Exam Study Notes
- Point-form suggested (cut to the chase)
- Write as much as you can
-Only about half a page each (Single spaced, so 1 page double spaced)
1. Web ct discussion + “liberal account of addictions” paper
2. The idea that began the course + slides from first class
3. Jackle & hyde paper + class slides
4. Becker paper has everything
5. “opium wars” paper + control that is associated with drugs
6. Class slides from last class + metaphysics
7. “Do drugs have religious import?” paper + last set of class slides
8. Class slides for pharmaceuticals
-Detailed development of ideas
-no need for citation
-6 pages [double spaced] [we think] per essay. If you want an A.
1) “Discovery of Addiction” Levine
-look at the last part of the paper
-changes in language. The way the drugs are talked about.
-shifts in class society
2) “Constructing the Pharmacological” paper
-class slides for bio politics
-class slides for pharmacological
-“Jim Crow’s War on Drugs” paper (Class 4)
-Paper on Valium. “The Pill you love can turn on you.....”- (Class 9)
3) “Official View on Addictions”
-Refer to 3rd set of class slides Notes:
1. What are the three major positions with regards to addiction? And, what are some of
their weaknesses? Use examples to illustrate your points.
a) The disease view: an addict‘s drug-seeking behavior is the direct result of some physiological
change in their brain, caused by chronic drug use.
Example: an individual who needed painkillers (such as oxycontin) after suffering from an injury
or illness that causes chronic pain may become addicted to the drug because they need it to
function in their everyday life.
Argument: Some critics argue that it is due to pleasure the addict continues to use
substance not chronic brain damages, not planning but pursuit of this pleasurable
b) The willpower view: some part of the addict wishes to abstain but their will is not strong
enough to overcome an immediate desire toward temptation.
Example: An individual who smokes cigarettes wants to quit for their health, but cravings for
nicotine overcome the want to quit.
c) The lay view: drug users are morally corrupt hedonists (a person whose life is devoted to the
pursuit of pleasure and self-gratification) who value immediate pleasure above all else and who
rely on others to handle their health and survival problems. (From the article ―A Liberal Account
of Addiction‖)Example: an individual who is addicted to a substance to the point where they will
put everything on the line and leave their problems for someone else to fix.
The Willpower View is motivated by phenomenology and self-report, whereas the
Disease View is based on neurobiological evidence. Both of these views do share
similarities: addictive behaviour essentially non-voluntary. Drug causes them to use it
due to drug-induced change in behaviour.
The Willpower and Disease Views, we argue, are both false. Ironically, the Lay View is closest
to the right view. Modern societies hold a number of very strong taboos against wanton pleasure-
seeking behavior. These taboos construct our conception of rational, sane behavior, and close our
eyes to an honest description of the addictive experience and of the biology that underpins it.
They cause us to define addictive behavior,which in turn colors the scientific study of addictive
The Liberal View is what the author argues as the way to define addictive behaviours, The
Liberal View contains only three claims about addiction. First, we do not know whether an
addict values anything more than the satisfaction of his addictive desires. Second, we do not
know whether an addict behaves autonomously when they use drugs. Third, addictive desires are
just strong, regular appetitive desires. (14) 2. How is the question, “what is a drug?” problematic? Use examples to illustrate your
This question is problematic for a number of reasons.
o First, because there is no agreed upon use of the term ‗drug‘. It can be categorized into a
number of things, such as; narcotics, pharmaceuticals, medication, and the list goes on.
Although, something that is said to be a medicine can also be a poison or in other words a
pharmekon. From this we get the question of what drugs are good or bad, but in reality it‘s the
use of them that is problematic; could be useful or detrimental).
o Secondly, drugs can be a part of many aspects of life such as religious ceremony (wine), food
and culture (alcohol), health and wellness (autheusca vine), and recreation and pleasure. The
pleasure we get from them is a reason why some have condemned drugs.
o Either way there is no agreement on what drugs are, there are so many uses for them, and so
many opinions, it is literally impossible to have a concrete meaning.
o The major point is that the term drug is an empty signifier that can mean anything we want it
to; this can represent the undecidability of drugs.
3. What is intoxication? What are the two main poles through which intoxication has been
understood in the West? What is the main binary distinction with regard to the effects of
alcohol intoxication? Elaborate your answer by using examples.
