Drinking, drugs and selfcontrol

1
Drinking, drugs and self-control

• Robin Room
• robin.room_at_sorad.su.se
• Lecture, 27 September, 2005 Sociology Department,
  University of Helsinki

2
The symbolic power of substance use

• Positive symbolism of use
• Champagne celebration
• Positive symbolism of abstaining
• Marker of faith for Muslims, Mormons ...
• Negative symbolism of use or heavy use
• drunkard, dope field, alcoholic, drug
  addict, dependent on drugs all stigmatized
• Negative symbolism of abstaining
• wowser
• Variation by time and place in the symbolism

3
Properties behind the symbolic power 1

• Valued physical goods
• Amenable to commodification, industrialization,
  globalization
• Access as a symbol of power and domination
• Use as a social behaviour
• A performance in front of others
• Demarcating the social groups boundaries of
  inclusion/exclusion
• Taken into body
• Intimate behaviour
• Fateful can contaminate poison, infection,
  sin, spirit possession
• Subject to prescriptions and taboos

4
Properties behind the symbolic power 2

• Psychoactive power to affect thinking
  behaviour
• Intoxication, taking on out of oneself
• Valued and feared Double edge of terms
• pharmakon, drug, intoxication
• Intoxicated behaviour as unpredictable,
  intractable, dangerous ? powerful
• Causing addiction/dependence
• Enslavement, loss of control of drug use and of
  life
• So multiple underlays of symbolic power
• Symbolism in everyday life
• Emotive symbolism in political movements for
  control
• demon rum then, scourge now

5
An example Kate Moss the coolest woman on
earthJess Cartner-Morley, Guardian, 15 Sept.
2005

• Sept. 14 chosen as guest editor for December
  French Vogue
• there is something magical about Kate -- Carine
  Roitfeld, Vogue editor
• Mosss influence over fashion grows by the
  minute. She stalks the catwalks and corridors of
  fashion power looking mischievous and haughty at
  the same time, like Madame Pompadour, only
  slightly less chaste.... Moss currently has two
  public looks. One is accessorized with a
  waistcoat, Pete Doherty, a bottle of beer and
  sunglasses which hint at late, late nights the
  other is elegant and decadent, in an F. Scott
  Fitzgerald kind of way, all expensive evening
  gowns and gin and tonics. The theme for Mosss
  birthday party at Claridges, after all, was the
  beautiful and the damned. (Cartner-Morley)

6
15 September Cocaine Kate

• The Daily Mirror publishes grainy camera-photo
  stills of her chopping and snorting cocaine.
  (Moss had previously won a libel suit against the
  Sunday Mirror.)
• As she parties on well into the early hours,
  she chats merrily about her 2-year-old
  daughter, looks unsteady and exhausted as the
  session continues.
• Between lines of cocaine, she repeatedly
  twitches her nose and rubs her nostrils.
• On five occasions she expertly prepares the
  lines of coacine, carefully using a credit card
  to cut the powder into neat lines for her,
  Doherty and the others in the recording session.
• ...Kate begins the night with shots of vodka and
  whisky.
• She then pours herself large glasses of wine and
  beer and chain-smokes cigarettes.

7
Cool Britain meets drug-hostile Sweden and U.S.

• 16 September Hennes and Mauritz, her biggest
  contract, initially gives her a second chance
• We strongly disapprove of her actions.... We
  have strict rules for engaging models. They
  should be healthy, wholesome and sound and we are
  strongly against drug abuse and we have made
  this clear to Kate Moss. After hearing her
  explanation and her regret we have decided for
  the time being to continue the campaign. HM
  statement
• There were quickly signs that the company had
  misjudged the mood of the public, and some
  sections of the media.... Stores were inundated
  withh calls of protest, a worrying development in
  conservative parts of America, where HM is
  seeking to expand. A. Duval Smith, N. Mathiason
  D. Smith, Observer 25 Sept.
• 19 September After further tabloid revelations,
  she is dropped by HM
• After the feedback from customers and other
  papers, we decided we should distance ourselves
  for any kind of drug abuse
• HM distances itself strongly from drugs and for
  several years has been actively engaged in drug
  prevention work with the Mentor Foundation. HM
  statement
• The man who fired supermodel Kate Moss ... Is a
  Swedish billionaire obsessed with corporate
  ethics and responsibility ... and a founding
  trustee of a charity dedicated to fighting
  drugs.... He would otherwise have faced severe
  embarrassment from Mentor, a drugs prevention
  organization fronted by the Swedish royal family
  and supported by HM, which told The Observer
  that Persson made the only decision possible....
  HM is an image maker and an example to young
  people. Smith, Mathiason Smith, 25 Sept.

