Human Dependence on Tobacco and Opioids: Common Factors

Recent years have seen increasing acceptance of the notion that tobacco is an addictive or dependence-producing substance, particularly as it is used in cigarette smoking. This idea is supported by the observations that tobacco serves as a reinforcer (i.e., it maintains behavior leading to its use) and that most people who smoke cigarettes would like to quit but cannot, even in the face of well documented health risks and economic sacrifices (Surgeon General’s Report 1979). The term “drug dependence” suggests that (1) the drug serves as a reinforcer, (2) behavior occurs which is maintained by the opportunity to take the drug, and/or (3) other reinforcers are sacrificed as a consequence of taking the drug (). Many cigarette smokers in some degree satisfy these criteria for drug dependence (). Since cigarette smoking has only recently been conceptualized as an instance of drug dependence, it should be useful to systematically compare cigarette smoking with another more thoroughly studied dependence process such as opioid dependence or narcotic addiction. At first blush, cigarette smoke and opioid drugs appear to produce vastly differing pharmacological and behavioral effects: large doses of opioids can produce Read more […]

Physicians as Suppliers

The great economic importance to Britain and the Netherlands of the intra-Asian opium trade in the 19th century has already been discussed in post The Colonial Opium Trade. But another legal branch of the opium trade evolved in the course of the 19th century, involving the transport of smaller, but by no means negligible, opium shipments from the Levant and South-East Asia to Western Europe and the United States. In the case of the intra-Asian opium trade, the state monopolies described above disrupted the free interplay of supply and demand, but trade to Europe and the United States was initially unrestricted aside from the usual import duties. Here price mechanisms reigned supreme, and when opium cultivation intensified in the Levant and South-East Asia in the 19th century, prices fell. As the demand for opium soared, a variety of experiments were conducted with the aim of cultivating the poppies closer to the European market. In the period 1740 1870, for instance, there were countless attempts to cultivate the crop on British soil. And much later, in the early 20th century, new harvesting techniques were tried out some in Western Europe the aim being to replace the labourintensive harvesting of opium as an intermediary Read more […]

The medical regulation of opiates in the Netherlands

In the Netherlands too, the process of state formation which meant a shift in the balance of power from local authorities to those of the state was at the root of the professionalization of pharmacists and physicians. Wittop Koning, in his Compendium voor de Geschiedenis van de Pharmacie van Nederland, rightly divides the period following the Middle Ages into a ‘local period’ (from about 1500 until about 1800) when local administrators regulated the rights and obligations of pharmacists and physicians, and a ‘national period’ (after 1800) when medical rights and obligations were laid down in statutory laws with nationwide application. This distinction shows clearly that the professionalization of pharmacists (and physicians) in modern Western societies was dependent upon the far more general process of state formation. The medicalization of the opiate regime in the Netherlands followed roughly the same pattern as in Britain, and took place around the same time. Nevertheless, two conspicuous distinctions may be discerned. First, intervention at the level of central government was an earlier and more intense development in the Netherlands, probably because of the country’s Napoleonic heritage. The first piece Read more […]

The medical regulation of opiates in England

The professionalisation of the medical occupations in England was largely completed in the nineteenth century. Physicians moved up the social ladder, partly by making their profession a protected one and thus sealing it off from outsiders. Legislation was an indispensable part of this process, now at supra-local — i.e. national — level. The passing of this legislation was far from automatic. It was only by achieving cohesion and solidarity among their ranks that the medical professions were able to compel the state to introduce laws that besides regulating the professions also endowed them with greater legitimacy. That ‘sanction from above’ should be expected from the national state rather than city or province was an entirely new development. Previously, when physicians had collectively belonged to guilds, the laws on medicine differed from one city to the next. But during the 19th century, as both trade and industry and the orientation of professional groups focused increasingly on the national state, the need for a national system of regulation came to be felt more keenly. And this in turn was intimately bound up with state formation. A certain degree of state formation and centralization were therefore Read more […]

The medical regulation of opiates in the United States

In the United States, opium was supplied in three separate ‘domains’ in the 19th century. There were qualified physicians who prescribed opiates — and later morphine — for their patients. (And just as in Europe, it was primarily the welltodo who could afford to consult a physician). Secondly there was the market of patent (or secret) remedies such as Scotch Oats, which were for sale everywhere outside the control of medical practitioners or pharmacists: they were obtainable from general stores and itinerant quacks. These were used primarily by the lower classes of white immigrants. Thirdly, there was the supply of smoking opium for Chinese immigrants. It is particularly the first two of these domains which are of importance in the present context. The rivalry between American doctors and pharmacists was little different from that in the two European countries that have been considered. Their common commercial interests too were abundantly clear. Nevertheless, it took much longer in the United States for any comprehensive federal legislation to be introduced that would regulate the state supervision of medical facilities. Some states and local communities, however, formalized the medical regulation of opiates Read more […]

Narcotic Addiction: A Changing Scene?

