Revisiting early sociological studies on addiction

Abstract

Addiction is a significant issue in many aspects but no explanatory closure has been attained. The overemphasis on the brain disease paradigm upheld by the National Institute on Drug Abuse may run serious risks, and the present study intends to counteract this partiality. Drawing on Ludwik Fleck’s notion of thought collectives, this article offers a close reading of the works of sociologists Bingham Dai and Alfred R. Lindesmith vis-à-vis other coeval biomedical approaches. Individuals within the same thought collective, such as Dai and Lindesmith, have different views although they share certain thought styles. As noted in this study, inter-collective communication is not typically antagonistic and may form some liaison under certain circumstances. These findings imply that communication among collectives may facilitate creative liaison, as suggested by Fleck. This study aims to enrich the understanding of addiction by coordinating biomedical and sociological sciences through minimizing, if not erasing, their intellectual antagonism and social distance.

Keywords

addiction collectives Bingham Dai Ludwik Fleck Alfred Lindesmith opiate

Introduction

Addiction is a significant medical, social, psychological, legal and political issue (Courtwright, 2001; Musto, 1999; Musto and Korsmeyer, 2002). No satisfactory explanatory closure has been provided on the cause of addiction at the individual and collective levels. The epistemic cacophony of various approaches has produced a variety of explanations and treatments to address this multi-faceted problem, thus generating a balkanized knowledge map rather than an integrated formulation. The brain disease paradigm upheld by the National Institute on Drug Abuse (NIDA) occupies the top of the hierarchy of credibility (Becker, 1967), but it has not developed an effective cure for addiction (Courtwright, 2010). However, this overemphasis on neuroscientific causes may have serious intellectual risks, such as biological essentialism and cultural ignorance, and practical risks, such as funding monopolization and biased policy orientation (Courtwright, 2012b). This limited vision may also inhibit qualitative social research (Rhodes et al., 2010).

To counteract this partiality, this study revisits early sociological studies on addiction in inter-war America and examines their formulations vis-à-vis other coeval disciplinary approaches, or thought collectives (Fleck, 1979; see also Campbell, 2007).

Ludwik Fleck (1896–1961) was a Polish-Jewish physician and historian of science during the inter-war period who argued that scientific truths develop from tentative pre-ideas through collectivization (Fleck, 1979). Scientific truths are not considered discoveries of individual scientists but are stylized outcomes of the thought collectives of which these scientists are members. A thought collective is defined as ‘a community of persons mutually exchanging ideas or maintaining intellectual interactions’ (ibid.: 39) with a particular thought style. This style is portrayed as ‘[the readiness for] directed perception, with corresponding mental and objective assimilation of what has been so perceived’ (ibid.: 99). Individuals within a thought collective share the same thought style, and the generated truth is thus a culturally conditioned product. Fleck’s perspective introduces sociological insight into the making of scientific knowledge by rejecting positivist views, such as logical positivism (Lowy, 1988). Thomas Kuhn’s view of normal science notably reflects Fleck’s influence (Kuhn, 1962).

The concept of ‘interactions with collectives’ examined in the current study is also central to the sociological formulations scrutinized herein; that is, addiction is first and foremost a social process that can be clarified by exploring the subjective experiences and self-identities of addicts as fashioned in social groups. These sociological formulations contrast sharply with medical and pharmacological discourses, both of which lean toward objectifying or even pathologizing addicts’ experiences. This study aims to highlight the double meanings of interactions with collectives in terms of the sociological theorization of addicts and inter-collective communication.

Then, why the inter-war period? Disagreements on the meaning of addiction have been present in the USA since the early days of addiction science that specifically focused on narcotics. The passing of the Harrison Narcotic Act 1914 and its enforcement in the next year were followed by the shutdown of several morphine maintenance clinics in the early 1920s (Waldorf, Orlick and Reinarman, 1974). Strict suppression and criminalization continued until 1962 when methadone was formally implemented as a treatment option for opiate addiction. Historian David Courtwright (2012a) thus referred to this period as the classic era of narcotic control. Despite the vehement legal restriction from the government, as represented by Harry Anslinger, who was then Commissioner of the Federal Bureau of Narcotics, biomedical sciences on addiction burgeoned along with the establishment of the Narcotic Farm, a prison-hospital for drug addicts, and the Addiction Research Center in Lexington, Kentucky in 1935 (Acker, 2002; Campbell, 2007; Campbell, Olsen and Walden, 2008). During the inter-war period, or the first half of the classic era of narcotic control, physicians, pharmacologists and sociologists, such as Bingham Dai and Alfred R. Lindesmith from the University of Chicago, actively explored the nature of opiate addiction. Drawing on Fleck’s definitions, the present study refers to the first two disciplines as the biomedical collective, as opposed to the sociological collective to which Dai and Lindesmith belong. Most historical studies on addiction science in this period, with the exception of Acker’s study (2002), did not closely investigate the discourses of Dai and Lindesmith as if their work was not concerned with addiction or science, but simply with deviance or society.

The current study attempts to address such negligence by closely examining existing dissertations, published papers, books and other relevant references. First, the convergence and divergence of the views of Dai and Lindesmith on the social process of addiction are delineated. Second, the ideas and formulations of different collectives on addiction are compared and analysed. This close reading discloses the complex interactions among thought collectives, as discussed in subsequent sections. This study aims to enrich the understanding of addiction by coordinating biomedical and sociological sciences through minimizing, if not erasing, intellectual antagonism and social distance.

