Introducing: The Points On-Line Library

As we promised last month, Points has developed an on-line browsing library for our loyal readers. To access the library, just pass your cursor over the “Points Library” heading on the banner page and select one of the four categories you’d like to browse: Websites, Academic Journals & Government Publications, eBooks & Periodicals, or Movies & Shorts. The …

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What We Talk About When We Talk About Sexual Addiction

I just don’t see how anyone can write about sexual addiction without also writing about masculinity and feminism. But before I do that, let me propose a few caveats:

  1. It is not my place (or ambition) to say whether sexual addiction exists or not.
  2. I am not claiming that there are not also women who identify as sexually addicted.
  3. When I question the ways we conceptualize sexual addiction, I am not doing so to trivialize or disrespect anyone’s experiences.
  4. Despite the possible inclusion of “hypersexual disorder” in the DSM 5, I will use the term “sexual addiction” because it remains the term of choice and because the word ‘addiction’ shapes our understanding of the disorder.
  5. There will be some explicit references in this post.

I feel the need to begin with these caveats because I have already learned that to speak about sexual addiction with any sort of doubting curiosity is to invite angry assertions of its existence. The invocation of addiction implies the absolute certainty of the recovery movement. It demarcates a clear trajectory into abjection as well as the redemptive potential of recovery. Cohering (as in: bringing together and making coherent) sexual excess under this term leaves little room for nuance. Yet, as I have argued earlier, sexual addiction remains an aporia that helps shape notions of sexuality, morality, and even addiction itself. If we do not pay close attention to what we mean when we say that certain destructive sexual behaviors are “addictions,” we risk losing sight of what we might learn about gender roles and entitlements.

The other response to any doubting curiosity is the seemingly inevitable reference to men who feel compelled to masturbate until they bleed. 

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Flying into the Unknown: On the Limits of Addiction History

Let’s begin with the story of a woman named Anna.

State Reformatory for Women, Bedford Hills, NY

In October 1917 the research staff of the Laboratory of Social Hygiene at the State Reformatory for Women, Bedford Hills, New York, examined a woman who identified herself, at different times and according to different documents, as Anna Dillon, Anna White, Anna Miller, and Anna Murray. Anna was both a heroin user and a prostitute, and the staff of the laboratory examined her closely in order to determine the causes of her deviant behavior. They studied her body in great detail, observing that the lobules of her ears “are attached,” her skin and mucous membranes “anemic,” and her vagina of “medium length and width.” They gave her a large number of psychological tests, eventually determining that she was “of normal mental ability with keen perception and fair reasoning ability.” And finally, they assembled a detailed case history of her life by conducting extensive interviews with her, soliciting documents from other institutions at which she had been incarcerated, and gathering information from her acquaintances. In all this, they sought to investigate and document the causes of her deviant behavior. They searched for an explanation of why she acted as she did in the details of her body, her mind, and the social experiences that made up her life. They collected and analyzed data, working to forge a coherent narrative explaining who she was and why she acted as she did. They did so in part to help her, and in part to advance scientific knowledge about sexual deviancy more generally.

Like our peers at the Laboratory of Social Hygiene, historians of addiction analyze the lives of the people we write about and try to come up with some sort of explanation for why our subjects acted as they did. Like our peers, we do so both out of an interest in the people we study and toward the goal of advancing knowledge more generally; through our work, we hope to find some sort of knowledge with which we can understand the world in which we currently live. Not surprisingly, we have a tendency to look in the same types of places for this information as the people interviewing Anna looked – including, most notably, the socio-economic environment and the physical workings of the body. There are, of course, complex arguments about the relationship between different approaches to explaining addict behavior in the past, and this blog is probably as good a place as any to explore the complexities of these debates – the recent series of posts responding to David Courtwright’s recent essay in Addiction is a great place to start. I do not want to downplay the importance of these debates, but I wonder: are we missing something important about the past when we try to explain it in this sort of way? Do we miss something important about Anna when we interrogate her life through the categories most familiar to us, those of historical and sociological analysis, biological explanation, or some combination? What is it that we hope to accomplish when we move from description to explanation, and what do we gain – or lose – when we do so?

