Drug Abuse

9 THE MORALITY OF DRUG CONTROLS

Thomas Szasz

In wise hands, poison is medicine; in foolish hands, medicine is poison.
—Casanova

DRUG CONTROL AS A MORAL ISSUE

Traditionally, in Judeo-Christian cultures, sexual behavior has con-stituted the core concern of morality, with other aspects of personal conduct occupying distinctly peripheral positions. This reigning role of sex in the moral calculus of our forebears is exemplified by the parable of the Fall. Although that act has always been interpreted, no doubt correctly, as referring to sexual intercourse between man and woman, it is important to remember that the Bible writers did not name that "crime" directly but only alluded to it through the metaphor of partaking of the Forbidden Fruit.

Inasmuch as that primal act of defiance of God's authority has always been couched in metaphorical terms, it has not proved overly difficult to replace sex with drugs in the grand morality play of hu-man existence. No longer are men, women, and children tempted, corrupted, and ruined by the irresistibly sweet pleasures of sex; in-stead, they are tempted, corrupted, and ruined by the irresistibly sweet pleasures of drugs. Thus, youth's defiance of adult authority and, more generally, man's defiance of societal conventions, is now enacted through ceremonies of drug use, called "drug abuse"; at the same time the collective celebration of the legitimacy and power of parental, societal, and scientific authority is now enacted through the counterceremonies of drug controls, called the "war on drugs."

THE WAR ON DRUGS

Ostensibly, the war on drugs is a struggle against "dangerous" drugs. But the substances we now call "drugs" are simply the products of nature (for example, coca leaves) or of human inventiveness (for ex-ample, LSD). They are material objects—leaves and liquids, pow-ders and pills—like trees or trucks. How, then, can human beings wage war against drugs? One would have to be blind not to recognize that the war on drugs must be a metaphorical war. But that cannot be all there is to it. Another part of the story has to do with our stubborn determination not to come to grips with what a drug is: in other words, with our refusal to recognize that the term "drug" is not only a medical but also a political concept.

In order to appreciate this, all we need to do is ask, for example, what is the difference between lithium as the third element in the Periodic Table of Elements and lithium as a now-fashionable "anti-psychotic" medication? The difference between them is, of course, the same as between description and prescription, fact and value, science and politics. In short, while seemingly the word "drug" is a part of the vocabulary of science, it is even more importantly a part of the vocabulary of politics. This explains why there is no such thing—why, indeed, there can be no such thing—as a "neutral" drug: A drug is either good or bad, effective or ineffective, therapeutic or noxious, licit or illicit. Precisely herein lie the vast powers of drugs in modern societies: We deploy them simultaneously as technical tools in our fight against medical diseases and as scapegoats in our struggle for personal security and political stability.

If history teaches us anything at all, it teaches us that human beings have a powerful need to form groups and that the sacrificial victim-ization of scapegoats is often an indispensable ingredient for main-taining social cohesion among the members of such groups. Perceived as the very embodiment of evil, the scapegoat's actual characteristics or behavior are thus impervious to rational analysis. Since the scape-goat is evil, the good citizen's task is not to understand him (or her, or it), but to hate him and to rid the community of him. Attempts to analyze and grasp such a ritual purgation of society of its scape-goats is perceived as disloyalty to, or even an attack on, the "com-pact majority" and its best interests.

In my opinion, the American "war on drugs" represents merely a new variation in humanity's age-old passion to "purge" itself of its "impurities" by staging vast dramas of scapegoat persecutions.' In the past, we have witnessed religious or "holy" wars waged against people who professed the wrong faith; more recently, we have wit-nessed racial or "eugenic" wars, waged against people who pos-sessed the wrong genetic makeup; now we are witnessing a medical or "therapeutic" war, waged against people who use the wrong drugs.

Let us not forget that the modern state is a political apparatus with a monopoly on waging war: It selects its enemies, declares war on them, and thrives on the enterprise. In saying this I am, of course, merely repeating Randolph Bourne's now classic observation that "war is the health of the State. It automatically sets in motion throughout society those irresistible forces for uniformity, for pas-sionate cooperation with the Government in coercing into obedience the minority groups and individuals which lack the larger herd sense."'

