New Books in Drugs, Addiction and Recovery

Though the conventional history of the U.S.-led “War on Drugs” locates the origins of this conflict in a reaction to the domestic culture of excess of the 1960s, a new book argues that international drug control efforts are actually decades older, and much more imbricated with the history of U.S. access to international markets, than we have previously thought. Suzanna Reiss’s We Sell Drugs: The Alchemy of US Empire (University of California Press, 2014) uncovers this history by tracing the transnational geography and political economy of coca commodities–stretching from Peru and Bolivia into the United States, and back again. The book examines how economic controls put in place during WWII transformed the power of the U.S. pharmaceutical industry in Latin America and beyond, and gave rise to new definitions of legality and illegality–definitions that were largely premised on who grew, manufactured, distributed, and consumed drugs, and not on the qualities of the drugs themselves. Drug control, she shows, is a powerful tool for ordering international trade, national economies, and society’s habits and daily lives. Learn more about your ad choices. Visit megaphone.fm/adchoicesSupport our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/drugs-addiction-and-recovery

Kristin Peterson‘s new ethnography looks carefully at the Nigerian pharmaceutical market, paying special attention to the ways that the drug trade links West Africa within a larger global economy. Speculative Markets: Drug Circuits and Derivative Life in Nigeria (Duke University Press, 2015) takes reads into a story that is part medical anthropology, part careful analysis of global economy, and shows that understanding one is vital to understanding the other in the modern West African pharmaceutical landscape. Peterson pays special attention to the Idumota market, an area that was strictly residential in the 1970s and has since become one of the largest West African points of drug distribution for pharmaceuticals and other materials from all over the world. Peterson looks at the consequences of major local and global historical factors in that transformation, including civil war in the late 1960s and migration that followed, a 1970s oil boom and bust, and changes in the global pharmaceutical market in the 1980s. By the early 1980s, Nigeria was deep into an economic crisis that had profound implications for the production, circulation, and marketing of pharmaceuticals. The pharmaceutical industry remade itself by becoming tied to the speculative marketplace, with wide-ranging implications that included the rise of new professional relationships & market formations in Nigeria, new relationships with firms in China and India, new forms of speculation, and new questions about the ontology of markets. Peterson demonstrates that these transformations continue to have important consequences for the bodies of individual Nigerians, including major problems with drug resistance and a mismatch between existing drug therapies and existing diseases. The book avoids the usual discourse of corporate greed, instead focusing on the “structural logics of pharmaceutical capital through which corporate practices can be understood.” It is a timely and fascinating study. Learn more about your ad choices. Visit megaphone.fm/adchoicesSupport our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/drugs-addiction-and-recovery

Drugs exist that are meant to help people feel better. The doctors who prescribe them might believe that they work, while their patients do not. In explaining the drugs to their patients, should those doctors use the medical terminology they themselves use – which might not be immediately understandable to their patients – or should they translate the description into terms more comfortable and familiar to the patient? And what are the practical and ethical consequences of each decision? Stefan Ecks‘ new book carefully considers these problems in the context of health-related practices in modern Calcutta. Eating Drugs: Psychopharmaceutical Pluralism in India (NYU Press, 2013) looks successively at the different and overlapping medical and healing contexts that together make up a significant part of the medical marketplace in Calcutta. Ch. 1 treats popular notions that include the importance of the belly as the “somatic center of good health,” the power of the mind to regulate good health, and the connection between modernity and pollution as causes of illness. Ch. 2 looks at Ayurvedic practices in Calcutta. It reflects on some of the most important ways that Ayurveda is changing in India – especially at the levels of practitioner training, language, and the patient-physician relationship – despite the fact that the centrality of food and digestion has remained constant. Ch. 3 looks closely at homeopathy, the second most popular type of medicine in Bengal, and focuses on the principles, histories, and pluralities of homeopathic practices in Calcutta. Ch. 4 looks at the ways that Calcutta psychiatrists position themselves with respect to popular beliefs about psychopharmaceuticals, general physicians, practitioners of non-biomedical treatments, and the pharmaceutical industry. This chapter pays special attention to how Bengali doctors use metaphors to help patients understand and respond to psychiatric diagnoses, with comparisons to nature, the Ganges river, fairytales, everyday over-the-counter drugs, diabetes, and food. The conclusion explores a key argument of the book, proposing that “patients’ suspicions of psychopharmaceuticals are based on suspicions of biomedicine’s ‘magic bullet’ model of drug effects,” looking at the implications of this conclusion, and considering the possible broader impacts of this study beyond Calcutta. It’s a fascinating study of potential interest to historians and anthropologists of medicine and healing, as well as readers interested in learning more about the medical marketplace of modern India and anyone interested in modern psychopharmaceuticals. Learn more about your ad choices. Visit megaphone.fm/adchoicesSupport our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/drugs-addiction-and-recovery

