This is the annotated script for the fifth podcast in our series on UK drug use in the 1950s and 60s: The Addict and Addiction, from Victorian Doctors to Eugenic Psychiatrists

This episode examines the early medical history of the addict as an identity and addiction as a diagnosis. Demonstrating how ideas around degeneration and eugenics were influential in the early development the 'addict'. In doing so, we will also explore the origins of the liberal 'British System' of drug control and why it diverged so heavily from the USA's policy of criminalisation.

You can find the full bibliography used to make this episode here.


Welcome to hooked on history this is the fifth episode of our series on the history of uk drug use. In the episode we will be examining the history of addiction.

We have finally made it to THE “drug”, the “Big Bad”, the monster at the end of the illegal drug daisy-chain: heroin. However, if you picked up a newspaper in 1955 you might be surprised by how it was described. In the Daily Express it was touted as “the doctor’s most effective pain killer.”[1]The Daily Mirror celebrated it with the line “The most learned physicians from the most famous centres of medicine commend the use of heroin with unanimity rare for the profession”.[2]1955 was an unusually complimentary year for heroin.

Behind the tabloids’ glowing reviews of the drug, was some good old-fashioned government bashing. The UK government, by request of the UN, decided to ban heroin to fall in line with the international community. Britain had a unique drug policy for the time. Anyone could register as an addict and get a prescription for the drug. These maintenance doses were meant to help the addict continue to lead a relatively normal life. The proposed ban threatened medical control over the drug and doctors launched a very public campaign against it.

Strong anti-prohibitionist morals were expressed by the press and doctors alike. The fact the UK only had 54 known heroin addicts, compared to the 100,000 which supposedly existed in the USA, made the move toward criminalisation look ridiculous. In the end the medical community won out and the government was dealt an embarrassing blow. However, the scale of the doctors’ opposition went beyond concern for heroin users. There was a principal at stake here, should the government be allowed to dictate to the medical profession which drugs they can or cannot prescribe? Similarly, The press focussed on the public being denied a painkiller. Despite the anti-prohibitionist morals, there was no love lost for heroin’s addicts.

One Daily Mirror article asked “Who should be allowed to suffer… the drug addict who ruins his health with dope, or the patient who is in terrible pain through no fault of his own? The answer seems obvious. Yet the Government has decided that it is the innocent patient who must suffer.”[3]

Many members of the medical profession did not hold addicts in higher esteem either. Dr J Hobson told the Society for the Study of Addiction that most heroin addicts were “instrumentalists in jazz bands” or “psychopathic”.[4]Psychiatrist Ellis Stungo announced to the society:

“Cases of addiction arise almost exclusively from the illegitimate use of heroin by sensation seeking psychopaths, hysterics in search of happiness or solace, and other unstable characters, for strictly non-therapeutic purposes.”[5]

Now when I first read these articles, I was quite shocked at how dismissive and insulting speakers at the Society for the Study of Addiction was being about their subjects. Our modern pop-psychiatry idea of a psychopath paints the picture of an unredeemable, immoral person incapable of empathy; a la Patrick Bateman. I chased down a 1956 psychiatric textbook to make sense of the diagnosis.

The text book described them as “the misfits of society, the despair of parents, doctors, ministers…”, symptoms were being “excitable, impulsive, eccentric, liars and swindlers, anti-social and quarrelsome”.[6]Along with drug addicts its ranks boasted homosexuals, which raised an eyebrow, and the mothers of illegitimate children, which raised the other.[7]Unsurprisingly, there was no obvious cause or cure to psychopathy.

So, because I am an unfocused researcher, I tried to find out what was going on with this diagnosis. How did unmarried mothers become psychopaths? Well, the thinking was, a child needs a “loving environment”, which a mentally healthy mother should wish to provide. A single mother cannot provide this because she has to work. So, a ‘healthy’ mother is one that secures a husband before having a child. Ipso facto, an unmarried mother cannot be very healthy.[8]Throw in a bit of psychoanalytical, unconscious theory and you have woman who are having children not out of sexual accidents but due to an unconscious, psychopathic will to have an illegitimate child.

These sorts of psychiatric truisms would cause a host of contemporary thinkers to accusing psychiatry of upholding dominant morals in the guise of science. Where if someone strayed from the social norm, say by having sex with someone of the same gender, the medical profession diagnosed them as mentally ill and offer reason for their incarceration.[9]

In this episode, we will use the history of the addict to investigate how a medical school became so morally dependant, the social developments that led to addicts being seen as a type, the psychopath and the substantial role eugenic theory had in all this. We will also explore the origins of the liberal “British System” which supplied addicts with a controlled amount of their habit and why exactly Britain’s system of control was so divergent from the policy of criminalisation in the USA.

