How to Treat an Addict: 

Institutional Confinement, Mutual Aid, and Self Realization in Postwar Los Angeles 

Jordan Mylet 

University of California, San Diego

Abstract: Responses to drug addiction in the twentieth-century United States are typically characterized in one of two ways: medical or criminal. Even more nuanced approaches tend to invoke these binary categories. This conceptualization obscures the fact that both approaches share a common logic of focusing on the individual addict and calling for her removal from society for the purposes of treatment. It also elides the extent to which public health and criminal justice authorities have relied on each other to implement a state-backed addiction treatment program. This article focuses on the life of a self-identified heroin addict, Betty Beckham, in 1950s Los Angeles to illustrate the limitations of this binary framework and point towards more generative analytic frames. 

Image of a black woman crouching
Betty Beckham

When Betty Jean Beckham, a Black thirty-seven-year-old woman, arrived at the beachside storefront of Synanon House in July 1959, she had been using heroin for nine years. It took one year after her first heroin “fix” for Beckham to consider herself addicted. Over the course of the 1950s, Beckham was sentenced to jail three times and committed to two government hospital facilities, a federal hospital-prison in Lexington, Kentucky, and a California state mental hospital. Though Beckham wanted to stop using heroin, she did not believe that medical experts or law enforcement officials could help her achieve that goal—a conclusion she made based on her disheartening encounters with both groups. In fact, when she first heard about “a little place down on the beach called Synanon” where “addicts were trying to help themselves,” she worried that it was a trap. She might show up, expecting “something new,” and instead be funneled into “another kind of hospital or some kind of treatment center, clinic, or something.”  

Beckham quickly realized that Synanon was not like anything she had experienced before. The night that she walked into the storefront, she saw men and women sitting on bare mattresses and “ragged couches,” visible only by candlelight, “quoting concepts and books.” Beckham moved in the next day, joining Synanon’s forty-person community. “They put me on one of the couches to kick,” she recalled, “It was a weird scene… I think I stayed those first two or three days just out of total fascination. I was sick as a dog, I was going through the usual withdrawal symptoms, but I was just fascinated.” Over the following weeks, Beckham slipped into the patterns of the group’s daily life.She helped hose down house furniture on the boardwalk and empty out the ashtrays full of the remnants of residents’ constant smoking. In the afternoons, she joined the others on the beach to read the latest book being passed around—Erich Fromm’s The Art of Loving or the essays of Ralph Waldo Emerson. At four o’clock, they gathered in the “men’s dorm,” which consisted of a few makeshift bunk beds, to discuss the text. Three nights a week, Beckham participated in group sessions, called “small s synanons,” in which residents were pushed to speak and scream freely and run “the whole gamut of emotions” with one another. After a time, Beckham noticed that “something had happened to [her] at Synanon”: 

For the first time, I guess on a gut level, I knew that if I wanted to, there was something that I could do about this problem [of addiction]. I never had this feeling before, except lightly, once, in Lexington with a doctor…who really spent a lot of time [with me] … I had a faint glimmer, but I was locked up five thousand miles from home and behind big red brick walls. But [Synanon] was a free thing. The door was opened. 

The distinction that Beckham made between her institutional experiences and Synanon was not one of treatment versus punishment, but confinement versus freedom. Even the most attentive physician could not change the fact that Beckham was “locked up,” nor would the lessons learned from treatment in a Kentucky institution necessarily have relevance in Beckham’s daily life in Los Angeles. What made Synanon different was its autonomy and the voluntary nature of its program. The furniture that Beckham cleaned was her own, in that it belonged to everyone who lived there; the reading groups discussed books from the Synanon Library that had sparked a member’s particular interest; and the group “small s synanons” were driven by their own insights, not the guidance of a psychiatric professional. For Beckham, her abstinence from heroin was all the more meaningful because it occurred in sight of an “open door,” out of which she could leave anytime to fix. Her choice to stay, every day, was a sign that a different life was possible—by virtue of her own decisions, not those of state authorities. 

Beckham’s enthusiasm was not shared by the Los Angeles County Probation Department or the California Department of Corrections. Authorities in mid-twentieth-century America generally held that drug addicts needed o be in mandatory treatment that was run by medical professionals yet also backed by the threat of state force. In the minds of officials, addicts not only suffered from severe mental illness, of which their addiction was a symptom, but also from a contagious disease that spread person-to-person. This disease concept of addiction rendered absurd the idea that drug addicts living together could ever be curative. Synanon’s model could not have been more antithetical. Within two months of her arrival, Beckham received an official order to leave Synanon or risk violating the terms of her probation, which would mean prison. “The word really came down,” Beckham’s probation officer had informed her, “that Synanon… was off-limits for addicts.” California officials ordered Beckham out of Synanon because the state had developed a treatment program of its own, modeled on the priorities that public health and criminal justice officials had determined were necessary for rehabilitation. Crucially, though, the struggle between Synanon and California officials was not whether addicts should be treated, but rather about how treatment should function, what its goals were, and who had the authority to conduct it. 

