Addiction, History and Historians: Samuel Roberts’ Response

Editor’s Note: Today, we present the final set of reflections in our Points symposium on addiction, history and historians.  Last week’s reflections on David Courtwright’s essay included thoughtful posts by Nancy Campbell, Alex Mold, and Daniel Bradburd.  Our final essay comes from Samuel Roberts, Associate Professor of History at Columbia University, and Associate Professor of Sociomedical Sciences at the Mailman School of Public Health.  Prof. Roberts is author of Infectious Fear: Politics, Disease, and the Health Effects of Segregation (University of North Carolina Press, 2009).

“There are Other (Quarrelsome, Social) Scientists”

On Thursday 17 February, 2012, Fox News commentator Eric Bolling, in a mock address to Congresswoman Maxine Waters, advised her, “Congresswoman, you saw what happened to Whitney Houston. Step away from the crack pipe, step away from the Xanax, step away from the Lorazepam, because it’s going to get you in trouble.” These words Bolling had addressed to Waters in response to a speech the congresswoman (D-CA) had made at a rally the previous weekend, In the speech, Waters had labeled the House Republicans (specifically Speaker John Boehner and  Majority Leader Eric Cantor) “demons” from whom she wanted Democrats to take the majority. Singer/actor Whitney Houston had been found dead in the bathtub of a Beverly Hills hotel room, only six days before Bolling’s response. Houston’s battles with drug abuse for years had been grist for late night punch lines, gossip pages, and even, implicitly, a reality show featuring her, her husband (R&B singer Bobby Brown), and their family. Although no official cause of death had been announced at the time of Bolling’s remark, it was widely rumored to have resulted from a combination of alcohol and Xanax, a benzodiazepine. 

Viewers rightfully criticized Bolling for his callousness. On one hand, it was disrespectful to Houston’s family, who at the time had yet even to bury her. Nor for that matter were Bolling’s comments befitting a news anchor’s discussion of a statesperson. Congresswoman Waters, he justly might have remarked, was using perhaps inappropriately hyperbolic language in her description of House Republicans as “demons” (of course, at the Fox News desk, where hyperbolic language is commonplace, the allegation could not have come off anything but disingenuous). Liberal critics decried the implication that Waters had been using mind altering substances as clearly racist and sexist. There never has been any evidence that her use of illicit or licit substances has affected her work performance, or that she ever has used illicit substances or licit substances inappropriately. The only aspect of their lives which Waters and Houston may have had in common was their both being black women.

Such natural guilt by association was one of many things bequeathed to us through the politics of crack cocaine during the Reagan-Bush-Clinton 1980s & 1990s. That inheritance also includes draconian mandatory minimum sentencing established by President Reagan and a Democratic Congress, a condition which helped to produce a spiral of carceral aggrandizement on an unprecedented scale. A cost accounting of the drug war must also consider the massive escalation of law enforcement and the retraction of recovery services for substance abusers. Nobody had sympathy for users. “Crackhead” became the punchline of a joke, synonymous with fool, anyone lacking reason. More insidiously, female users by the late 1980s drew particular fire, popularly labeled “crack whores”, “strawberries”, or worse, combining a lack of sympathy with misogynist loathing, as Fullilove, Lown, and Fullilove argued in 1992. The gendering and racialization of crack cocaine in political discourse extended to reproductive politics and law, especially on the issue of fetal drug exposure, where black and Latino women, and poor women more generally, often have been made to carry the burdens of inequality, as argued by legal scholars Dorothy Roberts and Laura E. Gomez, cultural anthropologist Aline Gubrium, and sociologists Assata Zerai and Rae Banks.