Biomedical views on addiction in the early 20^th century

Addiction theories within the biomedical collective manifest great variability. Alcohol intemperance was considered a more serious problem than opiate addiction at the beginning of the 20^th century because drunkards exhibit more erratic behaviors than satiated opium smokers do (Courtwright, 2012a). This view persisted until the 1950s, when Lawrence Kolb compared the physical harms caused by opiates with those induced by alcohol (Kolb, 1956). George Beard previously contended that neurasthenia and intemperance in alcohol and other drugs are both illnesses of civilization. Intemperance was observed among the lower classes, whereas neurasthenia mostly afflicted members of the upper class (Beard, 1871). However, numerous contemporary physicians considered alcohol or drug addiction to be a neuropsychiatric disease. For example, Emil Kraepelin stated in his influential textbook Clinical Psychiatry (1904[1899]) that morphinism is a form of toxic psychosis and is therefore an outcome of one’s defective constitution. By contrast, T. D. Crothers (1902: 32–3) took an eclectic position. He agreed that morphinism is a disease of modern civilization, but, unlike Beard, he opined that it arises because continuous use of morphine relieves the pain of neurasthenia, a consequence of modernization upon constitutionally vulnerable individuals.

The American Association for the Cure of Inebriety was renamed the American Association for the Study and Cure of Inebriety (AASCI) in 1888, 18 years after its establishment in New York City (Weiner and White, 2007). The principles and aims of AASCI are clearly defined in the 1893 volume edited by its secretary Dr. T.D. Crothers. In this volume, AASCI stated that inebriety is a curable disease, the constitutional tendency of which can be either inherited or acquired. The association also advocated the establishment of inebriety asylums in major cities with sufficient power of control over their inhabitants (American Association for the Study and Cure of Inebriety, 1893). Although alcohol was the main focus, the concept of inebriety also applied to opium, cocaine and ether. Primitive neuroscientific language was used to describe the pathogenetic mechanisms; for instance, meconeuropathia or chronic opium poisoning was defined as follows:

[It] is characterized by repeated nerve excitations, in which the nerve centers, not being completely overcome, a kind of tolerance is established, with progressively developing abnormal molecular neural changes, which are as repeatedly covered up and masked by the renewed doses, till some sudden deprivation of the drug or failure to appropriate it, reveals, in full force, the neural mischief which has been gradually done. (American Association for the Study and Cure of Inebriety, 1893: 317)

The description further stated that this neurochemical ‘mischief’ relies on an opium diathesis often observed in children of neurotic and defective parents, thus indicating the hereditary basis of degeneration. However, AASCI also stressed the pathogenetic effects of sufferers’ living conditions and surroundings, thus differentiating its viewpoint from that of Kraepelin.

This depiction of opium inebriety at that time appears similar to the present neurobiology of and clinical insight into addiction despite the terminological differences. The pathology was extended beyond craving into the brain: ‘The demand for opium is only a symptom; the removal of opium is not the cure. Some central brain degeneration has begun and is going on’ (American Association for the Study and Cure of Inebriety, 1893: 324). The following statement by Courtwright (2010: 139) may be partially correct: ‘What happened in the late twentieth century was essentially the confirmation and recasting of a series of shrewd hypotheses that these pioneers ventured.’ However, these early 20th-century pre-ideas (Fleck, 1979) are different from current concepts. For instance, the description of tolerance and withdrawal does not include stimulants in its scope.

The American Association for the Study and Cure of Inebriety (1893) advocated the removal of inebriates from their homes as a necessary initial step to effective treatment because their will-power is subverted, thus paradoxically reflecting the moral discourse this theory claimed to disregard. A protective environment, rapid reduction in opium use, Silas Weir Mitchell’s ‘rest treatment’, an exclusive milk diet, and the use of various medical agents such as bromide were also recommended.

The stereotypes of opiate addicts gradually shifted from ill, middle- or upper-class women to young, lower-class men (Acker, 2002; Courtwright, 2001; Musto, 1999). The classification of addicts became vital because the use of opiates by the former was considered accidental and legitimate, whereas that by the latter was deemed culpable or even criminal. Lawrence Kolb (1925a) examined the life histories and backgrounds of 230 narcotic-addiction cases and noted that 86% had exhibited some form of nervous instability prior to addiction even though some were perceived to be open in character. He summarized the common features of these individuals as follows:

[T]hey are struggling with a sense of inadequacy, imagined or real, or with unconscious pathological strivings that narcotics temporarily remove; and the open make-up that so many of them show is not a normal expression of men at ease with the world, but a mechanism of inferiors who are striving to appear like normal men. (Kolb, 1925a: 304)

Among the cases who were addicted to opiates for medical causes, 67.2% were considered psychologically abnormal (Kolb, 1928). Kolb’s conclusion that the majority of, if not all, opiate addicts is psychologically unstable diverted clinical attention from physical defects to psychological make-up. However, his formulation retained the notion of defective constitution, and he was more concerned with classification than with the development of these psychopathic traits. Thus, Kolb’s classification was used as a therapeutic tool rather than as a construct for scientific validation. Kolb eventually admitted that the idea of psychopathic personality is confusing because ‘it is a classification we put everything in when we do not know where else to put it’ (Kolb and Ossenfort, 1938: 921).

