Discovering Addiction D iscovering A ddiction The Science and Politics of Substance Abuse Research nancy d. campbell The University of Michigan Press Ann Arbor Copyright © by the University of Michigan 2007 All rights reserved Published in the United States of America by The University of Michigan Press Manufactured in the United States of America c Printed on acid-free paper 2010 2009 2008 2007 4 3 2 1 No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, or otherwise, without the written permission of the publisher. A CIP catalog record for this book is available from the British Library. Library of Congress Cataloging-in-Publication Data Campbell, Nancy Dianne. Discovering addiction : the science and politics of substance abuse research / Nancy D. Campbell. p. ; cm. Includes bibliographical references and index. isbn -13: 978-0-472-11610-2 (cloth : alk. paper) isbn -10: 0-472-11610-X (cloth : alk. paper) 1. Substance abuse. I. Title. [ dnlm : 1. Substance-Related Disorders. 2. Health Policy. wm 270 c 189d 2007] rc 564. c 33 2007 362.29—dc22 2007023393 Against amnesia, this book is dedicated to the researchers at Lexington and the postaddicts who served as human subjects in the obscurity of long-dead laboratories Acknowledgments The social worlds of drug policy historians and substance abuse researchers are convivial thought collectives. I would particularly like to thank Joseph Spillane, who forged a relationship with the University of Michigan Substance Abuse Research Center (UMSARC). Carol Boyd and Sean MacCabe facilitated our relationship with the College on Problems of Drug Dependence (CPDD), the modern-day incarnation of the original National Research Coun- cil committee described (under its various names) in this book. CPDD remains the premier professional association in the ‹eld but is now a large membership organization. The CPDD Board of Directors granted over twelve thousand dol- lars for the interviews on which this book is based. I am grateful to Martin and Toby Adler, Bob Schuster and Chris-Ellyn Johanson, Conan Kornetsky, Wal- lace Pickworth, and the dozens of CPDD members who allowed us to interview them. The University of Michigan Department of Pharmacology was especially hospitable, and I would like to thank Jim Woods and Gail Winger, Jonathan Maybaum, Ed Domino, and Graham Florry, who graciously volunteered time and insight without which this project would have been impossible. Of course, the author alone is responsible for all errors of omission and commission, as well as differences of interpretation. The interviews were transcribed by Elaine Farris with great generosity, good humor, and accuracy. At a crucial point, the National Science Foundation funded the oral history project (grant #SES-0620320) so that we could create a digital archive for the interviews, which will be housed on the UMSARC Web site and in the Bentley Historical Library at the University of Michigan. Joseph Spillane joined me on some of the interviews, and a veritable cavalcade of stars agreed to serve on our advisory board. I would like to thank UMSARC’s current director, Peggy Ngegy, for the initial inspiration for the advisory board; Carol Boyd for agree- ing to head it; and Caroline Acker, David Courtwright, Eloise Dunlap, Sheigla Murphy, and David Musto for joining us. These people comprise a substantial part of the small but committed research community in drug policy history and drug ethnography. Jonathan Maybaum, creator of the SiteMaker software, skillfully guided us through the design of the Web site over the course of sev- eral wintry weekends. The process of writing and submitting the grant itself would have been far more dif‹cult and less pleasant without the work of Dean Button of Rensselaer Polytechnic Institute. During the writing process, I was surprised to encounter independent ‹lmmakers J. P. Olsen and Luke Walden, who were as fascinated by Lexington as I was. Their ‹lm The Narcotics Farm tells the story of “Narco” from the per- spective of those who experienced another