Addiction and Modernity: A Comment on a Global Theory of Addiction. Robert Granfield. Over the years, alcohol researchers within the Kettil Bruun Society have ...
Addiction and Modernity: A Comment on a Global Theory of Addiction Robert Granfield Over the years, alcohol researchers within the Kettil Bruun Society have sought to articulate broad-based theoretical propositions regarding the social and cultural foundations of addiction that challenge biological reductionism. While the disease concept of addiction has reigned supreme over the years to the point that it is now hegemonic in that it possesses its own self-legitimating ideology, alternative conceptions of addiction that focus on the broader social contexts have been advanced. Certainly the growing recognition of the reality of natural recovery poses a direct challenge to the dominant disease-based narrative.1 Perhaps one of the greatest flaws of the medicalized construction of addiction lies in its methodological individualism, that is, the tendency to focus on individual experience to the exclusion of social context. It might be said that the prevailing views amount to an “addiction fetishism” in which the behavior of an addicted person is seen as though it was isolated from the social, cultural, and historical circumstances that produced it. Not unlike Marx’s notion of commodity fetishism that sees commodities as having an existence independent from the social circumstances of production, so to addiction fetishism is a mode of thought that alienates the personal experience of addiction from the broader social forces that contribute to its development. Thus, addiction fetishism makes an abstraction of actual people that is analogous to the abstraction of the commodity. By abstracting the conditions of production, commodity fetishism and addiction fetishism obscures the actual social realities, social inequalities, and social conditions of production. The ideology of addiction as an individual disease, the underlying assumption of addiction fetishism, constructs an illusory form of equality and individuality. Addiction fetishism places an emphasis on individualism without individuality, on a sense of humanism without humanity, and on biology without ecology. Addiction fetishism envisages addiction as an “equal opportunity disease” without addressing the reality that not everyone has the same opportunity to develop an addiction. Like commodity fetishism, addiction fetishism reduces humans to abstractions i.e., the disease metaphor, who are then dominated by those abstractions, never really questioning the social basis of the reified categories or the circumstances of their lives that contributed to addiction.
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See Granfield & Cloud (1999) for review of the natural recovery literature.
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An attempt to de-mystify the social, cultural, and historical forces leading to addiction has been explored by Alexander in a recent paper (Alexander 2000). In exploring the “globalization” of addiction Alexander undertakes a socialhistorical analysis of addiction that is a once a global theory of addiction as well as a theory of the self in modernity. While many diseases such as small pox (and you could add many others) have been eliminated by modernity, life style problems such as addiction and other health related ailments that increase mortality and morbidity have grown exponentially. Alexander focuses on the case of Vancouver, British Columbia that has shown dramatic increases in alcoholism, heroin-related death rates, self-reported drug usage, and availability of heroin and cocaine. This has occurred, despite the numerous and often punitive efforts to restrict the use of these intoxicants. This is because, as Alexander argues, addiction is mass-produced product of a free-market society itself. Drawing on a critical social history of Vancouver, Alexander adduces the proposition that addiction is propagated by a strong sense of dislocation, or as Marx might say alienation from the self and others, brought on by dramatic social transformations associated with the rise of capitalism. Alexander’s social analysis is not unlike that of Max Weber’s who, while seeing the rise of modernity as an unstoppable tendency within society, nevertheless considered such societies an “iron cage” that contributes to a widespread “disenchantment of the spirit”. Alexander makes the point that the Canadian Indian population is overrepresented in the alcoholic population in Canada and that “Canadian Indians have had an astronomical addiction rate” (Alexander 2000, 515). In Canada, as in the United States, traditional native practices such as hunting, dancing, and drumming, practices that marked one’s sense of self in the broader collective foundations of community life, were subjugated in the wake of the vanguard forces of modernity and the free market. Among traditional cultures, rituals of hunting, dancing and drumming were infused with profound meaningfulness that was tied to daily life in fundamental ways. In the western U.S., traditional hunting practices for subsistence by local indigenous populations were subverted by entrepreneurial values associated with tourism and economic development. In Vancouver, as Alexander explains, these traditional and collectively based avenues of meaning became legally unavailable. Certainly, Indian people in the U.S. and Canada are not the only cases of social and cultural dislocation that can be found in history. E. P. Thompson’s (1966) classic work on the transformation of the working class in England tells the story of dislocation experienced by the working class that, as German social historian Wolfgang Schivelbusch (1993) points out had a dramatic impact on the drinking practices of the new industrial proletariat. Alexander (2000) makes a similar point when he suggests that the dominant occupations in the Vancouver area – logging, fishing, and mining – separated working class men from their families for months, a fact that contributed to greater cultural dislocation. Norman 30