At first blush, this has little to do with the subject matter of David Courtwright’s “Addiction and the science of history,” a robust call to historians for historians to abandon, or at least stay, their oppositional stance in favor of the pursuit of an understanding of the (more empirically objective) neuroscience of drug action.  Failure to do so jeopardizes the little bit of dialogue which we historians have enjoyed with our bench science colleagues on the other end of campus. “While we have not yet reached such an impasse,” Courtwright warns, “I worry that mutual distrust and incomprehension will end the tenuous cross-fertilization between scientists and historians concerned with addiction.” There are good reasons for this call for at least two reasons. First, while I have come to regard claims of “objectivity” with great suspicion (as someone exposed to History of Science methods in the mid-1990s, I share this distrust with many of a similar training and cohort), I do – as do most scholars, I would hope – prefer studies whose arguments rely on well-measured evidence collected through transparent methods. I find it difficult to understand a historian – or most social scientists – who claims true objectivity, simply because outcomes may be different depending on the evidence collected, the manner in which it is collected, and the methods by which it may be analyzed. However, when a scholar is rigorous and honest about the data sets employed, an argument may be, as they say, “true within its method and approach.” This is not objectivity – which implies to me a third person omniscience – but it is good enough for me in that it maintains a standard of research at least largely insulated from bias. What also makes Courtwright’s advice worthwhile is similarly simple: any facility one group of scholars may develop through or for the purpose of interlocution with another group of scholars probably will produce positive results.

These are two worthy points. However, I am uncomfortable with what seems to me a conflation of the two: neuroscience with objectivity. If I may take one telling passage: “To avoid appearing foolish, scientists need to understand that history is the fruit of disciplined research, not something cobbled together from memory, oral tradition and prefaces from old journal articles. Historians, for their part, will gain credibility and insight by adding the new language of addiction neuroscience to the familiar languages of paradigms past. Historians, who are interested in the diachronic development of multiple scientific approaches, are multi-lingual in the classical languages of addiction; laboratory researchers, who are interested mainly in the synchronic elaboration of the current paradigm, are monolingual in their modern language—and blissfully unaware that it, too, will pass into the classics under the pressure of revision. Even so, historians should do their best to understand the latest dispensation.” (p3, italics mine). While I agree that there are valuable insights to be garnered from a facility with “the new language of addiction neuroscience,” I am not convinced that the “credibility” to be gained would be universal, even among neuroscientists. For one reason, a deep familiarity of the current science in brain-drug interactions, for example, would afford the ability to write an informed history of the development of the field. However, this knowledge on its own would not be sufficient to write a real history or to earn one the credibility of one’s peers. Unless one were to write a simple and whiggish “milestones” history, such a work necessarily would have to bring into relief the junctures – in past and present – at which consensus has not been assured, even at which actors are in determined disagreement with one another. A historian could be thoroughly versed in the language of neuroscience and still find that there would be historians and neuroscientists  alike (and for similar or different reasons) who might question the conclusions. This is simply because the field (at least in my understanding) is not entirely unified. Many advances have come as a result of research on drug action on the brain over the past fifteen or more years, but there still remains disagreement over some not-so-fine points.Read More »


Addiction, History and Historians: Daniel Bradburd’s Response

Editor’s Note: Our symposium on addiction, history and historians continues today, with a response to David Courtwright from Prof. Daniel Bradburd.  If you’re just catching up with our series, start with David’s essay first.  Readers may also wish to review the previous responses to the essay in this series, from Nancy Campbell and Alex Mold.  We are pleased to post Daniel Bradburd’s reflections today–he’s Professor of Anthropology at Clarkson University and, among other scholarly endeavors, he has published (with William Jankowiak) Drugs, Labor, and Colonial Expansion (University of Arizona Press, 2003). 

David Courtwright ‘s essay is short and has an elegant narrative;  it is a pleasure  to read, and on its surface provides a straight forward narrative of both the developing field of drug and alcohol history and of the relationship of historians working in that field to laboratory based drug and alcohol research.

As Courtwright notes, historians have compiled a considerable, and growing, body of work on addiction and drugs which seek to provide an ‘understanding of how historical actors saw evolving situations.’   Speaking as an anthropologist, much of the work that Courtwright cites is outstanding;  the body of historical scholarship emerging on drugs, alcohol, and addiction is an impressive one.  Put slightly differently, in my view drug and alcohol history as a field of study  is both making significant contributions in its own field and provides a base of very useful knowledge for those examining the use of drugs and/or of addiction in other disciplines.

