| Alfred R. Lindesmith | |
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Alfred R. Lindesmith
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| Born | August 3, 1905 Clinton Falls Township, Steele County, Minnesota |
| Died | February 14, 1991 Bloomington, Indiana |
| Fields | Sociology, Criminology |
| Institutions | Indiana University |
| Alma mater | Carleton College, Columbia University, University of Chicago |
| Known for | Advocacy of a medical approach to drug addiciton. |
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Alfred Ray Lindesmith (August 3, 1905 - February 14, 1991) was an Indiana University professor of sociology. He was among the early scholars providing a rigorous and thoughtful account of the nature of addiction.
Lindesmith's interest in drugs began at the University of Chicago, where he was trained in social psychology, earning his doctorate in 1937. His education there was a mixture of the analytical and theoretical, a balance that would later appear in his drug studies. The work at Chicago involved research with interactionist theory, including the research of Chicago's Herbert Blumer, emphasizing the idea of self-concept in human interaction.
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Lindesmith's work on drugs began with his questioning of the nature of addiction in a 1938 essay entitled "A sociological theory of drug addiction". This paper appeared in the American Journal of Sociology and involved in-depth interviews with 50 so-called addicts.
As this work progressed, it developed into a full theoretical and empirical account of the nature of opiate addiction, culminating in his book Opiate Addictions in 1947 (republished as Addiction and Opiates in 1968).
What Lindesmith developed was an account of opiate addiction that (1) distinguished between the physical reactions of narcotic withdrawal and its psychological (phenomenological) experience, and (2) described the relationship between these two phenomena and addiction. Addressing the question of why regular users of opiates do not necessarily become dependent or addicted, he found that, while continuous opiate use does cause many to experience physical withdrawal, the impact of withdrawal on the likelihood of dependence and addiction is not certain. Lindesmith's "addicts" revealed this, in part, as did general reports from individuals who, despite regular use of opiates, failed to become habitual users, stressing "the advantage of attributing the origin of addiction, not to a single event, but to a series of events, thus implying that addiction is established in a learning process extending over a period of time."
This learning process has two parts. First, opiate users must connect their drug withdrawal to their use of the drug, which is something that individuals exposed to opiates in hospital settings are more likely to do. When withdrawal is interpreted as a form of addiction, the perceived (and felt) need for more drugs grows. More recent research has shown that, because hospital patients often associate opiate analgesia with an illness and/or hospital care, and because the drugs cause sedation and other mind-altering effects, patients rarely experience any withdrawal.
Here is the second part of the equation: if and when an opiate user identifies opiate withdrawal as such, he or she must initiate a ritual activity that is a physiological, cognitive, and behavioral mixture. As Richard DeGrandpre writes in The Cult of Pharmacology,[1] "the opiate user must first experience withdrawal (a physical phenomenon), he or she must develop a concern over the withdrawal experience as such (a cognitive phenomenon), and then he or she must engage in drug use, taking opiates repeatedly to eliminate or avoid opiate withdrawal (a behavioral phenomenon). A breakdown in any part of this bio-psycho-social circuit can keep a pattern of dependent opiate use from emerging."
In Robert Scharse's study of Mexican-American users, for example, some interpreted withdrawal as a sign of emerging drug dependence, and subsequently reduced or quit their drug use. For others, the withdrawal experience caused an obsession over the prospect of withdrawal, encouraging them to repeatedly use in order to avoid it. This then completed a circuit, with Lindesmith's learning process being reinforced and strengthened.
As his career ended, Lindesmith held on to his belief that opiate addiction is not the simple product of one's exposure to opiates. Rather it is the result of a dramatic shift in a person's mental and motivational state. Once the individual concludes that he or she is hooked, it rarely occurs to them that they are engaging in a self-fulfilling prophecy, trapped within a belief that makes the experience exactly what it is feared to be.
While Lindesmith’s theory retains its canonical importance, it has been subject to several serious critiques. Most fundamentally, his theory relies on an outdated division of human perception into: (1) brute biological sensations the body passively experiences in immediate response to its physical environment, and (2) the mind’s active and deliberate interpretation of those sensations. This voluntaristic understanding of meaning and interpretation profoundly undermines Lindesmith’s capacity to theorize addiction as a loss of self-control, or as something suffered rather than chosen (Weinberg 1997).[2]
The fact that Lindesmith's work threatened the emerging demonization of heroin, etc., is clear from how the Federal Bureau of Narcotics (FBN)—predecessor of the DEA—worked to discredit him. This is outlined in a paper by Galliher, Keys, and Elsner, "Lindesmith v. Anslinger: An Early Government Victory in the Failed War on Drugs".[3] As early as 1939, FBN director Harry Anslinger had the Chicago District Supervisor of the Bureau notify Indiana University that one of their professors was a drug addict. An internal FBN memo also suggests that, some years later, a wiretap may have been placed on Lindesmith's phone by the Bureau. Incidentally, there is no evidence that Lindesmith ever used illegal drugs. As Galliher et al. point out, "the targeting of Lindesmith was possible because Lindesmith acted virtually alone in standing up against federal drug control policies."