8
Falling dominoes

• 19 Sept Mirror quotes Moss as telling her
  brother I dont need to go into rehab but Ill
  have to or it wont look good.
• 20-21 September Chanel, Burberry and Gloria
  Vanderbilt drop Moss and the Metropolitan Police
  announce an investigation of her drug use.
  Speculation in press about cancellations of her
  remaining modeling contracts.
• 21 Sept. Moss is now expected to admit to
  problems in her personal life and go speedily
  into rehab as damage limitation, S. Menkes, HM
  drops Moss from campaign, Intl Herald Tribune 21
  Sep., p. 14.

9
Various personal issues I need to address

• 21 September Mosss statement
• I take full responsibility for my actions.
• "I also accept that there are various personal
  issues that I need to address and have started
  taking the difficult, yet necessary, steps to
  resolve them.
• "I want to apologise to all of the people I have
  let down because of my behaviour, which has
  reflected badly on my family, friends,
  co-workers, business associates and others.
• "I am trying to be positive, and the support and
  love I have received are invaluable.
• Coty Beauty, which manages the Rimmel brand, puts
  out a statement
• "We are pleased to acknowledge the statement
  released by Kate Moss today apologising for her
  recent actions. We would like to express our
  support for all those who undertake the often
  difficult process of overcoming their problems.
• 23 September Mirror publishes a commentary by
  Corrine Sweet, psychologist and addiction
  expert, and a short editorial
• Sweet Saying sorry, and admitting shes going
  to get help, means shes seeing clearly for the
  first time in years.
• Kate might not realise it yet, but she will look
  back and realise that the day her drug abuse was
  exposed was the best of her life.
• Editorial Kate Moss has behaved incredibly
  stupidly, but she now accepts that she has done
  wrong.
• Her public apology is welcome if overdue.
• Her cocaine abuse has cost her financially and
  may even threaten her career. But Kate has
  acknowledged that she needs help, and for that
  she should be applauded.
• 24 September Kate, who has publicly apologized
  for her drug-taking, is due to check into a rehab
  clinic today (M. Fricker, Horse drug Kate,
  Mirror 24/9)

10
The brand of her new ad campaign Recovery

• A television and cinema campaign for Rimmel, the
  cosmetics manufacturer, was shot using Moss
  just days before the scandal broke.... Rimmel is
  reluctant to write off the entire campaign by
  ditching Moss now.
• Sources in the advertising world say that Rimmel
  brokered last weeks deal in which Moss issued
  her apology and in return received the companys
  support. She may seek treatment at a
  rehabilitation centre such as The Priory, the
  clinic in southwest London which is popular with
  celebrities.
• In the video, ... Moss is her old self. She is
  shown drinking and partying all night and then
  dabbing on a new foundation called Recovery
  on her face in a taxi before arriving at work
  looking beautiful and fresh despite her lack of
  sleep. M. Chittenden. Moss bounces back with new
  ad deal, Sunday Times Sept. 25.

