Medical theories of opiate addiction's aetiology and their relationship to addicts’ perceived social position in the United States: an historical analysis

Abstract

This paper uses qualitative methods to explore the relationship between US health professionals’ theories of opiate addiction's aetiology in the US during two time periods, 1880–1920 and 1955–1975 and contemporaneous perceptions of opiate addicts’ race/ethnicity, social class and gender. The author coded 297 medical articles on opiate addiction, published during the years of interest and randomly sampled from indices of medical articles, for descriptions of opiate-addicted individuals’ social position and theories used to explain addiction. Critical race theory and a social construction of knowledge framework guided the grounded theory analysis. This analysis indicates that during both periods health professionals typically attributed opiate addiction's causes to individual pathology when they believed that addicts were working class, poor and/or non-white women and men and to factors largely external to the individual when they believed that addicts were affluent, white women and men. This social patterning was consistent with contemporary efforts to reinforce inequitable social relations during these eras. Given the relevance of health research to public policy, this paper suggests that present-day health researchers critically reflect on the ways that their research is complicit in the creation of contemporary inequitable social relations.