Drug History Canada

Musings on the history of drugs in Canada.

Tag: drug regulation

Good drugs and their bad tendencies

After several decades of working on this (ok, worked on it in the 90s then took some time away) my book, When Good Drugs Go Bad: Opium, Medicine, and the Origins of Canada’s Drug Laws has been released.

You can order a copy of the hardcover here.

And for reference, here is a picture of the cover.  Below I will tell you more about it.

Malleck - Good drugs - cover image

In this book I look at the origins of Canada’s drug laws, the century or so before the creation of the Opium Act, 1908, and the Opium and Drugs Act, 1911.

My main question was simple: where did the idea come from that some drugs were bad and needed to be regulated. It may seem simplistic, but beneath this question are a bunch of related issues: Why is addiction considered a problem?; what is wrong with recreational drug use? How did the idea that government should be involved in the regulation of drugs come about?

These may seem odd questions, but they really are fundamental to our understanding of current debates over drug laws and drug use.

For example, we seem to have this idea that recreation is an illegitimate application of chemicals.  That is, you can take drugs for pain killing, to heal, to allow children to focus, to reduce coughs, and to get rid of the sniffles, but once you enjoy them purely for the sake of enjoyment, you are misusing drugs.

Here we get this idea of “drug abuse” which is linguistically connected to things like child abuse and spousal abuse, but in this way we’re really considered to be abusing ourselves by using drugs in a way other than one medically acceptable.

Why was medicine the only legitimate use of such substances?  How did physicians get that kind of power?  Why are pharmacists the ones who should be managing the sale of drugs?

The book takes a long view, stretching back to pre confederation, to look at the various uses of drugs, and the different ways that people began to suggest there are legitimate and illegitimate uses of them. It traces the creation of provincial pharmacy laws, which I argue are Canada’s first drug laws.  Here the idea emerged that the trade in certain substances should be governed by small groups of educated men rather than allowing the free market to do its thing.  Once you establish the idea that some things should be controlled by government pronouncement, and you deputize groups of professionals to do the controlling, that scope of control can be broadened. The idea of controlling drugs that could kill you broadens to include controlling drugs that could hurt you. Then the idea of “hurt” expands to include not just maim or debilitate, but perhaps just make you need them all the time (habituation, or addiction).

It’s a complex story, and one that needed to be told for Canada.

I hope you enjoy it. Buy multiple copies.  Christmas is coming, after all!

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Why do pharmacists control access to certain drugs?

I had a student who is diabetic come to speak to me today, and in the meandering way conversations I get into with students go (usually my fault), she ended up asking the rhetorical question “why do I have to get my insulin from a pharmacist?”

It is a good question.  As I noted in the last post, the issue of the “dangerous”ness of drugs drove the construction of control of access to some drugs.  But what about insulin?  It’s not addictive; it’s not really poisonous (at least no less so than non-drugs you could surreptitiously administer and kill someone, like antifreeze) and it’s an essential substance for some people to receive artificially.

To be honest, I’m not sure.  I told the student that she could do a directed reading with me and we could explore the idea. I love it when I have motivated students like that, and questions I can’t answer.

I do have some guesses, though.  They are really nothing more than suppositions based upon my thin knowledge of the process

  1. Insulin, when it was first isolated, was relatively difficult to get your hands on.  Controlling access through a pharmacist or doctor would allow its use to be judicious.
  2. Controlling access to insulin was easy to justify because diabetes itself had to be diagnosed.  Without such a diagnosis, you’d not know you had diabetes. So there was no real way to self-diagnose, and no need in the market to have it available for over the counter sale.
  3. By the time insulin had been isolated and seen to be an important medical tool, the idea of expanding medical jurisdiction over access to such technology was sort of a given. Maybe it was just natural that new important substances like insulin would be available only by prescription.
  4. It made it more expensive. Big pharma loves something that makes drugs more expensive (I doubt this was the case).
  5. It needs to be injected, which makes the hormone insulin need to be administered by docs.  See #2.
  6. None of the above
  7. Many of the above.

I really have no idea.  I will look into it though.  It’s a compelling thought, and will fill out the complexity of my narrative on the relationship between legislation that controls access to medicine, and the authority and social role of the medical industrial complex.

Interested in this question?  Have some ideas?  Post a response.  Share thoughts.  I have to come up with a reading list at some point, so you’d make my job a lot easier.

Your responses are copyright: you.

My post is (c) Dan Malleck. 2012.