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Victorian Women on Drugs, Part 4: The Female Addicts of Deadwood

Today, Points presents the final installment of guest blogger Kristina Aikens four-part series on Victorian women and drugs. Today, Kristina looks at the constructed reality of drug use in the HBO series Deadwood.

Alma and Trixie, two of the women of Deadwood

For my last blog post, I turn from texts actually from the nineteenth century to a story created in the twenty-first century but set in the nineteenth. HBO’s Deadwood was a successful television Western, set in a lawless gold-rush camp in the 1870s. While much of the plot revolves around male power struggles over the camp’s resources and financial opportunities as the frontier moves toward civilization, this post will focus on the show’s female characters, particularly the way Deadwood uses opium use to signal women’s attempts to escape a misogynistic society and form bonds with other women. It is striking that the three main female characters in Deadwood’s first season are all depicted as addicts: Calamity Jane is an alcoholic, while the prostitute Trixie and the Northern lady Alma Garret struggle with addiction to opium. For the sake of brevity and clarity, I will focus here on Alma and Trixie, asking what this says about the show’s depiction of femininity.**

In the commentary for the first episode of the series, creator David Milch says, regarding Alma Garret’s addiction: “When you’re raised essentially to serve someone else’s purpose sometimes you try to create an artificial environment where you can meet your own needs. I think that’s how a lot of junkies and alcoholics get started.” Though Milch suggests this description could apply to any substance abusers, male or female, his comment seems particularly resonant with the female characters on the show. Male drug addicts on the show are generally depicted one-dimensionally, being easily forgettable smalltime crooks. In contrast, drug addiction seems intimately, emotionally connected to femininity. After all, Milch’s comment follows an explanation of Alma’s background, which includes marrying her wealthy husband in order to get her father out of debt.

David Milch

Other scenes depict prostitutes getting high, presumably to escape the misery of a life of relentless submission to the violent desires of their male clients and employers. Although these prostitute characters are no more prominent to the plot than the smalltime male crooks mentioned earlier, their addiction is specifically connected to their profession in a way not implied with the male characters. Trixie stands in as representative of the other prostitutes and their addiction, and while she is never seen getting high, her past and present fit Milch’s description of being “raised essentially to serve someone else’s purpose.” Both Alma and Trixie mention that their addictions began early, around the time when they would be considered—in different ways and due to different circumstances—to be arriving at womanhood: Alma at seventeen, Trixie at twelve. 

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On Acid: LSD and the Sorcerer’s Apprentices

Editor’s Note: Readers coming to Points for the first time may be interested in some of our other posts treating psychedelic experience.  They include (but are not limited to) Religious Studies Professor Gary Laderman’s meditations on the place of LSD in the late 20th-century US; a two-part series by Comparative Literature scholar Tace Hedrick, looking at the influence of Gordon Wasson on US psychedelic culture and of psychedelics on feminist theorist Gloria Anzaldua; and some by Brian Herrera of Performance Studies.  Search under the Tag “psychedelics” for a complete inventory.

LSD is one of the most mythical drugs in history. As with regard to many other drugs, our culture is almost satiated with perceptions, sentiments and opinions about the substance. Most of them have a history that can be traced back to the Sixties, that strange and almost mythical period when the most fundamental certainties of western society seemed undermined – at least to those high on acid.  But more than myths and vague associations are hardly discernible when looking at present-day perceptions and sentiments around LSD in popular culture. Sixties and hippies are one set of associations often encountered; adolescent users becoming psychotic and jumping out of windows and of balconies or eating the bark of trees another. Or, on a more positive side, people envision mystical enlightenment and heightened sensual perceptions. As a mythical drug LSD can be everything to everyone, a focal point of contestations about social, political and metaphysical realities.

