Chapter One: INTRODUCTION

It was only in the early 1960s that drug taking in Britain became sufficiently widespread to be regarded as a social problem. Prior to this in the 1930s or 1940s when there were only about 350 known addicts, it was rare to see or know anyone who had taken drugs, least of all to know anyone who had been classified as a drug addict. In the late 1960s there were about 3,000 known addicts, and drugs, drug taking and drug addiction became fre-quent topics of conversation.

This increase in drug taking and drug addiction has led to a growing awareness that Britain has a new major social problem. In spite of warnings about an increase in drug taking in the 1950s and further warnings about the growth of the number of known heroin addicts in the early 1960s, it was not until 1964 that it became officially recognised that Britain had a problem of fairly wide dimensions. Having once recognised this, demands for action began to be made. Most of these came from certain professional groups such as probation officers, social workers or members of the medical profession, who were suddenly expected to 'treat' these new drug takers. Other demands came from interested parties such as journalists and teachers who, like the previous groups, argued for action mainly on humanitarian grounds, but who also wanted more 'treatment' facilities.

The history of social problems is now becoming well docu-mented, largely due to the work of Howard Becker.(1) Without going into a detailed discussion at this stage of Becker's work, his central argument is that social problems have histories which tend to follow a regular pattern. Initially they are identified and brought to the public's attention by a group of people whom Becker calls 'moral crusaders' or 'moral entrepreneurs'. This group leads the demand for action which often takes the form of a demand for new legislation or some other form of social control. Sometimes, although not always, these moral crusaders are what Becker calls 'meddling busybodies', whilst at other times they are wholly motivated by idealistic considerations. Once their message is accepted, then they often leave the matter in the hands of government officials who are expected to take the appropriate action.

Becker's analysis is particularly relevant to the study of drug taking in Britain, especially in the early 1960s. Drug taking, and particularly the use of opiates with the obvious dangers to health, is a field well suited to the activities of the moral crusaders. Too often however, their arguments, and those of the 'officials' also for that matter, have been based on very scanty information, some of which is probably highly unreliable. Unfortunately, this has never deterred some people from holding firm or fixed opinions, and drug taking, like many other forms of social deviance, tends to polarise opinions which crystallise fairly rapidly. In recent years these opinions have largely become translated into political issues centering around the future of modern society, especially in terms of the agents of social control. Those who take drugs—or sympathise with drug takers—are therefore seen to be anti-capitalist, anti-police and anti-authority, and to be somehow committed to a way of life which is opposed to the essential value systems which the non-drug takers are thought to hold. The validity of this view of the drug taker is difficult to assess; the main point is that drug taking is now becoming related to political issues about the nature of society, and this in turn has produced stereotypes about who is or is not a drug taker.

As part of our modern approach to new social problems, once a problem is officially identified, there are inevitable demands for more research. These demands almost always appear in terms requiring more information to help with new policy decisions. Also, as part of our modern approach, the demands for research usually take the form of wanting to know more about those who actually take the drugs. We tend to see the problem as being produced by the drug takers themselves, and only rarely do we ask for research which examines issues about the way in which drugs are legally prescribed, or even question the actions of those who do the legal prescribing. The result has been an undue pre-occupation with the drug taker and a surprising lack of attention to the legal or social controls.

