------- Forwarded Message Follows -------
Date:          Fri, 14 May 1999 09:27:32 -0500
Reply-to:      Kettil Bruun Society <[log in to unmask]>
From:          Richard Wilsnack <[log in to unmask]>
Subject:       Re: Less publicized tragedies...
To:            [log in to unmask]

        At 07:33 PM 5/11/99 -0400, Stanton Peele wrote:
>Dr. Wilsnak, do you make this out to be a "alcohol is bad" story, or a
>"making people drink illegal, uncontrolled alcohol is bad" story?  In
>othere words, control alcohol more, or permit more alcohol?<

        The story about mass poisoning in Bangladesh, apparently from
drinking alcoholic beverages containing methyl alcohol, did not prompt
either of those reactions. My reaction was more to the "who cares?"
aspect, and the past (and probably future) responses of officials
hypothetically responsible for preventing such tragedies. The story
reinforces my beliefs in three ideas, arranged here from the most to
the least obvious:

        (1)  The more simplistic (unqualified, undifferentiated) that
policies are for controlling other people's substance use, the more
(additional) problems they cause. Where alcohol is supposed to be
completely forbidden (e.g., in conservative Islamic regimes), victims
of illicit alcohol sales/use get little help. In the US, policies
forbidding chronic/dependent opiate use mean that users cannot be
given clean needles (thus spreading HIV), and patients in chronic pain
cannot be allowed to have enough painkilling medication.

        (2) Drug policies serve the interests *and* the ideologies of
those groups with the power to create and enforce those policies, and
not the interests or ideologies of people who lack such power. The
Bangladesh bureaucrats do not *have* to do anything about poisoned
consumers of illicit alcohol, unless and until the social groups most
adversely affected can mobilize in ways that make government inactivity
sufficiently costly or embarrassing for the bureaucrats. Over here, the
DEA is still a big expensive organization, without any political or
fiscal accounting for its cost-effectiveness.

        (3) The recognition of substance use patterns as "problems" that
need counteraction is affected not only by social *construction* but also
by social *indifference*. If *indifference* to a particular pattern of
substance use is rooted in popular culture and in social structures, this
will impede any efforts to get that use pattern recognized and dealt with
as a "problem." If most people in and out of Bangladesh *don't care* about
poisonings from illicit alcohol, the poisonings will continue and recur.
Consider how long any concerted social action against drunk driving was
delayed in the US. The creation and reinforcement of collective indifference
may have just as much impact on the construction of "social problems" as
the creation and reinforcement of collective outrage.

        Those are some of the messages I get from the Bangladesh poisonings.

Richard W. Wilsnack
Department of Neuroscience
University of North Dakota School of Medicine & Health Sciences
Grand Forks, ND  58202-9037
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