The recent Swiss documentary The Substance: Albert Hofmann’s LSD, directed by Martin Witz and produced by Andreas Pfaaffi, tries to reconstruct the tumultuous history of LSD from its discovery by the Swiss chemist Albert Hofmann in the Sandoz laboratory in Basel in 1943 until the end of the Sixties. In must be said at the outset that the movie basically follows the story as outlined for instance in Jay Stevens’ Storming Heaven: LSD and the American Dream (1987), though adding some material from psychedelic therapy sessions in recent years and interviews with participants. [Editor’s note: an article on some of these experimental protocols appears in last Sunday’s New York Times.] To those viewers who are familiar with the story the documentary offers nothing new. What is most interesting is the documentary footage

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Bridging the Gap: An Interview With Dr. Robert Whitney

This week we bring to Points an interview with Dr. Robert B. Whitney as part of an ongoing interdisciplinary dialogue inspired by last month’s “Courtwright Symposium.” Whitney served as Clinical Director of the Division of Chemical Dependency at Erie County Medical Center from 1976 to 2011.  In addition, Dr. Whitney worked for the Research Institute on Addictions in Buffalo, NY in the early ‘90s.

Can you tell us a bit about your unique professional experience, and perspective regarding addiction and the War on Drugs?

I have a slightly different perspective than people whose primary focus is research, including historical research.  My experience has been in trying to synthesize relevant information from any source and to apply that information in helping people cope with their drinking and drug problems.  Over the years, I’ve also been on different committees at the county and state level looking at addiction policy questions.  So most of my experience as a clinician, was a little different.  But I have some sense of what the policy issues are and how ill-informed most of it is.  So I have a slightly different take on the whole thing.

In your 35 years of experience, did the patient demographics change significantly?  If so, how?

Yes.  In many ways the demographics changed some.  People got younger.  I still don’t really know if that’s a product of changes in prevalence of drug use or whether we just got better at catching people earlier in the course of their problems.  I think it’s probably some of both.  We found other ways to engage people before they are having trouble with the law for example, or having trouble on the job.  So the age has changed and certainly the patterns of drug use have changed.  Ten years ago in Buffalo if we saw one or two people a month who were primarily in trouble with prescription drugs that was a lot out of say 100 admissions.  When I left in September [2011], and I don’t think it’s changed very much since, it was around 40% of admissions. That’s a huge, huge, change.

My research focuses on drug policy reform in the mid-to-late 1980s, reform largely associated with the emergence of crack.  Can you point to any significant changes in your own facility at ECMC during this period?

We certainly began to see people with shorter drug histories.  Clinical populations tend to be people who are more troubled than your average user or abuser.  If you’re having trouble spending too much money on cocaine every once in awhile you don’t necessarily end up in treatment.  If you spent the family fortune on it and everyone has given up on you we might expect to see you in treatment.  So often, it would be a number of years before they ended up in treatment.  I think when crack came to Buffalo, we did see a lot of people with crack as the main reason that got them to treatment earlier.  It seemed like they would get deep into trouble in months, rather than several years. People were getting into trouble with it, I think, because you could get started on it with smaller amounts of money.  You didn’t have to have a great deal of money in your pocket to get going. This seemed to be a difference in typical patterns.  Moreover, because of the rapid onset of inhaled cocaine, the drug is particularly reinforcing, contributing to more rapid progression of problems.

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Weekend Reads: Rihanna Edition

While Points has no official stance on American drug policy, it is a near certainty that the majority of this site’s readers consider America’s longstanding War on Drugs a failure. It’s also likely that many of our readers feel some investment in the ongoing – and escalating – national debates over the medicalization, decriminalization, and legalization of marijuana. The trend toward legalizing marijuana, and the easing of public prosecutions of drug use in general, has gained enormous traction with politicians, journalists, academics, libertarians, big business right-wingers, and big government left-wingers in the last decade, bringing the country to a drug policy crossroads. Americans live at a distinct moment in time when Presidential candidates speak of their resolute opposition to medical marijuana while state governments in California, WashingtonColoradoHawaii, and elsewhere move resolutely in the opposite direction. To doctors, criminologists, civil libertarians, and drug enthusiasts, the prospect of the Drug War’s demise and the liberalization of marijuana laws are hugely promising indicators. It seems, if nothing else, a move in the direction of common sense, as the idea that occasional recreational or medicinal marijuana use would create some sort of moral crisis in America seems, on its face, preposterous.

