Book Review

Drugs and Narcotics in History

N Engl J Med 1996; 334:1068-1069April 18, 1996

Article

Drugs and Narcotics in History
Edited by Roy Porter and Mikuláš Teich. 227 pp. New York, Cambridge University Press, 1995. $49.95. ISBN: 0-521-43163-8

The word “drug,” in its double sense of therapeutic agent and substance of abuse, has an ancient and tortuous heritage stemming from social attitudes and scientific knowledge in other eras and places. The demarcation between use and abuse has been debated contentiously, and the debate continues today. The editors of this wide-ranging book believe that those concerned with current drug policy may profit from pondering the past. What “type of society,” they ask, “engenders specific ideas and policies about drug matters, how [do] they come into being, are applied and change in time?” This “unifying thread” links the 11 disparate essays, running from Hellenistic and Roman times to the present and concentrating on Britain, the United States, and Germany since the 18th century. The emphasis, even with respect to opiates, is on legitimate medicinal use, pharmacologic experimentation, drug manufacture, and regulatory control.

John Scarborough gives a scholarly summary of the opium poppy in ancient medicine. Andreas-Holger Maehle summarizes pharmacologic experimentation with opium in the 18th century. Caroline Jean Acker traces the revolution in American physicians' attitude toward opiates. John Parascandola delineates how the word “drug” acquired its connotation of “abuse” in the United States. Rudi Matthee reports how tobacco, coffee, cocoa, tea, and distilled liquor spread around the world, each initially seen as a healing agent. S.W.F. Holloway analyzes the regulation of British drugs in the 19th century. Erika Hickel defines the role of the Imperial Health Office with respect to the German chemical industry in the late 19th and early 20th centuries. Judy Slinn describes research and development in the British pharmaceutical industry. Stephen J. Kunitz and Jerrold E. Levy trace and seek to explain changes in alcohol use among Indians of the American Southwest, especially the Navajos. Virginia Berridge shows how resorting to history as a means of understanding and guiding drug policy has not worked out so well in the case of AIDS. Ann Dally attacks the methods and the message of British policy toward drugs of abuse in recent years.

The essays are informed, incisive, and reflective, each one historically valuable, each presenting its subject in a broad social and intellectual context. Each may contain lessons useful in today's confrontation with a continuing problem. Readers must extract the lessons themselves, however. The editors might have provided a useful service to readers by composing a final chapter summarizing their view of the lessons to be drawn from the intriguingly written chapters by these learned authors.

James Harvey Young, Ph.D.
Emory University, Atlanta, GA 30322