CHAPTER 2. A HISTORY OF DRUG AND ALCOHOL ABUSE IN AMERICA Written by: Tammy L. Anderson
To appear in: Harrison, L., Anderson, T., Martin, S., and Robbins, C.
Drug and Alcohol Use in Social Context. Belmont, CA: Wadsworth Publishing
A HISTORY OF DRUGS AND ALCOHOL IN THE UNITED STATES Introduction The purpose of this chapter is to review the history of drug use and its social control in the United States so that students can gain an improved and thorough understanding of today’s problems and policies. Our approach to this matter is sociological, i.e., exploring how the interconnection between culture, social institutions, groups, and individuals function to create drug-related phenomena.
A sociological approach integrates many kinds of social, cultural, political, and economic factors that manifest themselves in everyday life. While pharmacology helps us comprehend how specific drugs impact brain activity, sociology can inform us about the social roots of drug-related behaviors which ultimately shape beliefs and behavior and motivate social policy. Therefore, a review of drug use in the U.S. and the social response to it must consider many diverse phenomena. This broader framework will move us beyond domestic borders and into the international community, for the history of drug abuse is an international, socio-political marvel.
Another idea warrants mentioning before we begin our history lesson. It centers on the idea that drug use and abuse are socially constructed phenomena. In other words, the meaning attached to specific drugs and drug use patterns is determined by how people –especially powerful people-- interpret them in everyday life. Today controlled substances are constructed as extremely undesirable, even dangerous. However, history shows us that many of these same substances were once viewed favorably and had considerable social value. For example, it may be difficult to believe that use of a drug like cocaine, for example, was at first viewed positively. This is a point leading historian, David Musto (1999), has effectively made in his comprehensive and detailed documentation of illicit drug use in America.
History shows us that, quite often, a particular substance initially occupies an instrumental place in U.S. society, finding use and value in rituals, ceremonies, and leisure activities. From there, it moves into the medical community, serving as a remedy for injury and illness. Massive distribution of the drug by the medical community follows to treat and cure all kinds of illness and injury. Soon, unanticipated problems begin to emerge: tolerance, abuse and dependence. Consequently, what begins as a social, cultural and medical phenomenon soon mutates into a public health and social problem.
This social trajectory can explain the U.S. experience with many, but not all controlled substances. An important point to make here, however, is that when drugs move into the medical community, or when cultural customs condone their use, they become a valuable commodity for the accumulation of profit. When economics enter the picture, use and abuse of controlled substances can grow rapidly. Politics emerge and conflict ensues to both promote and halt drug use. This is why it is important to understand the role of politics and economics, in addition to matters of bio-chemistry, public health and morality, when tracing the U.S. history with controlled substances. In fact, drug legislation is a mosaic of interlocking factors. In our society, there is often tension between them regarding the benefits and dangers of drugs. Tables 1 and 2 illustrate this point for major pieces of drug legislation throughout the 20th century.
When the social construction of a drug begins to shift from favorable to unfavorable, moral entrepreneurs (e.g., powerful people who take up the anti-drug cause) often utilize pronounced rhetoric about the drug’s problematic physiological and psychological effects in order to control its use. While these concerns have merit, they are not the only reasons some drugs become controlled substances and fall within the jurisdiction of the criminal justice system. Such public health concerns exist alongside economic and political motives, many of which the public remains unaware. This point will surface frequently in the text below.
Opium and Cocaine Use and Control: Late 1880s and early 1900s.
Most accounts of the history of drug use and social control begin with opiates and cocaine, two of the first drugs to be legally controlled in the United States. The present chapter, therefore, begins with the origins of opiate and cocaine use in our society and others, followed by the campaigns for social control of them.
Opium is the primary psychoactive drug- a narcotic- in the naturally grown poppy plant. It is used to make drugs like heroin, morphine, and oxycontin.
Recall that opium is derived from the poppy plant, which today is grown mostly in Asia and the Middle East. The principal active ingredient in opium is morphine. Opium has been with humankind for centuries, i.e., its use has been traced back to the Mediterranean and Asia in the 16th century (Brecher 1972; McCoy**). For 4,000 years, it was a folk medicine and a recreational euphoric. Its use was highly praised. Many called it God’s Own Medicine (Brecher 1972).
As its value in the medical community increased, a commercial opium trade spread across Europe (1640-1773) to supply the world’s demand (McCoy** ). Opium became extraordinarily profitable during this time. As an addictive drug, it required a daily dose. Soon, the opium trade was transformed from a luxury good into commodity for mass consumption, making it integral to the economies and lifestyles of both Asian and Atlantic nations.