Intoxication can be seen as the state of mind one enters after consuming a drug or
The two main poles can be seen as the different views on the way the person ―under the
o The first view is the demonic view; that they are under a demonic possession,
and are responsible for what they speak in that state. In other words, it often makes
people act or speak in ways they would not normally do. This can also be referred to as
the ‗alcohol doing the talking‘
o The second view is a divinity view; that the truth is spoken when under the
influence of alcohol. This can also be referred to as In vino veritas. The alcohol actually
dis-inhibits the individual, making them more honest, spontaneous and giving them more
courage to act then they would in normal circumstances. In other words the alcohol
allows them to express their true feelings which they would have kept hidden otherwise.
The binary distinction with regards to the effects of alcohol intoxication…
4. According to Howard Becker, how does one become a marijuana user? What does his
theory say about the nature of drug effects?
According to Becker one becomes a marijuana user for pleasure only when he
(1) learns to smoke it in a way that will produce real effects;
(2) learns to recognize the effects and connect them with drug use; and
(3) learns to enjoy the sensations he perceives
According to Becker‘s theory the nature of these drug effects comes from the behaviour of the
individual using them towards the marijuana; the state of mind one is in, or the way they feel about the drug itself will greatly alter and affect their experience. Also a key point is the person
develops a new conceptualization of the ‗object‘. This happens in a number of communicative
acts in which others point out new experiences to him, and new events that take place in order to
form a new conceptualization of the drug.
Examples in Becker‘s study were given, where ‗novices‘ were unable to feel the effects of the
drugs because they simply did not know the symptoms of being high. They remained in these
states until they were pointed out; so in other words the effects are what we conceptualize or
create them to be.
5. How are drug control regimes implicated in „biopolitical” systems of surveillance and
control? *** MIGHT NEED TO ADD TO THIS ONE!
Foucault conceived of power operating in a number of different ways, but 3 formations of power
are privileged in his analysis
o Sovereign Power
o Disciplinary Power
At the individual level the drug user emerged as a new criminal subject at the center of an array
of medico-penal technologies
At the collective level the drug problem is framed as a threat of epidemic proportion to social
health and national prosperity
The emergence of the narcotic control regime in the early twentieth century US provides a
historical case study of what Michel Foucault has called ‗‗biopolitics‘‘. At the collective level,
narcotic control policy emerged as a regulatory mechanism to secure the national population
from the spread of addictive substances through an elaborate system of surveillance and control.
At the individual level, the drug user emerged as a new criminal subject at the center of an array
of medico-penal technologies that sought to understand the psychological and somatic
dimensions of addiction, and to normalize the addicted person.
6. Psychedelic drugs unleash a number of effects that have been particularly difficult to
understand. As a consequence, this class of drugs has undergone a number of name
changes that directly reflect our understanding of what they do. What have they been
called? How do these name changes relate to the models used to understand these effects?
What are the two main factors that construct the psychedelic experience?
An early medical understanding of psychedelics, and LSD in particular, was that they were
‗psychotomimetics‘, temporarily placing users in the equivalent of a psychotic state. The first
wave of medical research on LSD suggested that the pharmacokinetics acted in the areas of the
brain responsible for schizophrenia – for example, a series of articles entitled ‗Schizophrenia:
A New Approach‘ was published in the 1950s suggesting that naturally occurring adrenaline
derivatives, similar in structure to LSD, might be the biochemical origin of schizophrenia
(Osmond & Smythies, 1952), and that schizophrenia could be understood as autotoxicity,
whereby the human body accidentally released a surplus of LSD-like chemicals that led to
persistent perceptual alterations Since the 1960s, the psychotomimetic theory of hallucinogens has declined and, for a while,
considerable interest developed in the therapeutic potential of LSD. However, the precise
cause of altered states of consciousness is still indeterminate. Julien says:
· § One speculation about the process by which hallucinogens manifest their
impressive alterations of mood, perception, and thought is that the pontine (dorsal)
raphe, a major center of serotonin activity, serves as a filtering station for incoming
sensory stimuli. It screens the flood of sensations and perceptions, eliminating
those that are unimportant, irrelevant or commonplace. A drug like LSD may
disrupt the sorting process, allowing a surge of sensory data and an overload of
brain circuits. Dehabituation, in which the familiar becomes novel, is noted under
LSD.(Julien, 2001, p. 344)
Link to the unconscious: Freudian therapists believed that LSD therapy proved the existence of
the Freudian unconscious. Grof believed the validity of his patients‘ revelations was evident
because his Czech patients were unfamiliar with Freudian ideas, yet still manifested Freudian
· · ―Delysid‖-Therapeutic tool: During the 1950s and 1960s, before Grof‘s
research was published, a considerable literature developed on LSD as a therapeutic tool.
