High

Drugs, Desire, and a Nation of Users

Ingrid Walker

• Publisher: University of Washington Press
• Year: 2017
• Print ISBN: 9780295742311
• eBook ISBN: 9780295742335
• Topic: Social Sciences
• Subtopic: Pharmaceutical, Biotechnology & Healthcare Industry
• Index: Social Sciences

Whether drinking Red Bull, relieving chronic pain with oxycodone, or experimenting with Ecstasy, Americans participate in a culture of self-medication, using psychoactive substances to enhance or manage our moods. A "drug-free America" seems to be a fantasyland that most people don't want to inhabit. High: Drugs, Desire, and a Nation of Users asks fundamental questions about US drug policies and social norms. Why do we endorse the use of some drugs and criminalize others? Why do we accept the necessity of a doctor-prescribed opiate but not the same thing bought off the street? This divided approach shapes public policy, the justice system, research, social services, and health care. And despite the decades-old war on drugs, drug use remains relatively unchanged. Ingrid Walker speaks to the silencing effects of both criminalization and medicalization, incorporating first-person narratives to show a wide variety of user experiences with drugs. By challenging current thinking about drugs and users, Walker calls for a next wave of drug policy reform in the United States, beginning with recognizing the full spectrum of drug use practices.

CHAPTER 1

PICTURE A DRUG USER

PICTURE A DRUG USER. WHAT COMES TO MIND? YOUR MENTAL image probably depends on what psychoactive substances you consider to be “drugs.” It may also depend on whether you consider yourself to be a user, or if you know drug users. Most likely, your immediate image of a drug user has been influenced by how they have been represented in US media and popular culture. Your characterization may be typical of the drug users depicted in television and film: a recreational user who struggles with drug addiction. Maybe you imagined an emaciated heroin user, an immobilized crack user, or a lesion-riddled meth user, some of the most prevalent images of drug use in US popular culture. Although caricatures of drug users have historically been part of US popular culture, those narratives have been refined in the decades of the drug war. Americans have been relentlessly bombarded with particular images about drug use through popular culture, news media, and advertising—characterizations that have become invested with a great deal of social and political power.

Are these pictures of users accurate? If the user you imagined is not based in your experience, how would you know whether it was a credible representation? What would you compare it to? Even for people with firsthand knowledge of psychoactive drug use and users, there are so many different kinds of users and situations that it is impossible to imagine a representative user. I start this book by raising the question about an imagined “drug user” because despite the countless kinds of drug users, characterizations in visual media and popular culture tend to depict extreme use—images that are more often than not inaccurate or not representative of user experience. Certainly, drug use can be normalized as well as caricatured in popular culture. For example, music and literature offer a range of exceptions to the United States’s usual representative dynamic. But, for the most part, cultural images reproduce pervasive misconceptions about the use and users of psychoactive drugs, reinforcing narrowly defined narratives that have significant political implications in public policy, law enforcement, and health care.

US popular culture has consistently traded in stereotypical, marginalized images of recreational drug providers and users like the mysterious clientele of Chinese opium dens in the nineteenth century, the menace of Mexican “reefer madness” in the early twentieth century, the dropout white hippy LSD user of the 1960s, or the crack-addicted black mothers and their babies of the 1980s. Over the last forty-five years, the drug war has amplified representations of recreational use in media campaigns that denigrate certain drugs and users. In distinct contrast with those drug narratives of self-destruction, pharmaceutical drug users have been celebrated through equally targeted media campaigns in images that represent healthy, fulfilled drug users. Pharmaceutical drug narratives feature people who experience improved physical and psychological well-being due to their drug use. These narratives enjoy a relatively unexamined role in US media culture, because Americans have come to accept the authority of pharmaceutical medications as a means to health. Yet pharmaceutical drug narratives cast self-destructive recreational drug narratives into greater contrast at a time (late 1980s to 2000s) when the drug war was waged with the greatest intensity. Through this vivid dichotomy, US popular culture continues to perform a prodrug and antidrug dialogue about drugs and their roles in Americans’ lives.

Where do these narrative constructs come from—and what interests do they serve? The search to answer these questions led me to think about how the representation of drug users in popular media has shaped American discourse about who uses drugs and, most importantly, why. Patterns of drug user representation during the era of the escalated drug war, from the mid-1980s to the present, engage political discourses that reach beyond drug sales or basic law enforcement. For example, the depiction of recreational drug use in popular culture news media and anti-drug campaigns covered considerable ground in this cultural war, developing from a public health concern to a matter of national security. The range of user characterizations, from self-harming to a public threat, has significant social and legal implications for users. While both antidrug and propharmaceutical narratives characterize users through the implications of their use practices, the imagined outcomes of those acts are vastly different. Drug use, these narratives tell us, offers divergent experiences and impact on others depending on both your reasons for taking drugs and the kind of drugs you choose. The predominance of images of dysfunctional drug users unable to deal with addiction, which leads to lives of crime, is offset by those of pharmaceutical users, who express effective agency in using drugs for better health and quality of life. The cultural context and social power of those narratives is worth exploring, because their ubiquity influences what Americans think about drugs and users in ways that are often unexamined. Most importantly, these narratives have been used to wage an expensive and devastating domestic war for decades.