side of that Lexington institution. My own archival work was ably assisted at the National Archives Southeast in Morrow, Georgia, by archivist Guy Hall and staple-puller extraordinaire Aaron Pevey and at College Park by Bureau of Prisons archivist John W. Roberts. Bene‹ting from the gifts of a fortuitous environment, I also enjoyed a ship- ment from the basement of Jon M. Harkness that illuminated the darker cor- ners of the prison research enterprise. Basements served as my archives more than once: I am grateful to Chuck and Barbara Gorodetzky for allowing me to spend hours in theirs despite my advanced stages of pregnancy. I thank Andrea Tone for directing me to the American College of Neuropsychopharmacology (ACNP); Oakley Ray, longtime secretary of that organization, for supporting travel to the archives housed at the Eskind Biomedical Library at Vanderbilt University; and archivist Jeremy Nordmoe. The Rensselaer Polytechnic Insti- tute Of‹ce of Research supported the ‹rst round of interviews with an internal seed grant to myself, Kim Fortun, and Mike Fortun titled “Pharmacogenomics, Toxicogenomics, and the Ethical Implications of Scienti‹c Research on Com- plex Conditions: A Research Program to Study Emergent Decision Domains at the Intersection of Biotechnology and Information Technology.” I owe a great debt to Bill Eppridge and his wife, Adrienne Aurichio, whose generosity in the ‹nal days of this project led to Bill’s extraordinary pho- tographs appearing in this book. As a Time-Life photojournalist working on the ‹rst story about middle-class white heroin use to appear in the mainstream press, Bill was dispatched to the monkey laboratory at Michigan and the clini- cal research facility at Lexington late in the fall of 1964, after spending three months the previous summer photographing “John and Karen, Two Lives Lost to Heroin” (a Life magazine story and photo essay published on February 26, 1965 and March 5, 1965). Given the paucity of visual images of Lexington avail- able in the National Archives, these photographs were extremely valuable for evoking the feel of the place. Writing the acknowledgments to a book ‹ve years in the making feels like bringing together multiple lives. The feminist community sustains me despite the fact that gender, social policy, and the politics of reproductive rights are viii / acknowledgments underplayed in this book. Michele Berger, Giovanna Di Chiro, Mary Margaret Fonow, Donna Haraway, Sally Kitch, Patti Lather, Nancy Naples, Lynn Pal- trow, Sandy Schram, Susan Shaw, and Rickie Solinger remain important to everything that I do. Carol Bohmer and Amy Shuman graciously extended speaking invitations during this time. I am indebted to my doctoral students, Maral Erol, Virginia Eubanks, Jenrose Fitzgerald, and Lorna Ronald, as well as colleagues elsewhere, including Alexine Fleck, Kim Hewitt, Marcia Meldrum, and Noemi Tousignant. I thank the graduate students central to the Rensselaer science and technology studies community, especially Colin Beech, Jon Cluck, Ayala Cnaan, Camar Diaz-Torres, Rachel Dowty, Jill Fisher, Ken Fleischman, Allison Kenner, Eun - sung Kim, Natasha Lettis, Torin Monahan, Dean Nieusma, Casey O’Donnell, Marie Rarieya, Erich Schienke, Jeannette Sim- monds, Peg Woodell, Shailaja Valdiya, and Bo Xie, as well as undergraduates Dalibel Bravo, Amrit Mohanran, Adam Marcus, Hasan Abdul-Mutakalli, Brandon Reiss, and Dane Dell and Jason Williams, who helped me with research in the last year of this book’s writing. Members of my more local com- munity who have helped me work through parts of this book include Steve Breyman, Linnda Caporael, Scott Christianson, Tamar Gordon, Kim Fortun, Mike Fortun, Rayvon Fouche, David Hess, Linda Layne, Sal Restivo, Sharra Vostral, Langdon Winner, and Edward J. Woodhouse. For collegiality and camaraderie at Rensselaer, I thank Sharon Anderson-Gold, Anne Borrea, Igor Broos, Dean Button, Lisa D’Angelo, John Harrington, Kathy High, Branda Miller, Don Moore, Pam Murarka, Barb Nelson, Allison Newman, Lee