Getting High in the CAGE

by S.M. Asiedu

The Medical Disease Model of Addiction is a Patriarchal and White Supremist ideology that covers up genocide and cultural destruction perpetrated on indigenous people and others affected by intergenerational oppression and poverty. 

According to Jean Kinney (2009), writer of “Loosening the Grip: A Handbook of Alcohol Information” (a well know and award winning addiction textbook), the disease model was created in reaction to the moralistic conception of addiction (p.82).  Kinney (2009) states that the disease model allowed people that were struggling with alcoholism to be treated with more sympathy (p. 82).

Sick people generally are awarded sympathy.  The accepted notion is that sick people do not choose to be sick… Society agrees that care should be provided to restore health.  During the period of sickness, people are not expected to fill their usual roles or met their responsibilities.  A special designation is given to them – that of patient.  Furthermore, sick people are not to be criticized for manifesting the symptoms of their illness. ..No longer the object of scorn, the individual with alcoholism is seen as requiring care.  The logical place to send the alcoholic is a hospital or rehabilitation facility, instead of jail. (Kinney, 2009, p.83). 

Ironic, because our jails are full of “addicts”. We are housing jails and prisons full of “sick people” (Kinney, 2009, p.83).  More than 400,000 people that are currently incarcerated in the United States have been diagnosed with a mental illness, according to the National Alliance on Mental Illness (as cited by Ford, 2015, n.p.).

According to scholar Joanne Woiak (1998), the concept of alcoholism being hereditary is rooted in the Edwardian Eugenics Movement which resembled earlier Eugenics movements in France and Brazil that were used for “improving racial health” (p. i).  I note this because there is a striking resemblance to our modern day, status quo discourse on mental health, addiction and the Criminal Justice System.

For these eugenists the "environmental" sources of ill health in the working classes thus did not refer to poverty and adequate diet, as would later be emphasized in more left-wing interpretations of environmentalism. Edwardians social reformers and eugenists tended to highlight personal failing, especially in the form of ignorance and bad habits such as alcoholism was the more easily remediable sources of infant mortality, physical deterioration, and racial decline.

Woiak, 1998, p. viii

Kinney (2009) also notes criticism towards medical professionals being indifferent, or unqualified to deal with addiction (p.85).  From what I have witnessed through my internship at the Suffolk County Office of Community Corrections in Boston as the Female Treatment specialist, psychiatrists generally know little to nothing about substance abuse, since they constantly prescribe cocktails of benzodiazepine, zanex, Neurontin and anti-depressants to people in early recovery from heroin addiction after their first appointment without referring them to counseling.  What medical professionals should be more concerned about is caring for the bodies of people that have been neglected for years during their addiction.  This is also because their addiction brought them away from health services, on the street and in jail.  There should be more attention brought to the long-term effects of hepatitis c, malnutrition and dental neglect.  People that have lived on the streets have forgotten how to care for their bodies, and no one else seems to care.  How they feel about their bodies is so important in their recovery, self-care, feeling their bodies again after years of neglect and trauma.

Although Kinney (2009) does admit that “by locating the problem in diseased brains, it is possible that we can lose sight of the social conditions and environmental factors that foster the use of addicting substances” (p.85), nowhere in her book does he mention oppression, sexism, racism or classism. Kinney (2009) “current thinking’ about alcoholism including “learning theory”, “Rational addiction”, “Expectancies”, “temperament”, environmental-sociological factors including “cultural orientation”, but in no place does Kinney (2009) discuss alcoholism in relation to oppression or trauma (p.131).


Canadian psychologist, Bruce K. Alexander, conducted the “Rat Park” experiment in the late 1970’s (Alexander, 2015, n.p.). The rats that were confined to a cage became addicted. When rats were introduced to an open environment where they had choices, almost all of them stopped using, despite the withdrawal.  (Alexander, 2015, n.p.). This research was brought to my attention when reading “High Price”, by Dr. Carl Hart, the first tenured Black professor of neuroscience at Columbia and member of the National Advisory Council on Drug Abuse. Hart (2013) conducted a human study with people that used crack cocaine daily.

The “dislocation theory of addiction” came as Alexander’s (2015) response to the world wide growth of addictive behaviors:

The word “dislocation”, in this view of addiction, refers to the absence of sustaining connections between a person and his or her family, friends, society, traditions, nation, and gods. Dislocation does not necessarily imply geographic separation. Rather, it denotes a psychological and social separation that can befall people who never leave home, as well as those who are continents away. I have described dislocation in social terms, but it has crucial psychological aspects too, including the disconnection of people from their identities, values, feelings of personal power, overall sense of well-being, and sense of spirituality.

Severe, prolonged dislocation entails unbearable despair, shame, emotional anguish, and bewilderment. It regularly precipitates suicide, [xxii] depression, and less direct forms of self-destruction.[xxiii] This is why forced dislocation, in the form of ostracism, excommunication, exile, and solitary confinement, has been a dreaded punishment from ancient times until the present. Solitary confinement is an essential component of the modern technology of torture.[xxiv]


It is not the drug, it is the perceived and real choices that people, (or  rats), have.  Perceived choice in humans is something very social as it is learned from an early age. For example, when you are growing up in a patriarchal household as a woman, you may learn that your choices are very limited. This may not be real, but it is your perceived choice.  When you are oppressed, when you do not feel you have choices, then why not try something that will change your mood. If you can’t change your environment, when you are imprisoned, why not get high?




Alexander, B.K., Coambs, R.B., & Hadaway. P.F. (1970). “The Effect of Housing and Gender on Morphine Self-Administration in Rats”,  Psychopharmacology 58:175-79


Kinney, J. (2009). Loosening the Grip: A Handbook of Alcohol Information.  McGraw-Hill Humanities/Social Sciences/Languages; 9 edition 

Woiak, J. (1998).  DRUNKENNESS, DEGENERATION, AND EUGENICS IN BRITAIN, 1900- 19 14, Institute for the History and Philosophy of Science and Technology University of Toronto, retrieved from your paragraph here.