Drug addiction as a social phenomenon is a relatively recent construct. That is, despite the use of psychoactive drugs for thousands of years, drug use and abuse only became a social problem when the functioning of a member of a particular group or the activities of the group itself became impaired through another’s drug-taking behavior. Thus, the construct of drug addiction evolved through the interconnectedness and impact that one person’s behavior has on another. Although the word addiction finds its roots in the Latin addictus, meaning “to deliver” or “to devote,” it was not until William Shakespeare modernized the word in Henry V that it took on a meaning similar to that of today. Still, Shakespeare’s reference to addiction referred more to the king’s predilections for theology than any drug use. Despite this evolution of the vernacular, the people of ancient Greece and Rome knew that many substances (e.g., opium) were capable of producing varying levels of dependence.
The rise of drug addiction as a significant global social problem began in the 17th century with the emergence of the opium trade between the Chinese and British Empires. Desperate to find a commodity to trade for Chinese tea, the British exported massive amounts of opium from India via the East India Trading Company. In the process, the British opium trade addicted a nation to the drug and eventually sparked two bloody wars, appropriately referred to as the Opium Wars. Trade also became the impetus for other notable drugs introduced to the masses. In fact, the trade of cocaine, tea and coffee (caffeine), and tobacco (nicotine) provided a considerable income for many countries with the ability to deliver these cash crops internationally. Thus, through global trade, many drug-naive populations were exposed to exotic mind-altering drugs.
Other significant changes during the Industrial Revolution also contributed to the global consumption of drugs. During the 19th century, more efficient drug delivery systems became available. For example, the invention of the hypodermic needle allowed for the delivery of morphine, a drug isolated from opium in 1805, in a manner other than by oral administration. Given the prevailing misconception during this era that drugs produced addiction only when administered through the mouth (as in the case of alcohol, nicotine, and snuff preparations of cocaine), the administration of drugs through a syringe lessened the population’s anxiety about the addictive potential of newer drug derivatives that, in some cases, were much more potent. Further, industrialization and the ensuing mass production of drugs by a variety of pharmaceutical companies exposed individuals of limited economic means to substances that were once only available to the upper echelons of society. The addictive potential of these drugs now knew neither geographical boundary nor social class, resulting in pandemics of drug abuse.
As drug use increased across the social spectrum during the 19th and 20th centuries, so did the opposition to drug taking. Analysts suggest that this change in society’s perception of drug use rested on several key patterns prevalent during this time. For instance, as excessive drug use increased, so did other risk-taking behaviors. This phenomenon resulted in an increase in mortality rates for drug addicts. Second, the loss of productivity resulting from drug use affected not only the individual’s ability to survive in an increasingly competitive world but also societal functioning, particularly in lost work hours, production, and sales. In addition, the association of drugs with certain minority groups shifted attitudes about their social acceptability. For example, during the expansion of the railways in the United States, a cheaper and more abundant immigrant Chinese labor force replaced domestic workers. Chinese immigrants also engaged in opium smoking, which by this time was a cultural practice. The job loss that resulted from the influx of Chinese immigrants sparked many prejudicial attitudes and discriminatory behaviors against this minority group. Merely through association, recreational drug use became a frowned-upon practice, only committed by members of an undesirable group. As such, the conditions were ripe for a significant shift in international and domestic drug policy during the early 20th century.
In response to the emerging threat of increased drug misuse, many governments worldwide reacted by enacting regulatory and prohibitive drug legislation. For example, in the United States, the Harrison Narcotics Act of 1914 levied a tax on narcotics. This tax was aimed at decreasing the open distribution and consumption of many drugs like cocaine and opium, even though taxes on other drugs (e.g., cigarettes and alcohol) provided considerable sources of revenue. Thus, in some respects governments relied on the drug trade for profit. Another example of legislation aimed at affecting the drug market was Prohibition (the Volstead Act of 1919). Rather than taxing alcohol, the purpose of Prohibition was to eliminate its consumption altogether. In retrospect, all this legislation accomplished was creation of a black market for alcohol and criminalization of a rather large population of individuals. In 1970, the Controlled Substance Act provided a more measured reaction to drug use. Although it severely restricted the use of many drugs, threatening large fines and prison time for those caught possessing or distributing drugs with abuse potential, it also allowed for many drugs to remain available within a medical setting.
A second response to increasing drug use was the proliferation of treatment options for the drug abuser. Notable psychiatrists like Sigmund Freud (despite being addicted to cocaine himself) and Carl Jung attempted to develop theories of, and treatments for, drug addiction. The U.S. government created the first prison farm/hospital in 1929 dedicated to the treatment of addiction. Bill Wilson devised the 12-step program for alcohol addiction in the 1930s, the significance of which was that drug misuse would be framed as a problem that was largely outside of the abuser’s control, rather than a moral failing of the individual. Methadone maintenance emerged in the 1960s as a viable option to heroin detoxification programs. Other opiate substitution and antagonist programs remain active and effective today.
Educating the populace about the dangers of drug addiction was a third front in the battle against drug use and abuse. Films like Reefer Madness attempted to scare the public into discontinuance. Such efforts, however, were largely uncoordinated and not rooted in any cohesive domestic or international policy. Attempting to focus the nation on the dangers of drug use, President Richard Nixon formally declared a “War on Drugs” in 1971, a war that still continues.
One beneficial product from increased public awareness of drug addiction as a significant social problem was the increase in efforts to understand its causes and consequences. If scientists could understand both the behavioral and biological bases of drug addiction, then better treatments could be devised. U.S. Addiction Research Centers, founded in the 1930s, sought to develop such viable treatment options. In the 1970s, the divisions of the National Institutes of Health, namely, the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism, took on this task. These institutes, in conjunction with many academic scientists, would provide the public with many groundbreaking discoveries about drug addiction.
Although the resulting research postulated multiple models of the etiology of drug addiction, people nonetheless use recreational drugs because they make them feel good (or, in some cases, different). Specifically, drugs produce a sense of euphoria by hijacking the natural reward structures within the brain (e.g., the ventral tegmentum, nucleus accumbens, and medial prefrontal cortex). Through the pharmacological action of drugs, these structures become active when they might otherwise lie relatively dormant. Recreational drugs, either directly or indirectly, increase the levels of the neurotransmitter dopamine within these brain regions. As dopamine levels increase, so does the sense of reward. Interestingly, these same neurophysiological systems are the ones thought to underlie the transitions from drug use to abuse, as neuroplasticity becomes associated with escalated and problem drug use. Not surprisingly, much research focusing on treating drug addiction attempts to devise new medications that either alter or block the action of recreational drugs at this level of the brain. In addition, other research efforts are also attempting to uncover why some individuals are more responsive than others to the effects of drugs within this system. Is the propensity to move from casual drug use to drug abuse a function of genetics, environment, or a combination of these factors? These questions, among others, continue to drive research efforts on addiction. Current understanding of addiction rests, in large part, on assessment of times past and the status of drug addiction in the present.
- Courtwright, David T. 2001. Forces of Habit: Drugs and the Making of the Modern World. Cambridge, MA: Harvard University Press.
- Goldstein, Avram. 2001. Addiction: From Biology to Drug Policy. New York: Oxford University Press.
- Hanes, W. Travis, III and Frank Sanello. 2002. The Opium Wars: The Addiction of One Empire and the Corruption of Another. Naperville, IL: Sourcebook.
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