Alcoholics and addicts

Whilst excessive drinking and its consequences were concerns since time immemorial, the nineteenth century invented "alcoholism" as a medical condition.[1] As has been noted, alcoholism was prominent amongst the list of the "curses of civilisation", with intemperance regarded as a general social evil that, if not contained or eradicated, might lead to revolt and unruliness by whole subsections of the population (Bynum, 1984; Donnelly, 1983). Morel, and others, drew scientific attention to alcoholism, with his emphasis on the role of external agents, intoxicants, in the degenerative process (Carlson, 1985); it remained unclear however, how much alcoholism was regarded as the product of degeneration or its cause. Intemperance sapped the social body and, associated with the logic of degeneracy, was a particularly powerful emblem of malaise. Addiction, conceived of as excess and illness, with a border on vice, was thus highly susceptible to symbolic embellishment in society (Foxcroft, 2007; Zieger, 2008). Indeed, Barrows (1981) argues that, "seldom has any disease been invested with an emotional resonance as terrifying and well publicised as was alcoholism in the late 19th century" (p. 71). One doctor, commenting on the Paris Commune, even diagnosed the whole event as the result of a "fit of alcoholic pyromania" (Sournia, 1990).

Alcoholism and habitual drunkenness, notwithstanding their actual consequences in society, were powerful metaphors of irrational behaviour. Alcoholism signified not only a loss of control by the individual of his capacities but more worrying, the loosing of controls by and over dangerous classes; violence, like drink, could overflow. Hence it was a small step to see alcoholic spirits (in particular, "hard", distilled spirits, although this was often extended to include all alcohol, especially for the working class) as the tangible source of social evil, exemplar par excellence of noxious, degenerative elements. Linking this to crowd psychology, Barrows (1981) argues, "The picture of alcoholism was terrifying ... and in comparing mobs to drunkards, crowd psychologists again provoked the spectre of race suicide, hereditary insanity and unmitigated violence" (p. 61).

Victorian society was saturated by drug use. Alcohol use was widespread, peaking in the 1870s. Likewise opium use, taken not only by distinguished writers and the wealthy, but by the populace as a whole, in manifold preparations and tinctures. The conditions which lead to conceptualizing substance use as "addiction" rather than as mere "excess", is a complicated historical topic. How was it, for example, that from being regarded as a way of life, albeit a sinful choice or an eccentric penchant, drug and alcohol misuse became a morally dangerous site of disease, christened by the appearance of the "inebriate" and the "addict" as social and personal identities? How did the shift occur, from locating the sources of addiction within intoxicating agents per se, to finding it within the suspect, individual body? And how did this new gaze refigure addiction as loss of control rather than as wayward choice? (Levine, 1978). Emergent medical taxonomies of disorder created new names for new phenomena: "morphinists", "morphinomaniacs" (distinguished from the former by their lack of interest in being cured (Crothers, 1902)), "drug habitués", "narcomaniacs", "cocainism", cocainomaniacs", and so on. It is one of the supreme paradoxes of our historical relationship with drugs, that substances that were once exalted as medicines and cure-alls, such as alcohol (the "good creature of God", in Puritan lore), opium, morphine, and cocaine (the latter trumpeted by Freud during the 1880s), ended up viewed as menaces (Berridge & Edwards, 1981; Jay, 2000). However, whilst the temperance movements and reformists regularly blamed alcohol—"demon drink"—for the nation's insanity, it must be underlined that medical and popular views remained mixed, with many doctors reserving a positive attitude towards alcohol, which was regarded as a potential medicine, restorative, and pain-killer. Opium preparations were rationalised and marketed as "mother's helper", and the like, whilst a growing number of injecting morphine users (many female), were introduced to the drug and procedure by enthusiastic medics. In America, concern over narcotics arose much later in the century, somewhat eclipsing earlier temperance concerns and associated mass publicity concerning heavy and habitual drinking.

Those who have researched the history of addiction as social construct have traced its complex surfacings in discourse—popular, scientific, and administrative—concerning notions of uncontrollable habit, vice, and pathological consumption, and coinciding with the early professionalization of the field (White, 1998; Zeiger, 2008). Newer disease concepts of addiction, as favoured, for example, by physicians writing in the distinguished Journal of Inebriety (1876-1914), challenged simplistic moralistic positions, and were infused with medical optimism concerning cures, remedies, and the potential for the reform of morbid habits through specialised asylums and inebriate homes (Weiner & White, 2007). In public policy associated with inebriates, however, there was a continual mixing of the moral and medical registers, with fears of licentiousness and degeneracy never far away (Berridge & Edwards, 1981).