Odell, and Kathie Vumbacco. The intellectual hospitality of Kim, Mike, Kora, and Lena Fortun knows no peer. Finally, I would like to thank my family—my par- ents, Sandra Campbell and David R. Campbell, MD; Connie Campbell, MD, and Tony Diehl; Dave and Amanda Campbell; Gary Campbell; and my partner in all things, Ned Woodhouse, who, along with our children, Isaac Campbell Eglash and Grace Campbell Woodhouse, graciously and grudgingly tolerated my sporadic absences, increasingly insomniac work habits, and obscure enthu- siasms. Getting me to play rather than work is their prime objective, and for that I am most grateful. Acknowledgments / ix Contents A Note on Sources xiii A Note on Interviews xvii Introduction 1 chapter 1. Framing the “Opium Problem”: Protoscienti‹c Concepts of Addiction 12 chapter 2. Creatures of Habit: Feeding the “Junkie Monkeys” of Michigan 29 chapter 3. “A New Deal for the Drug Addict”: Addiction Research Moves to Lexington, Kentucky 54 chapter 4. “The Man with the Syringe”: Pain and Pleasure in the Experimental Situation 83 chapter 5. “The Tightrope between Coercion and Seduction”: Characterizing the Ethos of Addiction Research at Lexington 113 chapter 6. “The Great Hue and Cry”: Prison Reform and the Ethics of Human Subjects Research 143 chapter 7. “The Behavior Is Always Right”: Behavioral Pharmacology Comes of Age 178 chapter 8. “The Hijacked Brain”: Reimagining Addiction 200 Conclusion 222 Notes 239 Selected Bibliography 263 Index 287 Illustrations following page 78 A Note on Sources Travel and transcription were supported by the College on Prob- lems of Drug Dependence, the University of Michigan Substance Abuse Research Center, the Center for Substance Abuse Research at Wayne State Uni- versity, and the Of‹ce of Research at Rensselaer Polytechnic Institute. Between 2003 and 2006, the following individuals were interviewed by me alone or with Joseph F. Spillane, at the places and times indicated in parenthe- ses: Howard S. Becker, PhD, professor emeritus, Department of Sociology, University of California at Santa Barbara (January 2005); Edward Domino, professor of pharmacology, University of Michigan (Ann Arbor, Michigan, November 2006); Charles W. Gorodetzky, MD, PhD, retired vice president, deputy department head, and department head, Neurology Team Medical and Scienti‹c Services, Quintiles Transnational (Kansas City, Missouri, July 2003); Donald Jasinski, PhD, chief, Center for Chemical Dependency, and professor, Department of Medicine, Johns Hopkins Bayview Medical Center (Baltimore, Maryland, May 2003); Herman Joseph, PhD, (Troy, New York, August 2005); Conan Kornetsky, PhD, professor, Departments of Psychiatry and Pharmacol- ogy, Boston University School of Medicine (Boston, Massachusetts, May 2003); Peter Mansky, MD, executive director, Nevada Health Professionals Assistance Foundation (December 2005, January 2006); Lucinda L. Miner, PhD, deputy director, Of‹ce of Science Policy and Communications, National Institute on Drug Abuse (May 2003); Sheigla Murphy, PhD, director, Center for Substance Abuse Studies, Institute for Scienti‹c Analysis (New Orleans, Louisiana, June 2003); Oakley Ray, PhD, Vanderbilt University (Nashville, Tennessee, February 2006); Mark A. Rothstein, JD, Institute for Bioethics, Health Policy, and Law, University of Louisville School of Medicine (Louisville, Kentucky, March 2003); Marjorie Senechal, PhD, Louise Wolff Kahn professor in mathematics and the history of science, Smith College (Northampton, Massachusetts, September 2005); George R. Uhl, MD, PhD, chief, Molecular Neurobiology Branch, NIDA, Intramural Research Program (Baltimore, Maryland, 2003); Daniel Wikler, PhD, Mary B. Saltenstall profes- sor of population ethics and professor of ethics and population health, Depart- ment of Population and International Health, Harvard University (2005); and James Woods, PhD, professor of pharmacology, University of Michigan (San Juan, Puerto Rico, June 2003; Ann Arbor, Michigan, March 2005). The following individuals were interviewed