Month: August 2020

The pandemic is exacerbating other, co-occurring epidemic(s)

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Editor’s Note: Today’s post comes from guest writers Mae Tidd and Deepika Rao, graduate students at UW-Madison in the Health Services Research in Pharmacy Program. 

Mae’s research interests focus on LGBTQ+ health and health communication in pharmacy spaces and wider medical spheres. She studies the promotion of health information (between physician and patient, health education, and public health campaigns), health activism, and community/stakeholder engagement. More specifically, she is working to understand HIV-prevention’s pre-exposure prophylaxis (PrEP) uptake, or the lack thereof, in the state of Wisconsin by identifying barriers that are obstructing health services along the cascade of the PrEP Continuum of Care. 

Deepika is particularly interested in studying the use of dissemination and implementation sciences in pharmacy, especially in the prevention and treatment of substance use disorders. Currently, her primary research involves using mixed methods approaches to explore and develop patient-centered interventions for opioid misuse that can be implemented in the pharmacy settings. 

The current pandemic continues to be the front of discussion, as it should be. Yet, we need not to forget the other epidemic(s) that continue to occur: opioid overdoses, HIV, and the effects of systemic racism chief among them. This is especially true because people among the subgroups affected by these epidemics are at increased risk for the coronavirus and face significantly more problems accessing health care.

As we head into the fifth month of seized day-to-day life, the repercussions of COVID-19 are more than apparent – numerous people are (still) unemployed, mentally drained, isolated, and even homeless. The high number of COVID deaths are compounded by the fact that there are also numerous long-term COVID patients who are still suffering from incapacitating symptoms. With no end in sight, society is flooded with uncertainty.

These repercussions are concerning as they impact the mass majority. Yet at a heightened concern is the pandemic has exacerbated issues for the 20 million+ people in the US battling a substance use disorder.

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The Points Interview: Danielle Giffort

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Editor’s Note: Today we’re excited to feature a Points Interview with Danielle M. Giffort, assistant professor of sociology in the Department of Liberal Arts at the St. Louis College of Pharmacy. She’s the author of the new book Acid Revival: The Psychedelic Renaissance and the Quest for Medical Legitimacy (University of Minnesota Press, 2020).

Describe your book in terms your bartender could understand. 

Acid Revival is about how a group of mental health professionals is trying to bring psychedelic-assisted therapy back into mainstream medicine and how they struggle with the past history of psychedelic drugs in medicine as they do this. My book looks at how these researchers grapple with this past by telling stories about what went wrong during the “first wave” of psychedelic therapy—a period stretching from the late 1940s to mid-1970s. And their stories all point the blame at one person: Timothy Leary, the infamous psychedelic researcher-cum-countercultural guru. 

For today’s researchers studying psychedelic therapy, Leary symbolizes what I call an “impure scientist”—a bad expert who does not respect and intentionally defies the boundaries of science. And in defying these boundaries, his presence supposedly had a polluting effect on the legitimacy of psychedelic therapy. So, researchers would tell me how Leary “contaminated” and “poisoned” psychedelic science. To contain that threat and offer an antidote to that poison, they perform as the Anti-Leary—a phrase I heard from several researchers. Another term bounced around was that they are “sober scientists.” So, essentially, the book tells a story about how, in the minds of contemporary psychedelic researchers, the misbehavior of an individual had contaminating effects on their whole scientific field—it boils down to a “one rotten apple spoils the whole barrel” story. 

But these boundaries between impure and sober scientists are porous. That’s the thing about boundaries—they aren’t given; they are constructed. The ways in which we draw lines in the sand between this or that is the result of struggle and those lines are subject to change across time and place. And the way that we see this happening in psychedelic science is this: these researchers push away from the pollution of the impure scientist by enacting the sober scientist persona, but at the same time, they still draw on the practices of the impure scientist. For example, among other things, they criticize Leary for failing to follow conventional scientific methods in his psychedelic research, so they actively work to follow the kind of hypothesis-testing methods that grant scientific credibility. But at the same time, they actively incorporate Leary’s insights about the psychedelic experience into their therapeutic models. Leary is so central to their stories and to the revival because he is the site of the continuities and divergences between the first and current waves of research. And from this discussion, I hope readers learn more about not just the history of psychedelic science but about how the ways in which people construct reality has real effects on their actions.  

