HLTHAGE 2L03, Winter 2021, Instructor: Dr.

Savelli SAS Notes

January 18, 2021: Lecture 2

Topics: History of drug use; Invention of “Addiction”; The Temperance Movement

w/ Dr. Savelli and Melissa

 
A little bit about Melissa:
 Masters student in HAS
 She's worked in an alcohol consumption program and an overdose prevention site
 Currently working on her thesis
 Collaborative research partner of Dr. Savelli's and has TA'd for the course before
 
OPENING STATEMENT TO KICKSTART THE DISCUSSION: "HUMANS BEINGS LOVE DRUGS"
 We see evidence across the world of drug use going back 1000s of years
 Drug use ranges from caffeine to opioids
o Previously wine was never thought as a concern
 Addiction had to be invented...
o Addiction as an idea w/ its own criteria has developed over the past 100 years; it's not a
naturally occurring entity
o Addiction changes over time
 We've been aware of how drugs affect people over time, but now we have a better scientific
understanding of how it changes the body
o But addiction is situated in a historical context
o For example, 100 years ago addiction meant something different from what it does now

How has the concept of addiction developed over time?

 We've had the idea for at least 400-500 years, that some substances could form habits (i.e.,
drawn to using them)
o The 4C's of addiction didn't exist then, though
 The idea of HAVING to use drugs came about in the 1800s-1900s
 Trotter pushed the medical idea of habit (specifically alcohol); said that it was a disease of the
mind and that the user loses control of themselves
 Rush argued that the habit of drinking was something that people were compelled to do,
however, instead of physicians dealing with it as a disease, he felt it was more of a moral issue
and that required intervention from the clergy
 People argue that the Temperance movement was central to the concept of addiction gaining
traction
 
The Temperance Movement
 Advocated against the consumption and sale of alcohol

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HLTHAGE 2L03, Winter 2021, Instructor: Dr. Savelli SAS Notes

 Framed alcohol use as a personal and moral failing on the part of the drinker
 Pushed prohibition and legal restrictions of the production, selling, and consuming of alcohol
 We can see how much this movement influenced prohibition
 This movement was SO influential and popular in this time; they adopted Rush's idea that there
was something immoral about it
o Talked about alcohol as a societal evil
o Dry counties STILL exist in the U.S. to this day
 Temperance was successful in creating prohibition, even though it didn't last long
 And the idea of adopting morality claims into the law speaks to its significance
 This movement bought into the exposure model
 
What else mattered in solidifying addiction as a concept?
 Increasing influence of the medical profession; specifically, psychiatry
o Doctors had a certain sway in how these things were understood; when addiction fell
into medicine, they got control of it
 Happened in conjunction with increasing urbanization
o Most people prior to this time lived in small towns where people might have been more
permissive to others' behaviour
o But when congregated in cities, disruptive behaviour (i.e., being drunk) became more
visible and intrusive
 Industrialization and the shift from farm work to factories; intoxication became more
problematic in factory contexts as opposed to independent farm work
o Workdays became set in place where you'd have to be productive and arrive on location
at a specific time
o Conversely, drinking was common amongst agricultural workers
 
What about other drugs?
 Up until the early 20th century, there were no prohibitions on drugs (except for poisons)
 What we know now as harsh, dangerous drugs could have been bought at the local pharmacy
(until the 1910s-1920s); there were no restrictions on use
o But people began to become concerned about the use of drugs
 Courtwright argues that the image of the drug user changed; things that were viewed as
medicinal (often associated with the middle-class) became more associated with immigrants and
the working class (who were deemed socially dangerous)
 The enlightenment: period of history where there were changes in how society functioned and
how people thought about things; sparked the decline of religious authority in favour of
scientific authority
o Value of it: the idea of rationality; people began to strive for the rational in their lives
o Drugs became a threat to rationality because they would alter your behaviour and make
you do strange things

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HLTHAGE 2L03, Winter 2021, Instructor: Dr. Savelli SAS Notes

 Hickman said that society was substantially changing between 19th-20th century, rapid
technological progress
o At that time, people were paranoid about new tech (i.e., the telephone, railroads, etc.,)
o Cocaine and heroine, as well as the hypodermic syringe, were the product of new
technology
o Thus, people became concerned about drugs
 
Final Comments
 The tension between exposure and susceptibility were already there when the concept of
addiction became popularized