To some extent a concentration on the drug taker has fitted in well with a view of social deviance which has long dominated our thinking. This view has tended to see the goals of research as being linked to the goals of medical, psychiatric or casework treatment. Those holding this view would argue that research should attempt to find the 'reasons' why people take drugs, and that these reasons are to be found in the personalities or social backgrounds of the drug takers. Once these 'reasons' are dis-covered or identified, some manipulation can take place, which by removing or changing them, will automatically remove or affect the need to continue taking the drugs. Personality defects are then uncovered so that they can be put right, and difficult or disturbed home backgrounds are identified so that their influence can be Modified. A typical example of this approach occurred in a recent study of a group of drug takers in a London Remand Home. Here the author of the study claimed that there were important differences in the family backgrounds of those who took drugs, and other boys in the Remand Home who were not drug takers. The drug takers came from 'worse' homes. Furthermore, it was seen to be relevant to show that those who took the worst drug, in this case heroin, also came from 'worse' backgrounds than those who took others, for example cannabis. The conclusions in this study were that the 'reasons' for drug taking were to be found in the drug takers' home background. No thought was given to how, or under what circumstances the heroin became available in the first place, or even how certain boys came to be selected for the Remand Home by the Courts, and whether these drug takers differed from those who did not go to the Remand Home. If these questions were ever considered, they were never discussed, so keen was the research worker to point to the 'defects' in the drug taker's background.

It would be wrong, I think, to argue that all research which is directed at the drug taker ignores wider issues, or even that these should be considered in every research project. But too often, by concentrating on the drug taker, our attention is directed away from many other issues. Also, implicit in much work on this subject is the assumption that there is something inherently different in a qualitative sense about those who break social rules. In the example of the research study in the London Remand Home, the drug takers coming from the 'worse' backgrounds are seen to be qualitatively different from the non-drug takers. Similarly, studies focussing on personality factors invariably invoke a personality defect to explain the drug taking. This defect quickly becomes transferred to a 'sickness' or other form of pathology. Yet as Howard Becker has noted, scientists have not ordinarily questioned such phrases, or questioned the values of those who label in this way. In so doing, they have accepted the values of the group who make the judgements.2 It never becomes necessary to ask how, or why drug taking came to be defined as deviant in the first place, or whether terms like 'pathology' or 'sickness' should be seen in a particular social context. `Bad homes' are, after all, only bad so long as one has a clear idea of what is 'good', and both terms must be related to a general level of social approval or disapproval.

The second difficulty with the approach which concentrates solely on the drug taker, is that it is becoming increasingly difficult to identify those special or peculiar features which drug takers are thought to possess. Often, where claims are made or results given in a clear cut manner, they are usually couched in sufficiently vague terms as to obscure more than they clarify. In a report of a study of drug taking in June 1970, drug takers ware described as having 'sociopathic' personalities, but no attempt was made to define 'sociopathic'. In other instances, these sorts of terms have contradicted similarly obscure ones. Recently, Professor Alfred Lindesmith collected a list of 33 different terms which have all been used to describe the personality of the drug taker. The list contains such varied terms as 'passive psychopath', 'hostile', 'weak', 'paranoid' and 'essentially normal', and Linde-smith must surely be right when he notes that this aspect of research may be said to be in a state of confusion.(3)

If the major criticisms about our limited knowledge have been directed at the treatment approach, which is essentially 'psychi-atric' in its formulation, it is also true that sociologists in Britain have rarely interested themselves in this particular field. One can echo Dr. Stan Cohen's words when he asks about the whole area of social deviancy—"What have sociologists been doing all this time?" By 1970 there were still fewer than 5 papers published by ,sociologists on drug taking.

In recent years, however, there have been a number of important developments in the sociology of deviancy which have reawakened our interest and enlarged and enriched our understanding. These have mainly stemmed from an approach which attempts to break away from the view that a 'social problem' such as drug taking can be examined in terms of the drug takers themselves. Much of what these theorists say is not entirely new, and has been implicit in so much of existing criminological think-ing, but what is new is a concentration as much on the agents of social control as on the deviants themselves. Thus, as Dr. Roger Hood has pointed out, "some criminologists have begun to consider the labelling process—to emphasise the similarities between conventional and criminal behaviour, to recognise that whatever behaviour is labelled deviant will depend on the situation in which it takes place, on the characteristics of the persons and the preconception of the audience.(4) This is an obvious enough statement perhaps, but as Hood points out, it is one that crimino-logical texts even 5 years ago virtually ignored. It is this approach, rather than "a catalogue of the deviant's so-called pathological attributes", that will be central to this essay. In order to under-stand whether such similarities between conventional or criminal behaviour in the field of drug taking exist—in this case the taking of legally prescribed or proscribed drugs—it is necessary to concentrate not only on the situations of the drug takers, but also on the audience.

