High Culture is a collection of essays containing reflections on addiction. Some of the essays are original and some are reprints. The volume is divided into two sections: the first dealing with literature, philosophy, and the arts and the second with sociology, psychology, and the media. The editors promise something different from the usual “insistent drive to medicalize, discipline, rehabilitate, and contain the subject of drugs within frameworks that disguise deeply rooted moral and religious fears, values and beliefs or prejudices” and that addiction will emerge as something “not reducible to substance abuse or compulsiveness per se” (p 15).

The editors also lay claim to demonstrating the “complexity, creative value and diversity” of addiction in place of what they describe as the limited view shaping most modern research into addiction. The “limited view” they claim, arises out of what they call the “disciplinary rhetorics of medicine, criminology, politics, and social psychology and psychiatry” and results in addiction being perceived as “a socially deviant, unacceptable behaviour” with the addict being “vilified”.

As someone with an interest in philosophy and literature and the concept of addiction, I approached this book with enthusiasm. The introduction whetted my appetite. It also referred to thought provoking ideas such as: the claim that addictive desires are a sign of civilisation or culture rather than being confined to the bare necessities of life (p 2); addiction without drugs (p 7); “Love Junkies” (p 11); the “modern obsession” with “the cure, the fix”, and “the ‘end’ of addiction”(p 12); and “hidden populations” of illicit drug users (p 14).

To some extent, as the editors promise, addiction is presented as something other than irrational action or substance abuse. A range of captivating ideas emerges from the essays such as the suggestion that drugs are what distinguish human beings from all other creatures: “Only for ‘man’ does being-on-drugs matter” (p 114); a connection between addiction and writing (pp 25, 305) or writing as addiction (p 61); and the idea of addiction as a temporal disorder (pp 133–55). There is also an intriguing comparison between the aesthetic experience of music and addiction—the connection being the way that music sets up anticipations by withholding and delaying resolution. The build up of tension and its release creates music that is “more ‘expressive’ and more richly satisfying” (p 51). The implication is that addiction belongs to the realm of culture rather than something to be pathologised.

Unfortunately the ideas referred to are only reflections and are not sufficiently developed. One essay that does deal with the issue of addiction in some depth is Jon Elster’s essay on gambling and addiction—ironically, which this reader had read previously in a collection of philosophical essays on addiction focusing on rationality and action.¹

It might be an exaggeration to say that the editors and the essays in High Culture romanticise addiction but the editors do seem to be adopting the view that there is a link between creativity and addiction or mental illness (p 3):

Who could even imagine the advent of modern literature without the addictive, visionary excesses of writers like Baudelaire, Rimbaud, De Quincey, Poe, Burroughs, Ginsberg, or Artaud; or, for that matter modern culture without its perennial outsiders, its incorrigible addicts, its defaced subjects: the smokers, tokers, overeaters, the alcoholics, the insane and “eccentric,” and so on?

Disappointingly, there is no clear or explicit discussion of this view.

As the title tells us, High Culture is also a reflection on “modernity” but what constitutes “modernity” and its relationship to addiction and to ethics or medical ethics is not clear. Unfortunately there is little in this volume for those interested in medical ethics and the philosophy of addiction. The essays do not have a unified theme. They don’t reflect the ideas presented by the editors in the introduction—that would require a more sustained analysis of addiction. Reflections rather than discussion or analysis seem inadequate to demonstrate the “complexity, creative value and diversity” of addiction. This book promised much but delivered little.