Researchers tried LSD along with Ritalin (an amphetamine now most commonly prescribed
for attention-deficit hyperactivity disorder) as treatments for a huge range of maladies
including generalized anxiety, writer‘s block, psoriasis (a skin condition thought to be related
to neurosis), migraine, female ‗frigidity‘, and male impotence (Ling & Buckman, 1963).
· Made the assumption that the LSD experience was a model psychoses (i.e. it
· As a consequence, the effects of LSD were usually compared with schizophrenia
· Between 1950 and the mid-1960‘s there were more than a thousand clinical papers
discussing 40,000 patients, several dozen books and 6 international conferences on
psychedelic drug therapy.
· Research found that after ingesting a psychedelic substance, some experimental
subjects were less depressed, anxious, guilty, and angry, and more self-accepting,
tolerant, deeply religious, and sensually alert
· Psychotic therapy‖:
· It was theorized that such moderate doses of LSD would aid in psychoanalytically
oriented psychotherapy by uncovering the unconscious roots of neurotic disorders
· Literally ―mind loosening‖
· Required relatively small doses (usually not more than 150 micrograms of LSD),
which were used mainly for neurotic and psychosomatic disorders.
· ―Psychedelic therapy‖ = mind manifesting
· Emphasized the mystical or conversion experience and its after-effects.
The central idea of psychedelic therapy is of a single overwhelming experience that produces a
drastic and permanent change in the way a person sees himself and the world.
It is assumed that if one traumatic event can shape a life, then one therapeutic session can
· These drugs had the ability to transport the user to an area of experience that was
preverbal or anti-verbal and this was a major drawback for any scientific enterprise
· ―Acid‖/Party drug 7. Do drugs have religious import? Outline the main debate surrounding this question.
In his trial-and-error life explorations man almost everywhere has stumbled upon
connections between vegetables (eaten or brewed) and actions (yogi breathing exercises,
whirling-dervish dances, flagellations) that alter states of consciousness. From a
pharmacological standpoint we now understand these states to be the products of changes in
brain chemistry. From the sociological perspective we see that they tend to be connected
in some way with religion. If we discount the wine used in Christian communion
services, the instances closest to us in time and space are the peyote of The Native
American [Indian] Church and Mexico's 2000-year-old "sacred mushrooms," the latter
rendered in Aztec as "God's Flesh"-striking parallel to "the body of our Lord" in the
If there is one point about which every student of the drugs agrees, it is that there is
no such thing as the drug experience per se-no experience that the drugs, as it were,
merely secrete. Every experience is a mix of. three ingredients: drug, set (the psychological
make-up of the individual), and setting (the social and physical environment in which it
is taken). But given the right set and setting, the drugs can induce religious experiences
indistinguishable from experiences that occur spontaneously.
How do we know that the experiences these people have really are religious? We can begin
with the fact that they say they are In the absence of (a) a single definition of religious
experience acceptable to psychologists of religion generally and (b) foolproof ways of
ascertaining whether actual experiences exemplify any definition.
Suppose that drugs can induce experiences indistinguishable from religious experiences
and that we can respect their reports. Do they shed any light, not (we now ask) on life, but
on the nature of the religious life? One thing they may do is throw religious experience
itself into perspective by clarifying its relation to the religious life as a whole. Drugs
appear able to induce religious experiences; it is less evident that they can produce
To begin with the weakest of all arguments, the argument from authority: William James
did not discount his insights that occurred while his brain chemistry was altered. The
paragraph in which he retrospectively evaluates his nitrous oxide experiences has become
classic, but it is so pertinent to the present discussion that it merits quoting once again.
To this argument from authority, I add two arguments that try to provide something by
ways of reasons. Drug experiences that assume a religious cast tend to have fearful
and/or beatific features, and each of my hypotheses relates to one of these aspects of the
experience. Beginning with the ominous, "fear of the Lord," awful features.