It is against this background that I have chosen to examine certain historical changes and tried to show how the twin themes of the drug taker and the agents of social control have 'inter-acted' together. In other words, I have asked how changes in one produced changes in another, if at all, and have tried to show how perceptions of the drug takers changed when they ceased to be predominantly middle-aged and middle class, but became younger or less secretive about their drug taking behaviour. I have also tried to show how a great deal of British* legislation has been derived from international Conventions, where the definition of whether a drug comes to be seen as a social problem has been dependent on how other countries view it themselves. In this way I hope to show that British attitudes have largely been formulated by decisions taken at these Conventions. I have also tried to show how, within Britain itself, these international decisions have been interpreted so that the addict came to be seen originally as a sick person, and later as a sick, deviant, person. The period under review is from 1900-1970, largely because 1900 provides a convenient, albeit arbitrary, starting point, just before the major pieces of legislation were introduced during the 1914-1918 war, and when international control first began to be exercised at the Shanghai Conference in 1909. The year 1970 is a convenient cutting off point, since this was when the new Drugs Act came before Parliament and when there was also another important Convention in the United Nations. A great deal of this essay will therefore be concerned with historical processes, and in later chapters dealing more fully with the way in which moral and social problems such as drug taking are transferred into legislative decisions.

This approach, which is a mixture of history and sociology, has certain inherent methodological problems which have been difficult to handle.(5) Which for example are the sociological facts that ought to be included and which are the historical ones? Where are the boundaries to be drawn between the two discip-lines, and when they merge which should be given the most emphasis? Is it possible to use both approaches without being left with a mixture of potted history and potted sociology? Without attempting to claim to have further clarified these issues, I have tended to use the historical method to specify events and the sociological method to analyse them. So, for example, changes in the legal framework or the numbers of known addicts, have been noted, and then analysed in terms of the now traditional ways in which sociologists of deviancy analyse most official figures. The tendency has been to produce a some-what disjointed sociological picture, but our conceptual tools do not seem to have been developed to the extent which would allow the two disciplines to merge with each other in a satisfac-tory way. I have mentioned this problem as I believe that it will continue to present difficulties whenever similar studies are attempted.

The lack of rigorous theoretical arguments has already been noted as being a very serious drawback to understanding many of the deeper issues involved. This has been partly due to a concen-tration on discussions about drug takers' motives etc., but it is also in part due to a lack of hard data which, one would have thought, would have been readily available. I am thinking here of such mundane, but highly important data as the annual amounts of drugs legally prescribed, or even the ages and sex of those drug takers convicted in the Courts on drugs charges. This theme, the lack of data, will recur throughout, and this shortage is particularly acute up to about 1960.

Another theme is the absence of an agreed or settled definition about the basic terms, such as 'addict' or 'drug', which is in turn related to the preoccupation with 'pathologies'. This problem is not merely a semantic one, however, for to label a person an addict is to imply that he is a deviant or an outsider, and to label a substance a drug can also mean that the user is no longer faced with a personal decision to use it, but with a legal one as to whether he will be allowed to. A good deal of the confusion—or lack of precision—has stemmed from the indiscriminate use of these terms. For example, in Britain a number of drugs have been controlled by the Dangerous Drugs Acts, but not all are dangerous. In the United States, the term 'narcotic' refers to substances which dull the senses, but under Federal law includes cocaine, and under some State laws includes cannabis.

There have been various attempts to arrive at a satisfactory definition of the terms 'addiction' or 'addict', but this Issue is still far from settled. The first authoritative definition appeared in Britain in 1926 in the Rolleston Committee's report.(6) An addict was defined as "a person who, not requiring the continued use of a drug for the relief of the symptoms of organic disease, has acquired as a result of repeated administration, an over-powering desire for its continuance, and in whom withdrawal of the drug leads to definite symptoms of mental or physical distress or disorder".

