Tracing the international and Australian history of both licit and illicit drug use, this investigation combines the topic of drug use with analyses of political power, the rise of the market, and social issues. It examines the way in which drug consumption is regulated in the era of global free trade by first looking at the start of the opium-growing industry and the racist origins of drug laws. Providing a social history of drug use through the lens of international politics, market forces, medicine, and race, this discussion also considers the paradox of contemporary, white Australian identity and an Australia as a nation of people whose per capita drug consumption often equals and surpasses that of most other nations.
Tracing the international and Australian history of both licit and illicit drug use, this investigation combines the topic of drug use with analyses of political power, the rise of the market, and social issues. It examines the way in which drug consumption is regulated in the era of global free trade by first looking at the start of the opium-growing industry and the racist origins of drug laws. Providing a social history of drug use through the lens of international politics, market forces, medicine, and race, this discussion also considers the paradox of contemporary, white Australian identity and an Australia as a nation of people whose per capita drug consumption often equals and surpasses that of most other nations.
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Tracing the international and Australian history of both licit and illicit drug use, this investigation combines the topic of drug use with analyses of political power, the rise of the market, and social issues. It examines the way in which drug consumption is regulated in the era of global free trade by first looking at the start of the opium-growing industry and the racist origins of drug laws. Providing a social history of drug use through the lens of international politics, market forces, medicine, and race, this discussion also considers the paradox of contemporary, white Australian identity and an Australia as a nation of people whose per capita drug consumption often equals and surpasses that of most other nations.
Product Details
| ISBN-13: | 9781921696732 |
|---|---|
| Publisher: | Fremantle Press |
| Publication date: | 05/14/2010 |
| Sold by: | Barnes & Noble |
| Format: | eBook |
| Pages: | 400 |
| File size: | 3 MB |
About the Author
Read an Excerpt
Consuming Pleasure
Australia and the International Drug Business
By John Rainford
Fremantle Press
Copyright © 2009 John RainfordAll rights reserved.
ISBN: 978-1-921696-73-2
CHAPTER 1
Doctors, quacks and self-healers: Drug use and the medical profession
In 1925 the International Opium Conference convened in Geneva by the League of Nations introduced the first effective global controls on drugs. The controlled substances were opium, morphine, heroin, cocaine and cannabis (described at the time as Indian hemp).
When the League of Nations became the United Nations following World War II, it extended its reach beyond the 36 nations that had attended the Geneva conference — most notably, it now includes the United States. In the second half of the 20th century controls became more stringent and the controlled drugs more numerous.
The most striking outcome of the prohibitionist policies adopted at Geneva was an environment that allowed the growth of an illicit industry that was to become one of the most profitable the world has ever known. Along the way, prohibition put hundreds of millions of consumers on the wrong side of the law, incarcerated millions of them, created a new class of 'narco-rich' and corrupted law enforcement agencies, judicial officers, banking institutions and politicians at all levels of government. What were the circumstances that compelled a policy approach that has had such disastrous, and surely unintended, consequences? What exactly was 'the drug problem' in 1925?
The Opium Conference
On an international level, the most pressing problem was addiction arising from opium smoking. This had been a concern in China for the better part of 200 years. Chinese emigrants had taken their opium habit with them, so that its use was now common not only in expatriate Chinese communities but also in the various communities where they had settled, most notably in Southeast Asia.
Among the more economically advanced Western economies, the widespread use, from the mid-19th century onwards, of what were commonly called patent medicines that contained preparations of opium, cannabis and cocaine, was seen by some of the delegates to be a problem. But as early as 1916, almost all of these proprietary medicines sold in the United States (the nation pressing most strongly for international controls) were already free of narcotics as a result of legislation. Similar initiatives in Australia meant that the worst excesses of the industry had been curbed even earlier (by 1910). In Britain the removal of morphine and opium from proprietary medicines had been evident from 1903: in the late 19th century there was a movement to restrict some of the more dangerous patent medicines, largely as a result of Chlorodyne poisoning cases. A Privy Council Committee investigated the composition of patent medicines in 1903 and reported that some, but not all, of the manufacturers had dropped morphine and opium from their preparations. The British Medical Association's investigations in 1909 and 1912 confirmed the trend.
