Factors Affecting Alcoholdrug Epidemics

Numerous factors contributed to the development of substance abuse "epidemics" or "plagues." One of the first of these, the gin epidemic (which involved other alcohol-containing beverages besides gin) in late 17th- and 18th-century England, was fostered by the following factors:

• English merchant ships returning empty from trips to its colonies loaded on gin, rum, and other alcohol-containing beverages as ballast before returning to England.

• Rum was derived from sugar cane grown with slave labor, and gin was from grains grown with indentured labor. With no import tax, calories of these alcohol-containing beverages were literally cheaper than calories of bread in London.

• The beginnings of the Industrial Revolution gave rise to repressive social conditions and a loss of traditional rural values, fostering widespread drunkenness with inexpensive beverage alcohol.

• Although traditions and social controls existed for the drinking of mead and ale, these traditions and controls did not extend to gin and rum drinking, with the result that daily excessive drinking appeared.

During this period, numerous sequelae of alcoholism were first recognized, including the description of the fetal alcohol syndrome (Rodin, 1981). The gin epidemic raged for several decades, perhaps as long as a century. It eventually receded under such pressures as an import tax on imported alcohol-containing beverages, anti-alcohol propaganda in the literature and art of the day, and evolution of abstinence-oriented Protestant sects for the working classes.

The opium epidemic in many countries of East and Southeast Asia began about the same time as the European alcohol epidemic. Several factors, some similar to the European situation but others different, contributed to the opium epidemic:

• Tobacco smoking was introduced to Asia from the New World; it became a popular pastime in smoking houses that were frequented by the artisans, artists, adventurists, and literati of the day.

• As European and New World concepts and artifacts flooded into Asia, tobacco-smoking houses were viewed as places of cultural change and even political sedition; they were gradually outlawed.

• Opium eating, primarily a medicinal activity that had never been a significant social problem, was combined with this new technology (i.e., drug consumption by volatilization and inhalation); recreational opium smoking subsequently became widespread.

• Political corruption, government inefficiency, and absence of statecraft skills to deal with widespread drug abuse, abetted by the political and economic imperialism of Western colonial powers, led to centuries of widespread opium addiction among various Asian nations. Some countries have reversed the problem in this century (e.g., Japan, Korea, China, and Manchuria); others have not (e.g., Thailand, Laos, Burma, Pakistan, Afghanistan, Iran, and India).

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