Courtwright’s essay is not just a paean to historians. Courtwright notes tensions in the relationship between historians (and other social scientists) studying alcohol and drugs and those doing  laboratory based work, and he worries about the consequences of those tensions.   Courtwright is far better placed than I to judge the discomfort of lab scientists with historians, but I would like to expand a bit on the roots of the tensions he perceives, setting out what are for me, personally, some of the concatenated issues that generate skepticism with and concern over the ‘NIDA paradigm’ and its accompanying or underlying ‘brain disease paradigm.’

First, there is the question of a paradigm that, as Courtwright notes, can appear reductive, and intellectually and politically reactionary to historians and other social scientists.  Courtwright may be too polite to say it, but the problem with this problem is an  old one.  The tools and techniques and the analysis involved in the science may be new, but recourse to reductionist explanations of complex human activities is not. Social Darwinism, a reductive view of evolutionary biology, was adduced to explain social class; nominally scientific theories proferred as good scientific practice justified discrimination based on race and gender.  So some historians and anthropologists may be concerned, as Courtwright notes, that ‘reductive’ explanation ‘sheds no light on culturally specific phenomena.”  Others may be concerned about the political ends to which that reductive work may be put, ultimately fearing its likely use as a means for simultaneously naturalizing and problematizing difference.   (Charles Murray’s recent work, and the small media frenzy surrounding it, provides a contemporary example of why this is a concern.)

Separating these concerns is not easy. At the least, it involves teasing apart the feelings of intellectual trespass that arise from reductionist explanations of complex social phenomena  from worries about bad social policy, in a context in which both science and social policy have become deeply politicized.  While it is important to note and stress that there is no direct link between the ‘brain disease paradigm’ and policies like the ‘War on Drugs,’ high rates of incarceration, particularly  of minorities in the US and death and destruction in Colombia, Peru, or Mexico, they are nonetheless parts of the same overall project. What Courtwright calls the ‘oppositional camp’ of scholars does not arise from nothing.

Another irritant, perhaps trivial but none-the-less real, is that reductionism seems to be in fashion, as evidenced by the re-emergence of socio-biology and evolutionary psychology.  Those, who like me, are not sympathetic to arguments of this kind see their hydra-headed appearance as evidence of a problem not a solution and are thus more likely to be skeptical about any work that has that cast.Read More »

Addiction, History and Historians: Alex Mold’s Response

Editor’s Note: Our roundtable on addiction, history and historians continues with a commentary on David Courtwright’s essay from Dr. Alex Mold.  Alex is currently Lecturer in History at the London School of Hygiene & Tropical Medicine, where she has been since 2004.  She received her PhD in Modern History from the University of Birmingham, and (in 2008) published Heroin: The Treatment of Addiction in Twentieth-Century Britain (Northern Illinois University Press).  More recently, Alex (together with Virginia Berridge) has authored Voluntary Action and Illegal Drugs: Health and Society in Britain Since the 1960s (Palgrave Macmillan, 2010).  We are delighted to post her commentary on David’s essay.  If you’re new to this roundtable, feel free to go back to the introduction, or read Nancy’s Campbell’s response (the first in the series).

Addiction Acrobats? A Response to David Courtwright, ‘Addiction and the Science of History’, Addiction, 107:3 (2012) pp. 486-92

David Courtwright is an adept addiction acrobat; deftly balancing on the high wire that spans the two worlds of addiction science and addiction history.  In ‘Addiction and the science of history’, he makes a powerful case for what historians and scientists have in common, where they differ and what they might learn from one another.  The piece is written with the lucidity and verve we have come to expect from one of the field’s leading historians, and also offers a brief survey of some of the key works in drug (and to a lesser extent alcohol) history over the last 30 years.  Courtwright locates this scholarship on a spectrum that runs from ‘oppositional’ (critical of the status quo) to ‘accommodationist’ (mildly reformist) to ‘dominant’ (conservative).  Unafraid to hint at addiction history’s cardinal sins as well as its cardinal virtues, the essay represents an attempt at outreach to a scientific community who, Courtwright suggests, need us as much as we need them.

