Although the topic of habitual narcotic use first surfaced in the United States during the 1820s, it was not until after the Civil War that it became a subject of widespread public attention. Beginning in the 1870s, an increasingly urgent discussion of what some described as a national epidemic of "drug addiction" could be found in both medical journals and the popular press. Today, nearly a century and a half later, the term is so commonplace we speak of people being "addicted" to just about anything. Yet as Timothy A. Hickman argues in this revealing interdisciplinary study, the meaning of addiction has always been as much cultural as scientific and never fixed. In The Secret Leprosy of Modern Days, Hickman resituates the idea of addiction within its original late nineteenth- and early twentieth-century context. Through close readings of a broad range of literary, medical, and legal texts, he shows how Americans of that era conceptualized the dangers of drug addiction in terms of other preoccupations and fears. Anxieties about the accelerating pace of technological change, the loss of personal autonomy, and the degeneration of society attributed to both foreign influences and a decline of manliness all fed into a widespread sense of cultural crisis—a crisis of which the spiraling "drug problem" was seen as both contributing cause and consequence. Not surprisingly, Hickman points out, deeply held assumptions of class, race, and gender also figured into the popular understanding of addiction. While white middle-class addicts were often depicted as helpless victims of the social and economic pressures of modern life, their less privileged and nonwhite counterparts were regarded as morally weak. Over time the distinction between "addict as patient" and "addict as criminal" came to be accepted by the emerging medical establishment and codified into law, eventually finding expression in the Harrison Narcotics Act of 1914, the first national anti-narcotic legislation in the history of the United States—and the basis for much thinking about addiction and drug policy ever since.

Timothy A. Hickman is lecturer in history at Lancaster University in the United Kingdom.