Let us not forget, too, that only fifty years have passed since Hit-ler incited the German people against the Jews—by "explaining" the various ways in which the Jews were "dangerous" to the Germans individually and to Germany as a nation. Millions of Germans—among them leaders in science, in medicine, in law, in the media—came to believe in the reality of the "dangerous Jew." Indeed, they more than believed in it; they loved the imagery of that racial myth, felt exhilarated by the increased self-esteem and solidarity it gave them, and were thrilled by the prospect of "cleansing" the nation of its "racial impurities." Today, hardly anyone in Germany believes the myth of the "dangerous Jew"—a change in point of view that surely had nothing to do with more research on, or fresh scientific discoveries about, the problem of "dangerous Jews."

Mutatis mutandis, every American president since John F. Ken-nedy, and countless other American politicians, have incited the American people against "dangerous drugs"—by "explaining" the various ways in which such drugs threaten Americans individually and the United States as a nation. Millions of Americans—among them leaders in science, in medicine, in law, in the media—believe in the reality of "dangerous drugs." Indeed, they more than believe in it: They love the imagery of this pharmacological myth and are inspired by the prospect of cleansing the nation of illicit drugs. In short, we are now in the midst of a medical or "therapeutic" war waged against "drugs" and the people who sell and buy them.

THE "DRUG" AS SCAPEGOAT

In 1980, crime and violence, long endemic to New York City, erupted in a new epidemic. Singly and in packs, hoodlums rampaged through the subways and the commuter trains, ripping gold chains off the necks of women. One such public mass robbery was described as follows: "Seconds after a packed Amtrak passenger train collided with a freight train last night, a wave of chain-snatching broke out at the scene. Gold chains and purses were ripped from commuters in a second passenger train, which screeched to a halt behind the Amtrak wreck near Dobbs Ferry."3

The public was horrified. The police were helpless. Although (New York State) Governor Hugh Carey could offer neither protection for the public nor compensation for the victims, he could—and did—offer an explanation for this mayhem. "The epidemic of gold-snatching in the city," he declared, "is the result of a Russian design to wreck America by flooding the nation with deadly heroin. In the streets, you know what's going on. Women are afraid to walk with a chain around their neck. Why? Somebody's grabbing that chain to get enough money for a fix. . . . [If the Russians] were using nerve gas on us, we'd certainly call out the troops. This is more insidious than nerve gas. Nerve gas passes off. This doesn't. It kills. I'm not overstating the case."4

When Governor Carey spoke these words (at a press conference in New York City on September 25, 1980), the American war against "dangerous drugs," especially heroin, had been going on for more than a quarter of a century. The political rhetoric about "drug abuse," the medical mendacity about "drug rehabilitation," the leg-islative prohibition of "illicit drugs," and the judicial persecution of drug users ("addicts") and drug sellers ("pushers"), aided and abet-ted by the popular media intoxicated with a blind faith in a holy war against unholy drugs—all this has been going on for much longer than the First and Second World Wars combined; much longer than Prohibition, or Nazism, or the war in Vietnam. Still, America's war against "dangerous drugs"—which has spread to Europe, to Aus-tralia, to Japan, and to any Third World nation the U.S. government is able to intimidate—shows no signs of letting up. Alas, Governor Carey's comments are simply the most immoderate example of the views commonly voiced by government officials when discussing the drug "problem."

The result is that the public is regularly faced with self-intoxicated politicians, posing as protectors of the people. Moreover, although the public is indeed endangered, it is endangered not by the threat from which the politician promises protection, but by the threat from which the politician is quite unable to protect it because he himself (together with his fellow politicians) has helped to create and unleash it. For the people from whom we need protection—those who are robbing, maiming, and killing us—are not foreign "drug pushers," as our protectors claim, but American thugs. Obviously, for anyone not in the grip of the scapegoater's ideology, the now fashionable antidrug exhortations are nothing but propaganda of the cheapest sort.

A SYNOPTIC HISTORY OF THE WAR ON DRUGS, 1974-1984

To appreciate better the nature and scope of current American drug controls, the context in which politicians continually seek to escalate the war on drugs while people continue to support it, and the can-cerous growth of unenforceable and unenforced drug prohibitions that have resulted from this mad scramble for protection from "dan-gerous drugs"—I shall next present, in synoptic form, a series of illustrative excerpts from newspapers, magazines, and books.5 (For the sake of brevity I am limiting the following summary to the last decade, that is, the period from 1974 until 1984.)

