Pharmaceuticals and modern statecraft in South Africa: the cases of opium, thalidomide and contraception.

This article provides a history of three pharmaceuticals in the making of modern South Africa. Borrowing and adapting Arthur Daemmrich's term 'pharmacopolitics', we examine how forms of pharmaceutical governance became integral to the creation and institutional practices of this state. Through case studies of three medicaments: opium (late 19th to early 20th century), thalidomide (late 1950s to early 1960s) and contraception (1970s to 2010s), we explore the intertwining of pharmaceutical regulation, provision and consumption. Our focus is on the modernist imperative towards the rationalisation of pharmaceutical oversight, as an extension of the state's bureaucratic and ideological objectives, and, importantly, as its obligation. We also explore adaptive and illicit uses of medicines, both by purveyors of pharmaceuticals, and among consumers. The historical sweep of our study allows for an analysis of continuities and changes in pharmaceutical governance. The focus on South Africa highlights how the concept of pharmacopolitics can usefully be extended to transnational-as well as local-medical histories. Through the diversity of our sources, and the breadth of their chronology, we aim to historicise modern pharmaceutical practices in South Africa, from the late colonial era to the Post-Apartheid present.

[Obligatory documentation for narcotic drugs over the course of time : the morphine and cocaine book for physicians according to the 1930 parliamentary law gazette]. / Dokumentationspflicht für Betäubungsmittel im Wandel der Zeit : Das Morphin- und Kokainbuch für Arzte nach dem Reichsgesetzblatt 1930.

According to the opium law and prescription statute of 1930, physicians were duty-bound to maintain a stock ledger to allow a traceable record of the location of narcotic drugs. If a simplification of the prescription of opiates was welcomed 10 years ago then 2 years after amendment of the addictive drugs statute thought should be give to safe use, as can be concluded from a morphine logbook from the time of the introduction of the Federal opium law. "Receipt and issue... deliverer and recipient" must be able to be extracted from the documentation, which means the delivery and the dispensing but not the individual application.

Lessons in ambivalence: The Shanghai Municipal Council's opium policies, 1906-1917.

BACKGROUND: Shanghai was considered to be a "capital of opium" in modern China, hence the history of opium in the city has received significant attention. In the Shanghai International Settlement, where Chinese and foreigners lived as neighbours, drugs were considered by the administration as both "trouble maker", and important financial resource. This paper explores how the Shanghai Municipal Council (SMC), the most senior governing body in the settlement, used its position to maximize political and economic profit from the trade and consumption of opium. METHODS: The paper is based on documentary analysis of records of the SMC board meetings and other related material stored at Shanghai Municipal Archives. Interpretive approaches were used to analyze the shifting SMC strategies on opium consumption, the competing power relations and the way they were negotiated between actors with a stake in the region, including semi-colonialism and world systems analysis. RESULTS: With the dual purpose of preventing damage and enhancing municipal management, the SMC introduced a licensing system permitting the consumption and trade of drugs. However, the anti-opium policies of the late Qing government and the Anglo-Chinese 10 Year Agreement meant SMC had to shut down opium "houses" (opium dens) and "shops" (for the sale of opium to be consumed off the premises). CONCLUSIONS: Over almost a decade, the SMC shifted emphasis from political regulation of a social, recreational practice to maximizing financial benefit. In the process, SMC made full use of the opportunities it gained from a period of ambivalent Chinese and British power relations and local community rule.

Opium in 20th-century Britain: pharmacists, regulation and the people.

AIMS: To indicate how the system of pharmaceutical regulation of the sale and use of opium in Great Britain continued throughout the first half of the 20th century. DESIGN: An oral history investigation of community pharmacy in Great Britain (n = 50), together with an analysis of standard pharmaceutical texts. SETTING: Community pharmacies in Great Britain during the 20th century. PARTICIPANTS: Retired community pharmacists with experience of the sale and use of opium during the period. MEASUREMENTS: Oral testimony of retired community pharmacists about the use and sale of opium, and quantitative analysis of numbers of official preparations of opium available during the period. FINDINGS: The popular use of opium continued well after the First World War, and its use as an ingredient of prescribed medicines continued well beyond the introduction of the National Health Service in 1948. CONCLUSIONS: Although the role of pharmacy in the regulation of opiates and other drugs was displaced by medicine following the passage of dangerous drugs legislation in the 1920s, pharmacists continued to play an important part in this regulation, exercising considerable discretion in the process.

Opium use in Turkmenistan: a historical perspective.

