The Invention of the Junkie

"Junkie" is one of the most loathsome labels in our society. Yet, the "junkie" is not the natural outcome of substance addiction, it's an artificial invention of our society. It's not the result of a bad personality type, or of a person who has decided to break bad, or even the result of the effects of the drugs.

One hundred years ago, there was no such thing as a "junkie" even though addiction was alive and well in North America. Today, the junkie is a deeply ingrained emblem of irredeemable immorality, of people with values so twisted that they choose drugs over love, family, and work... people to be scorned and removed from society.

The problem with the junkie image is that when these people get better - when they recover from addiction - they become useful and productive members of families, communities, and society... sometimes even much more so than before they were junkies. Many millions of junkies have beat addiction. And too, many respectable people of unimpeachable character fall and become junkies. So the junkie image doesn't hold up well to reality. Yet, this image of the junkie has resulted in the marginalization and criminalization of the people who suffer addiction and need help to get well again. And the image continues to constrain government policy and spending on treating addiction as what it is: a treatable illness. And the image is a powerful deterrent to people with addictions admitting they need help and coming forward to ask for it... they fear being labelled.

So what has happened to create this image? Let's look at how all that happened, so maybe we can figure out how to stop the ruinous effects of a made-up label.

 

The Original Drug Pushers... the British Empire!

In the short history of the collision of opiate narcotics with North American society, the marketing of opiates and the socio-political response to it underwent a rapid transition to the present-day highly stigmatized criminalized view of its addicts. In a stranger-than-fiction twist of fate, opium and its derivatives went from being used by a nation as a tool to establish a strangle-hold on a population to a full-out war by a nation on the people caught under the strangle-hold



In a way, the arrival of opium in North America is a legacy of the British Empire, and not an innocent one. In the 1700s, the British empire conquered a major opium-poppy growing region of India and promptly began shipping opium from India into China through the East India Company. China was xenophobic and the emperor forbid trade with foreigners, but the opium gave the British a strangle-hold on the people, forcing them to trade valuable silk, tea, porcelain, and other riches to support their "need" for opium, which was worthless to the Chinese economy.

And it worked. It gave the British Empire a captive trading partner willing to defy their emperor to support their opium habit.

Fast-forward to the 1800s, and thousands of Chinese came to North America to work on railroads and in the California gold fields during the 1849 Gold Rush. They brought with them the habit of opium smoking. Chinese immigrants soon established opium dens throughout the West. Opium smoking became a popular habit for many Americans.

Opiates Worm Their Way into American Society

Opium and its derivatives - especially morphine - became popular during the U.S. Civil War in the 1860s as an analgesic. While it played a major role in reducing suffering from the hideous bone-shattering injuries caused by the .51 Cal Minié ball and the beastly shards of iron produced by cannon-fire, it also produced a generation of opiate addicts who spread out across the U.S. after the war. As these opiate-addicted veterans percolated down into their homes - in cities and country roads alike - they brought with them a demand for opiates that an unregulated market was more than happy to capitalize on.

Opiate addiction came to be called, immediately after the civil war, "morphonism" or "soldier’s disease." The massive opiate epidemic produced by the war was obligingly filled by the burgeoning pharmaceutical industry, still in its infancy but hungry for growth. The opiate addicted masses provided the captive consumer base that fledgling pharmaceutical companies needed to become a fabulously wealthy overnight success. And this was no black market for drugs, like we know today... it was a perfectly legal market filled with patented medicines that contained not just cocaine and opiates, morphine mostly, but also alcohol.

Mrs. Winslow's Soothing Baby Killer

By the late 19th century, opiates remained unregulated. Doctors prescribed them for a wide variety of illnesses, and opiates could be purchased on request from any pharmacy for self-medicating symptoms, both physical and mental. They even came in a number of over the counter remedies, including children's remedies.



Mrs. Winslow, a real-life nurse who happened to be the mother-in-law of the owner of the company, presented a motherly figure adorning the packaging and advertisements for her "soothing syrup" for children. She provided a reassuring image of the safety and wholesomeness of the product... a product whose active ingredients were morphine and alcohol. And not just a little. One fluid ounce contained 65mg of morphine (by comparison, I usually give an adult in the ER 5 - 10mg of morphine for a painful injury). No wonder the product was considered a cure-all for fussy babies... no baby fusses while in a narcotic coma topped off by alcohol intoxication.

