Entitled to Addiction?: Pharmaceuticals, Race, and America's First Drug War

Abstract

Summary This article rethinks the formative decades of American drug wars through a social history of addiction to pharmaceutical narcotics, sedatives, and stimulants in the first half of the twentieth century. It argues, first, that addiction to pharmaceutical drugs is no recent aberration; it has historically been more extensive than “street” or illicit drug use. Second, it argues that access to psychoactive pharmaceuticals was a problematic social entitlement constructed as distinctively medical amid the racialized reforms of the Progressive Era. The resulting drug control regime provided inadequate consumer protection for some (through the FDA), and overly punitive policing for others (through the FBN). Instead of seeing these as two separate stories—one a liberal triumph and the other a repressive scourge—both should be understood as part of the broader establishment of a consumer market for drugs segregated by class and race like other consumer markets developed in the era of Progressivism and Jim Crow.

Withdrawal effects confounding in clinical trials: another sign of a needed paradigm shift in psychopharmacology research

“…6,23 Efforts to separate prescribed psychoactive drugs and their users from their illicit but similar counterparts intensified periodically, along with peaks in the War on Drugs and concerns over addiction to illicit substances. 24 Nonetheless, withdrawal phenomena are well-known in medicine and defined in medical dictionaries as responses or reactions to the cessation or reduction of a substance, 25,26 implying a causal relationship. The American Society of Addiction Medicine defines withdrawal syndrome as "the onset of a predictable constellation of signs and symptoms following the abrupt discontinuation of, or rapid reduction in, the dose of a psychoactive substance".…”

“…6,23 Efforts to separate prescribed psychoactive drugs and their users from their illicit but similar counterparts intensified periodically, along with peaks in the War on Drugs and concerns over addiction to illicit substances. 24…”

Societal Biases, Institutional Discrimination, and Trends in Opioid Use in the USA

“…2 Opioid prescribing declined during the early twentieth century; however, non-medical opioid use persisted despite stigmatization and demonization, particularly among immigrant, Latinx, and black individuals with limited access to the medical system. 6,7 Over the course of the mid-twentieth century, access to the medical system allowed middle-to upper-class white individuals to shift their substance use from opioids to less stigmatized prescription drugs, such as sedatives and stimulants. 7 Prescription rates of these drugs reached all-time highs in the 1950s and 1960s.…”

“…6,7 Over the course of the mid-twentieth century, access to the medical system allowed middle-to upper-class white individuals to shift their substance use from opioids to less stigmatized prescription drugs, such as sedatives and stimulants. 7 Prescription rates of these drugs reached all-time highs in the 1950s and 1960s. 7 Meanwhile, individuals who used nonmedical opioids suffered under a series of punitive prohibition policies.…”

Gender and Critical Drug Studies

“…Major social processes structure the drugs field, yet remain generalizations because the continuum between medicalization and criminalization has not operated in mutually exclusive ways, even in regimes founded upon prohibition (Campbell, 1995; Fraser & Moore, 2011; Netherland, 2012; Kohler-Hausmann, 2010; Schneider, 2008). Similar to policy toward “unwed mothers” (Solinger, 1992), this regulatory continuum operates as a palimpsest for racial ordering: medicalization regulated primarily White people through clinical practice, positioning communities of color to absorb the brunt of criminalization (Herzberg, 2017). While it is useful to understand how these social processes are gendered or racialized, actual interactions reveal considerable divergence and leakage between categories, particularly within the historical and cultural contexts of lived experience.…”