In his book The Addict and the Law,[4] he presents a detailed account of U.S. laws, regulations, police practices and court procedures, often in painful detail. He was describing what we now know as the beginning of the "war on drugs", although that term was not coined until 1971. It was published just 3 years after Anslinger retired. In his book, Lindesmith expressed hope that the relatively liberal drug policies of the Kennedy and Johnson Administrations would continue, but that was not to be.
Professor Nils Bejerot, the founder of the Swedish antidrug strategy, argued that professor Lindesmith's books had contributed to the drug problems in the US by making wrong conclusions from a comparison between England and the US, for example, what caused the low abuse of opium in the late 1940s in England.[5] Lindesmith preferred the so called British System founded on the recommendations from the Rolleston Committee of 1924. Bejerot claimed that Lindesmith wrote his earlier books from close personal interviews with a very limited number of addicts, about 50, almost all of them victims of therapeutic use of drugs when they were in health care for other reasons. Bejerot argued that this small group was a very lower and different risk than the more frequent addicts introduced in the habits by close personal contacts with other users of the drug. The therapeutic addicts could be treated as a personal health problem. The other type of users, the epidemic users, was also a risk for other citizens by introducing new users, particularly in the beginning of their drug career when the downside of the drug use was not so visible. Bejerot argued that Lindesmith's suggestions was adopted to the first group, the therapeutic addicts. One should be mindful that Bejerot never examined Lindesmith's field notes and consequently has no meaningful perspective on the type of addict he interviewed. To say that Lindesmith's research contributed to addiction is however a statement without basis. One of the ironies of Lindesmith's forty-year career was that the misinformation campaigns undertaken by the FBN and Anslinger drowned out most of proposed drug reforms he advanced. Virtually nothing came of Lindesmith's activities or his publications, while honored by the academy, they never had anything approaching a wide popular impact.[6]
Lindesmith had noticed that England in the 1940s had very liberal narcotics laws (see the Rolleston Committee Report of 1924) and draws the conclusion that this contributed to a low abuse of opium. Bejerot drew the opposite conclusion, the low abuse of opium in England in the late 1940s was the cause for the liberal opium laws in England; the low abuse of opium in England had other causes. An experiment in the late 1940s in England with free opium distributed by doctors to opium addicts had ended with a multiplied number of opium addicts.[5] When the number of addicts of heroin in England doubled every sixteenth month 1959-1968 the British government was forced to implement a more restrictive law.[7][8][9]
Bejerot argued that a policy with liberal drug laws, like neglecting smaller amounts of illegal drugs for personal use, would open the doors for a much larger epidemic [10] outbreak of recreational drugs to a level not acceptable for the government. Then the society will rebound with much more restrictive laws (compare with the War on drugs). He said, "A country can afford liberal narcotics laws as long as it has no widespread epidemic use of narcotics." Both Bejerot and Lindesmith criticized the way the American justice system worked in practices for drug addicts and advocated that more resources must be used in the treatment of drug addicts, but drew very different conclusions about what was the cause.[11]
Lindesmith was a careful and conservative man, never using drugs or advocating their use. He was however wedded to the idea that addiction was a disease and that national policy was misinformed on the notion that addicts were a criminal class.[6]
Lindesmith was born in Clinton Falls Township, Steele County, Minnesota, and gained an early fluency in German from his German-born mother. He attended public school in nearby Owatonna, Minnesota, where he graduated from high school in 1923. He graduated from Carleton College in 1927 and received an M.A. in education from Columbia University in 1931. Lindesmith taught school before entering the University of Chicago, where he received his Ph.D. in 1937. His teaching career at Indiana University spanned 40 years from 1936 to 1976. He became University Professor of Sociology there in 1965. He was president of the Society for the Study of Social Problems, 1959-1960.[12]
Lindesmith married Gertrude Louise Augusta Wollaeger (1907–1985) in 1930. They had one daughter. He died in Bloomington, Indiana. In his waning years Lindy suffered from Alzheimer's Syndrome and was afflicted with its complications.