Scholars have long challenged the idea that there is a clear-cut distinction between medical and criminal approaches to addiction. First, medical knowledge about addiction has often served the purposes of criminalization. Since the earliest narcotics prohibitions in Progressive-era America, physicians, psychiatrists, and pharmacological researchers have formulated a disease concept of addiction that aligned with an enforcement apparatus that sentenced offenders to jail and prison. Scholars have also shown how criminal models remained the dominant mode of response to Black and Latinx illicit drug users at the same time that white users were framed as victims of public health crises. And in the present day, treatment programs that position themselves in opposition to carceral facilities are often shot through with coercion and punishment, and have even come to rely on the criminal justice system for patients. However, even where scholarly thinking has illuminated the complex, intermingled relationship between the medical and criminal realms, it has still tended to invoke these binary categories. Underlying the framework is the implication that if some form of criminalization remains, full medicalization has yet to take place. 

Yet a careful look at Beckham’s life, as it unfolded in the context of post-WWII California, demonstrates the limitations of this binary. The pre-existing medical/criminal categorical framework especially fails to explain the state of affairs in 1950s California, which led the nation in narcotic-related arrests at the same time that it developed a pioneering system of mandatory addiction treatment that set the model for the rest of the nation by the 1960s. Beckham’s struggle with heroin addiction occurred in the midst of these events, and her story provides a chance to view state policy through the lens of the people most impacted by it. She found far more similarity than difference between the efforts of medical professionals and law enforcement officials. Furthermore, her analysis of what made Synanon different—it being “a free thing”—illuminates the crux of the dilemma over addiction policy in the 1950s, when state authorities puzzled over how to shift addict cases into treatment facilities while still maintaining control over individuals’ movements. Underlying this tension was a very different, more basic question: if addicts had the right to make their own decisions about whether to be treated at all. When California officials ordered Beckham out of Synanon, the answer appeared to be “no.”  

In this article, I argue that the continued emphasis on medical and criminal categories as the most fundamental logics of state policy obscures much about the way that historical actors thought about and acted against drug addiction. The first section focuses on how state authorities’ reliance on the medical/criminal binary obscures a) the shared conceptual foundation that undergirded all state approaches to addiction, whether nominally criminal or medical, and b) the logistical issues that made the criminal justice system an essential actor in securing the medical treatment of addicts. The second section returns to Betty Beckham’s life to illuminate alternative responses to addiction—responses that fit in neither the medical nor criminal domains, but instead can only be understood in relation to the broad category of social movements. The groups that motivated Beckham’s sobriety were not invested in framing addiction as a disease, nor did they conceive of their work as treatment. Instead, addiction was something that hampered the liberation and creative potential of the individual, which they sought to unlock and release through the power of collective action. To understand the complex terrain of addiction and the wide variety of responses to it in post-WWII America, we must look beyond the binary for new analytic frames.  

Footnote: With this insight, I am building on the work of Samuel Roberts and Eric Schneider, who have argued that opponents of carceral solutions to addiction are not necessarily in support of purely medical solutions, but may also agitate for social change in the form of anti-poverty programs, an end to racial discrimination in housing and jobs, and other such reforms. See: Eric Schneider, Smack: Heroin and the American City (Philadelphia: University of Pennsylvania Press, 2008) and Samuel Roberts, “‘Rehabilitation’ as Boundary Object: Medicalization, Local Activism, and Narcotics Addiction Policy in New York City, 1951–62,” The Social History of Alcohol and Drugs 26, no. 2 (Summer 2012): 147–169. 

3 responses to “How to Treat an Addict: 

  1. Chris Haberman Avatar
    Chris Haberman

    Interesting. It seems to me that fundamental to Synanon’s approach was the idea the addiction was the side effect of a society that engendered alienation. By rearranging the way the society was structured and interacted, the addict would heal as a side-effect.

  2. Gary L. Williams Avatar
    Gary L. Williams

    The work by Jordan centering around Betty D.’s fundamental journey to and through Synanon captures the turn of a structured societal negative byproduct on its head by the introduction of humanistic tenets. Naysayers were aghast and the system had to scamper in order to catch up with a new attempt to navigate the void between incarceration and rehabilitation. The concept of “clean man days” was birthed of which Betty D. compiled in excess of thousand till she passed in Synanon.

  3. Gary L. Williams Avatar
    Gary L. Williams

    The work by Jordan centering around Betty D.’s fundamental journey to and through Synanon captures the turn of a structured societal negative byproduct on its head by the introduction of humanistic tenets. Naysayers were aghast and the system had to scamper in order to catch up with a new attempt to navigate the void between incarceration and rehabilitation. The concept of “clean man days” was birthed of which Betty D. compiled in excess of thousand till she passed in Synanon.

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