11
The imagery of use positive

• Cocaine as a signal of affluence, luxury
• Functional for a fashion model
• How else to stay as thin as a prepubescent
  boy?... Many models subsist on a diet that
  includes generous quantities of cigarettes,
  caffeine, and cocaine.... Moss has, in the past,
  admitted to trying drugs becausen she was worried
  about getting fat. (A. Fortini, Slate 23 Sept.)
• Managing hard drug use as a symbol of
  self-control
• writers marveled at how amazing Moss looked,
  dressed in hot pants and Nancy Sinatra boots,
  even while allegedly getting high in the wee
  hours of the morning
• The negative as positive
• This being fashion, drugs go in and out of
  vogue. In the early 1990s it was heroin that was
  chic with Moss, ironically, being the teenage
  poster girl for this era. Magazine shoots and
  designer advertisements played with heroin
  imagery, featuring girls slumped on grubby
  sheets, pale and vacant. Sometime around 1995,
  cocaine replaced heroin shoots and
  advertisements now aimed to evoke the
  super-confident, sexually aggressive atmosphere
  of a coke-fuelled nightclub. Glass coffee tables
  became a favoured stylistss prop, and mirrored
  catwalks were de rigueur.
• Rumours of Kate Mosss lifestyle have abounded
  for years. But it has not been a case of
  designers and marketing directors wanting Moss
  despite those rumours they adored her, in part,
  because of them. (J. Cartner-Morley, Beauty and
  the bust, Guardian 23 Sept.)

12
The imagery of use negative

• Too positive
• The euphoria bleeds out everything else, so all
  you can think about is cocaine. It is such a
  powerful feeling. (Prof. J. Henry, Observer, 18
  Sept.)
• Getting caught
• The fuss about Kate Moss using cocaine reminds
  me of the police chief in Casablanca.... Nobody
  can possibly be surprised as so often, Ms.
  Mosss crime was getting caught. (S. Hoggart,
  Guardian 24 Sept.)
• There is a world of difference between hinting
  an naughtiness calling it decadence,
  bohemianism, partying and having drug-use laid
  bare, Now the line between that fantasy and
  reality has been laid bare, fashion has become
  retrospectively moralistic, however implausibly.
  (J. Cartner-Morley, Guardian 23 Sept.)
• Adverse physical and psychological effects
• I have been around a few hardened
  drug-takers.... What you learn is that, sooner
  or later, no one can take it. Your world comes
  apart. Your health goes. The mind rots. The money
  runs out. And the police come calling.
• It is different for the very rich. Money like
  youth, like good health will protect you from
  the ravages of illegal substances for a while.
  But only for a while.
• Those pictures of Kates bony legs ... reveal
  that she has had her run. (Mirror, 19 Sept.)
• And then there is addiction ...

13
Wild behaviour, abuse or addiction? 1

• So far from Moss (24 Sept.) behaviour which has
  reflected badly, various personal issues that I
  need to address and ... resolve
• Wild behaviour
• A former model who witnessed the wild bender
  said she was amazed at the amount of drugs Kate
  got through.... She couldnt stop talking and
  was also chain-smoking. She was acting quite
  big-headed, and boasting about how much drugs she
  could do. Then she started dancing on her own in
  the room. She was gurning and her eyes were
  rolling. (M. Fricker, Mirror 24 Sept.)
• Abuse (and illegality, and bad company)
• The trouble is that to Pete Dohertys circle a
  line of coke is just like smoking a cigarette.
  Shes in trouble being around Pete. It could
  wreck her career. (James Mullord, Dohertys
  ex-manager, inMirror 19 Sept.)
• A friend She wouldnt listen to warnings
  about her lifestyle.... The father of Lila,
  Mosss 2-year-old That stupid bastard. Shes
  not thinking of Lila. I know Kate is a good
  mother who loves our child. But Im no longer
  allowing our daughter to be in the same room as
  Doherty. Hes turned Kate into a druggie like
  him. (S. Moyes, Mirror 17 Sept.)

14
Wild behaviour, abuse or addiction? 2

• Addiction
• For years, Moss has managed to dodge any real
  trouble. But there have long been chinks in her
  image. In 1998, she checked herself into a rehab
  clinic for exhaustion. In a rare interview,
  she admitted that she modeled drunk throughout
  much of the 90s. She is almost always
  photographed with a cigarette in one hand she
  is said to have an 80-a-day habit and a
  cocktail in the other. (A. Fortini, Kate Moss,
  Slate 23 Sept.)
• Beating her addiction will be tough and she
  faces extensive therapy and emotional nourishment
  to build herself up again.... But letting things
  spiral out of control would be harder on Kate....
  At the core of addiction is need, a deep-seated
  craving, a ravenous, aching need that has no end
  and feels as if it cant be quenched or
  satiated. (C. Sweet, Confession that could turn
  Kates liffe around, Mirror 23 Sept.)
• Taking a dive the pluses and minuses of
  pleading addiction
• A source says that her brother Nick said she
  knows shes got to go into rehab. She doesnt
  want to but who would? The last time she went in
  she told Nick it wasnt a nice place..... Nick
  has told his sister she must enter rehab even
  if it is only for a few days. (G. Box S.
  Moyers, I dont need rehab but it will look bad
  if I dont go, Mirror, 19 Sept.)
• Under a recent British court judgement that a
  celebrity deserved privacy about attending
  Narcotiucs Anonymous, if Moss were to argue that
  she has a condition that requires treatment
  and as such it is personal and medical,... media
  intrusion into her privacy could attract privacy
  protection by the British courts. (E. Forbes,
  Sex, drugs and privacy, Guardian 20 Sept.)

