Public Health and Public Wealth: Social Costs as a Basis for Restrictive Policies

Historically, the most important rationale for coercive public health measures has been the prevention of disease and injury to others. However, as noncommunicable diseases and accidents have assumed increased importance as causes of morbidity and mortality, and as the connection between noncommunicable diseases and accidents and individual practices such as smoking and drinking has become more apparent, a new line of argument based on social costs has emerged. My purpose is both to describe and evaluate the social-costs argument, to explain why it has become so popular, and to show what must be done to make it consistent with its own utilitarian criterion

How Progressive Was Prohibition?

Commentary on Mark Lawrence Schrad, Smashing the Liquor Machine: A Global History of Prohibition (New York: Oxford University Press, 2021) for the Francesco Guicciardini Prize Forum, Cambridge Review of International Affairs, 2023

A Short History of Drug Policy or Why We Make War on Some Drugs but not on Others

Overseas trade and European expansion in the sixteenth, seventeenth, and eighteenth centuries turned psychoactive drugs, including spirituous alcohol and tobacco, into global products. From the beginning, the commerce provoked controversy. Doctors argued about the indications, dosages, and risks of imported drugs. When use spread beyond medicine, the state became involved. Some rulers resorted to mutilation and execution to enforce prohibitions, especially against tobacco smoking. None succeeded in stamping out the novel vice or in suppressing the cultivation of tobacco, which quickly became a global crop. ‘Mankind has found too few comforts,’ wrote historian V.G. Kiernan, ‘to let itself be robbed of them.

The Hidden Epidemic: Opiate Addiction and Cocaine Use in the South, 1860-1920

One of the many memorable characters in Harper Lee\u27s novel, To Kill a Mockingbird, is an aged morphine addict, Mrs. Henry Lafayette Dubose. Mrs. Dubose was a cantankerous widow who lived in Maycomb, a small, fictitious Alabama town. She had been addicted many years before by her physician, who gave her morphine to ease her pain. Informed that she had only a short while to live, she struggled to quit taking the drug, for she was determined to leave this world beholden to nothing and nobody. There were tens of thousands of real-life Mrs. Duboses scattered throughout the postbellum South. With the possible exception of the Chinese, southern whites had the highest addiction rate of any regional racial group in the country, and perhaps one of the highest in the world. At the same time southern blacks had a relatively low rate of addiction, at least with respect to opiates. Blacks, when they used drugs at all, tended to use cocaine. It has been alleged-and heatedly denied-that black cocaine use manifested itself in a major crime wave around the turn of the century. Even discounting these reports, it is apparent that the postbellum South had an unusually severe narcotic problem characterized by racial preferences for different drugs

Mr. ATOD’s Wild Ride: What Do Alcohol, Tobacco, and Other Drugs Have in Common?

All researchers agree that individuals can become intoxicated by and dependent on alcohol, tobacco, and other psychoactive drugs. But they have disagreed over whether, and to what extent, drug pathologies comprise a unitary medical problem. Most critically, does addiction have a biological common denominator? Consensus on this question has shifted back and forth. In the late nineteenth and early twentieth centuries, physicians often studied and treated various drug addictions together, working under the “inebriety” paradigm. By the mid-twentieth century the inebriety paradigm had collapsed. Tobacco and alcohol had split off, both in the medical research community and in western popular culture. This article argues that neuroscientific, genetic, epidemiological, and historical evidence helped to reunify the addiction field in the late twentieth century. A new unifying paradigm emerged, variously called chemical dependency, substance abuse, or simply ATOD—alcohol, tobacco, and other drugs

The Role of Calcineurin/NFAT in SFRP2 Induced Angiogenesis—A Rationale for Breast Cancer Treatment with the Calcineurin Inhibitor Tacrolimus

Tacrolimus (FK506) is an immunosuppressive drug that binds to the immunophilin FKBPB12. The FK506-FKBP12 complex associates with calcineurin and inhibits its phosphatase activity, resulting in inhibition of nuclear translocation of nuclear factor of activated T-cells (NFAT). There is increasing data supporting a critical role of NFAT in mediating angiogenic responses stimulated by both vascular endothelial growth factor (VEGF) and a novel angiogenesis factor, secreted frizzled-related protein 2 (SFRP2). Since both VEGF and SFRP2 are expressed in breast carcinomas, we hypothesized that tacrolimus would inhibit breast carcinoma growth. Using IHC (IHC) with antibodies to FKBP12 on breast carcinomas we found that FKBP12 localizes to breast tumor vasculature. Treatment of MMTV-neu transgenic mice with tacrolimus (3 mg/kg i.p. daily) (n = 19) resulted in a 73% reduction in the growth rate for tacrolimus treated mice compared to control (n = 15), p = 0.003; which was associated with an 82% reduction in tumor microvascular density (p<0.001) by IHC. Tacrolimus (1 µM) inhibited SFRP2 induced endothelial tube formation by 71% (p = 0.005) and inhibited VEGF induced endothelial tube formation by 67% (p = 0.004). To show that NFATc3 is required for SFRP2 stimulated angiogenesis, NFATc3 was silenced with shRNA in endothelial cells. Sham transfected cells responded to SFRP2 stimulation in a tube formation assay with an increase in the number of branch points (p<0.003), however, cells transfected with shRNA to NFATc3 showed no increase in tube formation in response to SFRP2. This demonstrates that NFATc3 is required for SFRP2 induced tube formation, and tacrolimus inhibits angiogenesis in vitro and breast carcinoma growth in vivo. This provides a rationale for examining the therapeutic potential of tacrolimus at inhibiting breast carcinoma growth in humans

“There was something very peculiar about Doc…”: Deciphering Queer Intimacy in Representations of Doc Holliday

This is an Accepted Manuscript of an article published by Taylor & Francis in American Nineteenth-Century History on 8-12-14, available online: http://dx.doi.org/10.1080/14664658.2014.971481This essay discusses representations of male intimacy in life-writing about consumptive gunfighter John Henry “Doc” Holliday (1851-1887). I argue that twentieth-century commentators rarely appreciated the historical specificity of Holliday’s friendships in a frontier culture that not only normalized but actively celebrated same-sex intimacy. Indeed, Holliday lived on the frayed edges of known nineteenth-century socio-sexual norms, and his interactions with other men were further complicated by his vicious reputation and his disability. His short life and eventful afterlife exposes the gaps in available evidence – and the flaws in our ability to interpret it. Yet something may still be gleaned from the early newspaper accounts of Holliday. Having argued that there is insufficient evidence to justify positioning him within modern categories of hetero/homosexuality, I analyze the language used in pre-1900 descriptions of first-hand encounters with Holliday to illuminate the consumptive gunfighter’s experience of intimacy, if not its meaning

Learning from Las Vegas: Gambling, Technology, Capitalism, and Addiction

Gambling has always led to addictive behavior in some individuals. However, the number and types of addicted gamblers have changed over time and in response to specific gambling environments. Recent work by historians, journalists, and anthropologists, reviewed in this paper, suggests that the situation worsened during the modern era, and that it has become worse still during the last half century. Technological, organizational, and marketing innovations have “weaponized” gambling, increasing both the likelihood that people will gamble and that they will gamble compulsively—a phenomenon with parallels to several other consumer products, including processed food, digitized games, and psychoactive drugs