This paper examines the evolution of ideas about narcotic addiction. In the eighteenth and early nineteenth centuries, addiction was not viewed as a medical condition, but as a ‘bad habit’. The contemporary reaction to De Quincey's Confessions demonstrates the general lack of medical involvement. The question of opium eating and longevity, first generated by the Mar case, brought increased medical interest and an embryo connection with the anti-opium crusade. In the second half of the century, addiction was more fully ‘medicalised’ (...) through the profession's involvement in the question of hypodermic morphine and the allied development of a disease theory of addiction. The ‘problem’ of hypodermic morphine owed much to medical perceptions; and the disease theory, too, was not scientifically autonomous. Medical thinking developed in close alliance with moral biases, temperance and anti-opium beliefs. Treatment structures and methods were elaborated in line with increased medical interest. In the early twentieth century there was a distinct move on the part of the government, and the Home Office in particular, to defeat the ‘disease’ view, and to substitute a penal policy. The 1926 Rolleston Report marked not simply a reassertion of the earlier moral-cum-medical emphasis, but a recognition of partnership between doctors and the state in which the limited nature of narcotic addiction at first ensured a liberal reaction. (shrink)

Studying national and local contexts is essential for understanding the ending of epidemics and related policy responses. This article examines HIV/AIDS in the 1980s and 1990s and swine flu in 2009-2010 in the UK as comparative “tracer epidemics” to understand the multiplicity of endings from the perspective of the contemporary history of policy. Such endings can include: the political ending, changes in definition away from epidemic, the medical end, different endings for different “risk groups,” local endings, and media endings. This (...) multiplicity of endings throws light on the nature of political and institutional structures and their change over time. (shrink)