’s eye-opening exploration of the role that peer-reviewed research played in facilitating the survival of Straight Inc. into the 1990s, as well as its ongoing legacy in coercive youth drug abuse treatment.

In the 1989 Journal of Substance Abuse Treatment article “Outcome of a Unique Youth Drug Abuse Program: A Follow-up Study of Clients of Straight Inc.”, Alfred S. Friedman, Richard Schwartz, and Arlene Utada state that 99 percent of Straight’s clients were white and that 30 percent of clients attended church regularly prior to intake. It is relevant to consider the type of teens that were recruited for “treatment,” as well as how they were recruited for treatment and why their parents placed them in Straight. Notably, several authors have reported that many clients at Straight were treated for a disease they didn’t have. This was due in large part to Straight’s assertion that even the experimental use of alcohol or marijuana was the symptom of a disease. And because this disease was the cause of even initial drug use, treatment was required whether teens had experimented with drugs or not. Many clients in Straight were “dry druggies” who had never used an illegal substance but were displaying “druggie behavior.”

Spot the druggies.
Spot the druggies.

Read More »

The Points Interview — Edgar-André Montigny

Editor’s Note:  Edgar-André Montigny’s edited volume, The Real Dope: Social, Legal, and Historial Perspectives on the Regulation of Drugs in Canada (University of Toronto Press, 2011) takes the spotlight today.

The Real Dope1.  Describe your book in terms your bartender would understand.

The Real Dope is a collection of scholarly articles exploring how the government and society in general have dealt with various drugs, from alcohol and tobacco to ecstasy and LSD. The articles introduce us to 19th-century moral reformers, 1920s flappers, downtown Vancouver heroin addicts, psychology professors, hippies, glue-sniffing high school students, ravers, post-war government officials and senators, all interacting in some way with intoxicating substances through using, studying or regulating them.

2.  What do you think a bunch of alcohol historians might find particularly interesting about this book?

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Setting the Record Straight, Part 4

Editor’s note: Marcus Chatfield continues his series on Straight, Inc., the coercive treatment program for children and teens suspected of drug use that flourished with White House and NIDA support in the 1980s. In today’s entry, Marcus breaks down the flaws in the peer-reviewed research that helped cement this official legitimacy.

In “Outcome of a Unique Youth Drug Abuse Program: A Follow-up Study of Clients of Straight Inc.” (1989), Alfred S. Friedman, Richard Schwartz, and Arlene Utada claim that their report will include: “(1) the description of the study sample, (2) the outcome of the improvement that occurred between intake and follow-up, (3) the comparison of the outcome between graduates and ‘dropouts,’ and (4) the relationship of the amount of time in treatment to treatment outcome.”

"This report is in fulfillment of NIDA Professional Services Contract #64986."
In their sights.

However, in each of these areas the study is flawed: (a) their description of the study sample reveals major problems, such as selective sampling; (b) the intake-to-follow-up comparisons show limited correlation and also, the authors state that they are meant to measure outcome of improvement rather than actual outcome; (c) they completely fail to discuss their promised comparisons between graduates and dropouts (they also claim to discuss a comparison between “respondents” and “nonrespondents” and then omit this comparison as well); and (d) perhaps most importantly, but left unexplained, they found that “time in treatment” had no effect on drug use reductions. Read More »

Setting the Record Straight, Part 3

Editor’s note: Today Marcus Chatfield continues his series on Straight Inc., the involuntary treatment program for adolescents suspected of drug use that operated in several states between the 1970s and 1990s. Parts 1 and 2 of the series can be found here and here.

In Help at Any Cost (2006), Maia Szalavitz reveals some of the troubling history of coercive programs. The sub-title of her book is, “How the Troubled Teen Industry Cons Parents and Hurts Kids,” and this is one of the hardest things for a survivor to describe – the deceit that protects abusive programs. Dr. Charles Huffine writes, “I cannot tell you how many youth I’ve been in contact with that do not tell their family about the painful aspects of their experiences for fear of making their family feel bad — though I can say they number in the majority. All too frequently, simply, they did not know they were abused, or worse, that the abuse was justified and necessary for them to ‘get better.’”

Straight-inspired TV movie Not My Kid (1985). Spoiler alert: they got their kid back.
Straight-inspired TV movie Not My Kid (1985). Spoiler alert: they got their kid back.

Tough-love programs often ritualize emotional testimonies and require testimony about conversion experiences as a prerequisite for release from treatment. Because there is no scientific evidence to validate the safety and efficacy of coercive methods, these anecdotes are the “hook” that this multi-billion dollar industry is built upon. Many victims of thought-reform treatments, like victims of domestic violence, will defend their captors as a self-protective survival response. Similar to abusive dynamics in families, when people are beaten down long enough they may believe it’s normal, deserved, and even good for them. As one former staff member of the program said to me recently, “at the time I graduated I was so duped into believing that I’d been helped, I couldn’t even begin to see the damage caused to me.”

Read More »