August 21, 2019
Drugs and stigma: a short history
The reasons a given drug becomes classified as legal or illegal are complex, in part because the criminalisation of some drugs has been influenced by the harms of the drug, as well as economic and political decisions.1
Historically, how a drug has been regulated – or not – has depended on the era, location and context of that drug.
Over time, most psychoactive drugs have become controlled substances, resulting in both expected and unforeseen outcomes. For example, the criminalisation of certain drugs in Australia and internationally has contributed greatly to the stigma experienced by the people who use them.
While one article cannot adequately explore all attitudes towards drugs in Australia today, looking at some key historic events can help unpack the complexity behind why some drug use is so stigmatised.
The international opium trade
During the 19th century, there was an expansion of opium trade internationally.2 A large portion of this trade was driven by British colonists who were manufacturing opium in India and selling it to China.3 This trade was a huge source of revenue for British authorities - however it was causing widespread use and dependence in China.3
The Chinese government was concerned about the increase in opium dependence and sought to cut off the trade, however British authorities did not want to lose their expanding revenue and refused.3 As a result, a four-year conflict began between the two nations, known as the ‘The Opium War’.3
Britain’s persistence with importing smoking opium in China was, in part, responsible for the introduction of smoking opium in Australia.2 During the 19th century, many Chinese immigrants were arriving in Australia for labour and work in the goldfields, some bringing smoking opium with them.2,3
During this time, there was no control over the sale or advertising of drugs in Australia. Although smoking opium was only used by a small section of the Chinese community, reports at the time described drug use and overdoses as increasing.3
Criminalisation in Australia
Opiates were used by members of both European and Chinese communities, however there were specific racially-biased fears around the importation and use of smoking opium by Chinese immigrants and the operation of so-called ‘opium dens’.3
These fears dovetailed with a backlash from Europeans over an increase in Chinese immigrants during a period of recession in Australia, contributing to the existing political and economic-based fears fuelling the growing hysteria surrounding the Chinese community.2,4
It wasn’t until 1905 that states began passing legislation prohibiting the sale, manufacture, possession and use of smoking opium.3 While these laws were applicable to everyone, they had the greatest impact on Chinese immigrants who more commonly smoked opium, while many Europeans were known to typically use other forms of opiates such as pills, tablets and tinctures.4
This legislation can be understood as contributing to a climate of racism, where smoking opium was used as a symbol of difference between cultures.4
Drugs, and the laws that regulate them, are not only about the specific drug in question. Drugs have been used in different times and places as ‘metaphors of social breakdown and social change, with particular racial resonances’.4 As an international example, the United States increasing restrictions on cannabis throughout the 1900s were linked first to racist fears toward Mexican immigrants then later to African-Americans, and by the 1960s and 1970s to the counter-culture, including anti-war activism.5
The complexities of the political, economic and social issues that become tied up with drug law make it difficult to identify all the forces at work and form a simple picture of decision-making.
Legislation aside, the use of drugs, including opiates, remains a public health challenge.
Post-World War I
By 1914, Australia had regulated the importation of ‘medicinal’ opium, morphine, heroin and cocaine to ensure that these drugs were used only for medical purposes.3
Despite these regulations, opiate use in Australia increased after World War I. Medical corps were increasingly prescribing opiate painkillers to servicemen, which led to some veterans returning with a dependence on ‘medicinal’ opiates.3 As a result, some chemists continued to illegally supply war veterans with prescriptions, leading to police raids and arrests.3
It became clear to the broader community that opiate use could no longer be solely associated with the Chinese community.3 A noticeable language shift in the press surfaced and drugs were now divided into two categories, either for legitimate ‘medical use’ or for ‘illegal use’, with illegal drug use being associated with ‘immorality, criminality and danger’.3
This language shift serves as a historical example of how some people, and some drugs, have been stereotyped and characterised as dangerous and immoral in the media.
What can be done to reduce stigma?
Stigma results from a process of labelling, judging and stereotyping.
Unfortunately, the stigma associated with alcohol and other drug use continues to have a significant negative impact on Australians who use illicit drugs or experience a dependence on alcohol and other drugs.
While exploring the complex reasons drug use has become so stigmatised is important, it is even more important that action is taken to address the harms caused by stigma. The next instalment of this series will focus on what can be done to reduce stigma in Australia.
- Nutt DJ, King LA, Phillips LD. Drug harms in the UK: a multicriteria decision analysis. The Lancet. 2010 Jan 1;376(9752):1558–65.
- Hamilton M, King T, Ritter A. Drug Use in Australia: Preventing Harm. 2nd ed. South Melbourne. Oxford University Press. 2004.
- Rowe J. Pure politics: a historical look at Australian drug policy. Alternative Law Journal [Internet]. 2001 [cited 2019 Jun 18];(3):125.
- Manderson D. Symbolism and racism in drug history and policy. Drug and alcohol review. 1999 Jan 1;18(2):179-86.
- Adrian M. What the history of drugs can teach us about the current cannabis legalization process: Unfinished business. Substance use & misuse. 2015 Jul 29;50(8-9):990-1004.
- Paquette CE, Syvertsen JL, Pollini RA. Stigma at every turn: Health services experiences among people who inject drugs. International Journal of Drug Policy. 2018 Jul 31;57:104-10.
- Conrad S, Garrett LE, Cooksley WG, Dunne MP, MacDonald GA. Living with chronic hepatitis C means you just haven't got a normal life any more'. Chronic Illness. 2006 Jun;2(2):121-31.
- Cama E, Brener L, Wilson H, von Hippel C. Internalized stigma among people who inject drugs. Substance use & misuse. 2016 Oct 14;51(12):1664-8.
- von Hippel C, Brener L, Horwitz R. Implicit and explicit internalized stigma: Relationship with risky behaviors, psychosocial functioning and healthcare access among people who inject drugs. Addictive behaviors. 2018 Jan 1;76:305-11.