Zinberg (1984), the late clinical professor of psychiatry at Harvard Medical School, maintained that controlled drinking practices in America began to subside around the time of the Revolutionary War and the Industrial Revolution. During this historical epoch the natural regulatory norms and rituals of social life that fostered controlled use deteriorated under the sway of rapid social change. The Revolutionary War and the Industrial Revolution created dislocating conditions that were ripe for alcohol abuse. In each case, men were brought together in large numbers, away from the regulatory function of family life, and under oppressive and fearful circumstances. It is not surprising that, in such turbulent settings, excessive consumption of alcohol was used to ease the psychological tension associated with wartime as well as provide a means of escape from the proletarian drudgery and alienation associated with factory life. Thus, for Alexander, dislocation as a cultural condition and the related loss of self in modernity must be recognized as a precursor to addictive practices. Indeed, Alexander sees dislocation as a cultural norm within modern free-market society that makes individuals ripe for addictions of all sorts. As Alexander (2000, 502) writes, “(al)though a person in any society can become dislocated, ‘free market’ societies inevitably dislocate their members, rich and poor, from traditional family, community, and religious ties” (emphasis added). Paradoxically, while modernity and free-market society may be the source of addiction, addiction to all sorts of practices may provide the seeds of personal meaningfulness for many. As David Forbes (1994) has pointed out in his book False Fixes addictions represent, “disturbed expressions within this culture through which we attempt to meet our needs for power, security, and self-expression. Addiction relations become a cultural problem as a result of our attempt to meet those social needs through drug use and other compulsive behaviors, since we may not be meeting them otherwise as we mature.” Like the American sociologist C. Wright Mills (1959), Alexander understands that private troubles are public issues, that is, an individual’s addiction transcends any individual in that its roots reside in the broader social and cultural conditions that prevail in society, and might even be said to be an expression of adaptation to prevailing social conditions. Addictions are not powerful because they promote a kind of biological or chemical “false consciousness” that dupe people into believing they are significant. Addictions are powerful precisely because they provide, at least for a time, effective avenues to personal meaning in societies in which the search for personal meaning has become increasingly relegated to an individual project. The great struggle in modern society as Anthony Giddens (1991) points out, is that the self has become a reflexive project, that is, the self is no longer found within the constellation of social institutions, but rather must be actively explored, cultivated, and constructed as a narrative without the clarity of pre-existing traditions. In such a condition personal problems like addiction become commonplace. As Giddens (1992, 74) 31
argues, addiction must be understood “in terms of a society in which tradition has more thoroughly been swept away than ever before” and in which the search for self correspondingly assumes critical importance. Addiction and dependency become ways of coping with the personal fragmentation experienced in social life. Thus, the dislocation experienced in modern society contributes to addiction because for many, addiction becomes a potent source of meaning in advanced society. As Norm Denzin (1993, 369) and others have asserted, addiction might even be characterized as a narrative of social critique in that addiction reveals a kind of “felt truth of the culture and the times”. In this sense, addictions of all sorts provide individuals with comfort and security in a world that is increasingly experienced as being out of control. Alexander argues that addiction is a political problem. It is this and more. Addiction is a cultural problem in which people currently seek out meanings in a world in which meaning making has become increasingly commodified. Is it really any wonder that there are addictions to all sorts of things when people are sold a bill of goods that promises that they will experience greater satisfaction in life if they use product A or product B? Individuals in advanced modern society more and more identify themselves on the basis of their material possessions and the images they are able to create through the products they consume. In the U.S. during the 1990’s cigar smoking became increasingly popular due to the elevated status associated with it. As one comedian said, people smoke cigars because they are unable to fit a BMW in their mouths. In such a cultural condition, the use and abuse of intoxicants in the pursuit of pleasure, status, and meaning becomes inevitable. Over the years, many social critics have described a kind of cultural devolution that has been taking place within advanced capitalist societies like the United States. This “cultural logic of late capitalism” (Jameson 1991) is characterized by the collapse of established patterns of social and institutional life. As a result, post-modern societies have seemingly lost their core as more and more people feel their world is spinning out of control (Wolfe 1991). As David Harvey (1989, 65) has commented, the contemporary condition of cultural life has produced a “profound shift in the structure of feeling” where individuals increasingly experience their lives as fragmented, ephemeral, disconnected, and chaotic. In such a cultural condition, the self becomes increasingly “saturated” and temporary. A sense of social isolation and loss of community characterize this pervasive crisis of meaning. For many, the social institutions of family, work, religion, and education no longer provide the comfort, support and continuity that are necessary to foster meaning and satisfaction. Dramatic population shifts, along with raging culture wars, unpredictable upward and downward mobility, major technological change, and the globalization of markets have produced increased levels of fear and vulnerability within society that have left people feeling 32
