Virginia Berridge: A Historical Perspective on Alcohol, Tobacco, and Drugs

Thursday, July 3rd, 2014

Cigarette resizeEditor’s Note: Virginia Berridge, Professor of History and Director of the Centre for History in Public Health at the London School of Hygiene and Tropical Medicine, is the author of Demons: Our Changing Attitudes to Alcohol, Tobacco, & Drugs. In her book, Dr. Berridge explores a history of substance use and its perception in society, examining the relationship across gender, race, the media, the government, the medical community and law enforcement. We spoke with Dr. Berridge about the findings of her book and how they can relate to drug use today.

Phoenix House: You explain that our attitudes towards drugs—and whether we view them as a vice, a sin, a crime, or a disease—have constantly shifted throughout history. How do you think these accepted narratives about drugs have impacted the resources available to people struggling with addiction?

Virginia Berridge: The concepts certainly have an impact on resources. In the nineteenth century, there were no resources at all, and the role of state provision was absent.

During that time, doctors in both the UK and the US fought to have those using alcohol and drugs problematically removed from the criminal justice system and into treatment through promoting the concept of ‘ inebriety’ as a medical one. However, the resources to support this approach were never forthcoming to any great extent and this attempt foundered.

More recently, treatment in the UK gained resources because it was seen as reducing prison costs—so there is a great deal of interconnection between the different approaches, penal and medical.

PH: You mention that various groups influence our attitudes about drugs—from government officials to pharmaceutical companies to public health activists. How big of a role do you think the media/pop culture plays?

The media plays a large role—and that has been the case really since the early twentieth century with the rise of the popular press. For example, during the First World War there was fear that drugs and alcohol were undermining the war effort.

Drugs and alcohol latterly have always provided good sensational copy. It’s interesting to see how that is beginning to change, at least in the UK. There has been more sympathetic coverage, for example, of the moves to dismantle or change the international control system for drugs. There seems to be a more tolerant attitude to drug use overall.

PH: Your book illustrates that government regulation can do little without public acceptance. Do you see this observation factoring into the current marijuana debate?  The latest Gallop poll shows that 58% of Americans believe the drug should legalized.

VB: It will be interesting to see how the balance works in relation to marijuana in the US. In the UK in the 1950s, certainly, politicians were unwilling to tackle cigarette smoking because so many people smoked. Smokers were also voters and no politician wanted to antagonise them at that stage. So the connection with public culture and views is an important one so far as policy makers are concerned.

PH: You talk about how our perception of various drugs throughout history has been largely shaped by fear—especially when a particular substance is linked to a minority group. How do you think fear has played a role in drug policies, specifically when it comes to criminal justice?

Fear has been specifically linked with groups in society who are seen as different or are simply not in the majority. For example, the Chinese opium smokers in London were dealt with through the criminal justice system rather than through a medical route. When the Rolleston committee on morphine and heroin addiction investigated drug use in the 1920s, it initially missed working class chlorodyne drinkers because they were not part of the ‘medical’ image. Prison was seen as more appropriate than medical help for particular groups.

PH: You also mention that so-called “independent women” have historically been vilified for drug and alcohol use to a greater extent than men who use. Do you think that double standard still exists today?

VB: The double standard certainly exists today. We have read a great deal about women’s ‘binge drinking’ in recent years, even though the proportion of men who drink is much higher. Women subverting traditional roles is always worrying to society and makes good media copy.

PH: Health Care Reform in the U.S. reflects a growing understanding among lawmakers that addiction is a public health issue—yet much of the public still views it as a moral failing. What do you think it will take to change this public perception?

VB:  That’s difficult to say. One of the problems is that the public maybe doesn’t know quite what ‘ public health’ means. It seems to have many different definitions and can mean different things at different times. Public health approaches can also have a moral element—there is not always a great separation between the two.

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