A review of The Administration of Addiction: The Politics of Medicine and Opiate Use in Soviet Tajikistan, 1924-1958, by Alisher Latypov.
Alisher Latypov’s dissertation breaks significant new ground in assessing an important and sensitive topic in modern Central Asian history. Despite what the title suggests, the research does not only address Tajikistan but also brings other Soviet Central Asian republics into the picture. During the Soviet state’s period of existence, the Party and the government exhibited a strong will to fight the consumption of opiates. The Bolshevik authorities presented their use as the persistence of ‘tradition’ and cultural backwardness on the USSR’s Asiatic periphery. However, the fight by Soviet and post-Soviet authorities against addiction never fully succeeded. During the Soviet era, the only policy in place was that of “social prophylaxis”, which consisted of isolating drug users from the rest of society. Alisher Latypov brilliantly presents the social history of medical policies with respect to use of opiates in Soviet Tajikistan from 1924 (the date of creation of the Socialist Soviet Republic of Uzbekistan, which was split in two parts when the Tajik SSR was created in 1929) to 1958, the key date for formation of post-Stalinist anti-drug and anti-alcohol measures.
The dissertation is constructed around six very well-documented chapters. The work is enriched by numerous illustrations, and is based on an impressive corpus of sources, the bulk of them retrieved from archives of difficult accessibility in Moscow and Central Asian repositories. In addition, this excellent historical work is served by Alisher Latypov’s very fine knowledge of addiction policies and drug control, and his empathy for the topic.
The first chapter recalls the modern history of drug use in Central Asia, a topic consistently overlooked in scholarship devoted to the region. The author focuses on numerous historical writings produced in the 1920s and 1930s by various figures of Soviet psychiatry, and analyses the ideological context in which they were written. Alisher Latypov underlines the importance of first-hand sources, which were made available during the glasnost years. These newly retrieved sources reveal the extent to which the history of drug production in the 1930s was distorted by Soviet authors compelled to show the victory of socialism in this particular battlefield. In this respect, Alisher Latypov shows how vertical power played a central role in the repression of drug users and the subordination of the medical establishment, the security services and the ideologists of the Communist Party as part of this repressive process (p. 64).
In the second chapter, the author deconstructs very finely one myth of addiction by showing that many drug users were in fact “non-native” Russians and Europeans living in Central Asia, challenging the notion that the ‘East’ was under the influence of narcotic substances. According to the author, “this myth serves the dual purpose of reinforcing the image of the ‘addicted’ Orient, which speedily inculcated ‘hashishism’ upon Russia, and of dramatically magnifying the ‘anti-drug’ achievements of Soviet ‘narkomats’ in freeing Central Asians from their ‘pernicious vice’” (p. 106).
Here the author returns drug addicts (narkomans) to the power structure in charge of categorizing, repressing, and treating them – the People’s Commissariats or narkomats. He thus incisively evokes the “making of narkomans by narkomats” to identify the state-drugs nexus, and how questions of addiction were dealt with at the state level (p. 115). State institutions were therefore simultaneously involved in the creation of drug addiction (narkomaniia) and its subsequent repression, and the crucial role played by the medical establishment in the prescription of addictive substances is underlined. Furthermore, the author opens a new door by showing the importance of opium and morphine addiction among Soviet physicians and health personnel, and their role in the diffusion of narkomaniia. Morphinism was perceived in the 1920s as an occupational hazard, another of the many paradoxes of Soviet policies. The medical establishment was not the only drug user as members of the security services, the army and the higher administration were also ranking high in the scale of drug addiction.
The ideological construction of narkomaniia was also directed against traditional practitioners, the tabibs, a category of traditional healers who used opiates for centuries within a precise nosographic scheme. The fight against “tabibism” is the focus of the third chapter of this dissertation. The author shows how the Party presented the tabibs as the main culprits of opium addiction, since they recommended these drugs under various forms to the population. Alisher Latypov comes back very rightly on the history of the tabibs, and their role in Central Asian societies since the early colonization of the Tsarist era. With respect to the treatment of opium drug addiction, the tabibs were inspired by Ibn Sina’s heritage, and the authors recall the incomparable richness of traditional medicine in Central Asia, based on this very syncretic scientific corpus.
