History and its contribution to understanding addiction and society

This overview will examine three areas: the origins of his- torical work at the Addiction Research Unit; the signifi- cance of that work; and the subsequent development of the field and its relationship with policy.

COMING TO THE ADDICTION RESEARCH UNIT

My appointment to a 1-year research fellowship post at the Addiction Research Unit in 1976 was entirely unexpected. My PhD was then unfinished because of major illness and I had answered a small advertisement in the Guardian. I did not know how to travel to Camberwell: the interview was on a Saturday in an otherwise deserted prefabricated build- ing (the Addiction Research Unit) on Denmark Hill. I had no background in medical history and was sure I had not got the job. But I had; and I began to research, spending much of my time in the cavernous and openly accessible basement library store of the Royal Society of Medicine, off London’s Oxford Street.

It was unusual for junior historians to publish in those days until later in their careers, but Griffith encouraged me to submit an early paper to the thenBritish Journal of Addic- tion (BJA). It was accepted and he was full of praise for my

achievement. Only later did I discover that all submissions to the journal were accepted in those days. The editor, Dr Max Glatt, was reported to keep a box of pending BJA papers under his bed with a lengthy waiting-list [1].

OPIUM AND THE PEOPLE

The major output from my time at the Unit was the book Opium and the People, which has been published and republished by three different publishers over time, latterly in an expanded version, taking on board the period through the 1920s, which it was always intended to cover [2–4]. The initial funding for this work came from the Washington-based Drug Abuse Council, headed by Peter Bourne, formerly President Carter’s special adviser for health issues, who had left the White House after an incident in- volving cocaine. The analysis of British drug policy and its development over time was of significance to US debates be- cause the apparent success of the ’British system’ seemed to undermine US prohibitionist policy on drugs. As a new entrant to the field I knew nothing of this policy context, which had already amassed a substantial literature [5].

Soon politics came to the fore. There were clear concerns in the United States about what type of history might be produced, given the funding source; and a US his- torian was funded to research the same period that I was

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covering. This added to the tensions around the book. Fur- ther tensions came when a draft was ready. Griffith and I differed on many points, not least the title, which he wanted to be Our Own Opium. Dick Eiser was called in from the corridor at the Unit to adjudicate and a modification of my suggestion proved acceptable.

The book was published with little or no advance pub- licity from the publisher and we later found it had not even been listed in the booksellers’ bible, Books in Print. It was therefore a surprise to receive a glowing major review in the Observer, from Anthony Burgess of Clockwork Orange fame, no less [6]. The book has gone on to have a long after- life. It has had a particular currency among thosewho seek a more liberal response to drugs, including drug users, as Alex Mold and I found when we conducted the research for our recent study of the drug user movement and its history [7]. I had, however, argued specifically against a ’naive’ interpre- tation of history in the book. One cannot transfer ‘lessons of the past’ simply and unproblematically to the present.

THE DEVELOPMENT OF THE FIELD AND THE RELATION WITH POLICY

The ‘mix’ of researchers at the Unit during my time there was an early example of the multi-disciplinary working which is now so much more common, and favoured by funders. Then it was highly unusual—especially where history was concerned. Historians did not generally mix with other disciplines, nor did they mostly tangle with any- thing which had remotely practical or policy application. My PhD (on the 19th-century popular press) had been su- pervised by E. J. (later Eric) Hobsbawm, so I was perhaps more attuned to a policy approach than some. After my de- parture, Griffith kept historical work going, in particular through the long-running interview series published inAd- diction. This has provided valuable material: the interview with Sir Richard Doll, for example, has been used by many historians and others in the smoking field [8].

The historical field for ‘the substances’ has expanded enormously. I cannot claim that the ARUwork I undertook started that. Well before Opium and the People appeared, David Musto had published his study on American drug policy, and David Courtwright’s US-based study Dark Paradise appeared shortly after my book [9,10]. If we fast- forward to 2013, the field is an expanding and lively one. The conference of the Alcohol and Drug History Society this year is being held at the London School of Hygiene and Tropical Medicine, and entitled ‘Under Control’ has attracted 150 abstracts. Topics at the conference range from colonial drug use and regulation to tobacco in Ruma- nia. The Society began its life as the Alcohol and Temper- ance History Society, and made a speciality of detailed case studies of temperance in particular areas of the United States. It is unrecognizable in its present form.

It is not the place in this paper to give a full survey of the many contributions to the field in recent years. A group of younger scholars have come into the area and have been pushing the boundaries with new research-based books and papers [11–18]. The research councils have been more willing to fund as, for example, with the network on intoxication funded by the Economic and Social Research Council (ESRC).

Recent work has many strengths. There is a greater willingness to make cross-national comparisons outside the standard Anglo American one [19]. The focus of inter- est has moved to the colonial context and also to the Chinese experience with drugs [20–22]; and historians have extended their gaze to more recent events, even crossing into areas which would in the past have been considered the province of policy scientists or sociologists.