To the extent that cocaine and heroin use was a large-scale problem anywhere, it was a problem in the United States, but by 1925 recreational use had already been prohibited for more than a decade. Gone were the days when you could readily avail yourself of the 15 different forms of cocaine (which came with a cocaine kit complete with hypodermic syringe) marketed by the Parke-Davis company. Laudanum at 10 cents a bottle, coca wine at 95 cents and as much opium as you like could no longer be conveniently bought by mail order from Sears, Roebuck and Company in Chicago. Even possession of their nickel-plated syringes 'in a neat morocco case' was prohibited in several American states by the early 1930s.
And despite the availability of 'Cigares de Joy' (cannabis cigarettes), the bulk of cannabis consumption occurred in those parts of the globe, such as India, where its use had been common for thousands of years. It would be several decades after the controls established at Geneva before the drug came into widespread popular use in other countries.
* * *
Opium smoking in Far Eastern countries, the revenue from which sustained much state expenditure in those countries, had been dealt with during the first stage of the Opium Conference, which began in November 1924: the supply of opium by private contractors was to be replaced by government monopoly and consumption was to be regulated by the registration of licensed smokers.
The 1925 conference was the second stage, and covered manufactured drugs, primarily heroin and cocaine. After long and sometimes acrimonious debate, the conference determined that participating countries would control the manufacture, sale and transport of designated drugs so as to ensure their 'legitimate' use.
The United States, which had refused to join the League of Nations but had attended the conference and earlier advisory committee meetings in an observer capacity, walked out in early February after failing to get agreement on heroin prohibition, stricter controls on coca production and a phasing-out of opium use for non-medical purposes.
US prohibition initiatives
The Geneva Conference followed the International Opium Commission (Shanghai, 1909) and the International Conference on Opium (The Hague, 1911-12). Both were convened at the instigation of the United States — the one country outside China that readily identified a 'drug problem'. (There was, however, a belief in the British Foreign Office that the US motives in convening the Shanghai commission owed something to gaining trade advantages with China.)
Fifty years before the Geneva Conference, in San Francisco in 1875, local authorities passed the first anti-drug laws in the United States. They were aimed at opium smokers, who were mainly, but not exclusively, Chinese. The federal Smoking Opium Exclusion Act 1909, which prohibited opium from being imported or used in the United States except for medical purposes, was preceded by drug prohibition laws — which criminalised opium use by imposing fines and prison sentences on individuals who operated or used opium shops — enacted in 11 state jurisdictions between 1877 and 1890. Similarly, the Harrison Narcotic Act 1914 prohibiting the recreational use of morphine, heroin and cocaine was preceded by laws passed in 46 states regulating cocaine use from as early as 1897.
Cannabis in the United States was commonly called marijuana, reflecting its popularity among Mexicans who migrated there in the early decades of the 20th century. As their marijuana consumption became conspicuous and was taken up by nonn-Mexicans, individual states legislated against its use for non-medical purposes, beginning with California and Utah in 1915. Federal regulation came somewhat later, in the form of the Marijuana Tax Act 1937.
So the United States, by the time of the Geneva Conference, had a comprehensive set of legislative controls prohibiting all of the drugs under consideration at the conference. As well as opiates, cocaine and cannabis, the United States also had a prohibition on alcohol, established via a constitutional amendment, that took effect from 1920.
Attempting to contain international drug supply in the face of a measurably rising domestic demand (most notably in the United States) seemed doomed to failure, and the truth of this was recognised in 1933 when the prohibition on alcohol was lifted. At the time of the Geneva Conference there were some 200,000 heroin addicts in the United States, whose supply, as with alcohol, came from an illicit market. But the lesson learned from prohibition was limited to alcohol; there was no attempt to understand the dynamics of demand for other drugs.