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Taming Cannabis in France

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Editor’s Note: Today’s post comes from contributing editor Dr. David A. Guba, Jr., of Bard Early College in Baltimore. His new book, Taming Cannabis: Drugs and Empire in Nineteenth Century France, will be released by McGill-Queen’s University Press next month.

The push to legalize cannabis in France, where the drug is widely consumed but prohibited, is gaining momentum.

The grassroots pro-grass activism of NORML France has, in the past decade, been bolstered by growing popular demand and public calls for cannabis legalization by French entrepreneurs, farmers, physicians, economists, politicians, and even police unions. In June 2019, seventy public figures signed and published an open letter in the popular news magazine L’Obs decrying the nation’s “costly,” “ineffective” and “repressive” prohibitionist policies and calling for the “supervised legalization” in France in the name of public health and violence prevention. 

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Teaching Points: The Urgency of History

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Editor’s Note: Today’s post comes from contributing editor Bob Beach. Beach is a Ph.D. candidate in history at the University of Albany, SUNY. He contributes to our Teaching Points series, which investigates the role of alcohol and drug history in the classroom. 

Things have changed.

In February, I wrote what now seems like a rather whimsical preview of my newly fine-tuned version of a Drugs in American History course at Utica College in the Spring of 2020. About two weeks into that ill-fated semester, I highlighted the “enrollment crisis” in history programs, perhaps the central issue among academic historians in the last decade, and how the History Department at Utica College was attempting to retool its history major to appeal to students’ interest in their world. I then discussed the results of my course survey, which brought out the various issues in drug history that interested my students and that I was going to center the course on.

At the time, based on the interactions at the start of the term, I was very optimistic. My optimism rose as we explored David Courtwright’s Forces of Habit as the course’s foundational/theoretical framework over the first seven weeks of class. As the Covid-19 crisis rose to engulf us here in New York State, the class was about to make the transition from theory to research. Students had chosen a “drug category” and were preparing to use basic research tools, also introduced during the first half of the course, to create a 5 minute research presentation (and accompanying 5-7 page research paper) exploring one of the major themes from Courtwright’s book within their chosen category.[1]

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“What if the CIA did Woke?”: Reviewing Netflix’s “The Business of Drugs”

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Editor’s Note: Today’s post comes from contributing editor Brooks Hudson, a PhD student in history at Southern Illinois University. He reviews the new Netflix series “The Business of Drugs.”

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Netflix’s new series The Business of Drugs investigates six psychoactive substances—cocaine, synthetics, heroin, cannabis, methamphetamine, and opioids—tracing them to global hot spots—from the remote villages of Colombia, to the ailing slums on Kenya’s periphery, to Myanmar’s contested regions, where ethnic strife is fueled by the factory-level output of methamphetamine (or “yaba”). Other installments are less global, and narrowly tailored for American consumers, catering to hot-button domestic issues: the causes and consequences of the opioid epidemic, MDMA’s potential as a breakthrough therapeutic, and the overregulation of California’s legal cannabis markets. 

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Cocaine and Canada in the Early 1970s

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Editor’s Note: Today’s post comes from contributing editor Dr. Stefano Tijerina, a lecturer in management and Chris Kobrack Research Fellow in Canadian Business History at the University’s of Maine’s Business School.

Canadians have been consuming cocaine since the early twentieth century.  They have traditionally been part of the larger western thirst for the stimulant that resulted in a transnational global industry that was initially controlled by European mafias.  Nevertheless, prior to the 1970s, Canadian media repeatedly published articles that highlighted the drug addiction crisis as an American and European problem, not a Canadian problem.[1]  While Canadians consumed cocaine that entered their borders via Europe and the United States, media distracted its readership with the “other’s problem.”  In 1970, for example, the Medicine Hat News reported that New York City authorities had confiscated US$9 million worth of heroin and cocaine.[2]  The arrest included an Argentinean, a Cuban, and two American men linked to a trafficking ring from Vichy, France.[3]  The drugs had been shipped from Marseilles and into the United States via Corsica.[4]  Cocaine trafficking was yet to be constructed as a Latin American problem.

This quickly changed in the 1970s, even though American urban centers along the 49th parallel became the core of the distribution networks for Canadian consumers.  In 1972, for example, Canadian authorities reported that there had been a “sudden jump in cocaine use, with large amounts being imported via Toronto, Montreal, and Vancouver directly from South America.”[5]  The advancement of this idea paralleled increasing reports of cocaine related arrests at the borderland, but even these reports gave minimum relevance to the U.S.-Canada dynamic, arguing that these petty crimes were “just side roads to the mainstream of drug trafficking.”[6]

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Unidad, Servicio y Recuperación: Twelve-Step Recovery in Civil War Guatemala, Part II

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Editor’s Note: Today we finish our two-part series from Dr. Heather Vrana on the history of Alcoholics Anonymous in Latin America. Check out the first part here. You can find out more about Dr. Vrana and her work here. 