Turning from the hellish to the heavenly aspects of the drug experience, some of the latter
may be explainable by the hypothesis just stated; that is, they may be occasioned by the
relief that attends the sense of escape from high danger. But this hypothesis cannot possibly account for all the beatific episodes, for the simple reason that the positive episodes
often come first, or to persons who experience no negative episodes whatever. Dr. Sanford
Unger of the National Institute of Mental Health reports that among his subjects "50 to
60% will not manifest any real disturbance worthy of discussion," yet "around 75 % will
have at least one episode in which exaltation, rapture, and joy are the key descriptions."
How are we to account for the drug's capacity to induce peak experiences, such as the
following, which are not preceded by fear
Like every other form of life, man's nature has become distinctive through specialization.
Man has specialized in developing a cerebral cortex. The analytic powers of this instrument
are a standing wonder, but the instrument seems less able to provide man with the sense
that he is meaningfully related to his environment: to life, the world, and history in their
o As Albert Camus describes the situatid. The drugs do not knock this
consciousness out, but while they leave it operative they also activate areas
of the brain that normally lie below its threshold of awareness
8. Pharmaceuticals, such as Prozac and Ritalin, inaugurated the era of cosmetic
psychopharmacology and have come to be identified as “lifestyle” medicines. What are
lifestyle medicines? How are they branded? What are some of the implications of this?
Lifestyle medicine is defined as the application of environmental, behavioural, medical
and motivational principles to the management of lifestyle-related health problems in a
clinical setting. (wiki)
They are branded as “breakthroughs” or “miracle drugs” that allow individuals to
Example of medications that are branded with specific diseases:
Prozac would have to be a drug aimed at the ―walking wounded‖ with mild to moderate
symptoms. The marketing strategy evolved from there, whose 2 main thrusts were:
o To grow the antidepressant market
o To push the features of the drug, such as the once-a-day dosing, rather than the
o It is claimed that Prozac could make people ―better than well‖ and that it offered
people the opportunity to give their brains a needed tune-up, a phenomenon he
dubbed ―cosmetic psychopharmacology
SmithKline Beecham positioned Paxil as the best treatment for ―depression with
associated symptoms of anxiety‖
The Paxil launch coincided with the release of DSM-IV, which finished the job of
breaking up the catch-all ―anxiety neurosis‖ diagnosis. The end result was that anxiety
became several distinct disorders. Thus SKB was able to obtain valuable new indications and Paxil was successively approved for the treatment of panic disorder, obsessive-
compulsive disorder, generalized anxiety disorder, post-traumatic stress disorder and
Sarafem® is one of the first pharmaceutical products to have been heavily promoted by
direct-to-consumer (DTC) advertising, and is prescribed for a highly contested syndrome
attributed to women, namely, premenstrual dysphoria disorder (PMDD). Sarafem is
fluoxetine hydrochloride—the same chemical marketed as Prozac by Eli Lilly.
o According to an Eli Lilly representative:
o ―We asked women and physicians, and they told us that they wanted a treatment
with its own identity. Women do not look at their symptoms as a depression, and
PMDD is not depression but a separate clinical entity. Prozac is one of the more
famous pharmaceutical trademarks and is closely associated with depression.‖
o Thus, pharmaceutical companies, as well as consumers, confront disease and its
treatment by looking beyond mere pharmacology.
o ―Generic fluoxetine is not identical to brand name Prozac in appearance. The
generic prescription you pick up at the pharmacy won‘t look like brand name
Prozac. Receiving medication with a different color or shape may be unsettling or
cause concern.‖ (From Eli Lilly‘s Prozac web site)
o The branding and the social coding of drugs is situated within medical contexts
where the attempt to make brands stick to diseases invites a whole new set of
tensions among pharmaceutical companies, health care providers, and insurance
o Thus, within different institutional settings, the patient/consumer encounters quite
different ideas of how disease, bodies, and drugs go together.
Public concepts of disease are increasingly formed on the bases of DTC
marketing of pharmaceutical products. Accordingly, there is a new
political economy of health care. The Web site for Sarafem, for instance,
disperses information to physicians differently from how it presents
information to patients.