Main Body

Charles Darwin’s 19th century theory of evolution is perhaps the crowning achievement of an epoch which strove to describe the world around them in scientific terms. The origins of the grass under your feet, the rats in your cellar, and even you and your species could be explained biologically. Deviations and variance were also biologically accounted for. However, the origin of species was not the only thing to be expressed in biological terms. The latter half of the 19th century saw this lens turned of society, which was militantly and dogmatically medicalised.[10]

It was this push that birthed the addict, and the homosexual too for that matter. Now I’m not some nut who thinks same-sex attraction, partnership and love is a recent invention. That is clearly not true. However, in the period before the 19th century you would only be committing an act: sodomy. While this act was treated as criminal or sin against nature, it did not define you as a type of person. The concept of categorising people by their sexuality in our modern, box on the census form, way did not exist. Just as earlier racial scientists focused on one seemingly important aspect of a person, the colour of their skin, to create a new biological category; Victorian “scientific” study developed the notion that homosexuality was the characteristic of a type of human.[11]  Here is how the philosopher Michel Foucault described this development:

As defined by the ancient civil or canonical codes, sodomy was a category of forbidden acts; their perpetrator was nothing more than the juridical subject of them. The nineteenth-century homosexual became a personage, a past, a case history, and a childhood, in addition to being a type of life, a life form, and a morphology, with an indiscreet anatomy and possibly a mysterious physiology. Nothing that went into his total composition was unaffected by his sexuality… The sodomite had been a temporary aberration; the homosexual was now a species.[12]

The origins of the addict (in medical terms) are very similar. In fact, you could take Foucault’s famous paragraph, substitute sodomy for opium eating and homosexual for addict and it would give you a rough impression of what took place.[13]

In the 19th century, opium eating was fairly commonplace in Britain. Drug habits were seen as a vice, a personal failing. While portrayed as weak-willed and sinful, they were otherwise normal people. However, under the late 19th century thrust to toward providing ‘scientific’ explanations for things traditionally seen as originating from social issues, addiction would become classified as a disease. With talk of predispositions and hereditary, the disease gained an exclusive quality. Rather than an affliction that could affect anyone, it was the defective who became stricken by the disease of addiction.[14]

Despite the new medical diagnosis which covered the condition, the theories surrounding the new disease still kept a moral dimension. Addiction was described as a “disease of the will”, the addict’s moral weakness of the character was imperative to the causation of the disease. Historian Virginia Berridge described this medicalisation of addiction as “Moral judgements… given some form of spurious scientific respectability simply by being transferred to a medical context”.[15]

This scientific edifice erected over traditional moral judgements can be seen in the feminisation of addiction. Initially, the disease model of addiction was largely applied to morphine addiction, a small middle and upper-class drug epidemic caused by doctors’ zeal for the new drug and the new tool, the hypodermic needle. This addict population was associated with women, perhaps because hypodermic morphine was used to treat “female complaints” (period pains etc.) and conditions which were thought to originate in hysteria. Popular and traditional tropes surrounding female weakness, like deceitfulness and pleasure seeking, were used to explain their propensity for the drug.[16]As the medical journal the Lancet explained:

“Given a member of the weaker sex of the upper or middle class, enfeebled by a long illness, but selfishly fond of pleasure, and determined to purchase it at any cost, there are the syringe, the bottle, and the measure invitingly to hand, and all so small as to be easily concealed, even from the eye of prying domestics.”[17]

Describing the disease of morphine addiction as the result of moral weaknesses rather than overzealously prescribing doctors, was also convenient for the profession. As historian Susan Ziegler described:

“If addictions were vices, then physicians were merely abetting sin; but if addictions were diseases, with shameless lying as a symptom, then physicians were desperately needed—not merely to cure them but to restore their patients’ moral integrity too.”[18]

Similar to how doctors identified some innate quality of women as the reason for their drug use, doctors, who saw mainly middle-class addicts, thought there must be something special about this group of people. Some took a materialist approach to explain this novelty. Sir Ronald Armstrong-Jones of Claybury Asylum explained that most morphine addicts were upper or middle class because:

“…there is generally a physical difference between the brains of those in the private [upper] and the rate-aided [lower] class… not only is the brain-weight heavier, but there is also in the private [upper] class an added complexity of convolutional pattern, and these differences, of necessity, carry with them psychological and physiological concomitants, which mean a higher sensitiveness and a greater vulnerability.”[19]

Similarly, an American contemporary theorised the addiction rate was lower among blacks because they had a less delicate nervous system.[20]

Another excuse for middle-class addiction was neurasthenia. The thinking here was the “brain workers” of society might overtax their nervous system trying to keep pace with industrial society.[21]In trying to shore up their mental capacity they might turn to drugs and alcohol. The working-class enjoyed a less forgiving explanation for their drug use.