Kolb did not associate individual psychopathology with society, but other physicians linked addiction to failed socialization. Based on their review of over 5,000 morphinism cases in 20 years of practice, Sceleth and Kuh (1924) described addicts as follows:

There is something wrong in the mental make-up of an individual who takes a sniff of heroin or a shot of morphin [sic] because some one [sic] tells him it will do him good. Call him a constitutional psychopath, weak-minded or what one will; he represents a type made up of our population’s misfits. (Sceleth and Kuh, 1924: 680)

This description highlights the convergence and divergence of ideas among practising physicians. Sceleth and Kuh agreed with Kolb that the desire driving drug addiction is psychological and not physiological. However, they argued that opiates function differently for addicts at various life stages; they boost self-confidence and life enjoyment in the young, help the middle-aged avoid life’s conflicts and overcome fatigue, and numb the elderly. What addicts ask for are, Sceleth and Kuh suggested, ‘normal plus’ states. In some cases, they agreed with Kolb that some addicts were constitutionally psychopathic (Kolb, 1925a). In other cases, they avoided labeling addicts as a peculiar class of people because ‘no person is immune to opiate addiction’ (Sceleth and Kuh, 1924: 679). Their reference to ‘our population’s misfits’ clearly posits that addicts are socially maladapted, especially those who reside in the overcrowded and unsanitary neighborhoods of large cities.

However, societal effects play a minor, if any, role in medical theories. The ethos of physicians in general is their commitment to the determination of a specific physical or psychological make-up that explains addicts’ vulnerability and intractability (Kolb, 1925a, 1925b). This commitment has persisted, and the investigation has been facilitated by new knowledge and equipment such as functional magnetic resonance imaging (Courtwright, 2010; Campbell, 2007; Goldstein, 1994).

On the other hand, pharmacologists Arthur Laurie Tatum and Maurice Seevers did not consider addicts’ psychology in their animal experiments. Since craving was considered a subjective state, it could therefore not be adequately manipulated and observed. Hence, Tatum and Seevers relied on explicit physiological and behavioral signs as indicators of withdrawal and thus addiction. These signs are controllable and useful in interpreting corresponding human behaviors because the results of a direct study on human subjects can be tainted by their states of mind (Tatum, Seevers and Collins, 1929).

Other pharmacologists, such as Reid Hunt and Lyndon F. Small, investigated molecules as another biological solution to addiction by producing non-addicting analgesic to replace morphine (Acker, 2002). However, considering the search for the nature of addiction, Seevers represented another subgroup in the biomedical collective (Acker, 2002; Campbell, 2007; Rasmussen, 2010), which stripped addiction of its subjective and experiential dimensions and pursued objective and visible signs. He established an animal model that could test the addictive potential of other substances; however, his model did not classify cocaine as addictive. One reason was that cocaine withdrawal symptoms are typically mild despite strong cravings (Rasmussen, 2010). In the stimulant-treated animals, sensitization was more often observed than tolerance, thus further discounting the addictive potential of these substances (Tatum and Seevers, 1929).

Sociologists stepped to the fore

Two subgroups of the biomedical collective have been observed from bedside to bench. These subgroups share an individualizing and pathologizing thinking style despite their varied approaches to addiction. By contrast, the Chicago School sociologists herein constitute a second thought collective that aims to understand addiction as a social process rather than as personal physical or psychological attributes. This approach to addiction was associated with research on other social phenomena, such as racism, urbanism and domestic migration. The focus on urban environment and its societal effects is presently considered as a defining feature of the Chicago School of Sociology (Abbott, 1999; Bulmer, 1986; Fisher and Strauss, 1978; Musolf, 2003).

Bingham Dai and Alfred R. Lindesmith both graduated from the Department of Sociology at the University of Chicago in the 1930s, when Robert Park, Ernest Burgess, Herbert Blumer and Erwin Sutherland were faculty members (Lengermann, 1988). Dai and Lindesmith examined opiate addiction in their doctoral studies under the same adviser, Herbert Blumer, and shared some case materials (Keys and Galliher, 2000). However, their formulations of addiction differed.

Bingham Dai and his culture-and-personality formulations of addiction

Bingham Dai was born in Shanghai, China, in 1899. He took up advanced study in the USA at the age of 30 but shifted from education to sociology under the influence of Robert E. Park. He also attended a seminar by Edward Sapir in Yale University and became a psychoanalytic trainee under Harry Stack Sullivan and Leon Saul (Dai, 1970). In 1932, Dai completed his Master’s thesis on speaking in tongues or glossolalia, in which he proposed a socio-psychological explanation regarding glossolalia as an adaptive rather than a pathological reaction to regain personal serenity and group acceptance. In his view, cultural, personal and situational factors influence people who speak in tongues. The cultural factor refers to religious background, the personal factor to attitudes that predispose individuals toward glossolalia as an act of Christianity, and the situational factor both to the social conditions and to the immediate occasion that stimulated the act (Dai, 1932). The perspectives that one is a part of a society and that one’s personality is a product of culture were extended to and formed the conceptual basis of his later doctoral dissertation on opiate addicts (Wang, 2006).

Dai’s doctoral dissertation Opium Addiction in Chicago was completed in 1935, published in 1937 and republished in 1970. Dai had long been interested in issues of opium because opium smoking took away the life of his beloved uncle who, tragically and ironically, used to be an anti-opium fighter. This personal experience accounted for Dai’s work with the Chinese National Anti-opium Association and participation in a number of anti-opium activities prior to his arrival in the USA (Dai, 1970[1937]). Intriguingly, these nationalistic endeavors left little mark on his dissertation, which concentrated on the social psychology of marginalized populations (Wang, 2006).