Zieger (2008), drawing on novels and literary representation of the addict, argues that addiction was "invented" (which is not the same as claiming that it did not exist) and can only be understood within a broad context of the cultural forces of society. In her view, it is not coincidental that addiction, which, after all, is a story of unmaking and self-loss, emerged during the fertile period of bourgeois self-making, with its ethics of improvement and social mobility. Alongside this were other social changes, including the growth in consumerism, reform movements, imperial expansion, and a widening public sphere. "Addiction", she writes, "with its incoherent subjects, chronic repetitions . presents its own distinct blur in the side of rational Enlightenment modernity and progress" (Zieger, p. 10). In the American context, Levine (1978) argues a not dissimilar case, that cultural shifts in definition, from those who simply drank to excess to the identification of the diseased and afflicted individual, was brought about partly through new social emphases on self-reliance and responsibility. This was, itself, linked to the requirements of the new republic, where there had been a weakening of traditional support networks for the nuclear family. The early inebriate asylums and homes, confident of their claims to cure, were institutions set up to "restore the power of self-discipline to those who has somehow lost it" (Levine, 1979, p. 498). One can thus begin to appreciate the links that formed between the troublesome individual addict and the breakdown in order and social discipline that might ensue through contagion; if individuals lost control, then so, too, might groups, which could then threaten the very fabric of society.[2] There are interesting parallels between the stories of minister John White and diarist Samuel Ward, with respect to the universities that had trained them: Oxford and Cambridge respectively. Both universities were to train the "reaching ministry", although Cambridge was said to be more successful in this regard. Protestant militancy in both universities countered the influence and threat of Catholic Fellows.}} The various Public Health Acts of the 1860s onwards, in Britain, galvanised an idea of sanitary protection, a concept eminently expandable to these other pollutants and threats.

Within this matrix, involving regulative ideals of (white) liberal, male selfhood and self-discipline, a new "suspicion of habit" arose (Zieger, personal communication). Addiction and its metaphors had travel value, endowing "other horrors" and unnamed desires with added meaning (Zieger, 2008). Addicts could symbolise a loss of (masculine?) control, the perversion of pleasure constituting a particular fulcrum of concern. Into the mix went a variety of concerns: class-based (whether those of drunkenness amongst "lower classes", or, indeed, of the "higher degenerates" whom some believed were more prone to neurasthenia and related illnesses of urbanisation); military (in times often preoccupied by "national efficiency" and population fitness); eugenic (the desire to curb "feeble-mindedness" and threats to moral fibre); or, and this is another aspect of unfitness, gender-based, with some believing that women were particularly liable to morphine use, via the hypodermic needle, due to supposed feminine vulnerabilities, hysteria, and mendacity (Zieger, 2005). Indeed, according to Skelly (2010) those in the nineteenth century most opposed to feminism, "invoked the plight of the female habitual drunkard in order to portray women as lacking the kind of will power and self-control necessary for self-representation and self-possession" (p. 502).

A further dimension in the formation of this exclusionary matrix, is that of nation-linked-to-race. In a metonymic sliding of associations, it can be argued, fears surrounding external agents taking over individual bodies and lives, produced and magnified the notion of "foreign body". Was it seen as the case, for example, that addicts had violated natural/unnatural distinctions and succumbed to a deviant, alien desire? "Addicts were 'unfit', whose appearance in many areas presaged, it was thought, national decline" (Berridge & Edwards, 1981, p. 157). In other words, foreign substances and foreign others were linked, with the changing position of opium, from everyday remedy to dangerous substance, being an apposite example, standing as it did as an imperial signifier for the British. Indeed, valuable research is emerging about the complex link between colonialism, opium, and images of the English nation as a potential victim of others, particularly the Chinese and other degenerate nations (Schmitt, 2002). The mystical, the exotic, and the dangerous merged, with Foxcroft (2007), and other historians, suggesting a semiotic synthesis within culture between China and "Darkest England", famously typified in Dickens' last, unfinished novel, The Mystery of Edwin Drood. Consider the imagery of the opium den in that novel, site of abjection, a moral slum; of its various visitors, one "haggard woman" is said to have "opium-smoked herself into a strange likeness of the Chinaman" (Dickens, 2009, p. 4). Powerfully, Foxcroft (2007) observes, "The portrait of opium dens and opium addicts that appeared in novels, newspaper articles, magazines and journals presented the reader with the same lost figures, the same sulphorous and wizened figures of smokers and the same poisonous, sickly atmospheres" (p. 75). As for America, Szasz (1973) analyses the "Yellow Peril", and how Orientals became "model scapegoats"; images of "negro coke fiends", and variations upon that theme, were also a feature of that legacy.

  • [1] Terms such as "habitual (or common) drunkenness", "dipsomania", and "inebriety"—the latter used to include all substances, as in "opium inebriety"—were used widely. Inebriety tended to replace common drunkenness as the century moved on, endorsed by the first generation of addiction specialists and the creation of asylums for inebriety. The term "alcoholism" was coined only in the mid-century (White, 1998). "Addict" has a less clear provenance, but was in growing use by the beginning of the twentieth century, associated as it was to narcotics and criminality in particular (Parsinnen, 1983).
  • [2] Botonaki's (1999, 2004) work offers further illumination of the insistence on self-examination and the regulation of conduct, as well as the possibility of new means of power and effectiveness, as it pertains to women. In her analysis, autobiographical spaces, that were neither entirely private nor public, were "disclosing enclosures" that enabled new forms of assertive femininity to arise; women could be as confident of scripture and equal to men in their capacity to understand God's will. Maternity could represent due spiritual stewardship and not just due care of the young or domestic management per se.{{ The range of terms included "contrary sexual desire", "inverts" (the term used by the major sexologists and by Freud), "urnings" (used by Ulrichs, the early champion of homosexual emancipation in Germany; Robb, 2003) as well as, in other contexts, acts that could not be named and "crimes against nature". On the legal side, 1885 saw (further) criminalisation in Britain of all acts of "gross indecency" between men; efforts to extend criminalisation to acts between women failed in England in 1921, with some MP's arguing that silence on the subject was preferable to publicising its existence (Lesbian History Group, 1989; Showalter, 1986)!
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