A definition some 40 years later by the Brain Committee in 1964 (7) seemed to have altered the wording slightly without neces-sarily improving the definition. This Committee defined an addict as a person who "as the result of repeated administration has become dependent on a drug controlled by the Dangerous Drugs Acts and has an overpowering desire for its continuance, but who does not require it for the use of organic disease." This, however, was a definition for "the purpose of medical practice in Great Britain." It still does not meet the major problem which is to avoid the word 'dependency' in any definition of addiction, since both words tend to be interchangeable. Furthermore, both Committees seem to suggest that an addict cannot be someone who has an overpowering desire to use the drug but still needs it for the relief of pain. Both are clearly possible, and in Britain a distinction is often made between the 'therapeutic' and 'non-therapeutic' addicts, the difference being that the therapeutic addict became addicted for medical, as opposed to apparently non-medical reasons.

The World Health Organisation has attempted a number of definitions of addiction, but they have still not been able to agree upon one. In 1950 they defined addiction as "a state of periodic or chronic intoxication detrimental to the individual and society produced by a repeated consumption of a drug (natural or synthetic). Its characteristics include an overpowering desire or need (compulsion) to continue taking the drug and to obtain it by any means; a tendency to increase the dose; a psychic (psychological) and sometimes a physical dependence on the effect of the drugs." (8) This definition presents as many difficulties as before, not the least being that, as Lindesmith points out, the addict here is said to be in a state of `intoxication'.(9) And what is "detrimental to the individual and society" supposed to mean; who is to decide what is not detrimental? Furthermore, this definition suggests that if the use of certain drugs produces effects which are not seen as detrimental, the user then ceases to be an addict, even though he may continue to take drugs such as morphine. In Britain many people regularly use opiates to relieve pain when suffering from an organic illness, and some of them would certainly say that they were addicted. Using the last World Health Organisation definition one could say there were only a very few addicts in Britain even in the early 1960s, and probably none at all before then, whereas by the use of a different definition one can show a much larger number.

In 1958 the W.H.O. proposed that a distinction should now be drawn between addiction and habituation. Addiction was thought to differ from habituation in that habituation created a desire but not a compulsion to continue taking the drug for the sense of well-being it engendered. There was little or no tendency to increase the dose; there was some degree of psychic dependence, but an absence of physical dependence and absence of an abstinence syndrome.(10)

In 1964 the terminology was further changed. This time 'drug dependence' was substituted for both the terms 'addiction' and 'habituation', and it was ruled that dependence should be dis-cussed when it is linked to specific drugs or drug types. The definition this time was the "Drug dependence is a state of psychic or physical dependence or both arising in a person follow-ing administration of that drug on a periodic or continuous basis. The characteristics of such a state will vary with the agent involved and they must always be made clear by designating the particular type of drug dependence in each specific case, for example drug dependence of morphine type, barbiturate type etc." The value of the new terminology is that it at least avoided the difficulties in definition encountered by the Rolleston and Brain Committees and also avoided the value judgments of the first W.H.O. definition. It also relates drug dependence to a particular drug, rather than seeing it as a reflection of the per-sonal characteristics of the addict, and it also reduces the pre-occupation with the drug problem, and suggests there may be different problems related to a number of different drugs. However, a year later, in 1965, the United Nations Commission on Narcotic Drugs at the 20th Session decided after all to retain the old terminology of 'addiction'. This may in part be a recognition of the popularity of the term and the difficulty of ever removing it from the vocabulary, together with the ease of refer-ring to an 'addict' rather than a 'drug dependent person'. It may also be a recognition that substitute terms such as 'dependency' only marginally affect the issue.