Dai’s dissertation first introduced existing pharmacological, historical and cultural understandings regarding addiction, followed by the demographic and criminal characteristics of 2,518 drug addicts and 327 drug peddlers as recorded from 1928 to 1934. Dai also listed 25 case histories to depict the development of an opium addict as a result of the interaction between individual personality and socio-cultural environment. Dai subscribed to the current definition of an addict as one who experiences dependence, craving and withdrawal as a result of repeated administration (Dai, 1970[1937]: 23). This definition excludes habitués who are unaware of a drug’s nature despite repeated use or have not learned to identify the physical discomfort of withdrawal symptoms. The last part of Dai’s thesis highlighted the cognitive factor that differentiates habituation from addiction. However, Dai did not push his thesis further as Lindesmith did. Lindesmith’s thesis focused on individuals’ perception of themselves as addicts following repeated opiate use, whereas that of Dai was concerned with how these individuals become susceptible to the temptation of opium use. Dai’s approach compared opium use with a spreading cultural practice in which addicts seek drug-induced euphoria to enjoy a ‘moral holiday’ or to attain a mental satisfaction that mimics sexual orgasm.

Dai described the demographics of the opium addicts he studied in detail. Four-fifths of these subjects were white, and most were native to Chicago. However, Dai noted that the addiction rate among African-American migrants was also increasing. He found that the levels of literacy and health in addicts were approximately similar to those of ordinary people. Addicts typically worked in service and recreation industries and began their habits between the ages of 20 and 29. Over half of the subjects were single. Dai employed an ecological approach following Burgess’s ideas regarding urban structure (Bulmer, 1986). He mapped the distribution of these addicts in the city and described the local characteristics of regions with high and low densities of addicts. He found that the density of addicts is associated with the degree of physical dilapidation and lack of neighborhood spirit in the region, as shown in the region’s rental level, population decrease and percentages of privately owned houses and vacant dwelling units.

These statistical descriptions undergirded Dai’s explanation about the interaction between social situations and personality factors and their contribution to the formation of addiction. Dai’s depiction of social situations specifically referred to pleasure parties, pool rooms, gambling houses, homosexual relations and associations with prostitutes, pimps, drug peddlers, or co-workers in hotels and restaurants. Dai’s previous classification of cultural, personal and situational factors in the manifestation of glossolalia shifted to a perspective about the addict’s self, in which the socio-cultural environment interacts with personality make-up, especially regarding the sense of inferiority, to tempt an individual into opiates as an escape from difficult life situations. In this drug-use-as-escape regard, Dai concurred with Kolb. However, Dai argued at the end of his dissertation that

[Addiction] is essentially a symptom of a maladapted personality, a personality whose capacity for meeting cultural demands has been handicapped by inadequate emotional and social development, for which, as shown by our case materials, the general cultural chaos and social disorganization that is characteristic of modern society is mainly responsible. (Dai, 1970[1937]: 191)

Dai pioneered the tradition of addiction as deviance and inspired future scholars of deviance such as Howard Becker (Page and Singer, 2010). His approach mixes psychoanalysis, culture-and-personality studies and Chicago School urban sociology. Important as it may appear, Dai’s work is mostly mentioned in passing in later studies on addiction partly because he left the field after PhD graduation and practised as a psychoanalyst in China and in the USA for most of his life (Wang, 2006). His subsequent publications mostly involve socio-psychiatric analyses of personality and culture (Dai, 1952, 1941). Dai’s concern with the tasks and responsibilities of a person as a socio-cultural being, which echoes the theme of his dissertation, is exemplified in his other works (Wang, 2006). Acker (2002: 198–202) acknowledged Dai’s insistence on ‘the cognitive component to addiction’ and ‘meaningful agency on the drug-using individual’; however, she also indicated that Dai’s work is constrained by his contemporary frame, which considers addicts as psychologically vulnerable and socially maladapted. This conclusion is valid but may also be deemed an imaginable outcome when Dai’s analysis of addicts merges Sullivan’s neo-Freudian psychoanalytic frame with the notion of social disorganization characterizing the Chicago School urban sociology (Page and Singer, 2010).

Alfred R. Lindesmith and his general theory of addiction

Lindesmith began his doctoral program in sociology at the University of Chicago in 1931 at the age of 26 after obtaining his Master’s degree in education from Columbia University (Keys and Galliher, 2000). In 1937, Lindesmith submitted in haste his doctoral dissertation ‘The Nature of Opiate Addiction’, in which he theorized the formation of addiction based on what he called analytic induction of the interviews with approximately 50 addicts living outside of institutions (Lindesmith, 1937).

Keys and Galliher (2000: 47–8) noted that the currently available version of Lindesmith’s dissertation is incomplete compared with his later published book Opiate Addiction (1947) and that he cited a number of cases from Dai’s study. Nevertheless, some prototypical concepts about the identity formation of addicts remain the same in the two versions.

Lindesmith argued that one does not become an addict until one learns the meaning of withdrawal symptoms from others and confirms this knowledge when the symptoms are relieved by opiates. In this argument, addiction certainly does not denote constitutional or psychological defects but describes a learning process in which one’s incessant need for opiates is incorporated into one’s identity. This process is predicated on one’s membership in social groups and one’s ability to use linguistic symbols in communication. ‘Addiction is therefore a phenomenon confined exclusively to man living in society’ (Lindesmith, 1937: 130).

