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Come One, Come All: ADHS and Addiction’s “Big Tents”

Updated: Aug 29, 2023

ADHS: The Greatest Show on Earth

This past weekend, the Alcohol and Drug History Society met for its biennial conference at Bowling Green State University. While preparing for my presentation, “(Insert Addiction Here): Twelve-Step Recovery and the Advent of the Addictive Personality,” I spent a lot of time thinking about the growth of the recovery movement since Alcoholics Anonymous. I noticed that by the 1970s several similarly “Anonymous” groups had been established throughout the country, but what really struck me was the number of process or behavioral addictions covered under their auspices. I dubbed the contemporary state of lay and expert addiction theory a “big tent,” since it invited virtually all comers from heroin addicts to compulsive gamblers and overeaters. I thought the shorthand would work for convenience and its clear imagery.

Pitching the tent at ADHS

Pitching the tent at ADHS

But that expanding concept of addiction mirrors the debates gently wracking our enterprise. It turned out that the big tent, in so many words, was a central theme of the conference. As Adam Rathage pointed out, the direction of the field and even what our name should include were hot topics in a plenary panel session featuring some real society heavyweights. Are we studying commodities, altered consciousness, spaces of substance use, the personal consequences of addiction, the social consequences of mass incarceration, all of these or something else? Lots of folks pitched new names for the organization (one gem: the Cheap Thrills History Society), but consensus seemed to rest on fostering a thematic big tent with clear definitions and distinctions provided by individual scholars. From conversations at ADHS and its roundtable reflections posted here, it is clear to me that the idea had conceptual resonance on many levels.

So, I’d like to take a moment to pitch the big tent as originally envisioned. In my view, the post-1960 emergence of “big tent” addiction was a largely the result of a new professional consensus on a more comprehensive theory of addiction, which has undergone substantial change in this century. (David Courtwright lays out this history of “governing ideas” in a 2005 essay, “Mr. ATOD’s Wild Ride.”) At the outset many authorities operated under the “inebriety” paradigm. This idea held that all addicts, regardless of their drug of choice, suffered from a general condition known as inebriety, which made them constitutionally susceptible to chemical dependency. Much debate surrounded whether inebriety was rooted in users’ inherent dispositions or the properties of drugs themselves. By the 1930s, researchers had coalesced around the idea of individual susceptibility. After all, not everyone who used drugs became addicted, a fact played up by tobacco and alcohol manufacturers. The latter found an unlikely ally in Alcoholics Anonymous and its “disease” model ascribing individual powerlessness. But by the 1960s, booze and cigarettes were losing their privileged status as their health risks became publicly known; meanwhile, polydrug use was rising just as scientists were discovering their complementary appeals at the molecular level. If “addiction” was a general condition, not to be divided into discrete iterations by substance, then it stood to reason that processes and behaviors could also trigger or be a symptom of that condition. Subsequent process addiction recovery groups have consistently attested to the theory of addiction’s big tent: Gamblers Anonymous (founded in 1957), Debtors (1968), Emotions (1971), and so many more.

The image of the big tent is cute, but I think it’s also effective. We can learn much from critically considering how “addiction” has been conceptualized in the past by experts and, perhaps more importantly, those living within recovery culture. Trysh Travis introduced several threads to follow in The Language of the Heart, her entrée into that cultural movement. Perhaps mapping the chronology and spatial distribution of new recovery organizations will also allow us to heed Claire Clark’s brilliant conference pitch for increased data visualization and analysis. In any event, my takeaway is that “drug history” is more than a three-ring show, and we want to make sure seats are full.


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