Paul A. Christensen‘s new book is a thoughtful ethnography of drinking, drunkenness, and male sociability in modern urban Japan. Focusing on two major alcohol sobriety support groups in Japan, Alcoholics Anonymous and Danshukai, Japan, Alcoholism, and Masculinity: Suffering Sobriety in Tokyo (Lexington Books, 2014) explores the ways that admitting to and living with alcoholism in Japan challenges prevailing norms of masculinity and sociability, and looks carefully at its profound consequences for the individual sufferer. After a brief history of alcohol and drunkenness in Japan, Christensen considers the ubiquitous coding of alcohol as fun and leisurely in mass media, and directs our attention to the difficulties that this framing creates for male alcoholics. The book then moves to a discussion of historical shifts in notions of addiction in Japan, as well as contemporary debates over treatment methodologies and the ways that methodologies transplanted into Japan from the US map – or not – onto local cultural and religious realities. Christensen follows this with detailed accounts of the major support groups available to sufferers in Tokyo, the languages and bodies of alcoholic experience, and much else. Throughout the study, Christensen offers an extraordinarily sensitive treatment of the struggle of individual men to build a new selfhood while their sense of masculinity, and of a place in society, have been dismantled. Learn more about your ad choices. Visit megaphone.fm/adchoicesSupport our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/drugs-addiction-and-recovery

Todd Meyers‘ The Clinic and Elsewhere: Addiction, Adolescents, and the Afterlife of Therapy (University of Washington Press, 2013) is many things, all of them compelling and fully realized. Most directly, the book is an ethnography of drug dependence and treatment among adolescents in Baltimore between 2005-2008. Meyers traces twelve people through their treatment in the clinic and beyond, into what he calls “the afterlife of therapy.” The group of adolescents was diverse–their economic and family circumstances, their demographics, and arc of their narratives from addiction to treatment varied widely. Yet they shared at least one important experience: “each had either been enrolled in a clinical trial or were currently being treated with a relatively new drug for opiate withdrawal and replacement therapy: buprenorphine” (4). In this way, the book is also the story of a pharmaceutical making its way and its mark in the worlds of therapeutics, law, public opinion and, especially, in the lives of its users. Meyers shows how the lives and experiences of these adolescents (as well as others in their lives) were often shaped and constrained by their roles as subjects in pharmaceutical trials evaluating the effectiveness of buprenorphine. Moreover, Meyers looks beyond the questions and answers asked and answered under the constraints of randomized controlled trials. Rather, as he puts it, “my ethnographic gaze is fixed upon the intersection of clinical medicine and social life, at the place where medical and pharmacological subjects are constituted under the sign of therapeutics” (17). As a result, The Clinic as Elsewhere locates palpable places where medicine and the social intersect in the material world and lived experience; as readers, we see the relationship between the medical and the social as much as understand it as a conceptual given. Ultimately, Meyers shows how therapeutics is not only a form of intervention, but a “sign”: under which people are constituted as subjects, and with which people “assign value, meaning, and worth assign value to pharmaceutical intervention” (116). Learn more about your ad choices. Visit megaphone.fm/adchoicesSupport our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/drugs-addiction-and-recovery