An ensuing question is if Soviet physicians actually succeeded in finding better treatments against narkomaniia. This key issue is addressed in the fourth chapter, which deals with the various approaches to the treatment of drug addiction in the Soviet health system. The chapter lists the various treatments used in Soviet psychiatry against drug addiction, and details the divergence between clinical psychiatry and “social prophylaxis” until the state outlawed the latter. As a consequence, the narkodispensers created in the 1920s initially as separate entities from the psychiatric hospitals would be later incorporated in the early 1930s. The change in paradigm under Stalinist rule led to classifying the narkomans as “anti-social”, “abnormal” and “non-productive”. However, massive consumption by Soviet soldiers during World War II would force a major shift in Soviet representations of opiate use.
The fifth chapter describes the Soviet project of drug prevention in Tajikistan. This project included the creation of “red teahouses”, the role of which was to educate people to the Soviet social order, in the logic of the transition to socialism. The author shows how the Bolsheviks had developed new forms of teahouses. By closing the opium and hashish dens the Soviets hoped to quickly resolve the problem, but this would prove unsuccessful as the policy naively underestimated the strength of ancestral traditions and the deeply-rooted social practices of local populations. Even if this initiative failed, in the 1940s and 1950s the Soviet authorities declared these social diseases to be eradicated. The propaganda turned towards the fight against infectious and parasitic diseases, infant and maternal mortality, and to a lesser extent against alcoholism. The problem of drug addiction was largely ignored or seemingly postponed to a later date.
At the end of his dissertation, Alisher Latypov raises a question of vital importance regarding our understanding of the administration of addiction in Soviet Tajikistan. If the overwhelming majority of opiate users were left untreated and if ‘cultural and sanitary enlightenment clubs’ did not deal specifically with the prevention of the consumption of narcotics among the local population, how, in fact, did the Soviet authorities eliminate drug addiction in Tajikistan?
This question is addressed in the last chapter, geographically focused on the Pamirs (administratively reshaped as the Gorno-Badakhshan Autonomous Province), one of the most geopolitically critical areas of Tajikistan. By crossing various sources, the chapter puts in perspective the issue with the pre-Soviet history of opium consumption, addiction, and trade in this key region of the nineteenth-century “Great Game.” He also recalls the difficult attempts at prohibiting drugs during the Tsarist era, and shows that in fact the Soviets were not more successful atne not more successfu;e ‘on madrces in central Russia (Moscow), in addition to other republics. drug control. The author scrutinizes the way the government pretended to have eradicated opium addiction, at least in official discourse, while the programs put in place remained largely ineffective. The war against opium ended with the terror years of Stalinist repression, while the biomedical response put in place in the Pamir during the 1930s remained embryonic. During the 1940s, the war strained the Soviet economy and reframed budgetary and political priorities: the fight against social diseases evolved towards other pathologies, especially those threatening the productivity of Soviet workers.
Alisher Latypov’s dissertation is a major achievement, and an important contribution to histories of medicine and drug addiction. It fills an important gap in the literature, since ideas about drug consumption in post-Soviet Central Asia are too often constructed on false premises and ignore the historical dimension of the problem. This dissertation provides useful keys to better understand the contemporary phenomenon of drug addiction in a region which is currently crucial for global narco-trafficking. The topic is all the more important, since in former Soviet countries anti-addiction programs are still undermined by an ideological approach partially inherited from their Soviet past. This framework informs policies which are instrumental in criminalizing drug users and stigmatizing them as non-productive social parasites.
Centre for Russian, Caucasian and East-European studies, (CERCEC/CNRS/EHESS, Paris)
The Central State Archive of the Republic of Tajikistan
The Party Archive of the Institute for Political Research of the Republic of Tajikistan Communist Party Central Committee – (PAIPI TsK KP RT)
The Archive of the Republican Clinical Psychiatric Hospital No. 1, Rudaki District, Republic of Tajikistan
The Russian State Archive of Social and Political History (RGASPI)
The Russian State Archive of Contemporary History (RGANI)
University College London. 2011. 342 pp. Primary Advisor: Guy Attewell.
Image: Tabib Treats His Patient Through Bloodletting Performed on the Head by Means of a Horn. The Tajik SSR, 1920s.