Addicts Who Survived: An Oral History of Narcotic Use in America before 1965 by David Courtwright, Herman Joseph, and Don Des Jarlais (review)

A common view of addiction in the United States is that it is a moral failing, a corruption of a person’s soul for which he or she is wholly to blame. This was especially true in the early years of the twentieth century, with Prohibition being one of the best-known expressions of that attitude. As the years passed, Americans’ fears surrounding narcotics and addiction began to grow, and popular opinion began to support the institution of violent punishments—such as execution by firing squads—as “permanent solutions for the drug problem, on the theory that the only abstinent addict was a dead one” (3). The greatest proponent of taking this hardline approach was Harry Anslinger, the head of the Bureau of Narcotics from 1930 to 1962, who served as the public face of these severe proposals, winning policy battles by appealing to the “nativist and racial fears” of ordinary Americans (13).

One such policy that had a number of consequences in the everyday lives of many addicts was Anslinger’s work against methadone maintenance programs, which were clinically regarded as a sort of panacea for opioid addiction but which Anslinger compared to “bars for alcoholics or department stores for kleptomaniacs or brothels for homosexuals” (13). Anslinger conflated unrelated issues in order to appeal to a puritanical sense of American morality, thereby removing a viable option for easing addicts away from narcotics and their role in a black market economy. During the early twentieth century, addicts were faced with the challenge of balancing harm reduction—that is, avoiding the assorted illnesses and dangers associated with narcotic use, sharing needles, and the “junk sickness” that comes from sudden withdrawal—with legal risk, as most methods of mitigating medical harm lacked legislative support; thus, the self-treating addict remained on the outskirts of the law.

The years leading upto and through 1965, described as “the zenith of the punitive approach” in drug law enforcement, are the focal point of Addicts Who Survived, an anthologized collection of interview excerpts from elderly individuals who have suffered decades-long addictions to narcotics (21). Courtwright, Joseph, and Jarlais identified thirty-seven individuals in methadone maintenance programs in New York City in the late 1970s and asked these individuals to participate in interviews between 1978 and 1982. Many in this selected group defy the typical stereotypes of drug addicts, namely being “male, rootless, disheveled, and dangerous” (117). In fact, many of the interviewees are female, were born into middle- and working-class homes, and/or maintained the facade of a “straight life”—career, homeownership, parenthood—for decades while hustling on the side for their drugs. Forced to live secretive lives underground, these interviewees recount their experiences, detailing the dangers they faced from needle-sharing, impure substances, theft, and other violent crimes, as well as the activities in which they engaged, such as prostitution, to make a living or barter for their drugs of choice. The nature of addiction and the culture of the time almost dictated that addicts could not, for the most part, keep written records of their experiences; as several interviewees note, it was generally felt among addicts that, “even if they possessed the talent and motivation to write, it was inexpedient to do so, given that the police might suddenly kick in the door and start seizing evidence” (27) These interviews are invaluable, then, in helping preserve individuals’ rare experiences with narcotics addiction.

The authors of Addicts Who Survived are well aware of the unique place it occupies in scholarship of this kind; very few studies relying on primary-source accounts of addiction in America, they write, have “focused exclusively on older addicts whose memories reach so far back into the twentieth century” (1). Courtwright, Joseph, and Jarlais’s work helps to shed light on the interviewees’ childhoods and their early...