Similar to his contemporaries, Lindesmith differentiated habituation from addiction. However, unlike Dai (1970) or McAuliffe and Gordon (1974), Lindesmith contended that the incentive for drug use is not pleasure but the ‘relief afforded by the drug and the anticipation and exaggeration of this relief in the mind’s eye’ (Lindesmith, 1937: 121). Addicts therefore seek a fix to feel ‘normal’ again (Lindesmith, 1938, 1947). The term ‘normal’ here is vaguely defined. It appears to refer to a state of mind, but it can also refer to a state of physical equilibrium, like the metabolic normalizing effects observed in people on methadone (Dole, Nyswander and Kreek, 1966). In addition, the term also implies the existence of social norms into which these addicts desire to fit with the assistance of drugs. However, whether ‘normal’ is something ordinary people feel, ‘normal plus’ as Sceleth and Kuh (1924) argued, or masked normality as Kolb (1925a) portrayed, remains an important but unanswered issue.

The coverage and theoretical assumption of Lindesmith’s formulation are controversial and have been internally and externally criticized. The formulation is considered inadequate as a general theory of addiction because he studied only opiate users and prioritized withdrawal experiences over tolerance development (Slight, 1938). Lindesmith argued that the perception of dope fiends as harmful and evil is nothing but a myth that favors punitive approaches (Lindesmith, 1940a); however, San Francisco judge Twain Michelsen castigated him for using incorrect data and for having a partial perspective (Michelsen, 1940). Behavioral pharmacology disproves Lindesmith’s argument that addiction is limited to humankind. His symbolic interactionist approach to addiction has also been criticized by sociologists as being overly dependent on the voluntarism and thus negligent of the so-called pre-reflexive or non-symbolic aspects of addiction (Weinberg, 1997).

Despite the ‘nearly unanimous condemnation from both the sociological and the medical communities’ of Opiate Addiction in 1947 (Keys and Galliher, 2000: 178), Lindesmith’s formulation of addiction has persisted partly because of its influence on Howard Becker (Plummer, 2003). Becker’s work adopts Lindesmith’s analytic induction method to address the social learning process of marijuana use (Becker, 1953). His approach to the social construction of deviance later inspired drug ethnographers (Page and Singer, 2010), several of whom have been sponsored by NIDA.

Lindesmith eventually compromised on some points in light of accumulated biomedical findings, especially with respect to behavioral psychology (Weinberg, 1997). Using behaviorist terms, he explained that addiction is a conditioning process that can befall both human beings and animals. However, Lindesmith did not entirely surrender his ideas; rather, he insisted that the conditioning process in human beings differs from that in animals because only human beings can conceptualize craving in the symbolically mediated manner that characterizes addiction (Lindesmith, 1965).

Convergence and divergence within a thought collective

Case no. 14 in Dai’s dissertation (1970[1937]) describes a boy born on an island off the Pacific coast. The boy barely knew his father, who was a heavy-drinking boat worker often living away from home. At 16, the boy hit his teacher for wrongfully accusing him of impregnating a girl and ran away in shame, eventually working as a messenger boy for prostitutes in Montana. He stayed with and learned to smoke opium from one of these girls. His first opium use was unpleasant, but he discovered that it considerably enhanced sexual performance. Thereafter, he continued smoking opium until his girlfriend left him to visit her sister several months later. He experienced insomnia, nausea, vomiting and cramps shortly after losing access to the opium supplied by his girlfriend. Another messenger boy told him that his physical discomfort was caused by withdrawal and gave him opium and coffee to relieve the symptoms. Only then did the boy realize that he was addicted.

Dai contended that opium use is not a vicious habit but is essential in the success of a pimp. This habit develops as a result of interactions between one’s personality and environment. His psychoanalytically informed formulation posits that case no. 14’s career is characterized by an intense feeling of inferiority during adolescence and a strong dependence on a mother figure, such as the prostitute he lived with. The drug addiction in this case is ‘connected not only with that part of the underworld culture’ but also ‘with such emotional trends or attitudes as may be considered as the earmarks of an infantile type of personality’ (Dai, 1970[1937]: 150). Addiction is therefore an interactional outcome of culture and personality.

Conversely, Lindesmith’s analysis of the same case (case no. 9 in his dissertation) simply recorded the time when the boy met his opium-smoking girlfriend and concluded with the relief of his withdrawal symptoms after using opium. Lindesmith argued that ‘[t]o a considerable extent, the addict’s life is a life of anticipation – anticipation of withdrawal, anticipation of a loss of supply, and anticipation of relief which is sometimes glorified as something pleasurable in itself’ (Lindesmith, 1937: 121). Anticipation characterizes addiction because the purely physiological conditions induced by drug use are assimilated into ‘a self-conscious symbolic structure’ (ibid.: 127). The symbolic structure providing meaning to one’s subjective experience is mediated through social interactions, including the use of argot.

Lindesmith did not conduct further studies on opiate addiction despite his lifelong career as a drug-reform advocate (Keys and Galliher, 2000). As a result, he failed to capture the greater social context and the nuanced interpersonal exchanges that contribute to the processes of recognition and identification, thus making his formulation somewhat reductionist (Acker, 2002: 202). Howard Becker’s later work on marijuana smokers (1953) supplemented the gap between the formulations of Dai and Lindesmith by detailing the process and rationale of social learning.