This paper presents a picture of how the patterns of opium use have changed in Turkmenistan over more than 100 years and the relationship between these transformations and formal and informal social controls of drug use. From the late 18th century, when opium use began to become a social problem, informal control weakened. Eventually, in the late 19th century, formal control was introduced, aimed at the prohibition of drug trade and use. From that time, the intended and unintended outcomes of implemented policies led to changes in the demographic patterns of users and the social-medical consequences of opiate use. The anti-drug policies, where criminal prohibition coexisted with strategies aimed at raising the population's general living standards and at providing free access to health care, were effective up to the early 1980s. New political and social-economic realities in the 1980-90s have radically changed the drug scene in the country, with heroin trade and use as the main concerns. The government's reaction, while following the old paths, has included new elements, based mainly on ideas of national consolidation.

Cannabis condemned: the proscription of Indian hemp.

AIMS: To find out how cannabis came to be subject to international narcotics legislation. METHOD: Examination of the records of the 1925 League of Nations' Second Opium Conference, of the 1894 Report of the Indian Hemp Drugs Commission and other contemporary documents. FINDINGS: Although cannabis (Indian hemp) was not on the agenda of the Second Opium Conference, a claim by the Egyptian delegation that it was as dangerous as opium, and should therefore be subject to the same international controls, was supported by several other countries. No formal evidence was produced and conference delegates had not been briefed about cannabis. The only objections came from Britain and other colonial powers. They did not dispute the claim that cannabis was comparable to opium, but they did want to avoid a commitment to eliminating its use in their Asian and African territories.

The price elasticity of opium in Taiwan, 1914-1942.

Between 1895 and 1945, the Japanese colonial government virtually eliminated opium use in Taiwan by licensing and treating existing users, prohibiting sales to others, and raising the price. We evaluate these policies using a two-part model to describe the fraction of the population using opium and consumption among users, and the rational addiction model by Becker et al. (1991). We confirm that opium is addictive and find no evidence supporting the rational addiction hypothesis. Demand is price-elastic with estimated short- and long-run demand elasticities of -0.48 and -1.38. These results have implications for control of other addictive substances.

Chasing the dragon: the cultural metamorphosis of opium in the United States, 1825-1935.

Many things to many people, opium has played a role in the emergence of several power bases in the United States. In turn, these bases of power have shaped what opium is for the rest of us. Allopathic medicine brought opium and its derivatives under its control around the turn of the century, promulgating "addiction theory" and addiction clinics as part of its rise to preeminence among rival forms of medicine. Opium also played a role in the U.S.'s international economic and imperialistic ascendance. When politicians began to deploy a new discourse on opium early in this century, they were able to appropriate medical rhetoric. As the politics of opium heated up, some doctors were able to exploit the emerging politically inspired discourse to generate a subtly different medical knowledge of opiates and addiction while establishing a new subdiscipline with the political support of lawmakers and state institutions.

"Its baneful influences are too well known": debates over drug use in Canada, 1867-1908.

This article examines the debates about drug addiction, as presented by medical and non-medical reformers in Victorian Canada, to explain the emergence of anti-narcotic legislation in the early twentieth century. Most of the studies of drug prohibition in Canada emphasize the anti-Chinese issues surrounding the drafting of the 1908 Opium Act. This study asserts that in order to understand why parliament unanimously accepted this legislation, we must look beyond the issue of anti-Chinese sentiment. It explores the discussions of drug addiction rhetoric. It concludes that the concern over both addiction in Canada and the Chinese in Canada drew upon parallel issues of freedom versus slavery, racial purity, and the need to protect the integrity of a moral and strong nation.

Opium and infant-sedation in 19th century England.

Infant cordials containing opium were commonly used in Victorian England to quieten babies and young children. The cordials were freely available and sold under a variety of brand names. JANET BRIAN describes the slow progress towards legislative control of the sale of opium and its use in infant cordials, in which opposition from the pharmacy lobby and government reluctance to lose income from the lucrative opium trade played a major part.

The political process and its relationship to the psychotherapy of substance misusers: an historical perspective.

There are massive changes underway in the allocation of funds for health care in the United States which will impact upon services provided for users and misusers of intoxicating substances. Recent findings suggest that conditions in the marketplace and the development of professions have effected standards of care rather than a reasoned analysis of need and outcome. Psychologists question to what extent they will be involved in public policy issues including what is clinically and socially relevant. The goal of this paper was to determine if an historical perspective upon federal regulation of intoxicating substances (tobacco/alcohol/drugs) would enlighten the psychotherapy scientist in the pursuit of standards for service. The methodology included a review of the economic and social structure of colonial America which included tobacco plantations, breweries, and distilleries as well as a review of the formation of the federal government and political system in which men, women, and slaves were each assigned different performance standards/roles and economic rewards within the community. The implication is that potential for self-regulation and psychological development is based upon the legacy of our forefathers.