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Substance and Shadow: Women and Addiction in the United States [Hardcover]

Stephen Kandall (Author)
4.5 out of 5 stars  See all reviews (2 customer reviews)


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Book Description

September 1, 1996 0674853601 978-0674853607

In 1989 Jennifer Johnson was convicted of delivering a controlled substance to a minor. That the minor happened to be Johnson's unborn child made her case all the more complex, controversial, and ultimately, historical. Stephen R. Kandall, a neonatologist and pediatrician, testified as an expert witness on Johnson's behalf. The experience caused him to wonder how one disadvantaged black woman's case became a prosecutorial battlefield in the war on drugs. This book is the product of Kandall's search through the annals of medicine and history to learn how women have fared in this conflict and how drug-dependent women have been treated for the past century and a half.

Kandall's sleuthing uncovers an intriguing and troubling story. Opium, laudanum, and morphine were primary ingredients in the curative "powders" and strengthening "tonics" that physicians freely prescribed and pharmacists dispensed to women a hundred and fifty years ago. Or a woman could easily dose herself with narcotics and alcohol in the readily available form of "patent" medicines sold in every town and touted in popular magazines ("Over a million bottles sold and in every one a cure!"). For the most part unaware of their dangers, women turned to these remedies for "female complaints," such as "womb disease" and "congestion of the ovaries," as well as for "neurasthenia," a widespread but vague nervous malady attributed to women's weaker, more sensitive natures. Not surprisingly, by the latter half of the nineteenth century the majority of America's opiate addicts were women.

The more things change, the more they remain the same: Substance and Shadow shows how, though attitudes and drugs may vary over time--from the laudanum of yesteryear to the heroin of the thirties and forties, the tranquilizers of the fifties, the consciousness-raising or prescription drugs of the sixties, and the ascendance of crack use in the eighties--dependency remains an issue for women. Kandall traces the history of questionable treatment that has followed this trend. From the maintenance clinics of the early twenties to the "federal farms" of mid-century to the detoxification efforts and methadone maintenance that flourished in the wake of the Women's Movement, attempts to treat drug-dependent women have been far from adequate. As he describes current policies that put money into drug interdiction and prisons, but offer little in the way of treatment or hope for women like Jennifer Johnson, Kandall calls our attention to the social and personal costs of demonizing and punishing women addicts rather than trying to improve their circumstances and give them genuine help.


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Editorial Reviews

From Library Journal

Kandall, the chief of neonatology at Beth Israel Medical Center in New York and professor of pediatrics at Albert Einstein College of Medicine, traces public attitudes and legal and government policy toward licit and illicit drug addiction, particularly women's addictions, from the mid-19th century to the present. Kandall's thorough combing of clinic records, previous studies, government documents, medical texts, and news accounts yields several conclusions. For example, although public perception and treatment programs have tended to focus on male addiction, women addicts have always made up a significant portion of the addiction population. Kendall finds a link between female sexuality and drug use and demonstrates the inadequacy of past treatment for women. While the first several chapters are slow going, later chapters build on this material to summarize the history of women's addiction, note treatment failures, and suggest alternatives. Kandall makes a significant contribution that will be of interest not only to historians and women's studies programs but to medical and social-service professionals.?Linda V. Carlisle, Southern Illinois Univ., Edwardsville
Copyright 1996 Reed Business Information, Inc.

From Booklist

Taking a historical approach to the problem of women and addiction, Kandall begins by examining the ways in which nineteenth-century physicians overmedicated their female patients. He also traces society's changing attitudes toward drugs, from general tolerance to the beginnings of antidrug legislation shortly before World War I. From the "classic era" of drug enforcement in the 1920s, through World War II and its aftermath, into the drug culture of the 1960s, and up to the present day, Kandall traces the evolution of a national drug policy, examines the link between drugs and crime, surveys the kinds of drugs that were prevalent, and discusses treatment options. He is also careful to point out that, though illegal drugs tend to get the most publicity, there is continued abuse of legal, prescription drugs as well. This careful, well-documented survey will be of special interest to anyone seeking a historical perspective on the complex problems of women and drugs. Mary Ellen Quinn

Product Details

  • Hardcover: 368 pages
  • Publisher: Harvard University Press (September 1, 1996)
  • Language: English
  • ISBN-10: 0674853601
  • ISBN-13: 978-0674853607
  • Product Dimensions: 9.5 x 6.5 x 1.1 inches
  • Shipping Weight: 1.4 pounds
  • Average Customer Review: 4.5 out of 5 stars  See all reviews (2 customer reviews)
  • Amazon Best Sellers Rank: #2,764,644 in Books (See Top 100 in Books)

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4.0 out of 5 stars substantial and well-referenced, July 28, 2010
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The author is a renowned neonatologist, and this book is scholarly, filled with references.The author talks about the paternalistic methods of physicians in previous centuries, and how their attitudes increased the risk for female addiction to opioids. He traces the history of drug policy in the U.S., paying special attention to how the policies affected female addicts in particular. This is heavier reading than many other books about women and addiction, but full of detail and moderately interesting.
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5.0 out of 5 stars Substance and Shadow: Women and Adduction, January 11, 2007
Phenominal historical view of the woman's experience with addiction. A detailed view of addiction to include all substances. Great for a text in a class or for personal knowlwdge. Fantastic book.
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Key Phrases - Statistically Improbable Phrases (SIPs): (learn more)
black female addicts, drug maintenance clinics, female opiate addicts, female narcotic addicts, lifetime prevalence use, female heroin addicts, drug use trends, addicted women, pregnant addicts, female addiction, iatrogenic addiction, methadone treatment programs, opium habit, drug treatment clinics, female drug users, opium users, addicted population, treatment slots, maternal drug use, one addict, opiate use, drug detoxification
Key Phrases - Capitalized Phrases (CAPs): (learn more)
New York Times, United States, National Institute, San Francisco, Harrison Act, Fort Worth, Des Jarlais, Department of Health, Federal Bureau of Narcotics, Susan Lydon, Los Angeles, National Commission, Odyssey House, American Medical Association, Florrie Fisher, Harry Anslinger, Fiscal Year, New Jersey, New Orleans, Beth Israel Hospital, Bingham Dai, Fitzhugh Ludlow, Horace Day, Second World War, Teen Challenge
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