Treatment, as it exists, is treatment for the few

Editor’s Note:  Today’s post comes from contributing editor Brooks Hudson, a PhD student in history at Southern Illinois University.

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If you look at recent coverage of opioid epidemic, media outlets admit that in the past they added gasoline to the fire during the “crack epidemic” and want to apologize for those mistakes. The New York Times editorial board gave a belated “whoopsie-daisy” for feeding the American people a steady diet of bad science and race-baiting incitement several decades ago. In their mea culpa they wrote:

“Today, with some notable exceptions, the nation is reacting to the opioid epidemic by humanizing people with addictions — depicting them not as hopeless junkies, but as people battling substance use disorders — while describing the crisis as a public health emergency. That depth of sympathy for a group of people who are overwhelmingly white was nowhere to be seen during the 1980s and 90s, when a cheap, smokable form of cocaine known as crack was ravaging black communities across the country.”

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The Sociological Approach, Part 1

In an article recently published in the Social History of Alcohol and Drugs, Joseph Spillane has given me some clues on how to proceed in my own work. “Inside the Fantastic Lodge” is Spillane’s consideration of the networks, identity-making and social limitations revealed in Marilyn Bishop’s narration of her days as a young white heroin user in 1950s Chicago. The Fantastic Lodge (1961) is a book-length transcript of interviews with Bishop conducted by sociologist Howard Becker. As Spillane explains, The Fantastic Lodge was a product of the mid-century rise of a sociological approach “that took the individual as the unit of analysis.”

Spillane’s reading of Bishop’s life story construes her as the center of her own universe of social networks. By describing her social world, including the actors in it and outside intrusions upon it, he creates a piece of empirical evidence that is at once specific and universal. Historians, he writes, should continue to do this type of work in spite of a historiographic current that seems to be flowing in a different direction.

Although I have always thought of my research style as inductive—proceeding from my searching and reading rather than from my big idea—I have not really attempted to closely think and write about a single drug user. But now I have a subject whose story seems to require such an approach.

He is Keeny Terán, an adolescent Mexican-American boxer and heroin user from the Boyle Heights neighborhood of Los Angeles. After his meteoric rise on the amateur boxing circuit in the early 1950s (Bishop’s era of heroin use), he became a target of the news media and the police over a drug habit that he described as essential to enduring the pain of boxing, but that had originally sprung from social networks in his neighborhood and possibly at the gym where he trained.  

Teran
Keeny Terán, seated leftmost in this April 1951 Los Angeles Times photograph. What insights could boxing’s social networks hold about his heroin use?

Once targeted, Terán endured a string of public humiliations. They began when he was at the height of his notoriety: recently married, a new father, and seeking to earn a greater share of boxing’s receipts. He was arrested in the locker room after winning a fight, then outed as a supposed narcotics informant (which he denied), prompting death threats against him. Soon afterward he suddenly called off a big match and disappeared, ostensibly to a rehab center. Upon his return, a reporter double-crossed him by revealing his addiction treatment in a splashy story about his “big comeback.” Soon he was again arrested and charged with selling heroin, receiving a five-year prison sentence; about a year into serving it, the media furtively covered his divorce. The moment he hit the streets on parole, the cops marked and hounded him. He did more time, wrote a memoir that might have been lost, and ended up on methadone, which he hated.  

Many pieces of Terán’s story are missing and might never be recovered. In pursuit of facts and events, I have failed so far to ask questions about his relationship networks and his internal life, about struggles related to his family and his neighborhood and to the overlapping social worlds of boxing and heroin. More importantly, I have not yet even described these things.

The process of “describing to know” (as I’m calling it) seems to spring rather naturally from a sociological perspective. I noticed this fact last year when Ceci Burtis, a senior sociology major who conducted some research under my hapless guidance, submitted to me a write-up describing similarities and differences between two celebrity drug users. Her skilled process of simply describing aspects of the lives of these two women—Billie Holiday and Judy Garland—was simple and effective. For example, she gave me this comparison chart as a note:

Judy GarlandBillie Holiday
1922-19691915-1959
singer/actressjazz singer
whiteblack
pills: amphetamines & barbituatesheroin and marijuana
alcohol and cigarettesalcohol and barbituates
middle class familypoverty
never arrestedarrested at least three times
cirrhosis of the liver, depression, hepatitiscirrhosis of the liver, heart and liver problems
died age 47died age 44
self-administered overdosegeneral organ failure due to chronic drug use
actress at 12 years oldprostitute at 13 years old
rehab/“rest cure” four times, numerous hospitalizationsrehab three times

Marilyn, Keeny, Judy, Billie. One aspect shared by three of these lives is something Spillane describes as the “most salient” of the outside forces that can disrupt social networks and impose costs unevenly on members of those networks: the criminal justice system. Garland perhaps escaped entanglement with the law, but another disruptive force in all these cases (except personally for Marilyn, though it touched her indirectly) was the attention of the news media.

In pursuit of better history, I hope that I can begin to practice a sociological approach to writing about drug users. I also hope you will enjoy reading Ceci’s write-up about Holiday and Garland in the post that follows this one.

Teaching Points: Using Drugs as a Gateway to Historical Methods

Editor’s Note: Today’s post comes from Dr. Adam Rathge, director of enrollment strategies and part-time history professor at the University of Dayton. Rathge is also a drug scholar and a longtime friend of Points. He continues our Teaching Points series here, explaining how drug and alcohol history can be brought into the classroom and can be a vehicle for understanding historical methods. Enjoy!