The controls implemented at Geneva in 1925 and at the subsequent 1931 Limitation Convention did limit the production of heroin and opium. But the most significant interruption to production, supply and consumption was World War II. After the war, illicit drug consumption continued to rise, even as prohibitionist legislation increasingly dominated the statute books of nations around the world.
Doctors and drugs
The international controls reflected in national legislation didn't prohibit the nominated drugs per se; rather they provided that their use by individuals be mediated by doctors. Typically, specific drugs were banned except for 'medical or scientific purposes'. The medical gaze now had to be accompanied by a medical scribble. In the United States heroin was at first the only exception: it was prohibited even for medical purposes in 1924.
When doctors in England began to restrict their prescription of opium they 'became the custodians of a problem which they had helped to define'. With the restrictions on the use of opiates and cocaine that came from national and international controls in the 20th century, doctors became a part of the proposed solution to a problem that was largely of their making.
From the latter part of the 19th century and into the 20th century, there was a clear gender divide with opiate addiction. Although addiction in Australia and the United Kingdom was almost insignificant compared to that in the United States, the pattern was the same. Morphine was the main drug of addiction, doctors were often the suppliers, and women represented the vast majority of those addicted. The morphine addiction described by Eugene O'Neill in his play Long Day's Journey into Night was based on the experience of his own mother, and was the story of many American women. According to a number of surveys, women represented between two-thirds and three-quarters of the total number of those addicted to opiates. Of the 250,000 opiate addicts that US public health officials estimated in 1900, the great majority were 'genteel, middle-class women'. Between self-medication and doctors' prescriptions, opiates had become both a sign of women's oppression and their attempt to gain relief from it. At the same time, a majority of male addicts were doctors, with some estimates suggesting that as many as 20 per cent of the profession were 'opium inebriates'.
Around the end of the first decade of the 20th century, the over-prescribing of morphine was widely recognised (including by doctors themselves) as the main cause of addiction, and there was a corresponding fall in the rate of prescriptions. But it wasn't just morphine that doctors too frequently prescribed. Cocaine use was similarly popularised, and although the percentage of medically addicted heroin addicts wasn't large, its use too, and the problem of addiction, came, initially at least, by way of the medical profession.
From around 1910 in the United States, heroin started to become more popular than morphine with recreational consumers. New York became the heroin capital, although morphine was still the mainstay of addicts elsewhere. Among the 10,000 addicts in the United States in various institutions such as hospitals and sanatoria in the 1916-18 period, the overall majority were still morphine addicts. However, in institutions such as reformatories and prisons, heroin addicts were more numerous. These addicts were increasingly young, male and 'deviant' (a deviant was merely a member of a disliked group which at the time included poor Catholic immigrants, Chinese labourers, big-city delinquents and African-American men). The medical profession now classified the older, morphine-addicted women as 'accidental addicts' (able to be treated to the benefit of patient and doctor alike), and the young male deviants as 'vicious addicts' who were beyond help.
Following the enactment of the Harrison Narcotic Act 1914, recreational opiate and cocaine users could either abstain or seek their drugs on the illicit market. Addicts, however, could expect from their doctors a maintenance regime accompanied, where appropriate, by a program designed to bring their dependence to an end. In some cities, public health clinics catered specifically for addicts. But in 1919 the US Supreme Court determined that the maintenance of addicts violated the Harrison Act. The public clinics were closed down and any doctor prescribing to addicts was liable to prosecution and a possible prison sentence. This attack by the Supreme Court might have been expected to provoke a response from the doctors' professional body, the American Medical Association, commensurate with the threat that it represented to independent judgement and practice. In fact, the opposite occurred. The American Medical Association supported the Supreme Court's decision by policy resolutions adopted in both 1919 and 1924. Still, many doctors
continued to prescribe to addicts: figures show that in the 16 years following the Supreme Court decision, more than 25,000 doctors were indicted under the Harrison Act and 2500 were sentenced to prison.