In 1874, heroin was isolated from morphine. By 1898, it was manufactured by the Bayer Company in the U.S. At first, many hoped it to be a cure for the growing problem of morphine addiction (Brecher 1972; Musto 1999). Heroin was also widely utilized, so much so that by the early 20th century, morphine and heroin had become a major global commodity, comparable to such things as coffee and tea.
As is often the case, widespread use of the drug soon resulted in undesired outcomes including abuse and addiction. In a now famous quote, Brecher (1972) stated:
“The United States of America during the nineteenth century could quite properly be described as a ‘dope fiend's paradise’" (Brecher 1972).
Cocaine is a stimulant, derived via chemical processing from coca leaves, which grow naturally.
For Brecher, the phrase ‘dope fiend’s paradise’ referred to the widespread availability, use, and abuse of opiates for a variety of purposes, some recreational, some medical. Opium and its derivatives were changing from God’s Own Medicine into something more like Satan’s curse!
Cocaine, which comes from the coca leaf, use can be traced back to ancient tribal customs of the Incas in the 16th century. Spanish conquistadores discovered coca leaf chewing among the Incans. Coca leaves, part of a mountain shrub, produced euphoria and other desirable effects. For example, the conquistadores gave coca to the Indians to keep them enslaved and secure more work from them (Brecher 1972).
The chief active ingredient in coca leaves is the alkaloid cocaine, which was isolated in pure form in 1844. Later that century, European and American scientists began taking an interest in the coca leaf. While chewing coca leaves did not become popular either in Europe or North America, numerous beverages were made from it. Europeans produced a coca-based wine called "Mariani's wine" (vin mariani), a red wine or elixir containing coca in 1863, while John Pemberton of the United States manufactured a syrup called Coca-Cola in 1886, which contained coca (Kahn 1960).
Vin Mariani was a red wine containing cocaine that was widely consumed in the late 19th and early 20th centuries.
The popularity of these beverages exploded simultaneously with the increased use of cocaine in medical treatment. Although scientists, doctors, and lawmakers did not concern themselves at the time with physical dependency to cocaine, they grew very concerned about the more psychological effects, which included psychoses, hallucination, and depression. The paragraphs below describe the United States’ experience with these two drugs, opiates and cocaine, and the various factors that motivated social control of them.
International Economics and Politics (British/China Opium wars).
Concern in the U.S. about opium addiction was initially driven by economic and political issues abroad in China, however, and not by concern over American’s abuse of the drug (Courtwright 2001a; Musto 1999). As an increasingly powerful capitalist and democratic society, the U.S. needed economic growth in order to empower it against foreign domination and accumulate wealth for domestic development.
Achieving these goals could be partially accomplished by investing in domestic markets. However, the infant U.S. capitalist economy would ultimately have to travel the globe in search of new markets so that the accumulation of profit could expand (Marx 1992). Fostering international trade relationships with other nations, such as China, became a necessity.
Opium Trade is a phrase that typically refers to Britain’s cultivation of opium in India for heroin sales in China during the 18th and 19th centuries. The trade led to the great Opium Wars of the 19th century.
Other nations had the same concerns and objectives. Perhaps the best illustration of the political and economic factors related to drug policy can be seen in the case of England and China. Nineteenth century relations between China and England were highly contentious. Up until this time, China was a closed economy, one with few imports and exports and which disallowed trade with other nations. The size of China’s population (about 450 million people at beginning of 1800s-- Wallbank et al. 1992), however, made it an attractive market for other nations seeking economic expansion. One such nation was England, which began forcing opium on the Chinese in order to amass wealth during the 1800s (Fay 1975; Waley 1958).
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Eighteenth century trade transformed drugs, such as nicotine, caffeine, and opiates, from luxury goods into commodities consumed by the masses (Courtwright 2001b). They subsequently became integral to the economies and lifestyles of both Asian and Atlantic nations. With a near monopoly on opium, the British East India Company (BEIC) achieved the highest profits from its export of Indian opium to China. For example, between 1729 and 1839, BEIC exports of opium to China increased from 13 tons to 2,558 tons respectively. In addition to the “forced trade” from Britain, opium smuggling along China’s south coast grew exponentially, for example, from about 9,708 chests in 1820 to 35,445 chests in 1835 (Fay 1975; Waley 1958).
China began seeing negative consequences of this trade activity shortly thereafter. By the 1830's, opium had become, perhaps, the most salient social problem in China. Evidence indicates that nearly all men under 40 years of age smoked opium and that the entire Chinese National Army was addicted to it. Everyone was affected, despite their social class. The total number of addicts in China in the 1830's was as high as 12 million (Waley 1958).