To no surprise, Mrs. Winslow's Soothing Syrup came to be known as “the baby killer,” because so many babies went to sleep and never woke up, or died from morphine and alcohol addiction and withdrawal. We have no statistics about how many children died from this "medicine," because often the child's mild illness was blamed for the death, or parents kept their use of the syrup a secret. No doubt many bottles were used by parents who developed an addiction themselves.

Despite its reputation, "the baby killer" sold in the U.S. until 1906, when Jeremiah Curtis was forced by law to remove the morphine from his product and remove the word "soothing" from the label. Mrs. Winslow's wasn't removed from the market until the 1930s.

 

The Original "Mothers' Little Helper"

Another major factor in bringing opiate addiction into the homes and families of America was the reddish-brown, caustically bitter concoction of wine and opium known as "laudanum." This tincture of opium was especially nasty because it was 10% opium, and contained all the opium alkaloids, such as codeine and morphine.

Laudanum became especially popular among women, who used it for menstrual cramping. Unfortunately for many, laudanum use became a daily habit that reduced them to shells of themselves and removed them from their many duties in the home, family, and society. Thus did addiction begin to invade homes and families, These addicts and their newly pathetic lifestyle became an object of widespread contempt, and gave rise to an image of deviance that has shaped American drug policy ever since and helped reinforce the moral underpinnings of the war on drugs a hundred years later.

It wasn't hard to obtain laudanum: pubs, grocery stores, pharmacies, general stores, even candy stores carried it. And it was cheaper than alcohol! As the problems with addiction escalated, so did the outcry for making opium and its derivatives illegal. But it took a long time to see any government action.

Unfortunately, in the 1800s people knew even less than we do now about about why some people were able to take it occasionally for specific pain and others were completely addicted. Like modern day opiates, some managed to take it briefly while ill, but others became hopelessly dependent. Many people throughout all levels of society, including "respectable" women depended on laudanum to function. Thomas Jefferson used it throughout his presidency, and even grew his own opium poppies on his estate.

Laudanum was responsible for more accidental deaths and suicides by overdose than any other poison throughout the 1800s. Laudanum has a tendency to dry out quickly, so a bottle that isn't used quickly may dry out and become fatally potent. Despite the ubiquitous newspaper headlines of death by laudanum, it continued to be a fixture in every home, much like Tylenol would be today. While researching this article, I was surprised to discover that Laudanum remains legal by prescription in the U.S. today, although I'm sure eyebrows would raise if any doctor actually prescribed it.

Corporate Drug Pushers

If the aggressive marketing and tremendous wealth generated by the pharmaceutical sales of opiates in the 1800s shocks you, then have a look at today, 150 years later. The pharmaceutical giant Purdue received FDA approval of Oxycontin in 1995, and they promptly launched a massive marketing campaign to push this drug, with the full knowledge that it was addictive and would thus produce a captive market of people who developed dependence on it.  Purdue Pharma marketed Oxycontin to doctors as a “continuous around-the-clock analgesic." I still remember as a young doctor their aggressive salespersons coming to my office regularly. Many believe the Purdue's aggressive marketing raised to a whole new level the epidemic of opioid abuse that is killing America in the 21st century. Although Purdue no longer markets Oxycontin - they had no choice, given the infamy of the drug - I still get regular office visit from their sales staff with new opioid products that they have developed. To be fair, they make other stuff, too.



 

The Addict Becomes Stigmatized

The addictive and destructive effects of laudanum and other opiates became more and more of a problem in society. The effects of its addiction on a person's life then were much as now, as can be seen by one man's lamentations about his dependence on laudanum: “I have in this one dirty business of Laudanum an hundred times deceived, tricked, nay, actually & consciously LIED. – And yet all these vices are so opposite to my nature, that but for the free-agency-annihilating Poison, I verily believe that I should have suffered myself to be cut in pieces rather than have committed any one of them.”