at the annual meeting of the Conference on Problems of Drug Dependence in Phoenix, Arizona, in June 2006: Anna Rose Childress, PhD, research associate professor of psychology in psychiatry, Treatment Research Center, University of Pennsylvania; Theodore Cicero, PhD, professor of neuropharmacology in psychiatry, Washington Uni- versity in St. Louis; James Inciardi, PhD, director, Center for Drug and Alcohol Studies, University of Miami; Bruce D. Johnson, PhD, director, Institute for Special Populations Research, National Development and Research Institute, New York; Beny Primm, MD, executive director, Addiction Research and Treatment Corporation, Brooklyn, New York; and Edward G. Singleton, National Institute on Drug Abuse. The following individuals were interviewed by me alone or with Joseph F. Spillane at the annual meeting of the Conference on Problems of Drug Depen- dence in Orlando, Florida, in June 2005: George Bigelow, PhD, professor of behavioral pharmacology, Johns Hopkins University; Thomas Crowley, PhD, professor, University of Colorado; William Dewey, PhD, professor of pharma- cology, Virginia Commonwealth University; Loretta Finnegan, MD; Roland Grif‹ths, PhD, professor of behavioral pharmacology, Johns Hopkins Univer- sity; Rolley E. Johnson, PharmD, Reckitt-Benkhiser, Richmond, Virginia; Michael Kuhar, PhD, chief, Division of Neuroscience, Yerkes National Primate Research Center, and Candler professor of pharmacology, Emory University; Catherine A. Martin, PhD, professor, Department of Psychiatry, University of Kentucky, Lexington, Kentucky; Jane Maxwell, PhD, research professor, School of Social Work, University of Texas at Austin; Charles P. O’Brien, MD, PhD, director, Treatment Research Center, University of Pennsylvania; Charles O’Keefe, Virginia Commonwealth University, Richmond, Virginia; Richard Spence, PhD, research professor, School of Social Work, University of Texas at Austin; and Frank Vocci, PhD, director, Division of Treatment Research and Development, NIDA. The following individuals were interviewed by me at the annual meeting of the Conference on Problems of Drug Dependence in San Juan, Puerto Rico, in June 2004: Robert Balster, PhD, professor of pharmacology and toxicology and director, Virginia Commonwealth University Institute for Drug and Alcohol Studies; Louis Harris, PhD, professor of pharmacology, Medical College of Virginia, Virginia Commonwealth University; Jack Henning‹eld, PhD, NIDA, xiv / a note on sources Intramural Research Program; Arthur Jacobsen, PhD, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH); Chris-Ellyn Johanson, PhD, director, Wayne State University Center for Substance Abuse Research; Herb Kleber, MD, PhD, professor of psychiatry and director, Division on Substance Abuse, College of Physicians and Surgeons, Columbia University; Mary Jeanne Kreek, PhD, Laboratory of the Biology of Addictive Diseases, Rockefeller University; Wallace B. Pick- worth, PhD, retired, NIDA, Intramural Research Program; Kenner Rice, PhD, NIDDK, NIH; Charles R. (Bob) Schuster, PhD, Wayne State University Center for Substance Abuse Research; Tsung-Ping Su, PhD, NIDA, Intramural Research Program; and Eddie Leong Way, PhD, professor emeritus, Depart- ment of Pharmacology, University of California at San Francisco. The American College of Neuropsychopharmacology archives enabled me to look at the papers of Leo Hollister and Heinz Lehmann and to read tran- scripts or view videotaped interviews from the Oral History Collection for the following people: Martin Adler (1996), Julius Axelrod (1997), William Bunney (2001), Jonathan Cole (1994, 1999), Leonard Cook (n.d.), Peter B. Dews (n.d.), Edward Domino (n.d.), Fred Goodwin (1996), Leo Hollister (1996, 1999), Jerome Jaffe (1998), Murray Jarvik (n.d.), Donald Jasinski (1997), Seymour Kety (n.d.), Eva Killam (1994), Keith Killam (1994), Herb Kleber (n.d.), Conan Kornetsky (n.d.), Louis Lasagna (n.d.), Charles P. O’Brien (1998), Candace Pert (n.d.), Roy Pickens (1997), Solomon Snyder (n.d.), and Larry