15
The idea of addiction

• the discovery of addiction -- (Levine 1978)
• alcohol in post-revolutionary U.S. -- 1800-1830
• Ideology of self-control
• Mobility ? nuclear family on its own
• objectively dependent on husband/fathers
  self-control
• Early temperance movement method the Pledge
• addiction as explanation for backsliding
• a disease of the will (Valverde, 1998) desire
  defeating the will
• implies a conceptual separation of desire from
  the will
• a new, darker view of habitual heavy drinking
  in post-1830 British novels (McCormick, 1969)
• not a totally novel idea (Warner, Porter), but ?
  part of popular thinking along with temperance
  (Ferentzy, 2001)

16
A profusion of terms addiction, inebriety,
alcoholism, dependence

• Addiction concept established in early 1800s
• Medical discussion by mid-1800s
• Forerunning discussions by Rush, Trotter around
  1800
• Medical and popular terminology in English
  varies inebriety, dipsomania, narcomania
• Alcoholism coined by Huss in 1849
• But only applied in modern sense after 1930s, in
  the context of the U.S. alcoholism movement

17
Addiction concept applied to other psychoactive
substances

• By 1900, the addiction concept has spread to
  other substances, e.g.
• Crothers, 1902, The Drug Habits and Their
  Treatment
• Uses addiction to describe inebriety from
  cocaine, chloral, ether, chloroform, etc.
• The delusion that these unfortunates have full
  possession of their will to abstain or continue
  is fast passing away. We are now able to
  recognize in most of these cases well-defined
  diseases that begin and follow a progressive line
  on to death or restoration.
• Towns, 1915, Habits that Handicap
• TOBACCO ADDICTION MORE DANGEROUSTHAN DRUG HABIT
  OR ALCOHOLISM ...
• A very wide experience in studying the result of
  the use of narcotics has convinced me that the
  total harm done by tobacco is greater than that
  done by alcohol or drugs.

18
The heart of addiction loss of control ...

• ... over drinking/drug use
• Loss of control in the moment, from intoxication
• Jellinek 1960 inability to stop once started
• Loss of control over time, pattern of use
• Jellinek 1960 inability to abstain
• Focus on the pattern over time, but
• inferred from events
• loss of control as explanation of continued
  behaviour despite apparent harm
• Edwards and Gross 1976 loss of control ?
  impairment of control
• Craving as the explanation of loss or impairment
  of control
• ... over life because of use (cultural rather
  than medical concept)
• We admitted that we were powerless over alcohol
  and that our lives had become unmanageable.
  First step of AA
• sobriety in AA means more than not drinking

19
Addiction and the WHO Expert Committees

• Expert Committee has the task under the
  international narcotic control treaties (1961
  1971 and earlier treaties) of classifying
  substances as addictive and in terms of degree of
  addiction
• Met annually (every 2 years lately), usually
  dominated by pharmacologists, often with US
  training
• 1957 last attempt to provide a pharmacological
  justification for which substances were under
  control
• addictive substances, versus
• habituating substances
• alcohol in between
• Addiction-producing drugs need strict control,
  national and international for habit-forming
  drugs, the warning label and national control
  measures should suffice,... but any warning
  concerning habituation should not carry the
  stigma of addiction. (1957 Expert Committee
  Report)