Circus Types
Can you spot Prof. Courtwright in the line-up?

The call for historians to engage with the contemporary science of addiction, made by Courtwright in his keynote lecture to the Alcohol and Drug History Society conference in 2004, and published in the society’s journal in 2005, has been echoed by other historians such as Howard Kushner and taken up by (among others) Nancy Campbell, Tim Hickman and Virginia Berridge.  The development of what Howard Kushner has a called ‘a cultural biology of addiction’, bringing together biological and social perspectives, is an important project.  The challenge, as I see it, is to absorb this work without ‘going native’: to take on the recent developments within addiction science but at the same time maintain a sense of critical distance.  Drug and alcohol historians, well versed in the knowledge-power play of addiction science over the last 200 years, are able to expose the socially constructed dimensions to addiction as they change over time and space.

All of this I think David would agree with.  My concern with the essay is not so much

Brain Imaging, MDMA
The Imaging of Ecstasy/The Ecstasy of Imaging

about what is said, but rather the way in which it reflects, and thus may serve to reinforce, two dominant approaches: one scientific and the other historical.  Contemporary addiction science, as it is presented in this essay, is closely allied with what Courtwright calls the ‘NIDA paradigm’ which regards addiction as a chronic relapsing brain disease, albeit one with social and genetic components.  Yet, neuroscience is not the only game in town and nor is NIDA (National Institute on Drug Abuse) the only agency interested in addiction and associated issues.  Browsing down the contents list for the issue of Addiction in which Courtwright’s essay is published reveals a wide variety of addiction research, taking place in a range of settings, and making use of numerous disciplines and methods.  Articles by scientists, physicians and social scientists offer insight into aspects of addiction such as the relationship between childhood depression and problem alcohol use, and the transition from first illicit drug use to injecting drug use amongst users in the Appalachians.

Of course, not all such work contradicts the brain science model, but the diversity of current addiction research should not be ignored.  Indeed, the NIDA paradigm is far from being universally accepted.  In a recent forum in Addiction a number of commentators questioned the extent to which the chronic relapsing disorder model was an appropriate way to view alcohol dependence.  Historians may think that they can hold themselves apart from such debates, but the difficulty with the chronic relapsing model is, as Jacek Moskalewicz points out, that it individualises drug and alcohol problems.  Locating addiction in the brain of the addict downplays the social, political, economic and cultural dimensions of the issue, the very elements that historians tend to be concerned with.  By engaging with the NIDA paradigm are we in danger not only of unquestioningly accepting the dominant view, but also of doing ourselves out of a job?Read More »

Addiction, History and Historians: Nancy Campbell’s Response

Editor’s Note: This week, Points offers readers a series of responses to David Courtwright’s reflections on history, historians, and addiction.  Today’s first entry comes from Nancy Campbell, a Points Contributing Editor.    

David Courtwright’s prose sparkles with wit and insight. The current stakes in the ongoing conversation between addiction researchers and historians of addiction are high. As a historian of addiction research, I share David’s sense of urgency that we might miss the intellectual opportunities now available.

The scientific communities who make addiction science—the behavioral pharmacologists, geneticists, medicinal chemists, molecular biologists, and neuro-imagers—inhabit what Courtwright calls “the latest dispensation.” I study this space—where addiction science comes alive. Some of my subjects are alive; others are dead. Some are as multi-lingual and hyper-aware as we historians. Others are reductionists. What moves scientists to reduction ranges from compassion, to the complexities of biography and memory, to the burning urges of scientific curiosity, and to widely held notions of what counts as scientific excellence, clinical significance, or objectivity. None are what I would call “mono-lingual” or hypo-aware of the stakes of their science.

Courtwright takes aim at persuading two groups of people to take each other’s insights more seriously. The first group is addiction researchers who have not yet realized the significant contribution that historians can make to the phenomena that they are trying to understand. Now I am familiar with this group, but I prefer to think of them as addiction researchers who have been overtaken by cravings and uncontrollable urges. They are in the grip of scientific fascination—and in that state nothing else is so compelling as the objects and subjects of desire.Read More »

Addiction, History and Historians: A Symposium

This month, the journal Addiction published an essay by David Courtwright, “Addiction and the Science of History.”  For readers unfamiliar with the journal, Addiction is one of the oldest and most influential interdisciplinary journals focusing on issues related to substance abuse and addiction.

