All posts by DeJuan Charles

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Blog topics: Courtwright’s addicts who survived: Hooked and Caroline Acker’s: How Crack found a niche in the American Ghetto.

In her article, Acker delves deep into the social mechanism through which a person tries and subsequently becomes addicted to a drug and asserts that drug addiction epidemics are not solely dependent on the anatomy of the drug but on “the social context of the drug” (Acker 6). She does this by examining three different time points and their respective epidemics. First, she examines morphine use in the late 19th century, then cocaine in the 70s and subsequently crack cocaine use in the 80s.

In the late 19th century, the use of morphine and other opiate derived products were widely normalized among the population. So much so that they were fully legal often overprescribed by physicians for the simplest of ailments. This combined with the invention of the hypodermic syringe which “offered a powerful new route of administration produced a population heavily reliant upon these drugs (Acker 8). Later on, she highlights a different social mechanism for the increase in cocaine use during the 70s citing that it was primarily because of the image and status associated with the drug. This was because the general public saw it as very “chic” because it associated with highly idolized people in society such as “rock stars and stockbrokers”(Acker 9). Onto her main illustration of how crack penetrated and anchored itself “in poor inner-city neighborhoods where illicit markets compete successfully against constrained opportunities in the legitimate workforce.

Crack cocaine existed within a specific niche of society, it was mainly used by the  lower working class in the inner city. This was primarily due to the fact that “crack was a market innovation” in the sense that it was “watered down” cocaine at a much lower price point which made it very affordable for less affluent neighborhoods (Acker 10). Cocaine was the opposite as it was primarily found “in the veins of affluent purchasers” from much more affluent neighborhoods (Acker 10). The price was not the sole reason for many people to start using. The atmosphere of inner-city was described as having “disproportionate rates of crime and disease” and overall lack of legitimate economy due to a decline in industrialization post World War II making the “decline in employment levels in the region” shockingly apparent. Consequently, this caused people to participate in the crack scene for a variety of reasons. 

Some theorize that it is because we have an innate “desire to alter consciousness” but Ackers states that it’s because people were “search for excitement or a more passive process of seeking identity and belonging” in a time where their surroundings were unforgiving as most users reported “abusive childhoods and disorganized families”(Acker 13)

 Courtwright’s journal documenting the etiology of surviving opium addicts was very interesting to read as they were in direct communication with Acker’s article. Courtwright has transcribed the experiences of three different addicts but two of them stuck with me as they seemed more interesting. The first one was about an addict named Ivory who was born to “poor black parents in Port Arthur, Texas, in 1920. His father, “a street guy who did nothing,” left when he was six years old” (3). Subsequently, Ivory was then arrested for stealing when he was just eleven years old, “and was in and out of reformatories and prisons for the rest of his life (Courtwright 3). It was in jail where he first tried heroin stating that it made him sick and caused him to throw up all over the place. After that, he swore he wouldn’t take it anymore until it was offered to him by a friend. During this experience, he still threw up everywhere but it was more enjoyable. The interesting part is that Ivory didn’t become addicted to heroin until he started selling it make ends meet. This is in direct communication with Acker’s article as the lack of employment due to various factors such as crime made it hard for Ivory to find a job that pays well, as a result, he resorted to selling heroin. It didn’t even seem to be something dangerous. Ivory described one of his clients as his “friend who would buy heroin from him and shoot up at his house” (Courtwright 6). This is reminiscent of Acker’s assertion that people use crack, or perhaps any drug, as a “passive process for finding identity and belonging”. This is also apparent in the way Ivory started selling and taking heroin. They were both introduced to him by friends.

The other interesting case was Sam, as he was reminiscent of Americans who acquired their addiction through prescriptions from a “physician, pharmacist, or patent medicine vendor” through the belief that “they were relieving their ailments with a little opium or morphine”. Similar to what was said in Ackers about opium use in the early 19th century.Sam was born to parents who became millionaires, he lived the high-class life which ultimately produced feelings of  “unhappiness and alienation”(Courtwright 10). These feelings manifested physically in the form of “50-minute long migraines” in which he cited the cause for the migraines as a product of stress from “ a woman with whom he was entangled; another was his unhappiness with his wife, and the third was the hatred of his father, and the loathing of the work he was engaged in. He hated his family business” as it did not “represent him or what he is capable of”(Courtwright 10) 

One contradiction I encountered had to do with Acker. She states in her article that “rates of problematic use dropped as people experienced or witnessed negative consequences of use” which was not observed in any of thememoirs from the addict. Especially in the cause of Ivory who had a terrible first time using heroin. He was still easily convinced to try it a second time. Maybe this was due to the social aspect of the way he was coerced into doing the second time because it was suggested by a friend.

Scientific frameworks that explain high rates of addiction in South

Opiate use in the United States was a huge problem around the beginning of the 20th century that spawned many political policies to combat this. The Hidden Epidemic: Opiate Addiction and Cocaine Use in the South by David Courtwright highlights the prevalence of opium addiction among the dominant demographic as well as several reasons for the higher addiction rate in the south. Similarly, Hannah Cooper’s Medical theories of opiate addiction’s etiology and their relationship to addicts’ perceived social position in the United States provide a more scientific explanation for addiction across several different time periods, most importantly 1880-1920, that go in tandem with Courtwright’s practical explanations of addiction in the south.