HEARTS AND MINDS: THE CULTURAL REPRESENTATION OF DRUG USERS

As a metaphor, the drug “war” scripts a specific cultural narrative. But what is the United States fighting for or against, exactly? How has enforcement of unsuccessful federal drug interdiction, targeting specific populations of users, endured for almost half a century? Put simply, the drug war has persisted because it has won the hearts and minds of Americans. The expression hearts and minds refers to a strategy to gain the consent and support of a population to wage a war against an invading army or insurgents. In the US drug war, the rhetorical approach that has been essential to the war effort was to win the hearts and minds of the American public. The key methodology in this process has been to persistently remind the public who the enemy is and the nature of its threat. Narratives that produce and recycle images of drug users in advertising, film, television, news media, and other popular forms of culture have taught American audiences about the enemy. Popular narratives have naturalized political positions about drug use expressed through criminalization and medicalization as if those ideologies are given, facilitating audience consent to particular norms about drug use. Sometimes these images are explicitly intended to instruct or deter (e.g., public service announcements or PSAs); in other contexts, their power to educate is implicit but nonetheless effective.

The rhetorical and representational strategies for winning hearts and minds over the last four decades have included humorous, banal, or hyperbolic narratives. Some images of drug use have had more cultural resonance with American audiences than others. Take an example from a drug market that is embattled, but not part of the drug war: the cigarette market. RJ Reynolds’s character Joe Camel was a colossal success in winning the hearts and minds of a new generation. The cartoon figure helped shift what had become the dirty, cancer-causing image of cigarettes back to “cool,” single-handedly increasing Camel’s market identity among adolescent smokers from nearly zero to 32 percent.¹ Joe Camel’s success in appealing to audiences expresses a key function of drug-user narratives and their contextualizing social discourses: they reinforce particular kinds of social and self-identity for drug users. The cultural knowledge produced through these characterizations acts as a kind of power, one expressed by and about those users who are identified with them. In other words, a user may identify as a smoker, but she may also be subject to the social meaning conveyed by characterizations and discourses about smokers. As smoking has become considered dangerous not just to users but also to bystanders, smokers have become “other,” prohibited in many public spaces. Smoking is an effective but benign example of how social discourses about drug use practices affect users. While few people go to jail for smoking or selling cigarettes, the ability of smokers to use freely has been significantly curtailed and taxed. Such identification of specific drugs and their users as “other” has framed use of particulars drugs as a social problem. Because the drug war’s discursive strategy for winning hearts and minds has been to convince the American public that it shares common enemies, recreational users and especially users of illicit drugs have become social antagonists.

Public discourses about drugs and users convey and enforce these sociopolitical positions; they establish and express the cultural norms and identifying factors to which people are all subject. Yet, one’s social identity is not necessarily static or entirely binding: subjects also have agency, an ability to act.² For example, although a recreational marijuana user’s practice may be illegal, she may reject that norm as an identifying factor and not identify as a “criminal.” Subject agency is not merely a position determined by and within a discourse, but is a more dynamic political position in which subjects act within a context of cultural norms.³ In this sense, a drug user’s agency is expressed when she makes choices—whether to follow medical advice, to follow public health dictates to “just say no,” or to take illicit or diverted pharmaceutical drugs. Different public drug discourses about users, such as those associated with licit versus illicit drug use, affect user agency and subjectivity in very real ways. For example, a white, suburban, middle-class prescription opiate abuser might be perceived differently by law-enforcement and health-care professionals than a white, urban, unemployed heroin abuser. Both users may have made similar decisions about using (agency), but their subjectivities might affect how an outsider perceives each user’s agency or ability to make decisions.⁴ The ideological partition between the drugs and users that Americans criminalize and those that they endorse amplifies many related social issues: from legal, medical, and economic inequities to the challenge of understanding that most drug users enact choice and control in their use practices. Subsequent chapters will focus on how defining drug use as either a medical necessity or an addiction has affected users across social services, criminal justice priorities, law enforcement practices, health care, and individual user experience. Understanding not just the detrimental social effects of criminalization or medicalization, but how these discourses constrain individual user agency, is critical to fully grasping the social impact of US drug politics and their narratives.