Stein (1995). David Healy’s published interviews from this series were also a valuable data set. Finally, I am grateful to Jon M. Harkness, Jackie Orr, J. P. Olsen, and Luke Walden, all of whom generously shared interviews they conducted with researchers who did time at Lexington. A Note on Sources / xv A Note on Interviews Charles Gorodetzky was hired at the Addiction Research Center (ARC) in 1963, became deputy director in 1977 and scienti‹c director of the ARC preclinical program that remained at Lexington in 1981, left public service for the pharmaceutical industry in 1984, and retired in 2005. Harris Isbell retired from the Public Health Service in 1963 to chair the Department of Med- icine at the University of Kentucky and died in 1994. He was survived by his daughters. Donald Jasinski was hired at the ARC in 1965, became director in 1977 and scienti‹c director of the ARC Baltimore in 1981, and was still working at Johns Hopkins University at the time of this writing. His pharmacist assis- tant, Rolley E. (Ed) Johnson, PharmD, spent several years on the Hopkins fac- ulty before moving to Reckitt Benkhiser, the company that brought buprenor- phine to the U.S. market. Herb Kleber, who was at the Lexington Hospital as a “two-year wonder” in 1963, was still directing the Division of Substance Abuse at the College of Physicians and Surgeons of Columbia University at the time of this writing. Conan Kornetsky was hired at the ARC as a University of Ken- tucky graduate student in 1948, departed in the early 1950s, and was still work- ing at Boston University at the time of this writing. Isbell’s successor, William R. Martin, was hired at the ARC in 1957 and appointed ARC director in 1963, retired in 1977 to become chair of pharmacology at the University of Kentucky School of Medicine, and died in 1992. He was survived by his wife, sons, and daughter. Charles R. (Bob) Schuster, former director of NIDA, was still work- ing at Wayne State University at the time of this writing. Abraham Wikler retired in 1963, went to the University of Kentucky, and died in 1983. He was survived by his wife, Ada Wikler, and his children, Marjorie Senechal, now a professor at Smith College; Jeanne Wikler; Norma Wikler (now deceased); and Daniel Wikler, now a bioethicist at Harvard University. Introduction Popular beliefs about drugs and drug addiction are increasingly pitched in the language of science, which has become part of the stew of assumptions and stories we serve each other in everyday life. Drug users speak of being overtaken by cravings or uncontrollable urges, a way of speaking drawn from notions of appetite, habit, and craving that come not from unmediated drug experiences but from psychoanalysis. When relapse is attrib- uted to “cues” or “triggers,” patients and providers draw on a vocabulary of operant conditioning introduced by experimental psychologists and behav- ioral analysts. When drug users speak of feeling “chemically imbalanced,” they rely on a late twentieth-century vocabulary of endorphins, neurotransmitters, opiate receptors, and brain chemistry drawn from neuroscience. Science offers specialized vocabularies that fuse with popular vernaculars—“the ‹x,” “the rush,” “getting high,” “hitting bottom,” or “kicking the habit”—through which people describe their innermost sensations. Expressive argots recursively feed into science: scienti‹c theories affect how people interpret drug experi- ences, and users’ reports in turn become research material. The frames used in science are consequential, for the production of scienti‹c knowledge is a social privilege inextricably bound to questions of social justice. Scienti‹c knowledge about drug addiction is believed to reveal the inner workings of brains, minds, and bodies. 1 Addiction knows none of the social distinctions imposed by policy regimes that have repeatedly constructed drug use as a crime or as a disease in the United States. 2 Calling something a “dis- ease” appeals to scienti‹c conventions and clinical vocabularies but generates a