Society for the Study of Addiction
Puzzling on Addiction Since 1884

Recently, the journal has begun a series called “Addiction and Its Sciences,” in which leading scholars from various disciplines discuss the relationship between their field and the addiction field generally.  Recent entries in this series include Bennett Foddy, “Addiction and Its Sciences–Philosophy,” Addiction 106 (January 2011), 25-31, and Jonathan Caulkins and Nancy Nicosia, “Addiction and Its Sciences: What Economics Can Contribute to the Addiction Sciences,” Addiction 105 (July 2010), 1156-1163.  David Courtwright’s essay has a kind of twofold purpose: first, to explain history (and historians) to the addiction research field and, second, to take stock of where both fields are in relation to one another.  In that latter instance, David’s essay offers a useful set of reflections for those of us interested in where history is/should be headed.  That includes Points readers, of course, and so it seemed like a good idea to make this essay available through this site.  The editors and publishers of Addiction have generously agreed, and readers of this blog may access the article for free by following this link.

But wait, that’s not all!  Read More »

Points on Blogs: Understanding Society

There’s plenty of self-promoting, self-referential nonsense out there in the blogosphere.  When it came time to thinking about “Points on Blogs,” well…let’s just say that your editor did not feel this feature needed to promote the self-promoting, or add layers of nonsense to the nonsensical.  Consequently, we were very pleased to be able to bring to the Points readership the earnest inquiry of the Drugs, Law and Conflict blog and the vivid explorations of the Res Obscura blog.  Last time, I promised we’d “go drinking” in this installment, but I’ve decided to “go thinking” instead.  Our third blog is Prof. Daniel Little’s Understanding Society, and it moves away from the realm of alcohol and drugs particularly, to the broad questions that animate our investigations.  Little is a professor of philosophy at the University of Michigan-Dearborn, where he is also currently university chancellor.  Here’s how he describes his intellectual orientation on the front page of Understanding Society: “I am a philosopher of social science with a strong interest in China and Southeast Asia. Right now I’m thinking about how to reformulate the philosophy of history in a way that is more closely related to the practice of contemporary historians. I think philosophers need to interact seriously and extensively with working social scientists and historians if they are going to be able to make a useful contribution.”

Crowds cheer war
Crowds cheer for war--understand them?

As for Understanding Society, calling it a blog doesn’t quite capture what Little is trying to accomplish.  The recipe for a typical academic blog mixes small amounts of extended analysis with a larger portion of timely reaction pieces, all baked together with heaping pile of whatever comes to mind at the moment.  In contrast, here’s Little’s goal, in his own words: “This site addresses a series of topics in the philosophy of social science. What is involved in “understanding society”? The blog is an experiment in thinking, one idea at a time. Look at it as a web-based, dynamic monograph on the philosophy of social science and some foundational issues about the nature of the social world.”  Indeed, one can find the entire site organized into a table of contents, or obtain the entire contents through July, 2011 in monograph form (obtained free from the site as a 1234-page[!] pdf file).

Needless to say, that’s a lot to go through.  Why should historians of drugs and alcohol care?

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Teaching Points: “Hooked: Addiction in American Culture”: Commentary on the Class

In the second half of her post to the “Teaching Points” series, Contributing Editor Michelle McClellan reflects on how interdisciplinarity works–and doesn’t– in the undergraduate classroom.

“So how many of these drugs have you done?”  It was the first day of class, and the question came from a student who was clearly much hipper than I had been as an undergrad, or am now for that matter.

“Excuse me?” I was flustered but managed to rejoin, “Why do you want to know?”

“Because,” he said with a faint smirk, “I don’t see how can you teach about them if you haven’t experienced them.”

“Well, I didn’t live through the Civil War either, but I teach about that too,” I replied.

