In the growing body of historical
and social scholarship about psycho-pharmacology and drug policy, a good
portion of studies hamper interrogation of past research efforts and criminal
justice policies by interjecting, often explicitly, arguments favoring the
implementation of liberal or zero-tolerance policies for drug use.  Following
rather specious logic, such authors mold their accounts to "prove"
the foolishness of contemporary policy and thereby make room to discuss their
own suggestions.  In Creating the American Junkie: Addiction Research in the
Classic Era of Narcotic Control, Caroline Jean Acker effectively organizes
her analysis to avoid this unfortunate trend and successfully generates crucial
lines of inquiry into the issues surrounding contexts for opiate use and the
fate of opiate-dependent users. 

Creating the American Junkie
challenges commonly understood ideas about addiction by showing the social
construction of the "junkie" persona as it emerged during the "classic
era of narcotic control," or the period from about 1910 to 1964.  Acker
examines this process of "knowledge production" by identifying the
main interests and conceptual models employed by federal and local criminal
justice authorities, the American Medical Association, and sociologists. She
thus explains the ways in which these interests (and sources of funding) shift
from the 1910s and –20s to the 1950s, as stiffening policies against opiate
use enable an illicit market to supplant physicians as the primary source of
opiates, creating an urban, predominantly lower-middle class subculture
increasingly threatened with incarceration and limited options for treatment. 

By employing historical analysis
Acker’s study gains the critical strength of elucidating the often competing
discursive processes of social construction.  This approach enables her to
highlight the problems with essentialist models of addiction — claims, for
example, that an addict is irretrievably vicious because of physiological,
psychological, or hereditary weaknesses — in use by both psychiatrists and
criminal justice workers during the first decades of the twentieth century.  By
advancing the notion of "construction" as an analytical approach,
Acker traces the logic through which government and medical authorities
inhibited inquiry into the possible uses of any substance beyond the scope of
therapeutics or criminal activity.  By remaining attentive to sociological
models, she points out precise moments in addiction research in which criminal
and psychiatric studies overlooked vital information about addiction by
ignoring the social contexts in which opiate addicts initiated and pursued drug
use.  Acker advances this analysis with several well-placed case studies.  Each
example enables her to elucidate her claims about how incarceration of addicts
resulted from research full of omissions, faulty logic, and expediency in favor
of contextualized evaluations.

As I mention above, her main tactic
is to uphold the promise and significance of sociological studies of
addiction.  Models such as the "career of deviance" framework
introduced by Howard Becker in the 1950s, for example, permit scholars to focus
on addiction as a dynamic process that challenges the static, essentializing
assessments made by psychiatrists and criminal justice researchers in the 1920s
and 1930s.  She goes so far as to claim that sociological ethnographic methods
enable researchers to tell addicts’ stories in neutral terms.  It is this bias,
however, that at times upsets the balance of her otherwise poignant
discussion.  For example, Acker introduces the notion of a "social
definition" of addiction, that is, as a type of behavior arising in
response to changing contexts of opiate use and to specific social pressures
surrounding family, labor, and the drug marketplace.  Despite the importance
this definition ascribes to the addict’s own ideas about opiate use, it
ultimately couches his behavior within the category of deviance.   In addition,
Acker’s own use of terms referring to opiate use slips: "opiate" and "heroin"
are often used interchangeably with "drugs," as is "opiate use"
and "addiction" with "drug abuse" and "use for
pleasure."  In light of her persistent claims to critique the history of
knowledge production, Acker shows surprising insensitivity to important shifts
in her own terminology.  As a result, she conflates "drugs" and
therefore all illicit substances with the dependence-producing opiates.  This
slippage undermines Acker’s stated critical aims.  Instead of challenging or
overturning criminal and medical purview, the text ultimately reencodes opiate
use — and given the pernicious conflation of opiates with other substances,
all drug use — with deviance without thoroughly analyzing the processes by
which opiates, or other "illicit substances" came to be
differentiated from socially invisible psychoactive substances like caffeine,
sugar, or chocolate and medically-approved substances like Prozac and Valium. 

Although this imprecision in
language use is problematic, the text remains vitally useful.  Creating the
American Junkie is a critical text for scholars and policy-makers alike
that underscores the importance of interdisciplinary approaches to developing
anything approaching an accurate model of substance-dependence and humane
policies for dealing with people dependent on opiates.

© 2004 Robin Pappas

Robin Pappas is an adjunct
instructor of Comparative Literature at the University of Oregon.  Her research
interests include rhetoric, the history of medicine and science, and poetry
about altered states of consciousness.

Categories: Addiction, Philosophical