Popular narratives concentrate the symbolic power of drug consumption through a couple of extreme characterizations. There is the comically disastrous user whose episodic experimentation goes awry, such as Taxi’s Reverend Jim identifying cocaine as the secret ingredient in Latka’s grandmother’s cookie recipe, or Carlton’s accidental consumption of speed in Fresh Prince of Bel-Air.⁵ Narratively, these indiscretions gently confirm the logic of illicit drug prohibition. More frequently, however, drug narratives feature the other type: the uncontrollable and self-destructive extreme user like Bubbles, whose painful struggle with heroin addiction is threaded throughout The Wire. US and worldwide data show that the vast majority of users of psychoactive substances do not experience drug abuse or addiction, yet the majority of user characterizations in popular culture and media represent those extremes. (See chapter 3, figs. 3.1 and 3.2.) It is hard to overestimate the function of US media culture in forming and circulating persistent ideas about drugs and users, ideas that Americans share and reproduce. Imagine that you know nothing about the effects of alcohol. You have never known anyone who drinks or even witnessed others drinking, and you have not sampled alcoholic beverages yourself. For the first few decades of your life, you were exposed to drinkers only in television and film, in magazine ads, and through school programs. The users you have seen are severe alcoholics like Mad Men’s Don Draper, Tommy Gavin in Rescue Me, or Lucille Bluth in Arrested Development. If these alcohol abusers were the only examples you had of drinking, you would be likely to draw very specific conclusions about alcohol as a dangerous drug that leads to addiction. Similarly, media and popular culture focus almost exclusively on extreme representations of illicit or recreational drug use in narratives that eclipse individual agency. An illicit drug user’s inability to express self-control leads us to believe that any drug use threatens individual agency and social engagement. Yet such stories frequently fit neither the self-reported experience of users themselves (including some addicts), nor the outcomes of clinical research focused on user agency.⁶

A counterpart to narratives of drug users with a distinct lack of individual agency is the cultural representation of a type of user who expresses agency that poses a serious social threat. US news media have repeatedly perpetuated grossly misleading stories about drugs and users as constituting an acute social danger. The transference of anxiety about crime, poverty, unemployment, and mental health issues onto drug users is not new; the fantastical view of drug use as the cause of these social ills goes all the way back to temperance ideology.⁷ Many drugs have been featured in a pattern of “false-alarm” drug panics over the last century: alcohol, opium, cocaine, marijuana, LSD, PCP, crack, Ecstasy, methamphetamine, and bath salts. The fabricated claims of these anxious, often racist or xenophobic news stories share common elements. Sociologists Erich Goode and Nachman Ben-Yehuda write that panic narratives focus on a drug’s addicting properties, its invasion into all communities, and a spike in abuse and overdose deaths. More importantly, through these drug-scare narratives a specific version of use comes to be representative for all use of that drug—as if there is a “paradigmatic experience.”⁸ Whether real or not, these imagined or actual worst-case episodes are retold repeatedly until Americans believe them to be the sole result of using that drug. They become archetypal narratives, standing in for many potential experiences with a particular substance.

This influence of news media and popular culture in directing viewer attention to particular issues is powerful. Stephen Siff, a historian of journalism, argues that this influence is based on two key dynamics. First, media have a greater power of persuasion when the topic is one with which audiences have no direct experience. Second, because news agencies often follow other outlets’ work when generating story material, some topics persist, regardless of the issue’s accuracy or prevalence.⁹ These dynamics are exemplified in a drug panic like the Strawberry Quick methamphetamine hoax of 2007. A web search for “Strawberry Quick” meth yields dozens of stories about the bogus drug, including images of what are allegedly hot-pink meth crystals. This story erupted nationwide after the sheriff’s department in Carson City, Nevada reported that they had seized this new substance. Major news outlets, like CBS, reported that police in other states had also found this new designer meth “that uses powdered drink mix to give the drug a pink coloring,” suggesting that the sweetness of the drink mix masked the harsh taste of meth.¹⁰ Months later, to check the media frenzy, the Partnership for a Drug Free America, the nonprofit antidrug agency that has created its own wildly misleading media narratives, took the unusual step of announcing that no such drug exists.¹¹ Such largely unchecked repetition of sensational misinformation explains ...

Table of contents

• Cover
• Title Page
• Copyright
• Dedication
• Contents
• Preface: Breaking User Silence
• Acknowledgments
• Introduction. We Are All Users
• Chapter 1. Picture a Drug User
• Chapter 2. Criminalization: Winning the Crusade but Losing the War
• Chapter 3. Medicalization: Defining Drug Use
• Chapter 4. Why We Use: The Pleasure and the Eros of Drugs
• Conclusion
• Notes
• Glossary
• Selected Bibliography
• Index
• About the Author