Degeneration was a sort of dark mirror of natural selection. The idea was that those who violated ‘natural law’ (conventional morals) would pass on this defect to their children and then grandchildren, eventually leading to madness. This was hedged in the belief that the mind, our intelligence and ability to control our primitive instincts, is our most recently evolved trait and therefore, the most susceptible to degeneration. So psychological conditions were the ideologies focus.[22]Psychiatry would find the degeneration theories extremely useful and applied it to all the pathologies of modern life: Working class modes of addiction like alcoholism, prostitution, delinquency, suicide, epilepsy, hysteria and the poor physical state of the malnourished lower classes.[23]

The Ideology was also significant culturally. French author Emile Zola wrote a 20 book series depicting how a mentally defective ancestor had caused madness, murder, tics, alcoholism and prostitution in her progeny. In the introduction to these books Zola stated he wished to demonstrate that “Heredity, like gravity, has its laws.”[24] Degeneration themes also became popular in British sensationalist fiction. However, when Henrik Ibsen’s 1882 play Ghosts portrayed immorality and degeneration amongst a rich and respectable family, it was less well received. The Daily Telegraph described the play as a “disgusting representation… of an open drain, of a loathsome sore unbandaged, of a dirty act done publicly… gross and almost putrid indecorum… literary carrion”. In general, ideas of degeneration were more accepted when applied to the poor and mentally ill.[25]

Fears over the degeneration of the British race escalated as the 19th became the 20th century, especially after the Britain attempted to recruit its urban poor to fight in the Boer War and found many of them to be unfit for combat. Ideas around public health arose; no longer did a doctor simply have to think about what was good for the patient, they also had to worry about what was good for the nation.[26]Tropes surrounding women started to change as well. The traditional view of a “weaker sex” that needed to be protected from moral vices, now shared the spotlight with conflicting tropes of individual women as dangerous vectors to communities, the spreaders of venereal disease and immorality.[27]

In this environment, eugenic theory rose in popularity. Eugenics was a sort of proactive update on degeneration, combining it with natural selection. The idea was to actively prevent a race from degenerating by controlling who breeds.  Because the main thrust of degeneracy was psychological—or moral—control over deviants was a major focus. Eugenic theory was influential in British medicine and politics and contributed to the Mental Deficiency Act of 1913. The act allowed the incarceration of those deemed “mentally deficient” or “feeble-minded”, largely to keep them from spreading their immorality and breeding. However, with morals so wrapped up in what it meant to be deficient, in practice it acted as a way to segregate working-class people who transgressed against gender roles.[28]With women becoming dangerous spreaders of immorality, those seen as sexually promiscuous, or simply the possibility of it, were more likely to be locked up under the law than those with a physical or mental impairment.[29]

Eugenics also influenced theories around addiction and alcoholism. The 1909 text Drugs and the Drug Habit emphasised the importance of good racial stock, along with increased education and welfare, to prevent the spread of addiction.[30] Increasingly, specialists and policy makers talked of the compulsory commitment of habitual drug and alcohol users, largely focusing on working-class modes of use like public drinking.[31]

The rise of the trope that individual women were corrupters within a community, effected drug legislation as well. There is probably no time in which young men are more precious to a society than during wartime, when the fate of the nation, after all, may depend on them. During the First World War, the physical and moral health of soldiers came under the spotlight. Scares began to surface in the press of women, especially prostitutes, either corrupting men with cocaine or using the drug to knock them out (the British public clearly did not yet appreciate the stimulating effects of cocaine).[32]

Reports and rumours of Canadian soldiers also spreading the drug’s use added the fear of foreigner’s component and gave birth to a full-blown modern drug scare. By the summer of 1916, Umpire Newspaper was running with the headings “Vicious Drug Powder—Cocaine Driving Hundreds Mad—Women And Aliens Prey On Soldiers”. The eugenicist physician and journalist Caleb Saleeby warned that “hundreds of soldiers” would be driven “mad” unless cocaine trafficking was stopped.[33]

Behind all this, there was a real up-tick in cocaine use, which concerned authorities. However, the laws on the books were for regulating pharmacists not locking up dealers, frustrating the police’s attempts to get convictions. A Home Office under-secretary, Sir Malcolm Delevingne, suggested adding legislation to criminalise the possession of cocaine, opium and morphine to the Defence of the Realm Act. This was a wartime ruling analogous to the US’s Patriot Act in suddenly granting the Government far reaching and ever-expanding power.

