Teaching Points: “The History of Drugs in Twentieth-Century America”

Editor’s Note: This post is brought to you by Marco Ramos and Tess Lanzarotta. Ramos is an MD/Ph.D. candidate in the History of Science and Medicine program at Yale University focusing on the production and circulation of scientific knowledge during the Cold War in the global south. Lanzarotta is a Ph.D. candidate in the same department focusing on the ways that contemporary interactions between biomedical researchers and indigenous populations are shaped by their historical antecedents. This summer, Ramos and Lanzarotta taught a course on the history of drugs in the twentieth century and we’ve invited them to contribute to our “Teaching Points” series. Enjoy! 

Over the course of five weeks this summer, we co-taught a course on “The History of Drugs in Twentieth-Century America.” As discussed in our earlier post, we decided to focus the course around historical processes of drug categorization, rather than on a single drug or class of drugs. We hoped that this approach would draw undergraduate students’ attention to the ways that systems of drug classification are and have been shaped by their historical contexts. In particular, we felt it was crucial to emphasize the ways that drug categories affect and are affected by the people who use and regulate drugs.

Part of the impetus for the course was our own sense that historical analysis makes a particularly useful tool for understanding contemporary dilemmas surrounding drug use and drug policy. Bearing that in mind, we structured our classroom discussions and course assignments to encourage students to draw lessons from the past and bring them to bear on the present. The class was a seminar format with sessions running for three hours, twice each week; we tried to break up this rather long classroom time by delivering short lectures, showing documentaries and television episodes, visiting the Yale Medical Historical Library and Yale Art Gallery, and by bringing in guest speakers who could share their perspectives and expertise.

In our first session, we gave two brief lectures on the Harrison Act and the Volstead Act. Through these lectures, we introduced our students to the idea that early twentieth-century drug regulation was not based on any new scientific discoveries regarding the chemical properties of narcotics or alcohol. Instead, we argued, these laws were shaped by anti-immigration sentiment, by the class politics that emerged alongside industrialization, and by anxieties that accompanied the shifting gender roles that characterized Progressive Era America. For our second session, we assigned two chapters from Caroline J. Acker’s Creating the American Junkie: Addiction Research in the Classic Era of Narcotic Control, which we found extremely helpful for centering our discussion around the impact of policy change on drug users themselves. Our theme for the session was “criminalization and medicalization,” so we decided to show the documentary “Narcotic Farm,” which emphasizes the sometimes blurry boundary between these two processes. The documentary also illustrated the complex ethics of addiction research, giving us a opportunity to further debate “harm reduction,” a concept we had introduced the previous week.

Our two next classes dealt consecutively with the concept of wonder drugs and with the pharmacological boom in early Cold War America. Both of these sessions were framed as variations on the theme of pharmacological optimism; we visited the Medical Historical Library to view archival collections related to the histories of pharmaceutical, tobacco, and alcohol advertising, the patent medicine business, drug development, and the role of drugs in countercultural movements. The library visit led to a vibrant conversation about the connections between these documents and the secondary texts we’d been reading: what beliefs about the power and potential of drugs to aid individuals or to reform society as a whole did primary sources reveal? Our students seemed particularly fascinated with the suggestion, introduced through chapters from Andrea Tone’s Age of Anxiety: A History of America’s Turbulent Affair With Tranquilizers, that consumers drove much of the pharmaceutical boom in mid-century America and felt relatively little trepidation about the widespread use of psychopharmaceuticals.

For our sixth session, we invited Dr. Jordan Sloshower, a Psychiatry resident at Yale University and co-founder of the Yale Psychedelic Science Group, to discuss the resurgence of interest in the therapeutic potential of psychedelic drugs within contemporary psychiatric and psychological research circles. Dr. Sloshower, well-versed in the history of LSD both as an object of scientific research and as a tool of countercultural rebellion, gave an insightful presentation on the difficulty of maintaining the scientific legitimacy of one’s research while working with chemical substances that come with considerable cultural baggage.

