Unhealthy lifestyle or modern disease? Constructing narcotic addiction and its treatments in the United States (1870-1920)

Abstract

The nature and management of narcotic addiction, and by extension, the nature and management of those who struggle with it, are not recent issues in the United States. Despite the current opioid epidemics and the apparent discovery of prescription-drug addiction, medical treatment of opioid dependence is already more than 100 years old. Is compulsive drug consumption a vice? A disease? A lifestyle? How does it affect the minds and bodies of those who suffer from it? How can they be cured? In the 1870s, physicians were already struggling with such questions when they pioneered what would become known as “addictology” in the 20th century. This article first endeavors to retrace the emergence of the conceptualization and perception of opiate addiction in the late 19th and early 20th centuries. From “imported vice” to “unhealthy lifestyle” and finally “nervous disease”, narcotic dependence became an increasingly important source of concern for turn-of-the-century physicians, precipitating a rapid and sometimes dangerously disjointed medicalization. This study then explores the different facets of early addiction treatments, their philosophies, their views on “addicted bodies” (particularly through the lens of lifestyle and heredity), and their impact on the evolution of addiction management programs.