What of history and policy? Later on in my career, I be- came more aware of the policy and politics surrounding drugs. I came back into the field in 1986 as the scientific secretary of the Drug Addiction Research Initiative (DARI). This was a planned cross-government research initiative which Griffith had hoped to direct, but which ran into the buffers for various strategic reasons. This bruising epi- sode openedmy eyes to the politics of the field. It stimulated an interest in ‘contemporary history’, which then fed into further work on HIV/AIDS policymaking and on the role of evidence and policy [23–25].

In recent years, historians have become much more interested in having input into policy analysis and policymaking. My role both at the ARU and in DARI was, in a sense, a harbinger of later relationships which spread more widely in the profession and which have become institutionalized through enterprises such as History and Policy [26].

History has been an integral part of some recent re- search and policy initiatives: for example, the Foresight ini- tiative on the future of psychoactive substances [27]. The current European Union (EU)-funded FP7 programme ALICE RAP, addiction and wellbeing, has a work-package on addiction through the ages, which I lead. Unusually in history, the partners in the work-package are all trying to work to a common model, using comparable sources in or- der to investigate the changes in the language of addiction over time in a range of European countries. One of our ini- tial findings is that the Anglo American ‘inebriety’model of the late 19th and early 20th centuries is just that—a con- cept which did not have more general European applicabil- ity. We plan, through this work, to explore further the distinctive European dimension of addiction and its concep- tualization [28].

History feeds into policymaking. In Britain, some civil servants are sensitized to the need for this approach and it has been heartening to see it integrated into recent devel- opments; for example, a consultation by the Chief Medical

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Officer, Dame Sally Davies, on the future of alcohol re- search. However, historical arguments and approaches can be difficult for those outside the field to assimilate. There is often no direct ‘lesson’, but an opening-up of op- tions or an analysis of key factors and issues. History can reveal the complexity of issues and make decision-making more rather than less difficult. It is also one of those areas which many feel they can do themselves without the input of professional historians. History is seen as just ‘facts’, rather than as the play of interpretation which is so essen- tial. Direct misunderstanding is also common. One leading figure in the field told me that he had first learnt that Queen Victoria used cannabis throughmywork. The oppo- site was the case: I had written a paper criticizing this mis- use of history [29]. The field is often comfortable with a standard mythology—for example, that ‘prohibition did not work’. The more sophisticated assessment of the im- pact of prohibition by historians makes little headway against such entrenched beliefs [30,31]. Julia Lovell’s re- cent dissection, in her history of the first opium war, of the ways in which the Chinese state has used the mythol- ogy of the opium war as a political prop to gather national support after Tiananmen Square will doubtless have little impact in that country, or on the standard anti-British interpretation.

In the later years of his life, Griffith himself provided the raw material for historical research, granting interviews to PhD students and lending swathes of archival material. Our user-group study was enriched by the early papers of Phoenix House in Camberwell, which he lent to us. The Addiction Research Unit itself is now a subject of emergent interest for historians, not least because of its early focus across the substances, drugs, alcohol and tobacco and also because of Mike Russell’s pioneering espousal of harm re- duction through nicotine [32]. Griffith’s role on the Advi- sory Council for the Misuse of Drugs (ACMD), on the cannabis committees of the 1970s, provided an important section of a recent PhD on the medicalization of cannabis. Griffith himself took part in a witness seminar on the sub- ject [33]. His papers and those of Mike Russell have been deposited in the Kings College archive.

CONCLUSION

The future of historical research on the substances looks bright, with a multiplicity of new avenues of development. Existing work tends to be substance specific—researchers are historians of alcohol, or tobacco, or drugs, and fewhave crossed the substance boundaries [34,35]. In addition, to- bacco history tends to be somewhat separate—‘naive his- tory’, advocacy-driven, with a focus on tobacco industry online documents as the sole source of archival material. The historian Robert Proctor has called for tobacco prohi- bition without any assessment of the impact of alcohol

prohibition [36]. The use of such documentation in law- suits against the industry in the United States is one area in which history has been used with direct effect [37]. This approach has tended to close down other avenues, and has led to a standardized approach in interrogation of the doc- uments with predictable results, attacking the ‘evil empire’ of the US tobacco industry. It would be as interesting to ask different questions, and to examine the relationships be- tween the different structures of the industry and the state in European countries and elsewhere. The assumption cur- rently tends to be that the US model has applied every- where. In Britain, that was certainly not the case during the period from the 1950s to the 1970s. The availability of online material is clearly a trend with which historians will engage, as we have been doing in the ALICE RAP ini- tiative. Theywill have to ensure that this development does not close down options and lead to a narrower form of his- torical approach.

Declaration of interests

None.

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