Intoxicating history

As the Department of Health gears up to publish its alcohol strategy for England later this year, it does so amidst newly published figures estimating that a failure to reform alcohol laws could lead to 210,000 preventable deaths in England and Wales in the next 20 years.

Substance abuse too is recognised as an increasing threat to public health. Although the first international drug treaty was signed a century ago in efforts to halt the opium, morphine and cocaine trade, last year the Global Commission on Drug Policy concluded that the global war on drugs had failed.  According to estimates by the United Nations (UN), opiate use increased worldwide from 1998 to 2008 by 35%, cocaine by 27% and cannabis by 8.5%.

How should governments respond? What is the best policy to safeguard public health against the dangers of intoxicants? Should policy makers treat these substances as separate or related? While scientific risk assessments provide one answer, we can also learn valuable lessons for policy making by looking at how society has tackled the issue in the past. If we want to understand how to design more appropriate international policies we need to understand how current policies developed and why they have failed.

In many respects, our understanding of this historical context has been distorted by the dominance of the prohibitionist and criminalisation models of intoxication management. But, if we look at the policies of Germany – a country which deviated from the more common model of increased criminalisation favoured by the West over the past century – we can see that prohibition was not the only history of intoxication management, and can gain new insights into how these alternative strategies managed the public dangers (and benefits) of intoxicants.

Rauschmittel

On 21 August 1883, The New York Times reported the emergence of a new temperance movement in Germany. Previous attempts to instil in Germans the desire to abstain from alcohol had been an utter failure. Alcohol had a central ritual and nutritional function, and the brewing industry was powerful.

The new movement was savvier, no longer urging Germans to pledge ‘total abstinence’. Nor did it any longer condemn politicians drinking beer while talking politics. Nor even the ‘jovial drunkenness’ of students. This contrasted sharply with Britain’s temperance movement which, by the late 19th century, urged abstinence. Teetotalism reached its most extreme legislative incarnation in the USA, where alcohol was illegal between 1920 and 1933.

When compared to American prohibition, German temperance activists’ acceptance of drunkenness seems bizarre. But not when compared to Germany’s treatment of other intoxicants. Germany introduced the world to cocaine, heroin, amphetamines and MDMA; it was also reluctant to criminalise them. Even with tobacco, Germans have been permissive, refusing to implement a European Union directive banning smoking in public spaces in 2008. In fact the German language treats intoxicants together: the word Rauschmittel describes alcohol, medicines, illicit drugs and cigarettes, and means ‘articles of intoxication’.

My research explores why and how Germany took this approach to managing Rauschmittel. It connects political and everyday history, examining how cultures of intoxication shaped and were shaped by policy, and what this tells us about German society. It asks: why was a country famous for its repressive dictatorship and its obsession with national health also so permissive?

Given smoking’s well-publicised dangers, it is initially hard to view Germany’s intoxicant policy as public health orientated. However, its approach to temperance demonstrates an early preference for recognising a user’s positive experiences and negative abuses of a substance, rather than treating a substance as inherently problematic. This attitude has informed Germany’s intoxicant policy and its treatment of users throughout the modern period. By closely regulating users’ activities, one could reduce a substance’s potential harm rather than criminalise it and, by extension, its users.

By contrast, prohibitionist-based policies and their corresponding histories have focused on the path to and from criminalisation and rarely on individual users and the society in which they lived. Because prohibitionist-orientated histories classify substances by their legal position, past trends in intoxicant use have become distorted by present-day legal realities. This is equally problematic for illegal drugs as for substances like alcohol and cigarettes, for which the lines of acceptability or taboo are more fluid, and for which a defensive justification for their legality in the West has developed.

Of course, effective regulation necessitates public acceptance of governmental interference. This might not have worked in the UK, with its history of liberal individualism. But in Germany, a country with a highly interventionist state, which boasted numerous positive and negative regulations that did not exist in the UK, intoxicant regulation was more culturally acceptable. However, it did not proceed smoothly. International treaties, which Germany chose or was compelled to support, increasingly favoured supply-side prohibition, undermining Germany’s preference for consumption-side regulation.

Christiane’s story

Despite its success in regulating alcohol consumption in a culturally acceptable manner, Germany was not immune to the destabilising effects of new ‘trends’ in intoxicant use. The most famous example is heroin which, although first produced in Germany in the late 19th century, was relatively well controlled until the late 1960s, despite (or perhaps because of) its legality. Addiction was a problem, but it was limited to doctors, their patients and their social circles.

This changed when younger, poorer, West Germans gained a taste for the drug. In 1967, the West Berlin police reported 57 drug offences; in 1970, 858; and in 1980, 4,429. By 1971, heroin was criminalised in Germany via a UN treaty.

But perhaps Germany’s most famous ‘heroin statistic’ is Christiane Felscherinow, who started using the drug aged 13 in 1975. Her experiences, recorded by two journalists and later made into a film, demonstrated to Germans the Berlin authorities’ lack of expertise in treating heroin. Individuals like Christiane were visible manifestations of a serious social ill, and less easy to stereotype as devilish deviants because of their youth and vulnerability. As a result, the authorities began to treat heroin use as a threat to public health, not as a criminal problem.

The Berlin authorities implemented a tightly regulated therapy chain, which followed users from the street through their social reintegration, and by 1981 Germany had changed its drug policy to legally favour therapy not punishment. Needle programmes were established in 1984, and today Germany has the largest number of needle vending machines in the world. Methadone treatment for addicts began in 1992; since 2003, Germany has also treated addicts with heroin. Switzerland and the Netherlands, which have similar intoxicant histories, have done likewise. Four cities from these three countries declared the ‘war on drugs’ a failure in 1990, calling most drug use a ‘temporary’ part of most users’ biography, best regulated, not criminalised – and 21 years later much of the world has followed suit.

Lessons from history

When the Global Commission on Drug Policy declared in 2011 that attempts to reduce drug use through supply-side prohibition had failed, they urged a science-based debate to develop ideas for new international policy. My research emphasises the importance of also taking a historical approach, one that does not base its exploration of substances on their current criminal or cultural status, but instead takes as its focus the entire category of intoxicants.

This historical approach demonstrates the importance of connecting policy to everyday experience. Doing so prevents the marginalisation of users in discussions of intoxicant policy and allows for a better understanding of intoxication’s dangers and enticements.

Dr Harris is at the Faculty of History.