20
Addiction vs. Habituation WHO Expert
Committee, 1957
21
A genealogy of dependence

• Pre-existing general meanings
• weak, dependent personality
• not self-sufficient welfare dependency
• Specific prior meanings in pharmacology
• withdrawal symptoms (as in cross-dependence)
• tolerance withdrawal, taken together ?
• physical dependence in 1964
• 1964 distinction between addiction and
  habituation of 1957 abandoned
• dependence as the term substituted for both
  addiction and habituation
• defined as physical but also psychological
  (craving, loss of control, etc.)
• 1976 applied also to alcohol as alcohol
  dependence syndrome (Edwards Gross)
• 1980 dependence replaces addiction alcoholism
  in 9th ed. of International Classification of
  Diseases

22
Four versions of dependence in the Anglo-American
tradition
23
Where does addiction/dependence matter in
practice?

• In treatment
• as justification of abstinence standard
• but not per se as the object or goal of treatment
• e.g., Addiction Severity Index (ASI) no measure
  of addiction
• as justification of maintenance (e.g., methadone)
• addiction too strong to be changed
• In policy and prevention
• drug policies are not directly aimed at addiction
  (MacCoun, forthcoming Is the addiction concept
  useful for drug policy?)

24
Where does addiction/dependence matter in
practice? (continued)

• In policy
• Rhetoric at the UN Commission on Narcotic Drugs
• drugs as scourge
• traffickers as evil
• youth as innocent and vulnerable
• but little about the addict or addiction/dependenc
  e
• addiction/dependence as the rationale for what is
  basically a system of criminalization and
  coercion
• dependence, sin, crime alternatives or
  complements as concepts?

25
Addiction/dependence and stigma

• Alcoholism concept originally promoted to reduce
  the stigma on the alcoholic/inebriate
• Within AA sickness concept as reducing the
  intolerable load of guilt for new recruits
• Alcoholism movement alcoholic distinguished from
  the common drunk (Marty Mann)
• But it carries its own stigma
• 7 presidents of tobacco companies swearing to
  U.S. Congress in 1994 that they do not believe
  cigarettes are addictive (stance abandomed in
  1998)
• Acknowledges failure of self-management and
  self-control
• Knowledge ? responsibility the duty to cooperate
  in the cure or management of the condition

26

• The general theme underlying American
  statements on alcoholism has to do with lack of
  self-control on the part of the drinker. This
  societal symbolism of the deviation as a sign of
  character weakness is one of the most vivid and
  isolating distinctions which can be made in a
  culture which attributes morality, success, and
  respectability to the power of a disciplined
  will. (Lemert, Social Pathology, 1951356)

27
Now you see it, now you dont

• Addiction as a rationale for policy
• but addiction tends to disappear in the content
  and application of the policies
• addiction vs. habit
• mysteriousness of etiology
• alienation from the true self
• possession by alien forces
• addiction/dependence as a modern, apparently
  scientific, substitute for old ideas of spirit
  possession?

28
Loss of control and modernity -1

• Rationality as the norm, the irrational needs
  explaining
• A preference for rationalizing explanations
• Intoxication as the archetype of impaired control
  
• A divorce between will and desire
• That we can find ourselves doing things we desire
  even against our will
• Is will something permanent with a continuing
  existence in us, or does it change from moment to
  moment?
• Jon Elster, Ulysses and the Sirens
• Economists and rational addiction the temporal
  structure of preferences
• The consumer society and the cultivation of
  desire
• The free market and promotion without limits
• Self-control in consumer choice as the only
  acceptable limit

29
Loss of control and modernity - 2

• The individuation of social control The cultural
  imperative of self-control in the moment and
  over time
• Norbert Elias, The Civilizing Process
• Demonstrating self-control with respect to drugs
  as a modern Pilgrims Progress?
• Within culturally determined limits? MacAndrew
  Edgerton, Drunken Comportment
• Except for the bohemian fringe? back to Kate
  Moss
• Intoxicating substances as a social sorting
  process
• Replacing no longer acceptable differentiations
  by race, class, inheritance
• Acceptable because based on the individuals
  behaviour, establishing moral worthiness or
  stigma
• But opt-outs for the privileged (George W Bush),
  moral opprobrium for the poor
• A postmodern justification for social inequality?