The Making of Addiction

The 'Use and Abuse' of Opium in Nineteenth-Century Britain

Louise Foxcroft

• Publisher: Routledge
• Year: 2016
• Topic: History
• eBook ISBN:
  9781317024811
• Subtopic: World History
• Index: History

What does drug addiction mean to us? What did it mean to others in the past? And how are these meanings connected? In modern society the idea of drug addiction is a given and commonly understood concept, yet this was not always the case in the past. This book uncovers the original influences that shaped the creation and the various interpretations of addiction as a disease, and of addiction to opiates in particular. It delves into the treatments, regimes, and prejudices that surrounded the condition, a newly emerging pathological entity and a form of 'moral insanity' during the nineteenth century. The source material for this book is rich and surprising. Letters and diaries provide the most moving material, detailing personal struggles with addiction and the trials of those who cared and despaired. Confessions of shame, deceit, misery and terror sit alongside those of deep sensual pleasure, visionary manifestations and blissful freedom from care. The reader can follow the lifelong opium careers of literary figures, artists and politicians, glimpse a raw underworld of hidden drug use, or see the bleakness of urban and rural poverty alleviated by daily doses of opium. Delving into diaries, letters and confessions this book exposes the medical case histories and the physician's mad, lazy, commercial, contemptuous, desperate, altruistic and frustrated attempts to deal with drug addiction. It demonstrates that many of the stigmatising prejudices arose from false 'facts' and semi-mythical beliefs and thus has significant implications, not only for the history of addiction, but also for how we view the condition today.

Chapter OneIntroduction

DOI: 10.4324/9781315555836-1

The first dose is taken, and mark the transformation. This overmastering palliative creates such a confident, serene, and devil-may-care assurance that one does not for once think of the final result. The sweetness of such harmony can never give way to monotony. Volition is suspended … when distress supervenes, you go at once for the only balm that abounds in Gilead, and every additional dose is but another thread, however invisible, of which the web is made that binds us fast as fate.¹

_______________

1 J.B. Mattison, ‘Opium Addiction Among Medical Men’, Medical Record, 1883, 23, pp.621–3.

Perspectives on addiction

What does addiction mean to us now, what has it meant to others in the past, and how are all these meanings connected? The phenomenon of addiction has a long socio-cultural history but the field of knowledge that has developed around it is very recent. Historically, certain individuals have used ‘certain substances in certain ways thought at certain times to be unacceptable by certain other individuals for reasons both certain and uncertain’.² But is this behaviour natural or pathological? Is it, even, morally reprehensible? This book is a social and intellectual history of the concept of addiction, concentrating on the use and abuse of opiates. It looks at public and personal perceptions of chronic opiate use in the nineteenth century and at the development of addiction as a medical condition, a disease entity, where, despite earlier experiences of ‘habit’ and ‘enthralment’, no such definition had previously existed. Contrary to Thomas De Quincey’s dictum this thesis takes the opium-eater as its hero and not opium itself.³

_______________

2 H. Schaffer and M.E. Burglass, eds, Classic Contributions in the Addictions (1981), p.xix.

3 ‘Not the opium-eater, but the opium is the true hero of the tale’, Thomas De Quincey, Confessions of an English Opium Eater (1821), p.78.

The personal and imaginative life of the nineteenth-century chronic opium user could not help but fashion the medical and popular understanding of addiction. The experiences and ideas of opium users informed, influenced and manipulated medical knowledge in a cross-referential manner. Addiction was initially understood from a non-empirical, non-scientific viewpoint and even later, after the mid-nineteenth-century epistemological shift towards medicalisation of the condition, the concept was not based exclusively on pathological and physiological interpretation.

The disease entity of addiction was constructed from the 1860s onwards through the agency of medical experience; but in many respects this was too limited an experience, an accumulation of scientific knowledge and prejudice patched together in piecemeal fashion. Personal experience and medical theory were always interdependent but did not always coexist without controversy and conflict. For this reason the book is divided into two parts: the first, ‘The Cultural History of Addiction in Nineteenth-Century Britain’, explores the felt experiences of addicts and those around them, and the ways in which addiction was interpreted and presented; the second, ‘The Medical History of Addiction in Nineteenth-Century Britain’, traces the development of medical theory and practice.

Part I is a history of the many sorts of people who took the drug and became addicted to it, their reasons, needs, beliefs and sufferings for it, and the pleasure they found in it. Those who used opium, particularly for pleasurable or non-medical ends, have been largely ignored and yet their experiences add significantly to an understanding and history of addiction.⁴ Chapter 2 focuses on the writings of Thomas De Quincey and Samuel Taylor Coleridge: their detailed and visceral experiences and explanations of addiction. Part I then goes on to look at the writings, letters and diaries of other opium users such as Elizabeth Barrett Browning, Lizzie Siddall, Dante Gabriel Rossetti, and Helen Gladstone, and at the responses of those who cared for, or were affected by, the opium user’s habits. It looks at press and inquest reports that reveal everyday use; ‘confessional’ pieces, a popular genre which appeared in publications such as London Society and Blackwood’s Magazine; articles on the Chinese opium dens of London which appeared under the cover of social investigation; and fictional descriptions in sensation novels employed as a melodramatic device. These are depictions that led a medical commentator in the 1870s to conclude that opiate use ‘may indeed be said to have reached the height of fashion’.⁵

_______________

4 For contemporary exposition of this argument see P. O’Malley and S. Mugford, ‘The Demand for Intoxicating Commodities: Implications for the “War on Drugs”’, Social Justice, 18, 4, pp.49–75.

