In my previous post, in this series centered around “Pharmaceutical inequalities”, I wrote about my experience working at an ibogaine clinic in Mexico. I shared that the seven-day program I developed there integrated individual counseling, group therapy, psychoeducation modules, relapse prevention education, art therapy practices, self-compassion journaling exercises, goal planning for after-care , and a 5-MeO-DMT therapy session; and that a future post would address the emerging use of 5-MeO-DMT as a mental health tool. In this second post, I am setting out to do just that.
Drug treatment
Psychedelics in the treatment of substance use disorders: the case of ibogaine for the treatment of opioid dependence.
Editor’s Note: This post by Anny Ortiz is the first in our Pharmaceutical Inequalities series. She explores the existing research landscape of psychedelics and then draws upon her own lived experience of working in a treatment center that offered ibogaine-assisted detoxification to discuss the affordances and unanswered questions of using psychedelics in treatment. The Pharmaceutical Inequalities series is funded by the Holtz Center and the Evjue Foundation.
Addictions, Media, and Power: Jay Richard Kennedy and Mind Control
Editor’s Note: Today’s guest post comes from Jocelyn Szczepaniak-Gillece, an associate professor of English and Film Studies at the University of Wisconsin–Milwaukee. She is the author of The Optical Vacuum: Spectatorship and Modernized American Theater Architecture (Oxford University Press, 2018) and the co-editor of Ends of Cinema (University of Minnesota Press, 2020).
In my earlier post, I told the story of To the Ends of the Earth, a docufiction hybrid about drug smuggling made with the assistance of Harry Anslinger. That movie’s production history includes Columbia Pictures and director Robert Stevenson, but the real engine behind the film was Jay Richard Kennedy, the credited Associate Producer. Born Samuel Solomonick, Kennedy was one of the twentieth century’s strangest and least-known charlatans. His bizarre career encompassed all manner of cultural phenomena: Hollywood, psychotherapy, drug and alcohol addictions, the Age of Aquarius, and, eventually, self-help cults. Like most self-aggrandizing fabricators, he kept focus on a single goal: the best way to manipulate American minds.
After his collaboration with Anslinger, Kennedy realized that mind control was not only possible with drugs and media. Another option was the talking cure. Kennedy’s wife, Dr. Janet Alterman Kennedy, was licensed in psychotherapy, and, like many therapists of her moment, Dr. Kennedy used psychodynamics, in which the interactions of the mind’s deepest energies were supposed to shape both the patient’s consciousness and reactions to other people. Kennedy found this irresistible. In 1949, a year after the release of To the Ends of the Earth, Kennedy wrote an article for the The Screenwriter arguing that the twentieth century’s two most important developments in constructive science and art were psychodynamics and film. Both, he wrote, served the “maximum function of revealing man to himself” [1].
These sentiments aptly summarized the later thrust of his life: that media and psychology were two sides of an instrument that ultimately promised control over others. As he had learned from Anslinger, mass media—like narcotics—were useful for tightening a grip on power. But without strict standards for both drugs and media, he believed, everyday Americans would become addicts and normal spectators would be transformed into madmen. Healing American society required specific approaches to addiction, governance, and media, and Kennedy knew the cure.
Hidden Addicts: The Elderly and the Opioid Epidemic
Editor’s Note: Today’s post comes from contributing editor Michael Brownrigg. Michael recently received his PhD in US history from Northwestern University, where he studied the relationship between emotion, white masculinity, and capitalism to explain the emergence of an antinarcotic consensus in America at the turn of the twentieth century.
“The face of the nation’s opioid epidemic increasingly is gray and wrinkled,” wrote The Washington Post in 2018, “but that face often is overlooked in a crisis that frequently focuses on the young.” Since the early 2000s, medical experts have grown alarmed by the precipitous rise in opioid-related hospitalizations and deaths among the elderly and deeply concerned that the burgeoning crisis among the geriatric population was going unnoticed.
