The Moral Divide

NATHAN: So I wanted to come back to this point that was raised by Carolyn Acker, and that you actually pointed to as well, Ed, about this moral divide around how reformers think about addiction. I mean, this is one of those things that keeps coming back in period after period. That there is a way in which the way we talk about these addictions has a direct impact with how we decide to marshal resources to deal with them.

ED: Yeah, Nathan. I’m actually struck by once policymakers decide who is the object of their attention, then they decide what words they’re going to use. If it’s people that you think are drug abusers for some fault that’s their own, then there’s a war on drugs. It’s their responsibility to “Just Say No.”

If on the other hand, these are people that you think of as victims in some ways, as people who have been lured into drug abuse, then they deserve treatment. And once you head down one of those roads, the language you use seems to reinforce the presupposition with which you began.

NATHAN: Right.

BRIAN: And I’m struck by the role that physicians, doctors play throughout. Right? They inadvertently create quite a bit of addiction in the late 19th century by using opiates to relieve pain for all kinds of maladies. Yet, it’s doctors who, in many ways, sound the warning bell about the potential of addiction through their inadvertent actions.

We have also Dr. Lawrence Kolb, who simply pronounces on the kind of division that Ed just talked about, “innocent users,” as he puts it. And then we have those “bad people.” The pleasure-seekers who are using the same drugs, but somehow, it’s their own fault. And what we see again and again is that these distinctions just don’t hold up over time, yet, we keep repeating them and reinforcing them.

NATHAN: In spite of the role that doctors play, one could argue that they’re not the be-all and end-all of the problem, nor the only ones who can level a solution here. Right? I mean, if you think about the larger policy atmosphere around the current crisis, doctors can certainly try to decrease the volume of opioids in circulation.

But it sounds like there really is a kind of cultural question, and really, a historical question that we need to be able to speak to here. Which is, how exactly do we establish and create a sense of social responsibility around addiction and drug use? What kind of political institutions or conversations have to happen to change the way that we respond, as a society, to this problem?

BRIAN: Nathan, I don’t disagree with what you just said. I do want to complicate it a little bit. I do believe that a century of scientific research into the physiology of addiction has lent some real authority to treatment plans, and approaches that are really quite different than “lock them up, and throw away the key.”

NATHAN: Right.

BRIAN: And I do think that has had an impact on giving policymakers different options in how to treat the problem of addiction. Now, whether they take advantage of that, that’s another matter.

NATHAN: You can’t argue with the science. I would only argue for more social science. Certainly, the disempowerment and poverty in rural America has been part of the ongoing and developing narrative about the opioid crisis in America. One could argue that there is even a racial divide in terms of how we think about rural and urban drug use. The only thing I would also add to that is that, again, what creates the political will to deal with these problems cannot be overlooked.

Just in the case of the 1980s. In 1986, driven in large part by the Reagan Administration, you see the Anti-Drug Abuse Act that was supported by Ronald Dellums, a Democratic Congressman from California, African-American, 15 members of the Congressional Black Caucus. And that bill introduces 100-to-1 disparity sentencing between crack and powder cocaine.

Now, this isn’t about opioids, but it’s certainly about the ways in which disempowered communities feel the need to stretch and reach for very draconian measures to deal with the violence, the under-employment, and the lingering problems that emerge around the drug crisis in major American cities.

ED: You know, it’s hard to find a silver lining to this very sad story, which has ravaged so many lives over such a long period of time. But it may be that as the problem seeps into other sectors of the society, and other parts of the geography of the country, that people may begin to shift their thinking about just what drug addiction means. Where it comes from, what causes it. And the less that it’s identified with any particular ethnicity or any particular geography, it seems to be a problem maybe the whole country needs to mobilize against.

BRIAN: I actually think as more families experience with a relative or a friend the inadvertent addiction that can occur from using these very powerful drugs, even when prescribed by a doctor, they will adopt what I would call a much more forgiving attitude towards what we need to do about these addictions.

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ED: That’s going to do it for us today, but you can keep the conversation going online. Let us know what you thought of the episode, or ask us your questions about American history. You’ll find us at backstoryradio.org, or send an email to backstory@virginia.edu. We’re also on Facebook, Tumblr, and Twitter at BackStory Radio. And if you liked the show, feel free to review it an Apple Podcast. Whatever you do, don’t be a stranger.

BRIAN: This episode of BackStory was produced by Andrew Parsons, Bridget McCarthy, Nina Earnest, Emily Gadek, and Ramona Martinez. Jamal Millner is our Technical Director, Diana Williams is our Digital Editor, and Joey Thompson is our Researcher.

Our theme song was written by Nick Thorburn. Other music in our show came from Podington Bear, Ketsa, and [? Gizarre. ?] And thanks to the Johns Hopkins University Studio in Baltimore.

NATHAN: BackStory is produced at the Virginia Foundation for the Humanities. We’re a proud member of the Panoply Podcast Network. Major support is provided by an anonymous donor, the National Endowment for the Humanities, the Provost’s Office at the University of Virginia, The Joseph and Robert Cornell Memorial Foundation, and the Arthur Vining Davis Foundations.

FEMALE SPEAKER: Brian Balogh is Professor of History at the University of Virginia, and the Dorothy Compton Professor at the Miller Center of Public Affairs. Ed Ayers is Professor of the Humanities, and President Emeritus at the University of Richmond. Joanne Freeman is Professor of History and American Studies at Yale University. Nathan Connolly is the Herbert Baxter Adams Associate Professor of History at the Johns Hopkins University. BackStory was created by Andrew Wyndham for the Virginia Foundation for the Humanities.

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