Physicians are informed that:
―Fluoxetine was initially developed and marketed as an
antidepressant (Prozac®, fluoxetine hydrochloride).‖
Patients, on the other hand, read:
―What is the active ingredient in Sarafem? Sarafem contains
fluoxetine hydrochloride, the same active ingredient found in
Both statements are technically true, but socially, they produce very different
meanings. Essay Questions:
1) An important shift occurred at the end of the 18th and beginning of the 19th century
with regards to our understanding of habitual drunkenness. According to Harry G.
Levine, the new configuration that arose in this period amounts to nothing less than “the
discovery of addiction.” What are the traditional ideas about habitual drunkenness? How
was alcoholism reconfigured after the radical break with these traditional ideas? In other
words, what are the main elements of the modern definition of alcoholism? And, most
importantly, how is the transformation in social thought concerning addiction grounded in
deeper changes in the structure of society?
The idea that alcoholism is a progressive disease – the chief symptom of which is
loss of control over drinking behavior, and whose only remedy is abstinence from all alcoholic
beverages. This new paradigm constituted a radical break with traditional ideas about the
problems involved in drinking alcohol.
Laymen(non-intellectual average men. Ie average hick *Christian) and physicians associated
with the two newly created temperance organizations developed theories about addiction and
brought the experience of it to public attention. Temperance movement and New Disease
The most important difference between temperance thought and the "new disease conception" is
the location of the source of addiction. The temperance movement found the source of addiction
in the drug itself – alcohol was viewed as an inherently addicting substance, much as heroin is
today. Post-Prohibition thought locates the source of addiction in the individual body – only
some people, it is argued, for reasons yet unknown, become addicted to alcohol.
Seventeenth-century and especially 18th-century America was notable for the amount of
alcoholic beverages consumed, the universality of their use and the high esteem they were
accorded. Liquor was food, medicine and social lubricant, and even such a Puritan divine as
Cotton Mather called it the "good creature of God." It flowed freely at weddings, christenings
and funerals, at the building of churches, the installation of pews and the ordination of ministers.
During the 17th century, and for most of the 18th, the assumption was that people drank and got
drunk because they wanted to, and not because they "had" to. In colonial thought, alcohol did not
permanently disable the will; it was not addicting, and habitual drunkenness was not regarded as
a disease. At the end of the 18th century and in the early years of the l9th some Americans began
to report for the first time that they were addicted to alcohol: They said they experienced
overwhelming and irresistible desires for liquor.
Beginning in the 19th century, terms like "overwhelming," "overpowering" and
"irresistible" were used to describe the drunkard's desire for liquor. In the colonial period,
however, these words were almost never used. Instead, the most commonly used words were
"love" and "affection," terms seldom used in the 19th and 20th centuries. In the modern
definition of alcoholism, the problem is not that alcoholics love to get drunk, but that they cannot
help it – they cannot control themselves. They may actually hate getting drunk, wishing only to drink moderately or "socially." In the traditional view, however, the drunkard's sin was the love
of "excess" drink to the point of drunkenness.
The invention of the concept of addiction, or the discovery of the phenomenon of
addiction, at the end of the 18th and beginning of the 19th century, can be best understood not as
an independent medical or scientific discovery, but as part of a transformation in social thought
grounded in fundamental changes in social life – in the structure of society.
Throughout the l9th century, people associated with the temperance movement argued that
intoxication, intemperance (excessive use of an alcoholic beverage) or habitual drunkenness was
a disease, and a natural consequence of the moderate use of alcoholic beverages. Indeed, the idea
that drugs are inherently addicting was first systematically worked out for alcohol and then
extended to other substances.
In the last decade or so of the 19th century, temperance ideology began to shift away
from its broad reformist orientation, toward a single-minded concern with Prohibition. The older
organizations, especially the fraternal ones, declined. The leaders who had guided the movement
since the end of the Civil War died, and were replaced by a new generation which prided itself
on its practical and scientific attitudes.
As was true at the beginning of the 19th century, developing a new model of alcohol problems
would necessarily be part of a reformulation of social problems in general. Thus even if a new
paradigm or model does emerge, it will have to compete and coexist with the addiction
perspective for a long time – just as, for the last 200 years, the addiction model has had to
compete and coexist with the pre-addiction view.
For those interested in criticizing and transcending the addiction model of drug use, it is
important to understand that the medical model has much deeper roots than has previously been
thought. The structural and ideological conditions which made addiction a "reasonable" way to
interpret behavior in the l9th century have not disappeared in the 20th: Many people still face the