They pointed to several factors to explain the phenomenon but primarily blamed polypharmacy—the practice of prescribing patients multiple, often dozens of, medications—for the dramatic increase in addiction rates. “An increasing number of elderly patients nationwide are on multiple medications to treat chronic diseases,” one specialist claimed, “raising their chances of dangerous drug interactions and serious side effects. Often the drugs are prescribed by different specialists who don’t communicate with each other.” Older Americans are essentially being pharmaceuticalized, medicated to death, or, at the very least, subjected to extreme distress.
Narrative Medicine
Overprescribing, as the Washington Post article noted, often results from a fractured medical community that impedes the type of collaboration and communication between practitioners necessary for providing integrated regimens tailored for specific patients. Instead of individualized care, elderly patients often receive standardized treatments, that emphasize the use of pharmaceuticals to alleviate chronic pain.
To better serve their patients, physicians need to listen more intently and more empathetically to fully understand the causes of their distress. In other words, they need to practice what Dr. Rita Charon, Professor of Medicine at Columbia University’s Irving Medical Center, has called “narrative medicine.”
By asking pointed questions about both mental and physical health, practitioners can prompt patients to explain their suffering and to situate their pain in narratives and stories that help foster more thoughtful patient-doctor relationships and, consequently, provide intimate and targeted care. Charon writes that:
Reflections on “American Rehab”
Editor’s Note: Today’s post comes from contributing editor Jordan Mylet, a doctoral candidate in history at the University of California, San Diego. She is working on a dissertation titled, “‘Dope Hope’: The Synanon Foundation, Grassroots Recovery Activism, and the Postwar Struggle over Addiction Rehabilitation, 1945-1980.”
When my grandfather moved into Synanon in Santa Monica in 1968, the organization had already inspired a Hollywood film, a jazz LP, numerous bomb threats and eviction notices, and kudos from the Kennedy administration. In the decade after his arrival, Synanon founded a multi-million-dollar enterprise, registered as a religion, and made headlines for placing a live rattlesnake in the mailbox of a rival attorney, who nearly died from its bite. By 1978—the year of the Jonestown massacre and the first federal charges brought against Church of Scientology leaders—Synanon had cemented its place in the ranks of America’s numerous bizarre and violent cults.
Now, when my grandfather sat on a bench in Synanon’s Santa Monica clubhouse lobby, he didn’t know any of this. A few days earlier, his father had found him sitting in a street gutter in the Bronx, nodding off from recent heroin use. He asked his son if he would get on a plane to go to Synanon in California—the best place, everyone in their neighborhood said, for a heroin addict to get clean. So, my grandfather went. Before landing in Los Angeles, he shot up in the airplane bathroom with some supplies that he had smuggled onboard. After six years of heroin addiction, this would be the last time he ever used. He stayed in Synanon, along with his wife—my grandmother—and hundreds of others until its dissolution in 1990.
Public Relations Language Disguises How Drug Discourse Today Is More Successful – and More Sinister – Than Anything Harry Anslinger Could Concoct In His Wildest Dreams
Editor’s Note: Today’s post comes from contributing editor Brooks Hudson, a PhD student in history at Southern Illinois University.
If you’ve followed the opioid issue, you might suspect, based on media reports and statements from policymakers, that we have turned over a new leaf in our attitudes toward drugs and are finally moving in the right direction: today we are “expanding treatment” and abandoning the former “punitive” morality play model. Elite discourse reinforces the perception that we have become more sophisticated, science-based and compassionate to users and those with substance use disorders.
That’s only partially true, but not because powerful institutional actors experienced a change of heart; they had to be dragged kicking and screaming into embracing, if only rhetorically, this new model. If anything, grassroots activists, harm reductionists, health workers and criminal justice advocates on the front lines have waged tireless, and at times seemingly thankless, campaigns to reform our draconian laws, and they have succeeded. (Prime examples of these successes include legalizing cannabis, decriminalizing psilocybin in Denver, and expunging criminal records for marijuana arrests in some states.) Activists also shifted the conversation away from the dehumanizing language used to describe people who use drugs among press and policymakers (“junkie,” “addict,” etc), a language that enabled us to conceive of other people as less than human, making it easy on our collective conscience to confine them to cages. Even now, further incremental baby steps are met with the same hostilities and recitations of the parade of horribles that would be unleashed as they used before.