As addiction to morphine, heroin, and opium became prevalent and its devastation became apparent, a move toward removing opiates from availability became louder. Calls to do something about opium grew in America, and a series of government actions made the opium and other narcotics - including the stimulant cocaine - increasingly controlled, and then - by the 1920s - outright illegal. Suddenly people addicted to substances - which they could pick up at their corner store with the blessing of their doctor and society - became criminals.

But as social disapproval produced criminal sanctions, it drove the market for opiates further underground, and addicts were forced to learn to manoevre in the world of underground production and distribution of narcotics in order to sustain their drug habits. Addicts were suddenly forced to go from obtaining their drug in the same legal and socially acceptable way as an alcoholic obtains alcohol, to adopting criminal behavior. These addicts and their newly required illegal lifestyle gave rise to an image of deviance that has shaped American drug policy ever since and has been used to substantiate the war on drugs.

---

XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

---

Want to get the whole story?

See the author's book, for a guided tour through the brain changes, genetics, and psychology that cause addiction... and how to use this information to beat addiction.

This successful book enables addicts and alcoholics to understand why addictive substances hold such power over them, and it allows non-addicts to understand addiction and all the behaviors that go along with it. Loved ones, teachers, clergy, supervisors, healthcare professionals... anyone who encounters addiction will find this book an eye-opener.

The book is presented in everyday language with a sense of humor that makes it a fun read.

This important book is available in e-book and paperback versions, and for download of free samples at amazon.com Click Here

---

XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

---

   

The War on Drugs

Surely the "War on Drugs" was declared with the best of intentions. Its author, President Nixon, stated his intention to address the disease by addiction prevention and the rehabilitation of those who are addicted, but that part did not receive the same public attention -- nor the same funding -- as the $51B a year military war directed toward eradication, interdiction, and incarceration. By most accounts it's been a failure. While it has had its victories, it was the final coat of polish needed for the invention of the junkie.

Perhaps the war on drugs has done some good. Certainly, the interdiction efforts to keep the drugs out of our country and reduce its presence on our streets has accomplished a lot. Although its efforts look a lot like a game of whack-a-mole, they have definitely destroyed a lot of harmful drugs and made it more difficult to produce and distribute. Of course, in doing so they have driven up the price of drugs, which deepens the motivation of the producers and traffickers, and driven addicts even further underground. The U.S. Office of National Drug Control Policy (ONDCP) finally dropped the term "war on drugs" during the Obama years, and substantiated their ongoing interdiction efforts by stating that "drug addiction is a disease that can be successfully prevented and treated... making drugs more available will make it harder to keep our communities healthy and safe."



However, the war on drugs has been a disaster for opium's forlorn victims: the people caught in addiction. These people were the very targets of the multi-million dollar pharmaceutical marketing campaigns, which successfully unleashed an epidemic of opiate addiction, and now many of them were the targets of government policy which criminalized the addicts. However, drug has never been black and white. The distinction between medical and recreational addicts is blurred. Most of the opiate addicts I have met in my research got started innocently enough with legitimate medical prescriptions. Many people who started out with "recreational" opiates found in them relief from longstanding mental health symptoms, such as depression or anxiety. The line between a sanctioned opiate user and "enemy" of the war on drugs became very blurred.

 

The Addict Becomes Criminalized

Despite whatever good it has done, the U.S. war on drugs had a fatal flaw that contributed massively to the opioid crisis we see today: the criminalization of addicts. This immediately worsened the stigma of addiction, prevented addicts from seeking help for fear of prosecution, drove addiction even further underground, and marginalized addicts from society. This marginalization was devastatingly severe, because suddenly people with no criminal past or criminal behavior were being removed from society and placed in the prison system, ruining their lives and the lives of their families.

The 2016 Human Rights Watch report, “Every 25 Seconds: The Human Toll of Criminalizing Drug Use in the United States,” reports that “every 25 seconds someone is funneled into the criminal justice system, accused of nothing more than possessing drugs for personal use. These wide-scale arrests have destroyed countless lives while doing nothing to help people who struggle with dependence.”

Many of these people are arrested for "drug residue," which means trace amounts of a drug found in their suitcase or other possessions. This amount is invisible to the eye, and can only be detected by taking swabs for chemical analysis. The amount is so miniscule that even lab machines cannot weigh it, and it is called "trace." Arresting someone for "trace" possession is a hollow victory in the War on Drugs. It does nothing to remove drugs from the streets.