5 Clifford Allbutt, ‘On the abuse of hypodermic injections of morphia’, Practitioner, 1870, 5, pp.327–31.

Why did people take opium? We might well ask ourselves why people do any of the things they do, and we could search for answers in an external scientific manner, empirically observing, measuring and interpreting behaviour, and also attending to personal accounts and explanations. It is attention to the latter which can best open up the history of addiction, and perhaps also give us valuable insight into the ways in which present-day theory and policy expose social norms, values and beliefs. Addiction as a medical condition or problem imposing a model of behaviour requiring treatment can then be seen as one more paradigm which can be deconstructed. It may be replaced with a ‘process model’ rather than the ‘stochastic model’ usually employed in pharmacological and psychological theories. The former is a ‘dynamic process occurring over time, multifaceted in its origins, influenced by incidents and sequences that are pharmacological, psychological, historical, social, economical, political, [and] spiritual’, whilst the latter implies an ‘immutable process occurring in stereotypical fashion, not affected by change over time [where] historical and causal factors are unimportant’.⁶ It is the pleasure that is experienced that defines what is now termed the ‘motivational’ factor in drug taking, and it is a history of use and pleasure that will redefine the basis of popular misconceptions common today. A greater understanding of this history would humanize the seemingly marginal figures who have used drugs in a non-medical way and dispel much of the demonisation which has attached itself to this behaviour.

_______________

6 J. Westermeyer, Poppies, Pipes, and People (1982), pp.60–1.

The development of nineteenth-century medical opinion and treatment of addiction forms Part II of this book, since medicine was the most visible forum in which much of the debate took place. A protracted discussion of the nature of the newly designated ‘disease’, its aetiology, and the merits or otherwise of proposed therapies, took place in the second half of the nineteenth and early twentieth centuries. Although historians of opium have always referred to physicians and to their texts, no intensive account of this debate has yet been given. In the early nineteenth century the medical colonisation of opiates, which took place within the larger struggle of the profession for increased status, did not seriously vilify the ‘luxurious’ use of opium. By the end of the nineteenth century, however, the ‘habitué’ was damningly diagnosed as suffering from a form of mental illness, and the treatment meted out to such persons was inextricably bound up in disease rhetoric as well as in prevailing theories of degeneracy and deviancy.

As the medical profession attempted to define addiction it unsurprisingly leant towards the iatrocentric, concentrating almost entirely on the physiological symptoms. Physicians noted, but did not accord any great significance to, the behavioural precursors and effects of an opium habit. By this means a schism of understanding was created between the physician and the user (assuming that they are in the main different creatures here, and for professional purposes they almost unfailingly were) and so allowed distrust and confusion, prejudice and fear, to arise around the condition. By the close of the century there was, broadly speaking, a parting of the ways resulting in two perspectives on perceived unorthodox drug use that would eventually be exacerbated by legislation in the first decades of the twentieth century. Neither approach could fully explain addiction and we might ask why one explanation came to be favoured over another and whether there was a ‘danger of subordinating life to “science”’, to the detriment of human well-being, inasmuch as the individual experience was marginalised.⁷

_______________

7 R. Richardson, Death, Dissection, and the Destitute (1988), p.xvii.

There are few recent historical works that include accounts of addiction, and, with the exception of Berridge and Edwards’s Opium and the People (1981), they have all adhered largely unquestioningly to the idea of addiction as a ‘given’, a presupposed existing fact which was gradually uncovered and duly dealt with.⁸ This persistent paradigm carries many misleading connotations and assumptions and it needs to be re-addressed. If it is, then addiction can be revealed as involving a known and ancient pattern of behaviour that gradually hardened into a recognised condition or disease entity, the latter emanating primarily from the animadversions of an increasingly cohesive and powerful medical profession.

_______________

8 See for example G. Sonnedecker, ‘Emergence of the Concept of Opiate Addiction’, Journal Mondial De Pharmacie, 1962, 3, pp.275–90; T. ...

Table of contents

• Cover Page
• Half Title Page
• Series Page
• Title Page
• Copyright Page
• Table of Contents
• Acknowledgements
• 1 Introduction
• Part I: The Cultural History of Addiction in Nineteenth-Century Britain
• Part II: The Medical History of Addiction in Nineteenth-Century Britain
• Conclusion
• Appendix 1: Opium strengths and doses
• Appendix 2: Opium and alcohol
• Bibliography
• Index