Chipping Away: Opioids, Autowork, and the UAW Yesterday and Today
Editor’s Note: Today’s post comes from one of our newest contributing editors, Dr. Jeremy Milloy. Milloy is the W. P. Bell Postdoctoral Fellow at Mount Allison University. A scholar of work, capitalism, addiction/substance use disorder, and violence, he began studying substance use and the workplace while researching his first book, Blood, Sweat, and Fear: Violence at Work in the North American Auto Industry, 1960-80, published in 2017 by the University of Illinois Press. His current book project investigates the historical relationship between work, capitalism, substance use, and recovery in Canada and the United States, considering how wage labor has influenced substance use, anti-addiction efforts focused on work, the creation of employee assistance programs, workaholism, drug testing, and methadone programs. You can reach Jeremy on Twitter (@jeremymilloy) or by email (jmilloy@mta.ca). And you can look forward to reading more of his work on Points!
Among the historian’s most valuable contributions is the knowledge that many current phenomena that seem new have actually been around for quite awhile. So it is with the current opioid crisis, which many have pointed out is a continuation of, not a departure from, longstanding trends in substance use and dependence in North American life.
The automotive industry is a good example. Today, both the major North American automakers and the UAW have identified opioid-related harms as a significant threat to their workforce, membership, and communities. As journalist Jackie Charniga has shown, the U.S. areas dealing with the most severe opioid-related harms overlap with the areas of the Big Three’s major American manufacturing facilities. Ford and the UAW in 2017 started the Campaign of Hope, which aims to educate and inspire workers to avoid the misuse of drugs. The UAW is bargaining with the Big Three to make more help available for workers and make it easier to access that help while keeping their jobs. Unionists and Ford are even working together to pilot a medical device that could possibly relieve some of the agony of withdrawal.
Gender and Critical Drug Studies: The Gendered Origins of Privatized Prison Drug Treatment
Editor’s Note: Today’s post comes from Dr. Jill McCorkel, associate professor of sociology ad criminology at Villanova University in Pennsylvania. In it, she explores the origins of how drug treatment and rehabilitation programs entered private prisons for women. Her full article appears in a special co-produced edition of SHAD and CDP, Special Issue: Gender and Critical Drug Studies. Enjoy!
I was recently in a taxi on my way to a speaking engagement in Dublin, Ireland. When the driver asked me what I’d be discussing, I told him I research prison privatization. “Ahh, yes,” he said, “the corporations run the American prisons and that’s why you have such a problem over there. They want everyone in prison. More prisoners, more profit!”
Although legal scholars would likely challenge his claim on the grounds that comparatively few prisoners in the U.S. are held in private prisons, his comments are not entirely off base. Over the last 30 years, private companies have become increasingly influential players in the American prison system. The source of their ascendancy is not private prisons. Rather, it is in the provision of a vast array of services ranging from cafeteria food to phone cards, medical care to behavioral health programming. Private companies contract with local, state, and federal authorities to provide these services in publicly managed prisons, jails, and community-based correctional facilities. The contracts are a lucrative source of profit and require little in the way of oversight. The duration and scope of privatized correctional services vary, but among the most profitable are contracts that involve the provision of drug treatment programming to prisoners, parolees, and pretrial detentioners. Drug treatment and related rehabilitative services are a multi-billion dollar (USD) a year industry. In my article for the special issue of Contemporary Drug Problems, I explore the origins of privatized, prison-based drug treatment. I argue that during the War on Drugs, women’s prisons were utilized as testing grounds for private companies interested in getting into the expanding business of drug rehab.