The idea of jail time for those possessing cocaine was very popular with Commissioner of the Metropolitan Police. He felt it would better allow them to combat groups he associated with the drug: Thieves, prostitutes, pimps, homosexuals and “other nefarious persons”. However, the commissioner was less enthusiastic with the inclusion of opium, which he described as “a more or less beneficent drug”. The police and army also wanted to leave out morphine – as did, medical and pharmaceutical interests (at the time Britain dominated the morphine industry). In the end, opium was left on and morphine taken out. In July 1916, for the first time in British history, possession of a drug had become a criminal offence.

Writer Marek Kohn wrote in Dope Girls, the drug underground now “had gone through its decisive rite of passage.”[34]In the post-war period, cocaine and opioid use spread through London’s nocturnal West-End habitat. Reports of drug use and overdoses among several young women, largely actresses, chorus girls, nightclub girls and prostitutes, sparked a media frenzy. However, as we discussed last episode, drug scares often have little to do with the drugs themselves and instead manifest societal anxieties. Here, just like in the last episode, the main themes surrounded the status of women and racial mixing.

The First World War upturned the societal role of women. As mass mobilisation into the armed forces sucked men from civilian jobs, women filled the vacuum. With greater economic freedom, women became more visible where previously women in public had been associated with prostitution.[35]There was a push for women to gain full citizenship. Their newfound autonomy was at the front of the nation’s mind. Yet, the eroticism of the female subjects in these drug scares (chorus girls and actresses) focused this anxiety into the long-standing fear of unleashing female sexuality.[36]

The related fear over racial mixing stemmed from opium’s presence in sensational stories covering white woman and Chinese men mixing. The drug was seen as breaking down racial barriers. It should surprise none of you that a society deeply concerned with racial degeneration found this severely troubling. The public outcry and implicit calls for drug control, acted as a proxy demand to control women, especially their sexuality; to put the genie that the war unleashed back in the bottle.

The Home Office where all too happy to oblige. The Drugs Branch was created, headed by Malcolm Delevingne, and in 1920 regulation expanded over medicinal opium and morphine.[37]Throughout the early 20s, the Home Office continued to move the UK toward a penal drug policy.[38]Now it might surprise you that by the 1950s Britain would end up with the liberal policy I described in the introduction. Well, all of this regulation started stepping on the toes of the medical and pharmaceutical profession. They chafed under the hoops they needed to jump through to obtain and prescribe “Dangerous Drugs”. As many of the addicts were doctors themselves, penal policy was aimed at addicts and overly prescribing doctors alike. Not to mention, that criminalisation flew in the face of the disease view of addiction.

Just like in 1955, doctors launched grass roots opposition to maintain their control over these drugs. For 4 years a power struggle between this sect of the medical profession and the Home Office kept the subject in flux. Central, was the medical treatment of giving opioid addicts maintenance doses of opiates. The Home Office hoped to end illicit drug use and addiction by damming supply. That the doctors were prescribing these drugs to addicts was seen as a significant leak.

In 1923, Delevingne asked the Ministry of Health to put together a committee to resolve the issue. He stated his hope was: “We want an authoritative statement we could use in dealing with practitioners, and to which we could refer the courts, that regular prescription of the drugs on the ground that without them the patient will suffer or even collapse… is not legitimate, and cannot be recognised as medical practice”.[39]However, Delevingne and the Home Office were genuinely looking for medical advice.