During the coming Spring semester at the University of Dayton, I’ll be teaching HST 299 – Historical Background to Contemporary Issues. This will be my second time teaching the course. It is offered once a year by the History Department and open to students of all majors, with rotating topics driven primarily by faculty expertise and current “headline news” issues. In my case, this means teaching about drugs by focusing on current trends in marijuana legalization and the opioid crisis. From the department’s perspective, the topics are somewhat secondary to the true purpose of the course, which is designed to “focus on the methodology of history as a discipline and on the utility of historical analysis for understanding contemporary political, social and economic issues.” As such, in my version of the course, drugs become the gateway to teaching historical methods.

Over the fifteen-week semester, I divide the course into three, roughly five-week blocks. The first block covers recent developments with marijuana legalization. The second block explores the ongoing opioid crisis. The third and final block provides time for scaffolding the research process on a headline news topic of each student’s choosing. In essence, the first two blocks are designated topics on contemporary issues that allow the class to work through a guided model of historical methodology together, while the third allows them to put those skills into practice for themselves on a topic of interest. Each five-week block, therefore, introduces not only the topic at hand but also skills relevant to reading, writing, and thinking like a historian.

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Many Scholars Think Drug Courts Harm Policy Reform, Not Vice Versa

Editor’s Note: Today’s post comes from contributing editor Dr. Sarah Brady Siff, visiting assistant professor of journalism at Miami University in Ohio. Enjoy!

The current so-called opioid epidemic has placed an urgent frame around drug-related policy debates in Ohio. Here, the current midterm election ballot includes Issue 1, a state constitutional amendment that would convert level 4 and 5 drug felonies—charges for possession and use of drugs—into misdemeanors, somewhat like California’s Proposition 47 in 2014. Ohio would be only the sixth state to take similar measures to reduce drug-related mass incarceration.

So Issue 1 was much on the minds and lips of panelists at “Facing Opioids: Drug Enforcement & Health Policy in Today’s Epidemic,” an Oct. 19 symposium at The Ohio State University’s Moritz College of Law. The event reminded me how little I know about current events and policies related to drug control, living, as I and many other historians do, in the past. I appreciated the chance to listen to legal experts in criminal justice and public health talk about Issue 1, drug courts, harm reduction, and other topics related to Ohio’s very high rate of overdose deaths.

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Bad History, Bad Policy: Maybe Historians Should Be Ostracized from Society

Editor’s Note: Today’s post comes from contributing editor Brooks Hudson, a history PhD student at Southern Illinois University. Enjoy!

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Historians aren’t the first people national publications go for hot-takes. That may be a good thing. But I’ve always been in the camp that says historians should be more active outside of academia. So, I’ve been encouraged by publications like The New York Times and Washington Post reaching out to historians, asking them to analyze the opioid epidemic in its historical context. On the other hand, it’s been frustrating to see those opportunities squandered. An example that caught my eye was Clinton Lawson’s op-ed for the Times, published in May. It’s well-written and pleasant enough to read, but his interpretation of effective policies, then and now, resembles a DEA spokesperson more than a member of the public. Overall, his argument is aesthetic, encouraging us to avoid bad things, like racism or overhyping stories in the news, while at the same time offering the conventional wisdom: penalties and prison.

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Special Response: Over 100 Researchers and Practitioners Respond to Rod Rosenstein on Safe Injection Sites

Editor’s Note: This post is in response to an op-ed published last month in The New York Times by Deputy Attorney General Rod Rosenstein, in which Rosenstein argued against supervised injection sites. 

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Rosenstein’s Op-Ed in the New York Times

In response to the current opioid crisis a number of cities in the United States are considering establishing safe injection sites for users of heroin and other illegal drugs. This is not a new idea. Cities in Canada and Europe currently have them, including a successful program in Vancouver. Safe injection sites provide a place for people to inject illicit drugs under medical supervision. In addition to a clean and warm space, they typically offer sterile injecting equipment and basic healthcare. Many also provide referrals to treatment, housing and other services. Critically, all safe injection sites include trained staff to respond to overdose, leading many experts to refer to them as “overdose prevention sites,” to better reflect this core aim.

In a strongly worded but poorly supported editorial in The New York Times, Deputy Attorney General Rod Rosenstein recently claimed that safe injection sites pose a dangerous risk to public safety and will make the opioid crisis worse. He has offered no evidence for these claims. He has also warned cities, counties and health services that open safe injection sites in the United States that they will be met with “swift and aggressive action” from the Department of Justice.

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Opioids, Addiction, Podcasts, and How You Can Help Points

science history institute The Science History Institute, formed by the merger of the Chemical Heritage Foundation and the Life Sciences Foundation, is a fantastic resource for those interested in researching the history of chemistry, chemical engineering, and the life sciences – topics that are necessary if we’re to understand the role that intoxicants have played in our lives.

Located in Philadelphia with outposts in Europe and California, the Science History Institute has an archive and library, an acclaimed museum, and a variety of fellowship programs that are definitely worth a look.

Through Distillations, their outlet for podcasts, a magazine, videos and blogs, the organization is also a publishing powerhouse. Check out their remarkable longform story on opioids, and subscribe to their podcast. The Institute is launching a new series on the history of addiction treatment, including The Narcotic Farm, Therapeutic Communities like Synanon, methadone maintenance, and buprenorphine/Suboxone. It’s definitely worth a listen.

One more thing: As we mentioned earlier, there’s a lot of excitement around here. Points and the ADHS’s journal, the Social History of Alcohol and Drugs, are both working hard to increase and improve our reach over the next few years, with the assistance of the University of Chicago Press.

But we need your help.

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