The belief that America’s War on Drugs has been a cynical thirty- year boondoggle is by no means, however, a universally-held opinion. It was only last year, according to Gallup, that half of Americans came to support the legalization or medicalization of marijuana. The debate over national drug policy is just now starting in earnest, meaning anti-Drug War advocates are now share a political identity and, in turn, a particular set of responsibilities in furthering their cause. The likely key to winning the national drug debate is capturing America’s political “mushy middle,” the ever-powerful group of “Undecideds” who, aside from deciding every Presidential election, have the political sway to alter drug policy. By their nature, they do not share the view that the American War on Drugs has been a catastrophic failure, though they can be convinced.

Those loveable Undecideds...

If one is to take anything from the last three Presidential elections, it should be that Undecideds are an unaligned group of conventional people who, while not “conservative” in any formal sense, are hesitant to enact sweeping political change, lest it challenge God, Country, or the American Way. Those in favor of liberalizing American drug laws, then, are charged with the task of convincing this disorganized amalgam of voters that new drug policies would not inconvenience the life of the mythical “Average American” in any meaningful way. Advocates of looser drug policies can only promote this message, however, combating the long-propagandized idea that more-liberal attitudes toward drug use would lead to the anarchic, hedonistic, and amoral cultural wasteland. In a rush to appeal to the mushy middle, both legalization advocates and Drug Warriors strive to seem as rational, reasonable, fair-minded, and sober as possible. Neither side would benefit from the electorate viewing the debate as being one between burned-out hippies and joyless moral hysterics.

The fight to win Undecideds has resulted in both sides of the debate increasingly representing themselves through the sort of conventional, wealthy, established politicos like George Soros and Mitt Romney, and respectable professional associations like the California Medical Association and the National Football League, with which Americans seem more comfortable. While celebrities often interject themselves into the debate, the young audiences that Hollywood stars have the most traction with are not really the key to crafting new policy. Rather, celebrities are often counterproductive figures within the drug liberalization movement, engaging in drug-related behaviour that lives down to the worst fears of their political opponents. This is where Rihanna comes in. 

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The NIAAA-NIDA Merger: Comments from the Field I

Editor’s Note: Following up on Ron Roizen’s two-part think-piece on the NIAAA and NIDA merger, we offer the comments of Paul M. Roman, Regents Professor of Sociology at the University of Georgia and Director of their Center for Research on Behavioral Health and Human Service Delivery in the Owens Institute for Behavioral Research.  Roman currently studies organizational change and innovation adoption in the delivery of treatment for substance use disorders. Earlier in his career he conducted extensive research on the adoption and implementation of employee substance abuse and assistance programs in the workplace.

(Chitttagong, Bangladesh)

Ron Roizen offers us a great contribution about the merger of NIAAA and NIDA. There is a remarkable amount of history and organizational process embedded in this event, which may provide some surprises as it unfolds.  I want to add some reflections, largely from the perspective of someone with active research grants from both NIDA and NIAAA that I hope can be continued beyond their current funding, but also from that of someone who “was there at the founding” of NIAAA.   In Ron’s piece,  I am initially struck by the vision of the two Institutes, like ships, being “decommissioned” although I guess the metaphor fails when we consider their being taken out to sea and sunk.

From my own perspective, my expectation of the merger has consistently been of a bigger and more visible NIDA with NIAAA tagged on as a division, and perhaps another division  that would include tobacco, depending on where that goes.  If  indeed we see a truly new organization, that will be striking.  For Points readers’ socio-historical skills, these developments are a challenge for close observation and recording.  I would add a prediction that for the first 5 years or so, there will be scrupulous and highly visible attention to alcohol research project support,

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