increasingly dislocated and disconnected. This sense of dislocation is further exacerbated by the continuing market revolution that “undermines local communities as jobs are moved off-shore or to wherever else capital can earn its highest return; families are uprooted; and workers are laid off in the name of corporate downsizing” (Fukuyama 1995, 312). As a result of these dramatic changes, modern society has been eulogized as being in the “twilight” of collective social life (Gitlin 1995). No longer do individuals feel a sense of community and commonality with others that naturally produce conditions of mutual trust and commitment. For the most part, there has been a collective turning inward, a kind of mass privatization of social space that inhibits the expression and experience of community. From this more global perspective, solving addiction cannot be accomplished by treating people for their “disease”. In fact, the reification of addiction as a disease, a concept that is fundamentally lodged in liberal, free-market thought, i.e., that individuals are sovereign entities existing independent from social and cultural conditions within which they are embedded, may even be part of the problem. As Alexander argues, addiction can’t be “treated” away in the conventional sense. Treatment, while beneficial for some, may do more to further mystify addiction by reducing it to individual pathology and by proclaiming that treatment experts are the single best source for effective recovery. Nor can we punish away addiction! It is ironic that the conference that gave rise to this book took place in a former prison in Stockholm. Prisons are warehouses for individuals considered to be threats to society. Prisons are powerful institutions not merely because they represent the power that the State has to relieve someone of their freedom and even their life. As Foucault (1977) has suggested, prisons represent power in that they embody a construction of the body as deficient, dangerous, and deviant.2 Prisons express the governing image that individuals must be changed to accommodate society, rather than the other way around. As Alexander points out, it is the minority perspective that sees individuals as being at the mercy of a troubled society confronted by an assortment of social, cultural, and political problems. Perhaps increased attention to the contextual factors associated with addiction will not only contribute to better understanding of how conditions present in a person’s life course can develop into an addiction, but also contribute to a less demonized view of drug use and addiction. Such a perspective might lead to a normalization of addiction within modern society, one that focuses more attention on widespread social transformation. Perhaps then we could make greater progress in the area of recovery, and turn more prisons into hotels and conference centers. 2
It should be noted that while Alexander attributes addictive behaviors to dislocation and alienation associated with free-market forces in modern society, he does not consider how addiction as a concept was and is produced by the entrepreneurial forces within a free-market. In other words, the concept of addiction is itself a “product” that has been packaged, commodified and sold to the public. Thus, the growth of addiction in modern society is, at least in part, due to the manufacture and intense marketing of this canonical “product” within the free-market.
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References Alexander, B. (2000): “The Globalization of Addiction.” Addiction Research, 8 (6), 501 526. Denzin, N. (1993): The Alcoholic Society. New Brunswick, New Jersey: Transaction Books. Forbes, D. (1994): False Fixes: The Cultural Politics of Drugs, Alcohol, and Addictive Relations. Albany, New York: State University of New York Press Foucault, M. (1977): Discipline and Punish: The Birth of the Prison. Pantheon Books. Fukuyama, F. (1995): Trust: The Social Virtues and the Creation of Prosperity. New York: Free Press. Giddens, A. (1991: Modernity and Self-identity: Self and Society in the Late Modern Age. Stanford: Stanford University Press. Giddens, A. (1992): The Transformation of Intimacy. Stanford: Stanford University Press. Gitlin, T. (1995): The Twilight of Common Dreams: Why America is Wracked by Culture Wars. New York: Henry Holt. Granfield, R. & Cloud, W. (1999): Coming Clean: Overcoming Addiction without Treatment. New York: New York University Press. Harvey, D. (1989): The Condition of Postmodernity. Cambridge: Blackwell. Jameson, F. (1991): Postmodernism or, The Cultural Logic of Late Capitalism. Durham, North Carolina: Duke University Press. Mills, C. W. (1959): The Sociological Imagination. London: Oxford University Press. Schivelbusch, W. (1993): Tastes of Paradise: A Social History of Spices, Stimulants, and Intoxicants. New York: Vintage. Thompson, E. P. (1966): The Making of the English Working Class. New York: Random House. Wolfe, A. (1991): “Out of the frying pan and into… What?”. In: Wolfe, Alan (Ed.): America at Century’s End. Berkeley: University of California Press. Zinberg, N. (1984): Drug, Set, and Setting: The Basis for Controlled Intoxicant Use. New Haven, CT.: Yale University Press.
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