DMT and the Soul of Prophecy:A New Science of Spiritual Revelation in the Hebrew Bible (Park Street Press, 2014) asks a number of provocative questions about drugs, consciousness, prophecy, and the Hebrew Bible–with attention to how a particular chemical can help us understand mystical experience. DMT (dimethyltryptamine) is a molecule endogenous to several mammals including humans, as well as the active psychedelic ingredient in a number of plant species around the world–most notably in an Amazonian brew called ayahuasca. Rick Strassman‘s first book, DMT: The Spirit Molecule, showcases his research in the 1990s at the University of New Mexico, during which he injected several volunteers with DMT as part of a government-sanctioned research project. During the trials, volunteers experienced a number of similar phenomena, such as communication with other-than-human beings, out-of-body experiences, and geometrically complex closed-eye visuals. DMT and the Soul of Prophecy complements Strassman’s first book, but it also stands on its own and gives enough context of his DMT research to make sense of his arguments about prophecy in the Hebrew Bible. The new monograph aims to further interpret the data from Strassman’s experiments in the 90s, by arguing that the notion of prophecy in the Hebrew Bible offers a compelling model for what happens in the DMT state. One might ask, then, if the Hebrew prophets were affected by DMT. Although it’s not possible to know for sure, and Strassman doesn’t claim that they were, he nonetheless draws significant parallels between DMT experiences and prophetic states in the Hebrew Bible. At the cross-section of biology, psychology, and religious studies, Strassman’s monograph is sure to spark provocative conversations about the relationship between religion, drugs, and the politics of research. Learn more about your ad choices. Visit megaphone.fm/adchoicesSupport our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/drugs-addiction-and-recovery

Commercial interests are often understood as impinging upon the ethical norms of medicine. In his new book, Medical Monopoly: Intellectual Property Rights and the Origins of the Modern Pharmaceutical Industry (University of Chicago Press, 2013), Joe Gabriel shows how the modernization of American medicine was bound up in the ownership, manufacture, and marketing of drugs. Gabriel unearths the early history of intellectual property concerns as they entered the domain of medical practice itself. Through his careful marshaling of evidence, he takes readers back to a time when the norms and legal structures of commercial capitalism in the U.S. were just as much at issue as those of the professionalization of medicine. This fascinating book serves as a pointed reminder that the sources of therapeutic rationale are just as much tied to the production and regulation of therapies as the collective decision-making on ethical practice. Along with my previous interview with Jeremy Greene, this discussion will hopefully make accessible a broad perspective on the development of medicine in the 20th century by focusing on its ties to industry. Medical Monopoly charts the history of property rights over medicines at the dawn of the 19th century through World War I. The important broader transition here is that while before the Civil War–at least in medicine–patents were seen as tantamount to granting problematic monopoly, by the end of the 19th century they were understood as the best available regulatory mechanism for preventing more problematic imitation. Whereas patent medicines had previously been linked to quackery, the emergence and rapid expansion of the “ethical” pharmaceutical industry after the Civil War was due to its adherents advocating for more effective regulation of commerce within medicine. Rather than reverting to secrecy, firms began to circulate and publish information on new remedies and the results of studies to physicians. As the explosion of new medicines remained at pace with the boom of consumer goods in the late 19th century, patenting and corporate investment in monopolistic practices became understood as a mechanism to advance the public good. The expansion of laboratory science and norms of chemical manufacturing in the 20th century only bolstered this union further.Medical Monopoly is a fascinating and important read that people interested in medical policy should pay attention to. Learn more about your ad choices. Visit megaphone.fm/adchoicesSupport our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/drugs-addiction-and-recovery

Is pain real? Is pain relief a right? Who decides? In Pain: A Political History (Johns Hopkins University Press, 2014),Keith Wailoo investigates how people have interpreted and judged the suffering of others in the US from the mid-1940s to the present. While doctors and patients figure in his story, the primary protagonists are politicians, judges, and ideologues, who variously understood the ambiguities of pain as political problems to be settled in legislatures and in courts of law and public opinion alike. For instance, in the 1940s and 1950s, the “pain complaint” of ailing World War II veterans became the locus of debates about manhood, federal disability benefits, and pharmaceutical interventions. Although physicians faced complex problems about adjudicating the pain of their patients, Wailoo shows that pain was also a deeply cultural problem, especially as new, competing theories of pain emerged to explain not only the experience of suffering, but the character, motives, and rights and responsibilities of the sufferer. In the Reagan administration-era, debates about pain were an index of America’s welfare problem, and in late 20thcentury, controversies over fetal pain and the “ultimate relief” of physician-assisted suicide reflected the polarized landscape of “liberal” and “conservative” positions. The last chapter, “OxyContin Unleashed,” compellingly shows how a de-regulated and pro-business pain policy led to the pain drug boom in a competitive and unstable medical marketplace. Ultimately, Wailoo claims that “we have a cultural problem understanding people’s pain.” Pain shows us how that has taken place throughout our recent history, and challenges us to acknowledge and attend to the way that we politicize the pain of others without regard for their suffering. Learn more about your ad choices. Visit megaphone.fm/adchoicesSupport our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/drugs-addiction-and-recovery