Almost all the attempts at definitions of addiction or addicts have been psycho-pharmacological in origin, and the W.H.O. definitions are no exception to this. Sociologists have rarely been involved except in a general way. The usual sociological definition of addiction is "an assimilation into special life styles of drug taking." (11) This definition recognises the importance of the drug taker's norms and values as well as the corresponding rituals and argot. Yet it is at best a very general definition and does not take into account the possible variations of life style related to dif-ferent forms of drug taking, e.g. by concentrating on the younger addicts of the streets, it ignores addiction in older, middle class persons, such as doctors, or isolated addicts who may be 'thera-peutic' in origin and who may all have different life styles. Also implicit in the definition is the view that drug taking can only be seen in terms of the 'drug subculture'. Becker, in his article 'Becoming a Marihuana User' stresses the importance of the user's need to define certain experiences as pleasurable, and at least attempts to be specific in the way in which he concentrates on one drug and in one particular setting.

One of the best known attempts at defining addiction has been by Professor Lindesmith.(12) Crucial to his approach is the view that any theory of addiction must penetrate below what he calls the superficial and historical changes that have taken place, and which have tended to distort and bias our thinking. Lindesmith sees the use of the hypodermic syringe as an example of one of these superficialities. In his quest for a general theory, Linde-smith rightly rules out any theory which is only applicable to, say, 20th century heroin addicts, as not being a general theory at all. He also dismisses for similar reasons all theories which view addiction in terms of motives, arguing that these explanations have to contend with those persons who become addicted without voluntarily or knowingly taking drugs, as well as those who do.

In Lindesmith's view, the central feature of all addiction is the craving for drugs. This exists whether it be in 20th century young urban male heroin addicts, or elderly middle class opiate smokers, and is present irrespective of age, personality, country of origin or method of administration. The tendency to relapse or continue taking drugs is a corollary or consequence of craving. This craving for drugs, Lindesmith argues, develops only when the drug taker understands the meaning of the withdrawal symptoms and attributes them to their cause, i.e. the use of the drugs. A person remaining ignorant of the source or who interprets them in some other way, cannot be said to be addicted. Hence in fact lower animals, feeble minded and psychotic persons are said to be immune from addiction.

Without attempting to give a detailed criticism of Lindesmith's theory, it is clear that he is using the term addict in a rather special sense—what he calls the "full human sense". He is also solely concerned with the opiates and the continuation in the use of these drugs, but it would seem that any general theory would need to be expanded to take account of the introductory period before withdrawal symptoms occur. In spite of this, Linde-smith's theory presents the most consistent attempt to develop a definition and a theory which avoids the value laden terms so often present in other definitions.

Even less consideration appears to have been given to the second major problem, that of defining the term 'drugs'. Most of the definitions are given in a strictly medical form, and they also avoid the complex problems, such as what is meant when we say a person is taking 'drugs'. Clearly we mean something special by this, and do not necessarily think of that person as taking drugs when he takes aspirins—which medically speaking are drugs—or even tobacco or alcohol, which could also be classified as drugs in the strict medical sense of the term.

At the international level, bodies such as the United Nations or the League of Nations have also been vague about this prob-lem. In 1952, the Commission on Narcotic Drugs defined addict-forming drugs as those which were "socially dangerous". This is also much too broad and clearly involves all the previous criti-cisms of the W.H.O. definition of addiction. It also includes such diverse substances as tobacco, aspirin, barbiturates and chloral which are themselves habit forming, but not considered by some to be socially dangerous. By 1970, the range of drugs controlled by the W.H.O. was so wide as to defy any attempt at classifica-tion, and the Commission simply stated that "it must be empha-sised that risk to public health is the prime determining factor in deciding for or against control of a particular type of drug".(13) In Britain there has been no authoritative attempt at any socio-legal definition, and in the Dangerous Drugs Acts the substances or groups of substances have been listed and reference is simply made to the drugs and substances to which the provisions apply.

