Date of Award


Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)



First Advisor

Naomi Rogers

Second Advisor

John Warner


“Speed freak” was a pejorative term that emerged in the late 1960s to describe young people who binged on amphetamines, often by injection. The accessibility of amphetamines during the 1960s and early 1970s coupled with the emergence of a radical youth movement produced this distinctive subculture. This thesis will address responses to this drug crisis in two parts, from the perspective of two activists working in very different fields. In 1971, Larry Clark, a photographer, and David Smith, a physician, each published their seminal works on “speed freak” culture. Separated by half a country, they had enmeshed themselves in communities devastated by amphetamine abuse. Both used their work to enter the political sphere, drawing on the unique advantages of photography in Clark’s case and addiction medicine in Smith’s. And both were, in many ways, successful as advocates; they brought popular and legislative attention to the issue of amphetamine abuse. But the most salient connection between these two men is that, over time and as their political aspirations grew, both lost sight of nuanced human stories. They began to paint amphetamine users with broad strokes, and in doing so, reinforced negative stereotypes. Their response was understandable: speed users were a difficult group for which to advocate. Amphetamines are profoundly addictive, and, at high doses, they are associated with agitation, psychosis and violence. But amphetamine users were not faceless monsters – they had stories to tell. We continue to grapple with the challenges that drug users and other vulnerable, stigmatized populations necessarily present – today’s opioid crisis is most pressing. The dilemma inherent in Clark and Smith’s work is one of scale: how do you bring widespread attention to a cause and continue to make the human connections that are essential to preserve our patients’ dignity?

Open Access

This Article is Open Access