The convergence of Dai’s and Lindesmith’s ideas in the same thought collective must not be ignored although they disagree on occasion. The Chicago School of Sociology to which Dai and Lindesmith belong is not a fixed group of individuals with clear definitional boundaries. Rather, it is a convenient but loosely grouped assemblage at best (Harvey, 1987), or, as Fisher and Strauss (1978) suggested, it is best conceptualized as an auction house instead of a homogeneous and consistent unit. ‘Auction house’ pragmatically refers to the notion that a school exists because it facilitates the spread of certain intellectual merchandise rather than the likelihood of passing on an intact ideational heritage. Howard Becker expressed a similar view regarding the perception of him as a symbolic interactionist: ‘It’s like all those “school” titles, you know, labels – they’re appropriated by all kinds of people for all kinds of reasons’ (cited in Plummer, 2003). The reason behind the adoption of this term in the present study is both pragmatic and analytical. Treating Chicago School sociologists as a thought collective with its internal divergence and convergence illustrates the complexity of the notion of thought collectives. According to Fleck, a thought collective is never a homogenizing unity; nonetheless, convergence maintains communication among individuals within a thought collective, thereby ensuring the thought collective’s longevity. Convergence for Chicago sociologists such as Dai and Lindesmith includes, among other things, attentiveness to interactions among individuals that make them who they are, shaping of one’s self through interactions with the (urban) environment and life vicissitudes, and research methods that address these social or symbolic processes behind what appears to be personal or, in this case, pathological. These concerns and features are adopted by other sociologists of this tradition, such as Howard Becker and Martha Rosenbaum (Rosenbaum, 1981; Acker, 2002).

Conclusion

Two thought collectives (biomedicine and sociology) are described and analysed in the current study, but this schematic classification may produce an impression that these thought collectives do not communicate. In fact, they do. Both collectives interact with each other, as partly shown in previous sections. For instance, Lawrence Kolb disapproved of Lindesmith’s general theory of addiction (Acker, 2002). Abraham Wikler, who was Kolb’s colleague in the Addiction Research Center, also criticized this theory (Wikler, 1948). On the other hand, Lindesmith (1940a, 1940b) attacked the thesis regarding addicts as psychopathic or even criminal. He especially objected to the idea that opiate use is an escape from a sense of inferiority or emotional distress (Lindesmith, 1940b). This objection distanced him from Kolb and, interestingly, his sociologist colleague Dai. His adamant belief that an addict is a victim of inhumanly suppressive drug policy contributed to his long-term antagonism with the Federal Bureau of Narcotics, especially its director Harry Anslinger (Galliher, Keys and Elsner, 1998). Nevertheless, Lindesmith’s position on de-criminalizing addiction paradoxically resulted in his embrace of psychiatric intervention, even not an abstinence-oriented one. The paradox is evident in his Federal Probation article, wherein he advocated the legitimate provision of opiates to addicts by physicians as in the British system. Kolb is cited in the last lines of this article: ‘[W]e have too often forgotten that the addict needs help rather than punishment. It behooves us, then, to look upon every drug addict as a sick individual’ (Lindesmith, 1948: 25). Despite mutual criticisms, rapprochement to a certain degree between two thought collectives is possible. In this case, sociologists and psychiatrists eventually formed liaisons against their common opponent, namely repressive drug policy (Kolb, 1956).

By contrast, Dai’s work was dismissed by members of the biomedical collective although it was ground-breaking in that it provided the first sociological perspective on addiction. This dismissal is largely attributed to his career shift toward psychoanalysis. As Dai posited, addicts require emotional and social adjustment treatment. This position is compatible with the view and practice of psychiatrists such as Kolb and Ossenfort (1938). Sociologically, addiction can be prevented through emotional education and social recognition of vulnerable individuals; however, an easy solution to the ‘general cultural chaos and social disorganization’ (Dai, 1970: 191) that allegedly undergirded personal vulnerability has not been provided by Dai or other sociologists thus far.

According to Fleck (1979: 109–10), communication among collectives may be inhibited by great differences, and the definitions of terms such as addiction may change according to their usage in inter-collective communication. Despite the likely alterations of ideas, the differences among collectives are not sufficient reasons to neglect or denigrate one another’s contribution, because, first, focal convergence between collectives does exist and, second, the exchange of different ideas makes a shift in the thought style even more likely, thus producing opportunities for creative liaison and discovery (see also Amsterdamska, 2004).

Therefore, separating the sociological perspective from the biomedical perspective in current addiction research or preferring the latter to the former is neither natural nor helpful. Recent progress in social neuroscience (Cacioppo and Berntson, 1992) has developed a new approach to addiction that is inspired by sociology, psychology and neuroscience (Schnur and Shurtleff, 2008). This advancement indicates that diverse views of addiction are not necessarily antagonistic but are probably reconcilable.

Discussions regarding research, treatment, or policy-making will be hopelessly inconclusive if debating parties do not coordinate the thought collectives involved in the theorization of addiction. The present study not only aims to enrich present understanding regarding addiction by reviewing the works of Bingham Dai and Alfred Lindesmith in the epistemic cacophony of addiction research during the inter-war period; it also indicates that the first step to managing addiction is generating serviceable truth (Jasanoff, 1990) by promoting communications among all potential collectives rather than prioritizing a single collective.

Footnotes

Acknowledgements

I sincerely thank Professor Adele Clarke (University of California, San Francisco) for her careful reading of an earlier draft of this article and Professor Wen-Ji Wang (National Yang-Ming University) for his encouragement during the revision of this work. I would also like to express my gratitude to the anonymous reviewers, whose comments significantly improved this article. The article’s revision, including editing, is sponsored by the National Science Council, Taiwan (NSC 102-2410-H-010-006-MY2).

