As its title suggests, this book is about how popular cultural perceptions and legal/public policy approaches to alcohol, tobacco and other psychoactive drugs have changed over time – roughly over the past two centuries. The book's main focus is on Britain, but its author draws extensively on international research and policy developments in her efforts to make sense both of important changes which she identifies as having already occurred and changes which are in train. Berridge is a historian with specialist research interests in those drugs about which human beings are so ambivalent: mind-altering drugs which are commonly used for pleasure or recreation but which also evoke strong moral condemnation, sometimes to the extent that they are credited with having demonic or diabolical properties.
The book begins with a reference to the work of the psychopharmacologist Professor David Nutt who argued that classification schemes for ‘drugs of misuse’ should be based upon rational, scientifically-derived knowledge of the various health and social harms caused by these substances. Professor Nutt, as is generally known, was thanked for his efforts by dismissal from his position as chair of the Advisory Council on the Misuse of Drugs: not because anybody questioned his scientific credentials or competence but because he was seen as having crossed the nebulous line between science and politics. However, as a historian, Berridge is simply concerned with describing and analysing changes in societal understandings of and responses to the use of alcohol, tobacco and drugs, a process which she refers to as the historic reconceptualisation or ‘repositioning’ of these various psychoactive substances. She is clear that the key changes which she identifies are not primarily attributable to scientific progress, and she herself does not take a prescriptive approach to her subject matter or make recommendations as to how public policy might best deal with these issues. Neither, despite the fact that she is better equipped than most people to do so, is she prepared to make definite predictions as to how public policy on psychoactive drug use is likely to evolve in the future.
In common with most books which deal with psychoactive drugs, Demons contains many entertaining but trivial snippets of historical fact: it is true, for instance, that William Gladstone prepared for important speeches in the House of Commons by adding opium to his coffee, but untrue, contrary to popular belief, that Queen Victoria used cannabis to manage the pain of childbirth. The main achievement of this book, however, is to explore in painstaking detail across twelve chapters how – regardless of pharmacological commonalities – the three drugs looked at have been treated in widely diverging ways over the period studied. Berridge structures her analysis of this historical material in relation to specific factors which she identifies at the outset as having been influential in this evolving process: these include the role of the state, of economic and professional interest groups, and of various other local, national and international stakeholder interests.
She ends her study by looking at the extent to which, towards the end of the twentieth century and in the first decade or so of the new millennium, we may discern greater policy convergence in relation to these drugs, particularly in the context of the application of public health models – originally associated with tobacco control – to alcohol and illicit drugs. On the other hand, she is aware that public health models of this kind, which are concerned with population health rather than with individual pathology, are challenged by developments in the neurosciences which argue that addiction is a brain disease. Whether clinical developments of this kind which are aimed at sorting out the ‘hijacked brain’ – and Berridge cites Stanton Peele who dismisses these developments as ‘high-tech phrenology’ (p. 212) – will prevail clinically and in policy terms over public health approaches remains to be seen.
For readers with a background in the social sciences much of what this book contains will not be startlingly new, in the sense that social scientists have for decades argued that public perceptions of psychoactive drug use and related public policy developments are best seen in terms of social construction. Writing as a historian, however, Berridge eschews the kind of theorizing which is often associated with social science research into psychoactive drug use; at the beginning of the book, for instance, she refers disparagingly to ‘tired, catch-all explanations such as “moral panic”, still over-used to explain responses to drugs’ (p. 5). However, it is doubtful whether readers, whatever their specific academic or professional backgrounds, will come across any other text which is as detailed, scholarly and generally well informed as this one. Demons is an ambitious text which does not pretend to provide easy answers to what are obviously difficult and complex questions; although not an easy read, it is ultimately rewarding and worthwhile.
Shane Butler
School of Social Work & Social Policy
Trinity College Dublin
E-mail: [email protected]