The resulting committee, the Rollenston Committee, was made up of 9 addiction specialists. While there were a variety of different opinions about how to regulate opioids, they all held onto the disease model of addiction.[40]A contingent also held firm anti-prohibitionist morals. They looked at the Harrison act in the USA, which criminalised heroin use, as backward. One committee member commented that “the law takes no account of the causes of addiction; the drugger is regarded as a criminal, just as the insane were in medieval times.”[41]Many of the doctors still held the same dogmatic view of what an addict looked like. The thinking was very much about the middle-class older addict, which doctors treated.[42]

In the end, the committee found that there were very few addicts in the UK. Addiction was to be seen as a medical condition rather than a vice. And, as such, maintenance doses to allow addicts to live a comfortable life were ruled as legitimate. The resulting policy, which would last until the 60s, is regarded as one of the beginnings of the ‘harm reduction’ concept.[43]

However, we should try and explain why Britain diverted so drastically from what was an international trend toward criminalisation. The anti-prohibitionist morals of a few prominent doctors probably does not tell the whole story. That these doctors still saw addiction as a middle-class and feminised affliction is likely significant. In the US, addict populations shifting from middle-class, female and medical to lower-class, male, and non-medical coincided with ever growing criminal policies.[44] It seems there is much more support for locking up ‘junkies’ than ‘respectable’ older women. This change had not happened in the UK. Addicts, at least the ones the committee examined and doctors thought of, were the middle-class patients doctors treated and likely first prescribed the drug. In the big picture, Britain’s welfarist policy of registering and monitoring addicts better fit the usual methods of controlling middle-class women than penal policies.[45]

However, psychiatric theory about addiction would follow their American counterpart’s lead.

By the 1920s ideas around degeneration and nervous disorders declined as explanations for addiction and new ideas battled to hold pathological domain over the addict. These increasingly focused on the psychology of the addict. Some psychoanalytical theories, for example, saw heavy drug and alcohol use as a refuge from repressed homosexuality.[46]Along this line of thinking, addiction and alcoholism were essentially symptoms of latent homosexuality.[47]This reflected a cultural suspicion of men using these substances, which were still feminised and so deviating from the masculine ideal.[48]The Home Office’s medical specialist and Malcom Delevingne would make public statements linking drug addiction with “unnatural sexual vice” and asserted their cross-recruitment with “perverts”.[49]

However, in the US, the mainstream psychiatric opinion of addiction that would win out was the psychopath diagnosis.[50]The so called “wastebasket” of psychiatry. The psychopathic diagnosis was on the rise in the 1920s because when the US started giving the people they incarcerated for “feeble-mindedness” IQ tests and they found them to be normal. A new diagnosis was needed to cover the habitually delinquent and morally deficient which did not imply inferior intelligence.[51]Psychopath better fit the pathologised rogue’s gallery: “hypersexual” women and prostitutes, unemployed men and habitual criminals, sexual deviants and now drug addicts. According to this line of thinking, the psychologically normal addicts were the anomalies, the true addicts were the morally bankrupt and the psychologically defective.[52]

In the UK, psychiatrists and eugenicists were similarly frustrated by the limitations of the Mental Deficiency Acts, which revolved around the feeble-minded diagnosis.[53] In 1932 the popular psychologist and eugenicist, Cyril Burt, was disappointed to find only 12 per cent of London prostitutes were certifiable under the Mental Deficiency Act, although he did proclaim that four fifths of them were “sub normal”.[54]It is these eugenicists who contributed the final turn in our tale.

Eugenics had grown in popularity and ideologically in the interwar period.[55]The First World War had inflamed Victorian fears around Imperial decline. In this environment eugenics reached a new height of popularity. The application of biological sciences continued to become more macro. By the inter war years even the rise and fall of nations could be expressed through biological terms by scientists and non-scientists a like. As doctor Charles Bond explained at a 1928 UCL lecture, as civilisations grew in complexity, their wealthy elites diminished while the masses reproduce “like the parasitic cancer cells”. The medical language reinforced Bond’s assertion that biological factors were “the chief source of the decline of past civilizations and of earlier races”.

Eugenicists always had a grandiose belief in their need. In 1909 one of the British eugenics movement’s founders, Caleb Saleeby, announced that “eugenics is going to save the world”. The inter-war pessimism and fear of decline seemed to increase its believers and the urgency of the cause. Its ranks boasted a number of prominent public figures like economist Maynard Keynes, sexologist Havelock Ellis, celebrity scientist Julian Huxley and playwright George Bernard Shaw. In the 1930s they would leverage their popularity among the progressive elite to launch a campaign to legalised sterilisation. It was to be voluntary (apart from those who were deemed unfit to make up their own mind). However, while eugenics was popular among the educated progressive types, it was very unpopular with Catholics and the Labour party, and so, failed.