Khat, the fresh leaves of the plant Catha edulis, is a mild psycho-stimulant. It has been consumed in Yemen, Ethiopia, Eritrea, Djibouti, Somalia for over one thousand years. Khat consumption is an important part of Yemeni social and political life. During the early part of the twentieth century, Yemeni dockworkers brought khat to Madagascar, where other members of the Malagasy population have adopted its use. In her excellent book Drug Effects: Khat in Biocultural and Socioeconomic Perspective (Left Coast Press, 2012), Lisa L. Gezon, Professor and Chair in the Department of Anthropology, University of West Georgia, analyzes the production and consumption of Khat on the island nation of Madagascar. Taking a cultural, medical, and anthropological approach, Gezon looks at the use of khat in pharmacological, cultural, political, economic and environmental contexts.As a student of plant drugs/medicines/intoxicants, her summary of the manner in which khat’s effects have been mischaracterized by many so called experts has echoes of reefer madness inspired characterizations of cannabis and its users.Like so many drugs, khat is a powerful force in the local economy, and the factors that have allowed khat to provide income for small hold farmers rather than becoming part of a centralized and commercial monoculture are worthy of further analysis. In addition to teaching me about the specifics of khat consumption in Madagascar, the background material provided a great primer on CMA approaches to substance use, as well as on the history, pharmacology and policy surrounding Catha edulis. I have been thinking a great deal about the economic forces that influence the consumption and availability of drugs.There are similarities and differences between poppy production in Afghanistan or the Golden Triangle, cannabis production in the Emerald Triangle, and khat production in Madagascar.The peaceful and widely distributed economic benefits of smallholder farming on Madagascar make this study particularly fascinating. Lisa Gezon was a pleasure to interview, and was very patient with my still developing interviewing skills.Her research included extensive field work as well as research, and the book is almost encyclopedic in its synthesis of the literature, the findings of her studies as well as her excellent and insightful analysis. Learn more about your ad choices. Visit megaphone.fm/adchoicesSupport our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/drugs-addiction-and-recovery

Is there any such thing as a generic drug? Jeremy A, Greene‘s new book Generic: The Unbranding of Modern Medicine (Johns Hopkins University Press, 2014) treats its subject matter with a learned skepticism that lets the reader see through the eyes of the historical actors who helped define the modern drug industry. By inverting preconceived notions about what we take to be mundane, mass-produced chemical identities, the book offers a broad yet pointed glance at an industry and its attendant regulatory structures that developed alongside modern consumer culture. Claims about the equivalence and lower price of generic medicines, uncoupled from the patents held by major firms, were always hotly contested, and Jeremy’s book shows how debates about branding–or lack thereof–were at the heart of the rationalization of medical practice. Generic opens with evocative stories about the legal and scientific crises and personal tragedies wrought by tense relations between medical science and industry. We then learn about early debates over international standardization of chemical names and the emergence of firms that marketed generics as a specific kind of product that were a part of the very same consumer-driven value system their proponents wanted to replace. These anonymous drugs prompted research that could establish sufficient similarity between them, while at the same time provoking disputes of authority between physicians and pharmacists that produced a new regulatory regime and standards which were embodied and shaped by emerging large, bureaucratic health care providers. In the end, the story of generics as champions of access and affordability in an age of elusive therapeutics and ‘me-too’ drugs designed to cash in on innovation is complicated by the global changes in production and trade they have wrought. Are ‘global’ drugs perceived as ‘universal’? Jeremy’s book will promote discussion and thought about the medical mundanities we so often take for granted. Generic takes the philosophically-inflected themes of the history of science into a realm of pressing urgency, and reveals fascinating parallels that actually make it more enjoyable for a broad audience. This interview is the first half of a pair of new books on the pharmaceutical industry; be on the lookout for my next interview with Joseph M. Gabriel about his new book: Medical Monopoly: Intellectual Property Rights and the Origins of the Modern Pharmaceutical Industry (University of Chicago Press, 2014). Learn more about your ad choices. Visit megaphone.fm/adchoicesSupport our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/drugs-addiction-and-recovery