Creating the American Junkie

by Caroline Jean Acker
Johns Hopkins University Press, 2002
Review by Robin Pappas on Apr 22nd 2004

In the growing body of historical and social scholarship about psycho-pharmacology and drug policy, a good portion of studies hamper interrogation of past research efforts and criminal justice policies by interjecting, often explicitly, arguments favoring the implementation of liberal or zero-tolerance policies for drug use. Following rather specious logic, such authors mold their accounts to "prove" the foolishness of contemporary policy and thereby make room to discuss their own suggestions. In Creating the American Junkie: Addiction Research in the Classic Era of Narcotic Control, Caroline Jean Acker effectively organizes her analysis to avoid this unfortunate trend and successfully generates crucial lines of inquiry into the issues surrounding contexts for opiate use and the fate of opiate-dependent users.

Creating the American Junkie challenges commonly understood ideas about addiction by showing the social construction of the "junkie" persona as it emerged during the "classic era of narcotic control," or the period from about 1910 to 1964. Acker examines this process of "knowledge production" by identifying the main interests and conceptual models employed by federal and local criminal justice authorities, the American Medical Association, and sociologists. She thus explains the ways in which these interests (and sources of funding) shift from the 1910s and --20s to the 1950s, as stiffening policies against opiate use enable an illicit market to supplant physicians as the primary source of opiates, creating an urban, predominantly lower-middle class subculture increasingly threatened with incarceration and limited options for treatment.

By employing historical analysis Acker's study gains the critical strength of elucidating the often competing discursive processes of social construction. This approach enables her to highlight the problems with essentialist models of addiction -- claims, for example, that an addict is irretrievably vicious because of physiological, psychological, or hereditary weaknesses -- in use by both psychiatrists and criminal justice workers during the first decades of the twentieth century. By advancing the notion of "construction" as an analytical approach, Acker traces the logic through which government and medical authorities inhibited inquiry into the possible uses of any substance beyond the scope of therapeutics or criminal activity. By remaining attentive to sociological models, she points out precise moments in addiction research in which criminal and psychiatric studies overlooked vital information about addiction by ignoring the social contexts in which opiate addicts initiated and pursued drug use. Acker advances this analysis with several well-placed case studies. Each example enables her to elucidate her claims about how incarceration of addicts resulted from research full of omissions, faulty logic, and expediency in favor of contextualized evaluations.

As I mention above, her main tactic is to uphold the promise and significance of sociological studies of addiction. Models such as the "career of deviance" framework introduced by Howard Becker in the 1950s, for example, permit scholars to focus on addiction as a dynamic process that challenges the static, essentializing assessments made by psychiatrists and criminal justice researchers in the 1920s and 1930s. She goes so far as to claim that sociological ethnographic methods enable researchers to tell addicts' stories in neutral terms. It is this bias, however, that at times upsets the balance of her otherwise poignant discussion. For example, Acker introduces the notion of a "social definition" of addiction, that is, as a type of behavior arising in response to changing contexts of opiate use and to specific social pressures surrounding family, labor, and the drug marketplace. Despite the importance this definition ascribes to the addict's own ideas about opiate use, it ultimately couches his behavior within the category of deviance. In addition, Acker's own use of terms referring to opiate use slips: "opiate" and "heroin" are often used interchangeably with "drugs," as is "opiate use" and "addiction" with "drug abuse" and "use for pleasure." In light of her persistent claims to critique the history of knowledge production, Acker shows surprising insensitivity to important shifts in her own terminology. As a result, she conflates "drugs" and therefore all illicit substances with the dependence-producing opiates. This slippage undermines Acker's stated critical aims. Instead of challenging or overturning criminal and medical purview, the text ultimately reencodes opiate use -- and given the pernicious conflation of opiates with other substances, all drug use -- with deviance without thoroughly analyzing the processes by which opiates, or other "illicit substances" came to be differentiated from socially invisible psychoactive substances like caffeine, sugar, or chocolate and medically-approved substances like Prozac and Valium.

Although this imprecision in language use is problematic, the text remains vitally useful. Creating the American Junkie is a critical text for scholars and policy-makers alike that underscores the importance of interdisciplinary approaches to developing anything approaching an accurate model of substance-dependence and humane policies for dealing with people dependent on opiates.

Robin Pappas is an adjunct instructor of Comparative Literature at the University of Oregon. Her research interests include rhetoric, the history of medicine and science, and poetry about altered states of consciousness.

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