The purpose of this paper is to explore changes in the narcotic addiction [Narcotic addicts are defined in this study as persons who have used opium, its derivatives, or synthetics for non-medical reasons four or more days a week for at least a month. Onset of addiction was defined in terms of the first occurrence of such a period] scene in an era of rapid social change. The quarter of a century covered by this study embraces an era in which major significant changes have occurred in this society. The Sample and Data A sample of 499 subjects was selected from a roster of male narcotic abusers first known to the Baltimore City Police Department Narcotic Squad between the years 1952-1976, inclusive. From each year’s contribution to the roster, ten whites [Only nine whites were available in 1956] and ten blacks were selected in a random, stratified manner, and 402 were interviewed. The data to be analyzed were drawn from a structured interview schedule devised by the project staff; each interview took approximately three hours and was administered by a staff member especially trained for this purpose. In this report, the data [All appropriate tables have been deleted from this abbreviated presentation and appear in Read more […]

The Colonial Opium Trade

Britain and the Netherlands: a profitable trade Although the action took place thousands of miles away, the European powers played a prominent role in the colonial opium trade, orchestrating or at any rate retaining a direct involvement in cultivation, refinement and trade. Crops intended for the opium trade with Asia were grown partly in the Levant and partly in India (As was shown in the previous chapter, most of the opium cultivated in the Levant found its way into the pharmaceutical markets of Europe). For various reasons, including the quality and volume of the yield and proximity to the buyers — in South-East Asia — and the degree of Western control over the territory, India was favoured, with production being concentrated in Bengal, and later also in Malwa. China was the largest market. Other population groups in South-East Asia also consumed the drug but the biggest users — certainly where smoking was concerned — were the Chinese. As merchants, sailors and migrant workers, the Chinese had spread throughout the entire region, and wherever they settled, there was soon a demand for smoking opium. Opium was only one of numerous products in a system of colonial trade relations — a trade that linked Read more […]

China and the English colonial opium trade

China’s role in this affair was largely a passive one. In the 17th and 18th centuries, Chinese rulers had derived great benefit from the rise of an intercontinental trade network which increasingly entwined their country in worldwide flows of trade. Unlike the situation in most other Asian societies, where traditional rulers had gradually been compelled to bow to European powers, the sovereignty of Chinese rulers was long unassailable. Until well into the 19th century, for instance, European trading ships entering Chinese waters to market their wares were admitted only to the port of Canton. China exported to Europe a large range of goods, including tea, porcelain and silk. And as it had no demand whatsoever for European goods, the Chinese balance of trade displayed a structural surplus. European merchants paid in silver, which continued to pile up in the Chinese coffers. This situation persisted until the early 19th century, when the tide turned, with the opium trade playing a pivotal role. Opium had long been a familiar substance in China. It was used medicinally, in the form of pills and infusions, as it was in other regions of the world. In the late 17th century, however, people in the Canton region consumed Read more […]

The opium trade in the Dutch East Indies

Although Britain had a stake in the opium trade through its own East Indies Company, it did not concern itself — formally speaking, at any rate — with the transport to China or the marketing of the product. It made its profits from cultivation and bulk sales, and to a lesser extent from selling opium to the indigenous population of British India. The involvement of the state of the Netherlands in the colonial opium trade in the Dutch East Indies was of an essentially different kind. Firstly, unlike the British, the Dutch colonial rulers gained their income precisely from transport and from retail sales. They achieved this by securing and exploiting a monopoly on supplies — granted in the 17th century to the Dutch East Indies Company (VOC), and later (from 1827) to the Dutch Trading Company — and also on retail sales of opium. Secondly, the Dutch involvement amounted to a more extensive type of state control. This was not specific to the opium trade. Dutch colonial politics — with its unique forced farming system — were shot through with an unparalleled degree of state involvement on all fronts (Influential English commentators such as J.W.B. Money (Money 1985 (1861):241-44) viewed with envy the profitable Read more […]

Opium cultivation in British India

The British East Indies Company played a crucial role in commercial opium growing. Trading companies such as these made ideal instruments for Western powers to control their overseas trade from the 17th century onwards, and later to rule their colonies. The British had acquired control of most of India in the course of the 18th century, having successfully defeated rival Western states eager for the same prize. The British East Indies Company was given the monopoly rights to the commercial cultivation of opium by the Crown. Bengal, which came under British rule in the latter half of the 18th century, was already the traditional centre of opium growing, and so it remained after the British took over. Once the British East Indies Company deemed it no longer prudent to continue the opium trade with China, not wishing to cause undue offence to the Chinese rulers who had proclaimed the ban, the prepared opium was sold at auction in Calcutta to private trading companies which would then arrange for the transport to China themselves. These private companies would often be under contractual agreement to ship the opium to China. And by way of quality guarantee, the buyers took scrupulous care to ensure that the opium remained Read more […]