Penalties for drug crimes among American youth almost always involve permanent or semi-permanent removal from opportunities for education, strip them of voting rights, and later involve creation of criminal records which make employment more difficult. Thus, the War on Drugs has resulted in the creation of a permanent underclass of people who have few educational or job opportunities, often as a result of being punished for drug offences which in turn have resulted from attempts to earn a living in spite of having no education or job opportunities. Single mothers of small children lose student financial aid, job opportunities, and the food stamps that many rely on to feed their children.

People who need treatment often find it is unavailable, and criminalization tends to drive people who use drugs underground, making it less likely that they will get care and more likely that they will engage in unsafe practices that make them vulnerable to disease and overdoses. Despite the intention of drug laws being primarily for stopping importation and distribution of drugs, four times as many people are arrested for possessing drugs as for selling them. Half of those arrested for possession are charged with nothing more serious than possessing marijuana for personal use. In 2015 police made 14 percent more arrests for simple marijuana possession than for all violent crimes combined.

 

Lots of $$ for Incarceration, No $$ for Treatment

The opioid crisis has been a major factor in the U.S. incarceration rate. Despite being home to less than 5% of the world’s population, the U.S. has nearly 25% of its prisoners. It has also been responsible for much of the tension between police and communities, as the unpopular and questionable "stop and search" policy has created a lot of resentment. This toxic relationship between the police and the communities has done nothing to make our communities safer, and has done nothing to address the drug problem.

While I seem to be picking on the U.S. here, most other countries are little better. Even in Canada, with its much more relaxed approach to drug possession, we see many examples of mind-numbing possession convictions and sentencing. I personally know people who have been sent to prison for selling enough drugs to support their own habit. When an addict has run out of resources and friends and relatives to beg, borrow and steal from, the drive to get that next high is so strong that many turn to crime: robberies, break-and-enters, prostitution and so on just to support their habit. For many, small-scale dealing is a more palatable way to support their habit at that point.

I have a friend who got caught doing some low-level dealing solely to support his habit. His arrest was the breaking point for his addiction, and he sought help and successfully broke free of addiction. By the time his case got before a judge he was more than three years in recovery, had a good job, and had his life together. He was involved in a 12-Step program where he helped others with addiction to get help. Nevertheless, the judge stated he felt compelled to make an example of him, and sent him to prison for four years. After prison, this man will have great difficulty in getting a job and putting his life and family back together, and may well end up back in addiction and dealing again in his frustrations. He was removed from a good and productive life in recovery and placed in a no-win situation for the sake of "making an example. I have no idea who will benefit from his example.

The culture of mass criminalization is one in which aggressive policing and incarceration are our default tools for dealing with a wide array of social problems that can and should be solved by other means. These punitive approaches far exceed what is necessary to maintain public safety and primarily target poor people and people of color.

 

No Way Out

While addicts are being funnelled into the criminal justice system, for many there is no treatment available.

The states in white are subject to an obscure Medicaid rule that prohibits the use of federal dollars for addiction treatment provided in facilities with more than 16 beds (source: Pew Charitable Trusts, Apr 5, 2017).

The amount of federal and state funds being pushed into the prison system in the United States is staggering, especially with the privatization of prisons. Prisons are now a lucrative private-sector business, and the more people that can be shoved into a prison, the greater the profits. Over-crowding is making the privatized prison owners fabulously rich! Where there is money there is political lobby, and there is a great deal of pressure on elected law-makers to keep the prisons full, and thereby keep their own election campaigns funded. Addiction is what keeps the prisons full, so there is tremendous pressure - behind closed doors -  on government to leave things as they are.

Addiction treatment is vastly under-funded. Most addicts are penniless, and therefore have no option to attend addiction rehab, even if they want to. There have been many addicts who have admitted to committing crime solely with the purpose of getting caught and going to prison where some kind of state-funded drug rehab is available. It is their only path to help.

The result: treatment for the middle and upper class, incarceration for the rest. Employment status, race, gender, and class all influence which response an individual encounters.

