Despite balanced coverage of substances that either energize or dampen the human spirit, Professor Benjamin Y. Fong’s Quick Fixes: Drugs in America from Prohibition to the 21st Century Binge is a real downer. Late in the book, he reveals “the only unassailable truth we’ve discovered so far about drugs: that some of them make some people feel better some of the time.” None of the substances Fong reviews—caffeine, tobacco, alcohol, opiates, amphetamines, psychotropics, psychedelics, cocaine, and marijuana—have come close to fulfilling the transformational potential their proponents promised. While they haven’t become the culture-destroying scourges foretold by their detractors either, after a century of attempts at regulating, legalizing, or prohibiting them outright, all of these drugs have and continue to destroy the lives of many of those in thrall to them or those whose lives are destabilized by their production and distribution.
Luckily, Fong’s survey of America’s pharmacopeia is just one part of the trip. His ultimate topic isn’t the substances he reviews, about which he says he has tried to remain neutral, but rather the role of American capitalism in our persistent attachment to them, about which he is anything but. Fong’s critique is fair, thorough, and compelling. Best of all, he offers a way out of our current addiction.
Through drug-specific chapters Fong has structured as standalone essays, he charts a chronological underlying narrative that holds for all the substances. The first stage marks the shift from an environment in which many substances were consumed freely to a regulatory order that coalesced in the late 19th century. With industrialization came the fear that workers would be unable to perform their duties if intoxicated. The obsession with productivity led to the embrace of some substances (coffee) and the vilification of others (opium and alcohol). This era culminated with the prohibition of alcohol in 1919.
The second stage marks an era of stability, the Fordist-Keynesian period, during which the working class thrived, temperance activism waned, consumerism emerged, and “sanctioned drug use” arose. This period includes the post-WWII-era, when amphetamines, the stimulants that enabled Allied forces to vanquish the Axis powers, became the substance of choice for a workforce called upon to win the Cold War from their office suites and factories. The US took its place as the leading capitalist economy, with a growing domestic pharmaceutical industry and an interest in the international illicit drug market.
Neo-liberalism of the 1970s ushers in the third era, characterized by a new class war (the war on drugs) and the reduction in the availability of licit and illicit drugs under the Controlled Substances Act of 1970. A “new diagnostic paradigm” that found drugs the answer for all disorders pushed back against the new control regime. Drug use increased, along with incarceration for working-class users.
The newly created Drug Enforcement Administration reduced the supply of heroin and marijuana but created a market for cocaine, which, according to Fong, “represents the neoliberal era quite well.” The wealthy treated it like “candy”, while poor and minority users were considered part of a drug “epidemic” and ended up in prison in far greater numbers than more affluent consumers.
We inhabit the fourth era, characterized by the end of neoliberalism. Without another dominant worldview to take its place, previously static categories have begun to break down (medicine/drug, legal/illegal, reputable/disreputable), and drug use is soaring. This is the “binge” of Fong’s title.
Fong has also structured Quick Fixes according to five “orienting claims” concerning the conditions that lead us to use drugs and our perceptions about them.
“Work structures ‘normal’ drug use into a dosing regimen”: we need drugs (uppers and downers) to make it through the workday. Abuse constitutes a regimen that affects our productivity negatively.
“Psychopharmacology is the science of treating atomization”: American life isolates us; for a century, the medical profession has assumed we need help coping with a culture that values individualism above collective experience and work over play. Americans now subscribe to “an ‘inherent illness’ model” that favors ongoing treatments based on risk factors over one-time interventions.
“Drug producers are typical capitalist organizations”: like all American corporations, they lobby or bribe, influence media representations of their businesses, ruthlessly work to eliminate competition, and market their wares or services without regard to benefits and harms.
“The difference between licit and illicit drugs is a class distinction”: who takes a drug is more important to its status than the drug itself. If you are “respectable”, your drug use is more likely to be accepted.
“Drug policy is not about drugs”: attempts to control substances are always attempts to control something else. Drug laws work to oppress minorities, justify the reduction of governmental benefits, or curtail freedoms.
The essays on the nine drugs Fong examines, along with addenda on peyote and dissociative anesthetics (PCP and ketamine) and appendices for drug use trends and key dates, emphasize the breadth of US drug dependence, while the underlying narrative and orienting claims underscore its magnitude and tenacity.
How can we make the next century different? Fong says we have to give up the quick fixes of the book title. He defines these as attempts to solve our drug dependence by unsystematically targeting one or more symptoms from the perspective of one of the two poles—”prohibition and peddling”—between which all attempts at intervention have fallen.
Legalization and drug reform alone won’t work. Alcohol and tobacco, both legal, are the most deadly drugs in the country. The legal marijuana industry has followed the alcohol and tobacco business model, focusing on profits and market share, not on the well-being of consumers.
According to Fong, we need “a free relation to drugs”, one not biased by compulsion and judgement. And since drug dependence stems from “the more fundamental problem of social and economic inequality and alienation”, the way out is to make systematic changes there. For Fong, that means providing good jobs and universal healthcare.
It’s a tall order, but given the immense amounts of money, resources, and energy already wasted on various wars on drugs, not to mention government experimentation at home and military action abroad, why not channel our efforts toward actions and policies that might work?