By the end of the 1930s the eugenicists were getting worried. They felt the UK was in danger of falling behind. You know, the USA had been sterilising their degenerates for years now and Germany has enacted some very robust policies for pruning their racial stock (although many eugenicist did feel they had gone too far). Drug addicts, as it turned out, offered them a late opportunity to try and sneak some legislation in.

Over the years, there had been a good deal of cross-pollination between psychiatry and eugenic theory.[56]The 1936 edition of A Textbook of Psychiatry for Students and Practitioners included a couple pages on how to best investigate the quality of a patient and their potential partner’s breeding stock.[57] The textbook moved on to the subject of birth control and segregation. While it applauded the segregation of the “mentally incapacitated” it warned: “while it is an easy enough matter to segregate those who show obvious defects, it is very difficult to obtain control of those who suffer from a moral rather than an intellectual defect. It is the so-called moral imbeciles or degenerates or psychopaths who do more damage in the community than any other types.”[58] The textbook went on to discuss the pros and cons of sterilisation.

In 1938, one of the textbook’s authors, R D Gillespie, was requested to join the Royal College of Physicians’ committee on drug addiction. Some prominent doctors were unhappy with the recommendations of the Rollenston Committee. Far from being the pride of UK drug policy, many drug specialists found the policy of maintenance doses troubling, especially with young addicts. This committee was set up to revise the policy.[59]

The committee was made up of members of the 1930s medical elite with a strong psychiatric presence; most of the members were also eugenicists. The meeting was opened by the Royal Physician, Bertrand Dawson, who had risen to celebrity in 1928 for saving the King’s life; and to infamy in 1936 for euthanising the King with a ‘speedball’, a mixture of heroin and cocaine, to the jugular. Dawson set the tone for the committee when he announced “the duty of the medical profession [is] to demonstrate in a practical manner how medical science could contribute to the solution of social problems which were sometimes considered to be outside its scope”. Dawson explained that lawbreakers usually had “one foot in crime and one foot in pathology”.

Dawson wanted the committee to focus on the larger problem of ‘deviants’ rather than confine themselves to drug addicts. Britain was falling behind in eugenics policy and the committee had been handed an opportunity to rectify that. They could use the historically uncontroversial suggestion of compulsory detention for addicts as the thin edge of a wedge for detaining all of Britain’s psychopaths, including alcoholics and sexual deviants. In essence, using drug addicts as a back door to enforce the segregation of psychopaths. Most of the committee’s members enthusiastically embraced this new, larger eugenics quest.

However, the eugenicists ran into two major hurdles. One was a minority faction, which formed around Russel Brain, who later would become one of the most important figures in British drug policy. Brain was also a eugenicist but displayed less zeal for embarking on this grand crusade. Pragmatically, he pointed out that it was going to be hard to define who exactly was and was not a psychopath. Instead, they should just focus on the problem in front of them, the small well-defined condition of drug addiction.

The second was from the Home Office. In order to find out how best to proceed, the Committee talked to the head of the Drug Branch and the Home Office’s lawyer. These bureaucrats did no share the medical professionals’ imagination, a consistent problem for eugenicists. The head of the Drug Branch, Major Coles, was more interested in implementing methods for prosecuting the doctors who supplied addicts. The lawyer described the task of legally defining the psychopathic as ‘baffling’. He also found the committees plans of incarcerating a large proportion of the population as unrealistic. Other reports from the Home Office pointed out that the British public would never tolerate the detention of alcoholics.

So, after these roadblocks, why not scale back, take Brain’s pragmatic approach and just suggest the compulsory detention of addicts. Well, the problem for some in the grand eugenics camp is that they were actually not very good at curing addiction. They were worried that the inevitable failure in curing addicts with compulsory detention would weaken their case for the segregation of homosexuals, habitual thieves, promiscuous women, and the rest of the eugenicist wish list. If this was to happen, it had to be in one fell swoop. So, in the end, nothing happened.

There is an arbitrary nature to history. As drug historian Christopher Hallam pointed out, given the Home Office’s historical preference toward incarceration, had the committee been less ambitious, Britain could have ended up with a sort of medico-penal drug policy instead of the liberal “British System”. On the other hand, it was the eugenicist ambition which made locking up drug addicts so important. This arbatrarity is endemic in drug history, where drugs and their users are a bubble on the tide of great cultural forces. Fears over the status and activities of women, concerns over racial purity and national health and, of course, the attempt to construct a biological view of the world.

