Discovering Addiction: The Science and Politics of Substance Abuse Research (review)

Historians of addiction have contextualized our understanding of the claims of addiction science. Having exposed the cultural constructions of past scientific theories, they have been reluctant to engage current scientific findings. Persuaded that substances alter brain function and human behavior, scientists feel no need to consider cultural and historical contexts. In Discovering Addiction, Nancy D. Campbell aims to change this lack of engagement and "to jog conversations about drug policy and science beyond venues currently dominated by the criminal justice enterprise, the Drug Enforcement Administration, the FDA, and the pharmaceutical industry" (p. 134). Campbell believes that if historians and addiction scientists listen to one another, history will become an essential tool, persuading addiction scientists to abandon the impossible goal of abstinence in favor of more realizable strategies to reduce the harms associated with addiction.

Campbell draws on a variety of sources, including interviews with key American addiction researchers, to reexamine the history of human and animal experimentation among addiction scientists from the 1930s to the present. Much of this book focuses on the key addiction research centers, including Maurice S. Seever's monkey laboratories at the University of Michigan in the 1950s and 1960s and the U.S. Public Health Service Center for Drug Addiction at the federal prison hospital at Lexington, Kentucky, from 1935 until its termination in 1979. Informally labeled "Narco," the facility was designed to be a treatment hospital for incarcerated addicts. In 1948 the research unit became the first basic research laboratory of the newly formed National Institute of Mental Health Addiction Research Center (ARC). Inmates became voluntary participants in ARC experiments that tested reactions to a wide variety of substances including alcohol, barbiturates, heroin, methadone, major and minor tranquilizers, and psychedelics. Inmates often were readdicted "for the sake of science," and some of the information obtained "was used by pharmaceutical companies seeking to bring drugs to market" (p. 76). Campbell examines the ethical and controversial issue of using prisoners as research subjects. She engages Michel Foucault's claims that in the clinic such relations are inevitably informed by power discourses, making objects out of subjects.¹ She also examines the views of those who have found parallels between the Lexington research and the infamous Tuskegee "experiments." Indeed, the exposure of Tuskegee led to congressional hearings on the Lexington experiments that resulted in the transfer of ARC from Lexington to a nonprison hospital in Baltimore. Defending the Lexington experiments, Campbell concludes that "far from being unethical, the research program yielded broadly distributed benefits to persons from the addicted class" (p. 142). "Research ethics," she insists, "must be situated within the social conditions, material restraints, and commitments that prevail in specific institutional contexts" (p. 144). From that perspective, Campbell believes that her "analysis has shown how essential these studies were to establishing a knowledge base" (p. 142).

Often what has been learned was ignored in succeeding addiction science paradigms. Despite this, unconscious attitudes about addicts persist. Thus, Campbell points out the rhetorical resilience of a traditional "moral lexicon" of addiction. Citing the work of current National Institute on Drug Abuse Director Nora Volkov and her colleagues as exemplars, Campbell finds that their notion of "disrupted volition" parallels nineteenth-century constructions of addiction "as a 'disease of the will' subject to voluntary control." Thus, writes Campbell, with "amnesiac gesture toward its own repressed past, the addiction enterprise comes full circle into the present" (p. 221).

The history of addiction science exposes the failure of adherence to interventions and policies aimed at achieving abstinence. As others have shown, humans have employed substances to alter consciousness since time immemorial. For Campbell, this history demonstrates the impossibility of a drug-free society. The "treatment at Lexington," Campbell writes, "was not 'cure' but gradual withdrawal, detoxification, and abstinence, mixed with psychotherapy and vocational rehabilitation" (p. 144). However, the ARC goal of releasing prisoners who would...