Cooper sampled 297 physicians’ articles from the U.S National Library of Medicine across two different time periods,1880–1920 and 1955–1975. Her analysis used serval frameworks such as the “social construction of knowledge” which “maintains that all knowledge, including scientific knowledge, is socially produced and thus reflects the contexts, concerns, limitations” of the people living during that period (Cooper 437). Another integral framework used for her analysis was the critical race theory which highlights “the processes through which inequitable racial/ethnic relations are produced, maintained and contested(Cooper 437). This theory also suggests that the dominant racial groups of the society will continue to perpetuate these inequitable relations for their own personal gain. 

Her article begins by making a claim that “drug-related laws and policies in the US have frequently contributed to the establishment and perpetuation of inequitable social relations” (Cooper 436), meaning that these policies are not universal but instead are tailored benefit the dominant demographic which in the 1880-1920 time period, were mainly affluent white people then shifted to poor working-class whites. From 1880-1894 opium users were found in “higher and more cultivated classes” that is, the upper class which included affluent white women, physicians, and literary intellectual males (Cooper 437). The homogeneity of this class of opiate users was seldom seen in a negative light mainly due to the ease and legality (from physicians) in which they obtained these drugs. Opium in this time period wasn’t seen as a highly addictive and harmful drug but rather a necessary and powerful medicine that had the ability to treat the many ailments of this time. Consequently, the prevalence of addiction was seen as a “devastating sequela of a necessary medical treatment”(Cooper 438). As a result, physicians’ records regarding opium addiction during this time utilized the coping and medicinal theory. The coping theory refers to self-medication as a means of reducing stress and in this case, opium use was in response to the emerging stressors and “rigors of living in—and often creating—a modern civilized society” (Cooper 438). The characteristics of these theories, especially the fact that they saw addiction as curable during this time lead me to the conclusion that addiction during wasn’t regarded as a problem with a lot of gravity but rather the side effects of the affluent life.

In the subsequent time period, 1895-1920, there was a shift in the main demographics of opiate users from affluent whites to poor and working-class whites although the upper class still continued to use opiates. During this time period, two new theories were developed to characterize this emerging demographic of addicts. First, there was the “innate degeneracy theory” which posited an innate disposition for addiction and was a non-curable form of addiction that was inherited from the parents. The vice theory then stated that people used opiates for personal reasons which subsequently made this form of addiction curable. Going by classes, the middle or working class that consisted of poor whites were often diagnosed using either the innate degeneracy or the vice theory as they were seen as “congenitally inferior and [had] a biological tendency to degeneracy that predated their addiction” (Cooper 439). Due to this perception and social class, their addiction was seen as a part of them, it was something they depended to complete daily tasks rather than something to cope with daily life, which in the eyes of the upper class made them incapable of contributing to society. Contrastingly, affluent white addicts were rarely diagnosed using these theories but mainly through medicinal and coping theories which in turn validated their addiction in the sense that society and its demands are at its roots.

 Courtwright’s article provides more practical examples and theories for the higher rate of addiction in the south mainly through the use of clinic records, pharmacy reports, and state records. He posits that the south’s higher rate of addiction was due to widespread diseases such as “diarrhea, dysentery, and malaria” which was easily treated by opium, therefore, it was prescribed at a higher rate by physicians in the south. This falls in line with the medicinal theory used in Cooper’s article as the origins of addiction for some came from the physicians the sought out for help. These high rates of opium use were hidden by “exaggerated fears of black cocaine rampages” that was used by Hamilton Wright to secure support for his anti-narcotic legislation.

Before the Civil War, the socioeconomic status of most southern whites was drastically different than after. The south suffered a lot more casualties than the north which created a shift in the socioeconomic status of the users that resulted in affluent white men and women being “impoverished by the rebellion” and having to resort to “eating and drinking opium to drown their sorrows” (Courtwright 66). This provides a practical example of the coping theory presented in Cooper’s paper and in this case opium was used to drown out the depression associated with the south’s defeat in the Civil War as well as sooth many of the physical injuries. Another interesting overlap between these two readings came from the Harrison’s Act of 1914 which was a law that regulated the distribution of opium and coca products through taxation but failed to help actual addicted patients, as a result, they resorted to the illicit market for cheaper opium. 

These two articles have a lot of overlap in the sense that Courtwright’s account of southern opiate use is explained, more scientifically by Cooper’s framework of analysis. For example, Courtwright states that one way people become addicted was by originally being introduced to the opiates by their doctors which is just an example of how the medicinal theory of addiction works. Although Courtwright’s article used statistics that were underestimated due to the fact that most addicts generally wanted to remain anonymous, they do display an overall trend worth exploring. Together these articles provide vivid examples and illustrate the path to addiction