The sale and use of opium not only created social and public health problems for China, but also economic ones. The opium trade shifted China’s balance of trade to the negative, threatening to destroy its government and the very social fabric of its society (Musto 1999). Chinese officials viewed the opium problem as problematic from all angles. Addicted civilians were unable to be productive and dependent army personnel were incapable of mounting a defense against foreign attack. This threatened China’s ability to progress politically, technologically and economically. The solution, as they saw it, was to end the immoral and forced trade of opiates.
Treaty of Nanking- a spoil of war for the British that gave it control of Hong Kong for many years after defeating China in the Opium Wars.
Two Opium wars between China and England followed. The first broke out in 1839 when China disrupted British merchant vessels and their opium delivery in Canton. For three years, China tried to battle the technologically superior English military, only to be defeated handily in 1842. China’s loss of this war cannot be overstated, for in addition to failing to halt the British opium trade, it also was forced to cede Hong Kong to British control for many decades (the infamous Treaty of Nanking). Soon thereafter, China was forced to open its ports of trade not only to Britain, but to other western powers including the U.S. The second opium war started in 1856, after Britain responded with military force to an “alleged” search of a British vessel by the Chinese government. China lost this battle too (Waley 1958).
The defeat of China and the opening of its ports of trade was critically important to the growth of the U.S. economy. With numerous political victories in hand and a growing economic base, the U.S. was now widely perceived as a world power. Its growing dominance in the world economically and politically meant, however, that it would inherit problems that existed in other countries, especially if it had a viable economic or political interest therein. This is a consistent theme that continues to shape U.S. domestic and foreign policy today.
Overwrought by economic, social, public health and political problems related to the trade of opium, the Chinese government elicited U.S. assistance. In return for helping China deal with opium addiction among its population, the U.S. would receive favorable trade status and economic access. But what would be the nature of that assistance? How could countries outside of China, like the U.S., assist a foreign nation with its population’s drug addiction?
Shanghai Opium Conference- the first international effort to develop policies—via the discovery of facts-- to control addiction opiates.
The first step was to organize a fact-finding mission on opiate addiction. Since, China needed outside assistance on this matter, an international body of 13 nations was assembled to study the nature and extent of opiate addiction in the world and to offer policy recommendations for all. This unprecedented fact-finding mission was called the Shanghai Opium Conference and it took place in 1909. Two years later, the International Conference on Opium followed (Courtwright 2001a; Musto 1999; Terry and Pellens 1928).
While the two conferences on opium were a significant step in international drug control, they fell short of producing real and immediate changes in manufacture, distribution and consumption of the drug because they put forth only recommendations, not policy. Individual countries were left with the task of adopting the recommendations (Musto 1999). The U.S. acted swiftly by ratifying the International Opium Conference on Opium in 1913. This paved the way for later domestic opiate control policies. However, this was no easy accomplishment. Moral entrepreneurs had to first convince government officials that opiate addiction was a problem in America, not just in a foreign land far away (Courtwright 2001a).
Public Health, Dependency and the Patent Medicine Industry.
China was not alone in experiencing public health problems related to opiate consumption. The U.S. also was beginning to witness similar consequences by the early 1900s. However, the U.S. experience with dependence and abuse of opiates was less often the result of recreational opium smoking but rather an unintended “side effect” of medical practice (Terry and Pellens 1928; Musto 1999).
Drugs such as opium (from which heroin, morphine, and oxycontin are made) and cocaine were viewed favorably in the U.S. until the early 1900s. The anesthetizing and pain-killing properties of morphine revolutionized the practice of modern medicine by allowing doctors to perform actual surgery instead of barbaric amputations (Courtwright 2001a; 2001b). With its discovery, doctors could greatly improve their treatment of all types of sickness or injury. This was especially critical in the U.S., given the extent of personal harm and suffering experienced during the Civil War. Widespread endorsement of morphine followed (Musto 1999) from the medical community, which began prescribing it to cure many conditions. Soon, morphine was in a large percentage of all patent medicines and the general public was, unknowingly, becoming addicted to this powerful narcotic.
Patent Medicines- a government grant to an inventor for the exclusive rights to make or sell the invented or discovered drug.
The story for cocaine was much the same. At first, it was given to soldiers to improve the endurance for battle (e.g., prevent fatigue). Within a few short years (e.g., 1890), the addicting and psychosis-producing nature of cocaine was well understood in medical circles. However, its use in the United States continued in tonics and patent medicines (e.g., for sinus illnesses and eye surgery). Slave owners in the south used it as did the Conquistadores; to obtain more work from the negro slave. Dr. Charles B. Towns wrote (1912): "When in overseer in the South will deliberately put cocaine into the rations of his Negro laborers in order to get more work out of them to meet a sudden emergency, it is time to have some policy of accounting for the sale of a drug like cocaine." (As cited in Brecher 1972).