Treatments tell us about more than scientific understandings of ailments. They also reveal cultural and social beliefs. Injections of strychnine and insulin characterized treatment for alcoholism, addiction, and their related manias for about six decades from the late 1800s into the mid-20th century in Latin America. Incarcerated in a logic of addiction as disease, treatment was individual and invasive. Then, the twelve-step method—the 1960 Prensa Libre article called it the “gregarious exercise”—took over. Suddenly alcoholics and addicts could help one another without the risks and costs of hospitalization. While the civil war raged outside the doors, recovering alcoholics and addicts recited the Oración de la Serenidad.

One of the most intriguing, yet largely ignored, legacies of the civil war in Guatemala is the proliferation of twelve-step recovery groups like Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and Neurotics Anonymous (N/A) in every department, city, pueblo, and aldea. The previous blog post discussed the arrival of AA to Guatemala. This post addresses NA and N/A and how their proliferation fit within the nation’s complex and violent civil war. 

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Unidad, Servicio y Recuperación: Twelve-Step Recovery in Civil War Guatemala, Part I

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Editor’s Note: Today’s post comes from Dr. Heather Vrana. Vrana (Ph.D. Indiana University, 2013) is Associate Professor of Modern Latin America in the Department of History at the University of Florida. Vrana’s research interests include disability, social movements, human rights, photography, and youth and student movements in Central America. She is author of the monograph This City Belongs to You: A History of Student Activism in Guatemala (University of California Press, 2017) and the anthology Anti-colonial Texts from Central American Student Movements 1929-1983 (Edinburgh University Press, 2017). She is co-editor with Julie Gibbings of Out of the Shadow: Revisiting the Revolution from Post-Peace Guatemala (University of Texas Press, 2020). Her articles have appeared in the Journal of Genocide Research, the Radical History Review, and elsewhere. Vrana has conducted archival and oral history research in Central America since 2007, focusing first on Guatemala, then on Nicaragua and El Salvador.

Today’s post is the first of a two-part series on AA in Latin America; the second part will run on Thursday. 

Alcoholics Anonymous (AA) and its sister fellowship Narcotics Anonymous (NA) arrived in Central America during the region’s nearly four-decade crucible of civil war. Incredibly, at a time when gathering in private was suspicious, if not explicitly forbidden (by countless states of emergency, curfews, and skirmishes), anonymous alcoholics and addicts met in homes and rented rooms most nights of the week. In their move to Central America, very little changed in the texts and practices of the fellowships. The literature and spoken rituals (like the Serenity Prayer, or Oración de la Serenidad) of group meetings were direct translations from the English-language texts. But the mid-1990s saw the emergence of a new and distinct twelve-step program, Neurotics Anonymous (N/A). 

The civil wars have largely been the purview of social movement history. At the same time, social movement history and alcohol and drug history are essentially separate subfields. But together they suggest why twelve-step recovery was so popular in Central America and, in turn, how some Central Americans responded to the trauma, political violence, and religious tensions of the wars and their aftermath. Histories of alcohol and drugs have turned decisively toward transnational and global approaches, a turn the upcoming bi-annual conference of the Alcohol and Drugs History Society aptly reflects. This research proposes that the same approaches might be usefully brought to bear on transnational and global exchanges of recovery.

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Dr. Heather Vrana

In this and a follow-up blog post, I summarize the history of three central twelve-step recovery groups in Guatemala: Alcoholics Anonymous, Narcotics Anonymous, and Neurotics Anonymous. Like Stanley Brandes, whose wonderful Staying Sober in Mexico City offers a rare ethnography of AA outside of the U.S., I am curious about the reasons for AA’s impressive expansion in Latin America. But where Brandes emphasizes AA’s adaptability, I find orthodoxy. Through that orthodoxy, twelve-step programs provided an apparently apolitical outlet for affects, thoughts, and outlooks that were outcomes of political turmoil before and during the civil war (1960-1996). I also suggest that meeting spaces and fellowship practices provided a space for community that was largely unfettered by surveillance and political repression at a time when that was hard to come by. 

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