Mr. ATOD’s Wild Ride: What Do Alcohol, Tobacco, and Other Drugs Have in Common?

Abstract

All researchers agree that individuals can become intoxicated by and dependent on alcohol, tobacco, and other psychoactive drugs. But they have disagreed over whether, and to what extent, drug pathologies comprise a unitary medical problem. Most critically, does addiction have a biological common denominator? Consensus on this question has shifted back and forth. In the late nineteenth and early twentieth centuries, physicians often studied and treated various drug addictions together, working under the "inebriety" paradigm. By the mid-twentieth century the inebriety paradigm had collapsed. Tobacco and alcohol had split off, both in the medical research community and in western popular culture. This article argues that neuroscientific, genetic, epidemiological, and historical evidence helped to reunify the addiction field in the late twentieth century. A new unifying paradigm emerged, variously called chemical dependency, substance abuse, or simply ATOD-alcohol, tobacco, and other drugs. When you write global drug history, you quickly discover the limits of your knowledge, and you rely on the work of others. Many of the scholars whose research has guided and inspired me are present this evening. I first want to express my debt to you and my gratitude for the opportunity to address you. I am truly honored. My title, "Mr. ATOD's Wild Ride," is an anagrammatic play on a celebrated episode from Kenneth Grahame's The Wind in the

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