References

Abbott

(1999) Department and Discipline: Chicago Sociology at One Hundred. Chicago, IL: University of Chicago Press.

Acker

C. J.

(2002) Creating the American Junkie: Addiction Research in the Classic Era of Narcotic Control. Baltimore, MD: Johns Hopkins University Press.

American Association for the Study and Cure of Inebriety (1893) The Disease of Inebriety from Alcohol, Opium, and Other Narcotic Drugs: Its Etiology, Pathology, Treatment and Medico-Legal Relations. New York: E. B. Treat.

Amsterdamska

(2004) ‘Achieving Disbelief: Thought Styles, Microbial Variation, and American and British Epidemiology, 1900–1940’, Studies in the History and Philosophy of Biology and Biomedical Science 35: 483–507.

Beard

G. M.

(1871) Stimulants and Narcotics: Medically, Philosophically, and Morally Considered. New York: G. P. Putnam & Sons.

Becker

H. S.

(1953) ‘Becoming a Marijuana User’, American Journal of Sociology 59: 235–42.

Becker

(1967) ‘Which Side Are We On?’, Social Problems 14: 239–47.

Bulmer

(1986) The Chicago School of Sociology. Chicago, IL: University of Chicago Press.

Cacioppo

J. T.

Berntson

G. G.

(1992) ‘Social Psychological Contributions to the Decade of the Brain: Doctrine of Multilevel Analysis’, American Psychologist 47(8): 1019–28.

10.

Campbell

(2007) Discovering Addiction: The Science and Politics of Substance Abuse Research. Ann Arbor: University of Michigan Press.

11.

Campbell

Olsen

Walden

(2008) The Narcotic Farm: The Rise and Fall of America's First Prison for Drug Addicts. New York: Abram.

12.

Courtwright

D. T.

(2001) Dark Paradise: A History of Opiate Addiction in America. Cambridge, MA and London: Harvard University Press.

13.

Courtwright

D. T.

(2010) ‘The NIDA Brain Disease Paradigm: History, Resistance and Spinoffs’, BioSocieties 5: 137–47.

14.

Courtwright

D. T.

(2012a) ‘Introduction: The Classic Era of Narcotic Control’, in Courtwright

D. T.

Joseph

Des Jarlais

(eds) Addicts Who Survive: An Oral History of Narcotic Use in America before 1965. Nashville: University of Tennessee Press, pp. 1–44.

15.

Courtwright

D. T.

(2012b) ‘Addiction and the Science of Policy’, Addiction 107: 486–92.

16.

Crothers

T. D.

(1902) Morphinism and Narcomanias from Other Drugs: Their Etiology, Treatment, and Medicolegal Relations. Philadelphia, PA and London: W. B.Saunders.

17.

Dai

(1932) ‘Speaking with Tongues or Glossolalia’, Master’s thesis, University of Chicago, USA.

18.

Dai

(1941) ‘Personality Problems in Chinese Culture’, American Sociological Review 6: 688–96.

19.

Dai

(1952) ‘A Sociopsychiatric Approach to Personality Organization’, American Sociological Review 17(1): 44–9.

20.

Dai

(1970[1937]) Opium Addiction in Chicago. Montclair, NJ: Patterson Smith.

21.

Dole

V. P.

Nyswander

M. E.

Kreek

M. J.

(1966) ‘Narcotic Blockade’, Archive of Internal Medicine 118: 304–9.

22.

Fisher

Strauss

(1978) ‘The Chicago Tradition and Social Change: Thomas, Park and Their Successors’, Symbolic Interactionism 1: 5–23.

23.

Fleck

(1979) Genesis and Development of a Scientific Fact. Chicago, IL: University of Chicago Press.

24.

Galliher

J. F.

Keys

D. P.

Elsner

(1998) ‘Lindesmith v. Anslinger: An Early Government Victory in the Failed War on Drugs’, The Journal of Criminal Law and Criminology 88: 661–82.

25.

Goldstein

(1994) Addiction: From Biology to Drug Policy. New York: W. H. Freeman.

26.

Harvey

(1987) ‘The Nature of “Schools” in the Sociology of Knowledge: The Case of the “Chicago School”’, The Sociological Review 35: 245–78.

27.

Jasanoff

(1990) The Fifth Branch: Science Advisors as Policymakers. Cambridge, MA: Harvard University Press.

28.

Keys

D. P.

Galliher

J. F.

(2000) Confronting the Drug Control Establishment [electronic resource]: Alfred Lindesmith as a Public Intellectual. Albany: State University of New York Press.

29.

Kolb

(1925a) ‘Types and Characteristics of Drug Addicts’, Mental Hygiene 9: 300–13.

30.

Kolb

(1925b) ‘Pleasure and Deterioration from Narcotic Addiction’, Mental Hygiene 9: 699–724.

31.

Kolb

(1928) ‘Drug Addiction: A Study of Some Medical Cases’, Archives of Nerology and Psychiatry 20: 171–83.

32.

Kolb

(1956) ‘Let’s Stop this Narcotic Hysteria!’, Saturday Evening Post (28 July): 19, 50, 54–5, accessible @: http://www.unz.org/Pub/SatEveningPost-1956jul28

33.

Kolb

Ossenfort

(1938) ‘The Treatment of Addicts at the Lexington Hospital’, Southern Medical Journal 31: 914–20.

34.

Kraepelin

(1904[1899]) Clinical Psychiatry: A Textbook for Students and Physicians, trans. Defendorf

A. R.

. New York: Dover.

