These days, the smart money – actually, pretty much all the money – is on addiction being a chronic, relapsing brain disease whose cure will involve repairing or mitigating organic lesions. But many of the most important aspects of addiction are forged not neurochemically but socially and culturally: the line between addiction and other forms of chronic behaviour; how much addicts should be held responsible for their actions; the impact of ‘structural’ factors (eg., racial segregation) on the epidemiology of addiction; and, not least, how authorities should understand and respond to the social problems associated with addiction. Such judgements have profoundly marked experiences with unproblematically biomedical illnesses such as tuberculosis, cancer and the flu, and the same remains true for addiction, too, no matter how the science plays out. This is why we need books like Howard Padwa’s Social Poison: The Culture and Politics of Opiate Control in Britain and France, 1821–1926, which analyses the cultural processes that produced two dramatically different responses to the same biological phenomenon – which, in turn, meant dramatically different experiences for addicts.
Padwa argues that writers, politicians and other commentators were as significant as medical researchers in establishing beliefs about opiates and addiction. The English writer Thomas De Quincey, for example, was the most powerful articulator of prevailing beliefs in the nineteenth century, helping cement opium’s reputation as an ‘emblem and pastime for outcasts and recluses, individuals who were, paradoxically, united by their radical individualism and passion for personalized reverie’ (p. 48).
This reputation was more of a problem in France than in Britain, where individualism and productivity were understood as hallmarks of good citizenship. Strongly coloured by their national interest in continuing the opium trade between colonial India and China, British cultural and imperial authorities ultimately concluded that opium was ‘not necessarily incompatible with an industrious and self-sufficient lifestyle’ (p. 66). The French, however, placed a much higher importance on ‘the collectivity of the nation as a more active player in the cultivation of individual liberty and prosperity’ (p. 70). Novelists helped draw cultural links between addiction among French soldiers and treason, which were then given greater currency by political discourse around actual episodes such as the Ullmo Affair. As a result, France ended up with the more incendiary panic over addiction, despite apparently higher rates of opiate use in Britain.
These national understandings of addiction shaped drug policy as it emerged in France and Britain in the years around World War I. British authorities confronted addiction only as an economic issue: lax laws made their nation a haven for smugglers, who created problems for legitimate trade interests. As a result, ‘repressing the international drug traffic, more than limiting domestic drug use’, was their principal aim (p. 109). France, on the other hand, cracked down on addiction itself, criminalising not only the sale and use but ‘encourag[ing] the possession or illegal use of opium’ (p. 115). Ultimately, Padwa argues, British authorities saw opiate control as ‘largely a means to an end’ whereas for French authorities ‘drug control was an end in itself’ (p. 138).
Despite these difference, the 1920s saw a similar situation in both nations: plenty of addicts with no easy access to drugs, but also no realistic hope of ‘cure’. In Britain, addicts and physicians successfully marshalled cultural arguments about individual liberty and productivity to defeat anti-drug crusaders and secure the famed ‘British System’ of tightly controlled medical maintenance. French doctors made the same pleas on behalf of addicts but they fell on deaf ears. Much later, both nations would adjust their regimes to circumstance: tightening controls in the countercultural 1960s, and then expanding maintenance and public health approaches (a much more dramatic shift in France) in the age of HIV/AIDS. But throughout, national self-perception powerfully shaped each stage of drug control.
That said, this is a valuable story: deeply researched, consistently insightful in analysis and crisply written. The comparative model is an excellent way to show the fundamental importance of social and cultural factors in shaping the history of addiction, and Padwa uses it deftly. Today’s addiction researchers would do well to read this book and think about the cultural (and moral) assumptions that frame their own work, and that will most assuredly frame any policies that rely on their conclusions.
The representation of national cultures can be strangely static in this otherwise compelling story. They appear like fields naturally generated within a nation state, homogenous enough that almost any discourse produced within it – poetry, medical journals, novels, etc. – provides evidence of the same underlying structure. But culture is better understood as a verb rather than a noun, with discourse serving not as evidence of what is generally believed, but as competing and dynamic efforts to create general beliefs. In light of the recent ‘transnational turn’, this is especially important to recognise in nationalist discourses, which should be understood not as pre-existing characteristics but contested cultural projects. This suggests a slightly different question: why did drugs play such a prominent role in the project of establishing national identities in Britain and France? This is obviously not the question Padwa set out to answer, and while cultural historians might wish he had, its absence in no way detracts from the many valuable contributions of this excellent book.