Canada is little better. Even with its "free" healthcare, many addicts do not have ready access to drug rehab treatment. Addiction rehab has been privatized, and most treatment centers have the minimum number of government-funded beds as they are allowed to in order to keep their funding. So, the people with private health insurance that covers drug rehab or who have $9 - 12K to pay for three or four weeks treatment get in quickly, usually within a few days. Those who don't, face waiting lists that are many months long: an eternity when dealing with such a deadly disease. We have no statistics for how many have died of Fentanyl overdose or who have been arrested and incarcerated while awaiting rehab, but it's likely high.

So, even Canada - with its vaunted universal healthcare - has a two-tiered system when it comes to treating this fatal illness.

These are people asking for help. They want to get better, they need and want treatment.

   

Un-Inventing the Junkie

So, in the end we have a massive profit-driven pharmaceutical industry that pushed addictive opiates and created a market for them, in the full knowledge that sales would be sustained by the people who became addicted. We have a medical-political  system that participates in this market, and provides grossly inadequate help for those who become addicted. And we have a political-justice system that crimilaizes those who are caught with drugs, even for their own use.

This process has resulted in the creation of the "junkie:" the criminalized, marginalized, stigmatized social reject forced underground. Even in recovery, the "junkie" may never shake the consequences of this stigma and branding as a criminal. These consequences can separate families; exclude people from job opportunities, welfare assistance, public housing, and voting; and expose them to discrimination and stigma for a lifetime.

So, how do we un-do the horrible creation: the junkie? Do we even want to, or do they deserve what they get? Well, when a person gets to a point where substance use is no longer a choice, they become unlovely in their behaviors. But, it's remarkable how the real person comes to the surface when that person finds recovery and gets all the mental and emotional garbage of his or her shoulders. It's a common phenomenon that such people become better adjusted to life and more productive members of society than even before they ever touched a drug of addiction. No matter how pathetic a person becomes in their addiction, they are not a write-off (To support this, I suggest watching the incredible 5 minute video "A Fire-fighter's Incredible Story of Addiction and Recovery" Click Here).

Many suggest that de-criminalizing all drugs is the answer. The idea is that it would reduce the demand for drugs. Or, maybe it'll just make for a free-for-all. I don't know. It would certainly have its advantages and disadvantages.

Certainly, decriminalizing drug possession would be a very helpful step. Stop sending people sick with a treatable sickness to prisons. It's actually cheaper to put someone through drug rehab program than it is to put them up in prison. A lot cheaper. And, unlike prison, it actually addresses the problem.

And the judicial system needs to begin differentiating the cases of people who import and distribute drugs for personal wealth, versus the low-level dealer who is simply trying to support his or her drug habit. The arrests for drug "residue" have to go! "Stop and Search" using I smelled marijuana as a pretext is killing the police's chances of repairing their relationship with neighborhoods. Crimes resulting in harm to others, such as violent crime and cutting drugs with Fentanyl need to be taken very seriously, to be sure, as supporting an addiction cannot be used to excuse those kinds of victimizing behaviors. In short, we need to move from punitive justice to reparative justice when it comes to the addict.

In terms of enforcement, efforts to restrict the supply of drugs, with non-enforcement-based efforts to reduce demand and build recovery; supporting people to live a life free of addiction.

To accomplish any of the dismantling of the junkie, the drug war mentality must be dropped once and for all. It has caused immeasurable damage to the stigma of the addict, and has blocked government funding and public sympathy for the plight of people caught in the grip of addiction.

     

References:

Acker, Caroline. (2002). Creating the American Junkie: Addiction Research in the Classic Era of Narcotic Control. Johns Hopkins university Press: baltimore, MD.

Drug Policy Alliance. (2018). Drug War Statistics [Web log post]. Retrieved from: http://www.drugpolicy.org/issues/drug-war-statistics

Human Rights Watch. (2016, Oct 12). US: Disastrous Toll of Criminalizing Drug Use. Retrieved from: https://www.hrw.org/news/2016/10/12/us-disastrous-toll-criminalizing-drug-use

Rock, Paul. (1977). Drugs and Politics. New York, NY: Routledge.

Stauffer, Brian. (2016). Every 25 seconds: The human toll of criminalizing drug use in the United States. Retrieved from: https://www.hrw.org/report/2016/10/12/every-25-seconds/human-toll-criminalizing-drug-use-united-states