The addict was born out of a period swept up in a post-Darwinist attempt to explain the world through a biological lens. However, despite the scientific trappings and objective pretence, the addict was still a product of moral deviance.  A flawed type of person, perhaps with an over stressed nervous system, or a degenerated mind, or a psychopathic personality.

The medicalisation of society pathologised those deemed abnormal and, in the process, codified normality. As philosopher Sadie Plant wrote, “By the turn of the century, using drugs was something only addicts were supposed to do, just as gay sex was confined to homosexuals. Occasional flirtations with life beyond the straight lines of normality were no longer legitimate options.”[60]As with homosexuals and sexually deviant women, the story of the addict in this period is not unique, but the story of how society decided to treat those who were now scientifically deemed sub-normal. Eventually leading to the position we saw in the introduction in the 1950s, where even having a child outside of marriage could land you in the psychopathic category.

Historian Susan Zieglar has argued that eugenic influence on addiction theory has had a serious effect on the cultural perception of addicts. Addict would increasingly be seen as a dangerous vector within society and calls for segregating them became stronger.[61] While the Rolleston report may be seen as bucking this trend, it is important to note that the addicts examined were almost entirely middle or upper class, sections of the population that were usually excluded from eugenic policy. Once demographics changed, in the 1960s, the UK changed quickly changed it stance on heroin addiction.

This class divide in how we treat addicts still exists today. As is often the case in drug issues the divide can be seen most clearly in the US. The middle-class medical addict tends to be treated far more sympathetically in the courts than more impoverished users who must turn to street drugs to maintain their habits.[62] The rich addicts still can get access to maintenance doses through fabulously expensive rehab clinics. Those arrested for possession of street drugs only have going cold turkey and a high chance of overdose upon release to look forward to.

[1] ‘Who Should Suffer?’, Daily Express, 7 June 1955, p. 4.

[2]‘Cassandra Says: The Way Out’, The Daily Mirror, 29 November 1955. P. 6.


[4]J. Hobson, ‘The Proposed Legislation Banning the Legal Production of Heroin in Great Britain’, British Journal of Addiction, Vol.53, No. 1, pp. 48-50.

[5]Ellis Stungo, ‘The Banning of Heroin’, British Journal of Addiction,1956, Vol. 53, No. 1, pp. 66-67

[6]Ibid. P. 385.

[7]Roger Davidson, ‘Psychiatry and Homosexuality in Mid-Twentieth-Century Edinburgh: The View from Jordanburn Nerve Hospital’, History of Psychiatry, 2009, Vol. 20, No. 4, pp. 403-424.; David Henderson and R. Batchelor, A Text-Book of Psychiatry: For Students and Practitioners, (London: Oxford University Press, 1956). Chapter 12, Psychopathic States.

[8]Martine Spensky, ‘Producers of Legitimacy: Homes for unmarried mothers in the 1950s’, in Carol Smart (ed.), Regulating Womanhood,(e-book: Routledge, 2002), pp. 100-118.

[9]Daniel Burston, ‘Psychiatry and Anti-psychiatry: History, Rhetoric and Reality’, Journal for Philosophy of Culture, 2018, no 2, vol 4.

[10]Michel Foucault, Birth of the Clinic. Quoted in Virginia Berridge, Opium and the People, (London: Free Association Books, 1999). P. xxxi.

[11]Elizabeth Brown and George Barganier, Race and Crime (Ebook: University of California Press, 2018). Pp 70-72; Jeffery Weeks, Sex, Politics and Society, (Abingdon: Routledge, 2018). P. 110.

[12]Michel Foucault, The History of Sexuality, Vol. 1, (New York: Pantheon Books, 1978).Pp. 42-43.

[13]An analogy I lifted from Eve Sedgwick, ‘Epidemics of the Will’, in Tendencies, (Eve Sedgwick ed.), (London: Routledge, 2005), pp. 129-140.

[14]Virginia Berridge, Op.cit. P. 157.

[15]Ibid. P. 155.

[16]Susan Ziegler, Inventing Addiction, (Amherst: University of Massachusetts Press, 2008). Ch. 4, Needling Desires.

[17]Virginia Berridge, Op.cit., (London: Free Association Books, 1999). P. 145

[18]Susan Zieglar, Op.cit. P. 135.

[19]Virginia Berridge, Op.cit. P. 158.

[20]David Courtwright Dark Paradise, (London: Harvard University Press, 2001).P. 125.

[21]Ibid. P. 124

[22]Mathew Thomson, The Problem of Mental Deficiency: Eugenics, Democracy, and Social Policy in Britain, c. 1870-1959, (Oxford: Oxford University Press, 1998). P. 19-20.