* * *
In Australia the recreational use of opiates didn't surface as a problem until the 1960s. But in many other ways our experience was similar to that in the United States. From the early 20th century, the typical Australian drug addict was a middle-aged, middle-class woman initially prescribed morphine or heroin by her doctor for some painful or chronic condition. And as in the United States, more than one-third of known addicts were doctors, nurses or other health professionals.
Australia had an 'unofficial' policy of maintaining addicts under medical supervision. Various state regulations prohibited the supply or prescription of opiates to addicts, but in practice, Australia followed the British system, based on the Rolleston Report of 1926, which established the principle that it was solely a matter for doctors to determine the appropriate treatment for their addict patients. Supplying them with heroin or morphine therefore reflected a considered and respected medical judgement.
Britain's addict population was similar in profile to Australia's. The known number of addicts was comparatively low; they were more likely to be female than male; a considerable number had become therapeutically addicted; and a disproportionately large number were doctors themselves. In 1938 there were just over 500 addicts, the majority of them women. Of the 383 known addicts in 1947, 219 were female and 82 were doctors.
The problem of patients becoming addicted to prescription drugs that was evident before the Geneva Conference didn't go away as a result of any of the deliberations of the conference. Nor, for that matter, did the self-administered heroin addiction that was equally apparent in the United States at the time—drug consumption continued to increase. While the interruption of war led to a decrease in the non-medical consumption of opiates, it also led to many combatants consuming large quantities of amphetamines, drugs that were judged by the medical profession to be well suited for military purposes.
To see why the state vested the medical profession with the authority to mediate drug consumption, we need to look at the history of healthcare, and in particular at the role that the profession came to play in it.
The rise of the medical profession
That any sane nation, having observed that you could provide for the supply of bread by giving bakers a pecuniary interest in baking for you, should go on to give a surgeon a pecuniary interest in cutting off your leg, is enough to make one despair of political humanity.
George Bernard Shaw
On French philosopher Michel Foucault's account, 'modern medicine has fixed its own date of birth as being in the last years of the 18th century'. This view from the heights of postmodernism notwithstanding, it was still possible, in the early decades of the 19th century, to set up in practice as a doctor in Britain (and in colonies such as Australia) by the simple expedient of purchasing, at the cost of less than £2, a medical degree granting its recipient, according to one contemporary complainant, 'a patent to slay thousands according to the law'.
The American Medical Association's Council on Pharmacy and Chemistry would report early in the 20th century that the conditions of medical practice at the time when the first controls on opium were introduced in San Francisco, in 1875, were essentially the same as when Thomas Sydenham developed laudanum in the 1660s. Medical practice as we know it today is indeed of quite recent origin.
When human activity began to change from hunter-gathering to settled agriculture and animal husbandry some 10,000 years ago, it brought with it the capacity to end starvation. Surplus food production led to population growth, permanent dwellings and the development of social hierarchies. It also brought disease, much of it a result of our close relationship with animals. The disease-producing bacteria of cattle gave us tuberculosis and smallpox; pigs and ducks gave us influenza; horses, the common cold; and measles came to us from either cattle or dogs. Drinking water contaminated by animal faeces spread polio, cholera, typhoid, whooping cough and diphtheria. The productive agricultural environment attracted parasites, disease-carrying rodents and insects, such as mosquitoes that brought malaria. With varying degrees of success, we have battled with these, and other more recent diseases, ever since.
(Continues...)
Excerpted from Consuming Pleasure by John Rainford. Copyright © 2009 John Rainford. Excerpted by permission of Fremantle Press.
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Table of Contents
Contents
Cover,Title Page,
Copyright,
Sighs of the oppressed,
Doctors, quacks and self-healers: Drug use and the medical profession,
Pills, potions and pharmaceuticals,
The food drugs, tobacco and alcohol,
Stimulants for work and pleasure: Cocaine and amphetamines,
Hallucinogenic dreaming: Cannabis, LSD and ecstasy,
Opium and the masses,
Drug laws and changes in supply,
The Cold War and the CIA,
Australia's heroin market,
The triumph of the market?,
The defeat of communism and the revenge of religion,
Endnotes,
Bibliography,