35.

Kuhn

T. S.

(1962) The Structure of Scientific Revolution. Chicago, IL: Chicago University Press.

36.

Lengermann

P. M.

(1988) ‘Robert E. Park and the Theoretical Content of Chicago Sociology: 1920–1940’, Sociological Inquiry 58: 361–77.

37.

Lindesmith

A. R.

(1937) ‘The Nature of Opiate Addiction’, PhD thesis, University of Chicago, USA.

38.

Lindesmith

A. R.

(1938) ‘A General Theory of Addiction’, American Journal of Sociology 43(4): 593–613.

39.

Lindesmith

A. R.

(1940a) ‘Dope Fiend Mythology’, Journal of Criminal Law and Criminology 31: 199–208.

40.

Lindesmith

A. R.

(1940b) ‘The Drug Addict as a Psychopath’, American Sociological Review 5: 914–20.

41.

Lindesmith

A. R.

(1947) Opiate Addiction. Evanston, IL: Principia Press.

42.

Lindesmith

A. R.

(1948) ‘Handling the Opiate Problem’, Federal Probation 23: 22–5.

43.

Lindesmith

A. R.

(1965) ‘Problems in Social Psychology of Addiction’, in Wilner

D. M.

Kassenbaum

G. G.

(eds) Narcotics. New York: McGraw-Hill, pp. 118–39.

44.

Lowy

(1988) ‘Ludwik Fleck on the Social Construction of Medical Knowledge’, Sociology of Health and Illness 10: 133–55.

45.

McAuliffe

W. E.

Gordon

R. A.

(1974) ‘A Test of Lindesmith’s Theory of Addiction: The Frequency of Euphoria among Long-Term Addicts’, American Journal of Sociology 79(4): 795–840.

46.

Michelsen

(1940) ‘Lindesmith’s Mythology’, Journal of Criminal Law and Criminology 31: 375–400.

47.

Musolf

G. R.

(2003) ‘The Chicago School’, in Reynolds

L. T.

Herman-Kinney

N. J.

(eds) Handbook of Symbolic Interactionism. Walnut Creek, CA: Alta Mira Press/Roman Littlefield, pp. 91–117.

48.

Musto

D. F.

(1999) The American Disease: Origins of Narcotic Control. New York and Oxford: Oxford University Press.

49.

Musto

D. F.

Korsmeyer

(2002) The Quest for Drug Control: Politics and the Federal Policy in a Period of Increasing Substance Abuse, 1963–1981. New Haven, CT and London: Yale University Press.

50.

Page

J. B.

Singer

(2010) Comprehending Drug Use: Ethnographic Research at the Social Margins. New Brunswick, NJ: Rutgers University Press.

51.

Plummer

(2003) ‘Continuity and Change in Howard S. Becker’s Work: An Interview with Howard S. Becker’, Sociological Perspectives 46: 21–39.

52.

Rasmussen

(2010) ‘Maurice Seevers, the Stimulants and the Political Economy of Addiction in American Biomedicine’, BioSocieties 5: 105–23.

53.

Rhodes

Stimson

G. V.

Moore

. (2010) ‘Qualitative Social Research in Addictions Publishing: Creating an Enabling Journal Environment’, International Journal of Drug Policy 21: 441–4.

54.

Rosenbaum

(1981) Women on Heroin. New Brunswick, NJ: Rutgers University Press.

55.

Sceleth

C. E.

Kuh

(1924) ‘Drug Addiction’, Journal of the American Medical Association 82: 679–82.

56.

Schnur

Shurleff

(2008) ‘Social Neuroscience: Application to Addiction’, Drug and Alcohol Dependence 94: 285–90.

57.

Slight

(1938) ‘Comment’, American Journal of Sociology 43(3): 610–11.

58.

Tatum

A. L.

Seevers

M. H.

(1929) ‘Experimental Cocaine Addiction’, Journal of Pharmacology and Experimental Therapeutics 36: 401–10.

59.

Tatum

A. L.

Seevers

M. H.

Collins

K. H.

(1929) ‘Morphine Addiction and Its Physiological Interpretation Based on Experimental Evidences’, Journal of Pharmacology and Experimental Therapeutics 36: 447–75.

60.

Waldorf

Orlick

Reinarman

(1974) Morphine Maintenance: The Shrevport Clinic, 1919–1923. Washington, DC: Drug Abuse Council.

61.

Wang

W. J.

(2006) ‘“This All-Important Job of Being Human at the Present”: Bingham Dai’s Lay Psychoanalysis’, New History 17(1): 91–142 [in Chinese].

62.

Weinberg

(1997) ‘Lindesmith on Addiction: A Critical History of a Classic Theory’, Sociological Theory 15(2): 150–61.

63.

Weiner

White

(2007) ‘The Journal of Inebriety (1876–1914): History, Topical Analysis, and Photographic Images’, Addiction 102: 15–23.

64.

Wikler

(1948) book review, ‘Opiate Addiction’, American Journal of Psychiatry 105: 74–5.

Revisiting early sociological studies on addiction

Abstract

Keywords

Introduction

Biomedical views on addiction in the early 20th century

Sociologists stepped to the fore

Bingham Dai and his culture-and-personality formulations of addiction

Alfred R. Lindesmith and his general theory of addiction

Convergence and divergence within a thought collective

Conclusion

Footnotes

Acknowledgements

References

Biomedical views on addiction in the early 20^th century