The following week, we assigned David Herzberg’s article, “The Pill You Love Can Turn on You: Feminism, Tranquilizers, and the Valium Panic of the 1970s,” and chapter, “Busted for Blockbusters: ‘Scrip Mill,’ Quaalude, and Prescribing Power in the 1970s,” for a session on “Drug Panics” and the 1970s backlash against the pharmaceutical industry. We also gave short lectures on “The Anti-Psychiatry Movement” and on “Women, Alcohol, and Alcoholism” to provide some additional context for the readings and to help explain the rising skepticism surrounding medical authority in the 1970s. We found that Herzberg’s work set us up perfectly to contrast the societal response to widespread pharmaceutical addiction amongst white women in the 1970s with the persecution of African-American drug users during the War on Drugs (the topic for our next session) by clearly illustrating how one drug panic helped shape the conditions of possibility for the next.

Our session on the War on Drugs was based on readings from Michelle Alexander’s The New Jim Crow: Mass Incarceration in the Age of Colorblindness, Paul Gootenberg’s article “Cocaine’s Long March, 1900-2010,” and Philippe Bourgois’ classic piece “Breaking Rocks in El Barrio: Workaday World, Crack Economy.” If these readings seem as though they’re trying to cover too much ground for one session, it’s because they were! We had initially hoped to address the War on Drugs in two sessions, one dealing with its domestic facets and one with its international implications, but there simply wasn’t time. Our students arrived at this session armed with strong opinions about the War on Drugs; Bourgois’ work in particular generated interesting debates over how we might understand the motivations of crack dealers and users, how Bourgois’ description of crack dealers differed from that presented by the Reagan administration and law enforcement officials, and over the ethics of speaking for populations (in this case, crack dealers and users) whose voices might not otherwise reach a wide audience.

Session eight focused on “Drugs as Agents of Prevention and Optimization.” Students read Ken Silverstein’s article “Millions for Viagra, Pennies for Diseases of the Poor” and Alan Schwartz’s New York Times piece, publishing in 2012, about a child psychiatrist who openly admitted to prescribing ADHD drugs to underprivileged high school students in order to help boost their academic performance; through these articles, we were able to frame lifestyle drugs as a social justice issue. Our students were familiar with debates surrounding study drugs and were quick to put their own experiences and observations in context; the most passionate and vocal students in our class were uneasy about, if not entirely hostile towards, “lifestyle drugs” and “pharmaceutical optimization” as morally defensible concepts, given their potential to maintain and amplify systems of inequality both internationally and within American society.

We focused our final class around drug issues related to HIV/AIDS. We were fortunate to have Dr. Alexander Bazazi, an epidemiologist and member of the Yale Global Health Justice Partnership, join us to discuss contemporary efforts, driven by pharmaceutical companies, to decrease the FDA’s regulatory power and expedite the process of drug approval. Students had read selections from Steven Epstein’s Impure Science: AIDS, Activism, and the Politics of Knowledge and so were prepared to contrast current arguments for deregulation to those that had been raised by HIV/AIDS activists, desperate to gain access to potentially life-saving medication, in the 1980s and 1990s. During this session, we also watched a CNN special about InSite, North America’s only supervised injection site, which we used to continue the discussion about harm reduction as drug policy that had started weeks earlier.

A summer term class at Yale runs for just five weeks and it was challenging to develop a a classroom rapport in such a short time. In the interest of encouraging students to read and comment on one another’s work, we created a class blog; students were required to post contemporary media relating to drugs and to write historically-informed reflections. In addition, students did primary source analyses, so that their classroom assignments required them to not only connect the past to the present, but also to learn how to take the past on its own terms. We concluded the class with a final exam, because, while some of our students expressed a desire to do deeper research on topics that interested them, we felt there simply wasn’t time for a research paper in a five week course!

For both of us, this was our first time developing and running our own course, so we’d welcome any feedback, questions, etc. on the design of the class!