Abstract

This paper examines how cultural, scientific, and political understandings of addiction in the United States have shifted over time, arguing that systems of punishment have consistently overshadowed care. Using a historical-sociological approach, it draws on texts such as Carl Erik Fisher’s The Urge (2022) and Johann Hari’s Chasing the Scream (2015) to analyze how narratives of addiction have been socially constructed and mobilized to justify policy. By incorporating recent public health data, the paper positions addiction not only as biological dependence but also as a condition shaped by inequality, trauma, and systemic neglect. The analysis shows that early U.S. drug policy was driven more by racial and moral panic than by medical concern. The Harrison Narcotics Act of 1914, Harry Anslinger’s campaign against marijuana and jazz culture, and the later War on Drugs each reframed addiction from a matter of care to one of control. These policies embedded stigma by reducing complex human suffering to labels such as “addict” or “junkie,” reinforcing social hierarchies around whose pain is recognized and whose is criminalized. Despite advances in research, treatment, and harm reduction, these punitive logics persist. The opioid epidemic, for instance, reflects both corporate influence and class-based inequities in response and care. Ultimately, this paper argues that the United States has historically punished pain rather than addressed it. It calls for a shift from criminalization to education and social recovery, proposing addiction education across schools, healthcare systems, and communities as a means of reorienting public health toward collective care and a more equitable understanding of suffering.

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