As a powerfully reinforcing stimulant, it was widely available in beverages (as mentioned above with coca-cola and vin mariani) and medications in the late 1880s and early 1900s. It’s ability to energize and generate feelings of well-being made it popular. However, it also found use in the medical community when physicians began using it as a cure for morphine addiction (Courtwright 2001b; Musto 1999; Terry and Pellens 1928).
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The father of psychoanalytic thought, Freud, believed it a wonder drug able to cure a plethora of mental and physical conditions. He consumed it himself and praised it extensively in his book “Cocaine Papers.” Freud’s love affair with cocaine ended dramatically, however, when his treatment of a friend’s morphine addiction with cocaine resulted in the friend’s overdose and death. Soon thereafter, cocaine came under fire as evidence amounted to dispel its fame as a cure for morphine addiction. However, abuse and addiction to cocaine were rampant by this point. The medical community withdrew it’s endorsement of cocaine and Freud was discredited. He later relocated to Vienna and began working on the Interpretation of Dreams (Musto 1999).
Morphine and Heroin- two powerful narcotics and painkillers extracted from opium, which is produced by the poppy plant.
It is important to highlight that addiction to opium and cocaine was less an outcome of recreational activity, but rather a more accidental result of modern medicine. The extraction of morphine from opium was considered a modern medical marvel. Unfortunately, once a patient’s illness and injuries subsided or were healed, many found themselves addicted and suffering withdraw. The isolation of heroin from morphine was also, originally perceived as a medical marvel as heroin was extolled as a cure for morphine addiction. The world would soon discover, however, that heroin was ten times stronger than morphine and was even more addicting.
The Opiate and Cocaine Policy in the U.S.: Race-Related Anti-Drug Campaigns.
Early Drug Czars. For the first quarter of the 20th century, Presidents Roosevelt, Taft and Wilson relied, primarily, on two men to address the nation’s concerns with drug abuse (see Table 1). Reverend Charles Henry Brent and Hamilton Wright represented the U.S. internationally and brought the drug issue, visibility in the U.S. Congress and the Oval office. For example, Hamilton Wright took the lead in crafting a U.S. policy to control opium and cocaine after returning from Shanghai, where he and Reverend Brent assured the other participating nations that the U.S. would follow the conferences’ recommendations to establish controls on opiates. In return, China would open its ports to the U.S. for trade (Musto 1999).
Wright’s first effort – the Foster Bill of 1911- found support among some U.S. senators, but ultimately died when its proponents were unable to convince Congress that cocaine and opium use comprised a real threat to the American public. Despite considerable and growing abuse of and addiction to opiates and cocaine, there was more concern over alcohol abuse in the U.S. at this time (Gusfield 1963). This frustrated Wright.
Under pressure to deliver, Wright and others resorted to race-based rhetorical strategies to drum up increased support for a revised bill– eventually called the Harrison Act of 1914. The use of racist imagery and rhetoric to secure support for and pass drug legislation had, consequently, debuted at the Federal level. However, precedent for it had been set by states like California, which had used racist tactics to curtail Chinese immigrant actions in northern California around the turn of the century (Morgan 1978). The early success of moral entrepreneurs in using racist strategies–based on deep-ceded prejudices would lay the groundwork for many others in future anti-drugs and alcohol legislation. In fact, many concur that today’s drug war continues in this vein.
Two race-based campaigns would eventually produce the kind of support that Wright and others needed to secure passage of opiate and cocaine legislation. The first one linked the cultural custom of opium smoking among the Chinese to deviant sexual activity with and rape of white women. The equation extolled in this campaign was simple: Chinese men + opium smoking = sexual assault against white America (especially white women).
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To summarize the story told by opiate moral entrepreneurs, Chinese men, who came to America to work on the trans-continental railroad, brought with them their cultural custom of smoking opium in “dens” (i.e., perhaps yesterday’s version of a dope or crack house or even a bar or tavern). Wright and others claimed that these Chinese men lured White women into the dens to smoke opium and, while under its influence, they initiated deviant sexual acts with the women and forced others intosexual relations and eventual opiate dependency. The proposed policy solution was, therefore, to make opium smoking illegal to the Chinese first (Chinese Exclusion Act – see Morgan 1978) and eventually to all Americans via the Harrison Narcotics Act (Courtwright 2001a; Musto 1999).