McClellan's Pedagogy: Take No Prisoners

Thinking back on that exchange from several years ago, I now realize that for me, teaching about addiction intensifies many aspects of pedagogy.  The classroom can be crowded: not just with ideas, but with emotions and backgrounds that are often invisible and therefore all the more powerful.  Many of these issues have been thoughtfully explored by Guest Blogger Eoin Cannon.  As the student’s challenge to me was meant to show, we instructors also bring a point of view into the classroom, whether we articulate it or not.  This is a useful reminder for me in all my classes.
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Teaching Points: Culture, Medicine, & Society: Commentary on the Class

Editor’s Note: In the second part of our inaugural post to the “Teaching Points” series, Contributing Editor Joe Gabriel ruminates on teaching to both medical students and PhD candidates in the humanities.

Interventions in the Teaching of American Mediine

Yesterday I posted the syllabus to a class I taught for the history department here at Florida State. As I mentioned, I’m actually on faculty at the medical school and so I spend most of my time teaching medical students. If you haven’t done it, teaching medical students is incredibly rewarding – they are extremely hard working, very smart, and it’s gratifying to know that you might actually be helping them become better doctors. However, it’s also very nice for me to get the opportunity to interact with doctoral students in the humanities, as it allows for different types of conversations that just aren’t possible in the medical school.

As you’ll see from the syllabus, the course is an effort to provide a broad overview of the history of medicine in the United States. I tried to organize the class both chronologically and methodologically, with both earlier periods of history and more traditional approaches to the history of medicine being covered earlier in the course.  There are, I think, some problems with the syllabus.  Read More »

Reminder: Pub/Street/Meds is Going Fast

The window is closing fast for next month’s scintillating Alcohol and Drugs History Society Conference on The Pub, the Street, and the Medicine Cabinet, 24-26 June in Buffalo, New York.  By “window” in this instance we mostly mean “conference hotel special discount rates.”  Those bargain basement prices will be available to all and sundry starting 15 May, and are only guaranteed through the 23rd, so make your reservations NOW by clicking here.  The conference will feature ADHS celebrities from around the globe, and I’ve heard rumors that upon registration participants receive P. Diddy goodie bags stuffed with Big Pharma swag.

If I Had Only Registered for the ADHS Conference in Time, My Life Might Feel More Meaningful Right Now

All session rooms are apparently equipped with chocolate fountains, perpetually re-stocked raw bars, and all the Four Locos you can drink (shrewdly sourced before it was banned by wily conference organizer and Points contributing editor David Herzberg). If you do only one conference this summer, this should be the one.  Don’t delay, register today!  Otherwise you might end up like this small plush cow, looking out at all the festivities and wishing you could join in.

Historical Scholarship as a Subordinate Enterprise

I was recently speaking with a very prominent psychiatrist about the history and science of various mental illnesses, and he told something along the lines of “what historians can do to help is to explain how diseases came to be defined as they are; that way we can have a better idea of what we are dealing with.” I looked at him for a moment, and thought to myself: “Fine, but what can you do to help me?” Of course I didn’t say that. The question of what he could do to help historians better understand the past had clearly never crossed his mind. So I just nodded and smiled and muttered something that he didn’t find particularly interesting. We soon moved on to talking about the beer selection.

I mention this anecdote to bring up what I consider one of the central problems facing historians and other scholars in the humanities interested in doing interdisciplinary work: our relatively lowly status in the institutional and epistemological academic food chain. I’ve very much enjoyed reading both Michelle McClellan‘s and Trysh Travis’s posts about the general lack of interest among feminist scholars toward addiction studies, but my initial response to both posts was: “hey, disinterest may not be so bad. At least they aren’t insulting you.” I’ve spent a bit of time here and there working with people from the so-called “hard” sciences, and I’ve found it surprisingly easy to walk away from those conversations feeling a bit put off. I don’t think the scientists involved in these conversations have been intentionally trying to insult me, but they sure have done a good job at it nonetheless – and I’m not particularly sensitive to such things. Here, then, is an issue that I think those of us working in the humanities need to confront: the assumed subordinate position of our disciplines to the sciences in the hierarchy of academic knowledge production.Read More »