Social Poison: The Culture and Politics of Opiate Control in Britain and France, 1821–1926

Introduction: A Tale of Two Drug Policies

i n t r o d u c t i o n A Tale of Two Drug Policies For an otherwise law-abiding morphine addict struggling to overcome addiction in the late 1920s, Britain was a more welcoming place than France. Although narcotics were subject to similar controls in both countries, the British government was willing to permit maintenance treatment in intractable cases of morphine and heroin addiction, but the French government usually was not. British doctors had the freedom to provide nontapering doses of opiates to confirmed addicts, provided they followed proper precautions . The French authorities, however, saw such maintenance as an indulgence of addiction rather than an appropriate way to treat it, and they were not reluctant to take action against doctors and pharmacists who provided opiates to addicts. Any French doctor who wrote a prescription for more than one week’s worth of opiates to ease the pains of withdrawal was liable to prosecution. Thus, whereas some Britons had the option to continue leading relatively normal lives in spite of their addictions, their French counterparts were trapped in a state of medical and legal uncertainty,constantly compelled either to undergo tremendous physical suffering if they quit using drugs or to risk breaking the law. One of the aims of this book is to explain why and how this difference between the two countries arose. British and French policies concerning opiate addiction were created during the period surrounding World War I. But 2 Social Poison attitudes about opiate use, and the addictive disorders it often caused, had their roots in the Victorian era, when both the allures and the dangers of the drugs captured the attention of writers, doctors, and, eventually, policymakers . The drug discourses that developed over the course of the nineteenth century in Britain and France shaped the thinking about opiates well into the twentieth century, influencing the timing, content, and character of the national drug policies that would emerge in the 1910s and 1920s. Changes in medical knowledge, culture, politics, and drug-using demographics merged to create distinct ways of understanding the problems that opiate use could cause, transforming it from an issue that concerned only the health and character of addicts into one that, if left uncontrolled, could have widespread ramifications for the British and French nations as a whole. I explore this transformative process, comparing the different paths taken by Britain and France in developing their drug control regimes at the beginning of the twentieth century. The Historical and Comparative Analysis of Drug Policy The historical literature on narcotics and narcotics control in the first half of the twentieth century has become increasingly rich in recent years, yet there has been little comparative work examining differences in national drug control policies of the period. Jan-Willem Gerritsen’s The Control of Fuddle and Flash, which discusses early control policies in Britain, the Netherlands , and the United States, is the only explicitly comparative history of nineteenth- and early-twentieth-century drug policies in the industrialized world, though it focuses more on the history of alcohol than other psychoactive substances.1 Other researchers have integrated comparative points into their studies of substance abuse policies from this era, though generally as an aside, not as a main focus of their research. Most drug policy comparisons looking at the early twentieth century focus on Britain in the 1920s, probably because more recent critics of punitive drug policies have heralded the so-called British System as an exemplar of restraint, reason, and compassion.2 Comparative discussions of British addiction policy generally fall into two camps. Some authors frame the divergence between British and other national drug policies as a philosophical one, claiming that whereas Britain developed a more “medical” approach to addiction, other countries were more moralistic or chose to marginalize medical input during their policymaking processes.3 Other researchers sug- gest that the differences between British and other national policies were not so much ideological as demographic. They argue that the British were willing to make concessions allowing maintenance treatment primarily because their addicts were less numerous, were of higher socioeconomic standing, and used drugs in a less socially menacing manner. The British, therefore, were able to sanction maintenance treatments, not because they viewed the drug problem differently, but because they had a different sort of drug problem altogether. More detailed research on British drug policy from the 1920s through the 1960s tends to support...