One attempt to remedy this position was recently made by Michael Ginsburg, who defined 'drugs' as "substances which will produce changes in living organisms that are expressed as an alteration in functional state, usually referred to as the effect of the drug".(14) He then goes on to distinguish varying uses of 'drugs', e.g. medicinal, industrial, political, and is left with a final category which he calls 'social'. This covers those drugs used by self-administration with the intention that they should alter mood and mentality. Although Ginsberg recognises that this definition is only a very general one, it is still to be preferred to the more common one of "any substance used in medicine" as it does go some way towards meeting the basic problem of what we mean when we say a person is taking drugs, by suggesting that these may fall into the category that Ginsberg calls 'social'.

There is of course no particular virtue in having agreed or settled definitions as such; definitions are after all for use as conceptual tools. Neither is the variety of definitions unique to the study of drugs. Similar problems exist, for example, in the field of subnormality. What is important is that usage has certain consequences, one of which is to direct attention at societal reaction to the phenomena being studied. This area more strictly belongs to the field of the sociology of knowledge, but the point I want to make at this stage is that many of the previous defini-tions of terms such as 'drugs' or 'addict' conjure up images of a particular type of person who produces a particular type of social problem. The definition by the W.H.O. of addiction as being "detrimental to the individual and society" is a typical example of this. The stereotypes about the 'addict' who takes 'drugs' are reinforced by the language we use, and often these stereotypes have been linked to those notions of pathology which were men-tioned earlier and which have long dominated our thinking. In this way, so much of the research and so many of the definitions of the problem have been inextricably linked, the one giving support to the other.

As the focal concern of this essay is to relate changes in the legal system of controls with the phenomena being studied I have not attempted to clarify the terms, but rather link their usage to the particular period under review. Implicit in this approach is an attempt to show that societal definitions of `drug addiction' and `drugs' have varied with the type of people who became the drug users. In other words, the definitions used can give important insights into the sociology of law as they reflect societal attitudes to the phenomena. For example, they are particularly relevant in the classificatory systems used by the Home Office to delineate the various categories of 'known addicts'—the therapeutic being seen as less blameworthy than the non-therapeutic group.

This essay is divided into two parts. In Part I, I have been concerned with the historical process from 1900-1970, and in Part III have attempted to link these to my general thesis of an inter-action between the legislative framework and the type of people who were defined as the drug takers.

* By this I mean England and Wales. Where Scotland and Northern Ireland are mentioned, this will be specified. I have used the term Britain to mean England and Wales simply because it is a more convenient and shorter title, but no disrespect is intended for Scottish or Northern Irish readers.

REFERENCES
1. Becker, H. Outsiders, Free Press, 1966.
2. Ibid.
3. Lindesmith, A. R. 'Basic Problems in Addiction and a Theory' in O'Donnel, J. A. and Ball, J. C. (eds.) Narcotic Addiction, Harper and Row, 1964.
4. Hood, R. G. 'The Contribution of the Labelling and Social Inter-actionist School to Criminological Thought' Paper given to the 4th National Conference on Research and Teaching in Criminology, Cam-bridge, July 1970.
5. See also Erickson Kai Wayward Puritans, Wiley, 1966, for a discussion on similar issues.
6. Report of Departmental Committee on Morphine and Heroin Addiction H.M.S.O., 1926, para. 21.
7. 'Drug Addiction', The Second Report of the Interdepartmental Committee, para. 17, p. 7.
8. Expert Committee of W.H.O. at Second Session in 1950.
9. Lindesmith, A. R. 'Basic Problems in Addiction and a Theory', op. cit., p. 92.
10. See also Bulletin on Narcotics, 1966, vol. 18, No. 1, p. 39-40.
11. Narcotics and Drug Abuse, Task Force Report, 1967, p. 1.
12. Lindesmith, A. R., op. cit., p. 91-109.
13. Quoted in Amphetamines and L.S.D., H.M.S.O., 1970, p. 3.
14. Ginsberg, M. What are Drugs?, I.S.T.D., 1970, p. 13.