[23]Andrew Scull, Madness in Civilisation, (London: Thames and Hudson, 2020). P. 245.


[25]Andrew Scull, Op.cit. P.250.

[26]Carol Smart, ‘Social Policy and Drug Addiction: A Critical Study of Policy Development’, British Journal of Addiction, 1984, no. 4, vol. 79, pp. 31-39.

[27]Mathew Thompson, Op.cit. P. 251; Marek Kohn, Dope Girls, (London: Granta, 2001). Ch. 2: Snow on Their Boots.

[28]Mathew Thompson, Op.cit. P. 299-300.

[29]Jan Walmsley, ‘Women and the Mental Deficiency Act of 1913: citizenship, sexuality and regulation’, British Journal of Learning Disabilities, 2000, vol. 28, no. 2, pp. 65-70.

[30]Virginia Berridge, Op.cit. P. 157.

[31]Ibid. P. 164-169; Susan Zieglar, Op.cit, P. 204-206.

[32]Marek Kohn, 2001, Op.cit. Ch. 2: Snow on Their Boots.

[33]Susan Ziegler, Op.cit. P. 238.

[34]Marek Kohn, 2001, Op.cit. P. 66.

[35]Ibid. P. 52-53.

[36]Toby Seddon, ‘Women, Harm Reduction and History: Gender Perspectives on the Emergence of the ‘British System’ of Drug Control’, International Journal of Drug Policy,2008, vol. 19, no. 2, pp. 99-105.

[37]Virginia Berridge, Op.cit. P. 262.

[38]Ibid. P. 264.

[39]Ibid. P. 272.

[40]Ibid. P. 275.

[41]Richard Davenport-Hines, The Pursuit of Oblivion, (London: Phoenix Press, 2001). P. 181.

[42]Virginia Berridge, Op.cit. P. 276.

[43]Toby Seddon, Op.cit.

[44]David Courtwright, Op.cit. P. xi.

[45]Toby Seddon, Op.cit.

[46]Susan Ziegler, Op.cit. P. 158.

[47] C. Stanford Read, ‘Homosexuality’, Journal of Mental Science, 1921, vol. 67, no. 276, pp. 8-12; Edward Glover, ‘On the Aetiology of Drug-Addiction’, The International Journal of Psycho-Analysis, 1932, vol. 13, pp. 298-328.

[48]Marek Kohn, Op.cit. P. 107.

[49]Susan Ziegler, Op.cit. P. 158.

[50]David Courtwright, Op.cit. P. 129.

[51]Estelle Freedman, ‘”Uncontrolled desires”: The Response to the Sexual Psychopath, 1920-1960’, Journal of American History, 1987, vol. 74, no. 1, pp. 83-106.

[52]Marek Kohn (1987), Op.cit. P. 82.

[53]Stephan Garton, ‘Criminal Minds: Psychiatry, Psychopathology, and the Government of Criminality’, in Paul Knepper and Anja Johansen (eds), The Oxford Handbook of the History of Crime and Criminal Justice, (Ebook: Oxford University Press, 2016), pp 396-415.

[54]Richard Overy, The Morbid Age, (London: Allen Lane, 2009). P. 112.

[55]Ibid. Ch. A Sickness in the Racial Body. The following account of inter-war eugenics is derived from this chapter.

[56]David Pilgrim, ‘The Eugenic Legacy in Psychology and Psychiatry’, International Journal of Social Psychiatry, 2008, vol. 54, no. 3, pp 272-284.

[57]David Henderson and R D Gillespie, A Text-Book of Psychiatry: For Students and Practitioners, (London: Oxford University Press, 1936). P.39.

[58]Ibid. P. 41.

[59]Christopher Hallam, White Drug Cultures and Regulations in London, 1916-1960, (ebook: Palgrave Macmillan, 2018). P. 132; All subsequent information on the Royal Physicians Committee on Drug Addiction comes from Ibid. Ch. 6: The Royal Physicians Committee on Drug Addiction, c. 1938-c. 1947.

[60]Sadie Plant, Writing On Drugs, (London: Faber and Faber, 1999). P. 154

[61]Susan Zeigler, Op.cit. Ch. 7, ‘Afterword’

[62]Laura Appleman, ‘Opioids, Addiction Treatment, and the Long Tail of Eugenics’, Ohio State Law Journal, 2019, vol 80, no. 4, pp. 841-857.