Cover

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Frontmatter

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Contents

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p. vii

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Introduction

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pp. 1-12

The American junkie is a product of American history. The heroin addict— typically portrayed in movies, newspapers, and folklore as a heroin-addicted male urban hustler—emerged during a period when the marketing of opiates and the management of urban vice was undergoing profound transformations. These changes created the context for a particular pattern of exposure to now criminalized opiates...

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1 Heroin Addiction and Urban Vice Reform

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pp. 13-42

In 1908, James Martin, then aged 21 and working in a Coney Island music hall, joined a fellow waiter on a double date with two women his coworker had chatted up. Apparently wanting to impress his new friends, James suggested that they go at midnight to an opium den where he had entr

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2 The Opportunistic Approach

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pp. 43-61

New York was the first American city to appoint a vice commission to study the problem of prostitution. Its Committee of Fifteen was established in 1900 and produced its report, The Social Evil, in 1902. Across the United States, social hygienists and social purists publicized what they saw as the evils of prostitution, and they persuaded Congress...

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3 The Technological Fix: The Search for a Nonaddicting Analgesic

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pp. 62-97

As hopes of effective intervention dimmed, addicts became patients that physicians did not want to treat. Physicians had been blamed from within and without the profession for causing alarming levels of iatrogenic addiction; they were exhorted in therapeutics textbooks to avoid creating new addicts by reducing administration of opiates...

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4 Constructing the Addict Career

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pp. 98-124

If the search for a nonaddicting analgesic under the Bureau of Social Hygiene’s sponsorship was moderately successful, its efforts to promote a psychiatric understanding of addiction met with frustration and failure. BSH-sponsored research at the Philadelphia General Hospital was designed as a comprehensive study of the clinical material provided by the hospital’s narcotics wards...

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5 The Junkie as Psychopath

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pp. 125-155

Lawrence Kolb’s formulation of addiction as a problem arising from the defective personality of the addict dominated medical, scientific, and policy thinking about addiction for several decades following the publication of his classic works in 1925. Kolb framed addiction in the terms of the new psychiatry, a reform ideology...

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6 Healing Vision and Bureaucratic Reality

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pp. 156-183

To criminalize opiate addiction with the stroke of a pen was one thing; to process and manage addicts as they were swept up in arrest and moved through the court system and into jail or prison was quite another. Addicted prisoners presented a problem to the law enforcement system at every jurisdictional level...

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7 The Addict in the Social Body

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pp. 184-211

The 1950s marked the apogee of American scientific medicine’s power and the nadir of status for opiate addicts. Physicians had become paradigmatic of the cultural authority of the professions, while, in both professional and popular venues, “drug addict” was shorthand for profound and unreclaimable deviance...

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Conclusion

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pp. 212-230

By 1940, all the elements were in place for a configuration of ideas about opiate addiction that remained essentially stable until the enormous demographic changes in drug use that characterized the 1960s. For psychiatrists and pharmacologists, social concerns about opiate addiction in the 1920s and 1930s had created opportunities for disciplinary growth and creation of new knowledge...

Notes

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pp. 231-260

Acknowledgments

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pp. 261-266

Index

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pp. 267-276