1974 An article in the American Journal of Psychiatry advocates treating alcoholism in American Indians with peyote (an illicit drug), because it "offers the alcoholic Indian both occupa-tional and cultural therapy including participation in the ser-vices of the Native American Church (peyote meetings)."6

1975 Jerome H. Jaffe, former top White House drug abuse offi-cial, "urge[s] that people who smoke a pack [of cigarettes] a day or more be described as suffering from a 'compulsive smoking disorder.' " To a Third World Conference on Smok-ing and Health, Jaffe explains that "a new term—`compul-sive smoking syndrome'—has been proposed as a disorder to be listed in the Diagnostic and Statistical Manual of the American Psychiatric Association.'"
The family of Frank Olson, a civilian biochemist who died in 1953 after being drugged, without his knowledge or con-sent, in a secret CIA project involving psychoactive sub-stances, settles its claim against the U.S. government "in return for a payment of $1.25 million and the release of all CIA files concerning the case."8

1976 An article in the New York Times Magazine entitled "Vali-umania" warns that "Americans are spending almost half a billion dollars a year on a drug [Valium] to relieve their anx-iety—a fact that is in itself a considerable cause for anxiety."9
It is revealed that between 1972 and 1975, the United States government "has helped to pay for the shipment overseas of hundreds of tons of pesticides so poisonous that they are not permitted to be used in the United States. . . . Leptophos, DDT, aldrin, heptachlor, and chlordane were all included on the list of commodities for which U.S. government financing was available to foreign buyers. The use of these chemicals either has never been authorized or has been sharply circumscribed."10

1977 A British story on the war against laetrile reports that "U.S. Federal Marshals last month seized 50 tons of apricot stones . . . probably the largest seizure of an illegal drug base in the history of U.S. law enforcement.""11

The Labor Department directs employers with federal con-tracts "to take 'affirmative action' to hire alcoholics and drug abusers. . . . Alcoholics and drug abusers are covered by the 1973 Rehabilitation Act, which protects 'handicapped people' against job discrimination. 'Employers who fail to consider qualified alcoholics and drug abusers for employment be-cause of their handicap are clearly violating the law,' Mr. Elis-burg [Donald Elisburg, assistant secretary of labor for employment standards] said." 12

1978 Peter Bourne, special assistant to the president [Carter] and director of the White House Office of Drug Abuse Policy, writes an illegal prescription for Quaaludes for one of his aides and is forced to resign. On leaving the White House, he tells the press that there is a "high incidence of marijuana use . . . [and] occasional use of cocaine" by members of the White House staff.' 13

1979 In Jacksonville, Florida, actress Linda Blair is "ordered to become a crusader against drug abuse as part of her probation after pleading guilty to a federal misdemeanor charge of con-spiracy to possess cocaine."1'4

1980 Dr. Lee Macht, a Harvard professor of psychiatry who treated David Kennedy, admits that "he prescribed drugs illegally to the 24-year-old nephew of Senator Edward Kennedy. . . . [He is] fined $1,000 and . . . his license to prescribe Class 2 drugs [is] suspended for at least one year. The Middlesex County assistant district attorney said that at least 50 prescriptions over a 21/2-year period were written for the young-Kennedy, involving the drugs Percodan, Dilaudid . . . and Quaaludes.''"15
Japan agrees to provide concessions to the U.S. tobacco industry "that could increase sales there from $35 million to about $350 million [annually]." In a new trade agreement an-nounced by Steve Lande, assistant U.S. trade representative for bilateral affairs, Japan would "reduce tariffs on cigarettes . . . increase the number of retailers selling imported tobacco products . . . [and] permit U.S. companies to advertise in Japan."16
Christopher Lawford, son of Peter Lawford and Patricia Kennedy Lawford and nephew of Senator Edward Kennedy, is arraigned in Boston on a charge of possessing heroin.17

1981 Responding to questions concerning the problems created by the PCB contamination of a state office building in Bing-hamton, New York, Governor Hugh Carey volunteers "to drink a glass of PCB's . . . to demonstrate that the building was safe. 'I offer here and now [said Carey] to walk into Binghamton or any part of that building and swallow an en-tire glass of PCB's.' "18

Janet Cooke, a Washington Post reporter, wins a Pulitzer Prize for her story entitled "8-Year-Old Heroin Addict Lives for a Fix," which turns out to be a complete fabrication. The Post's executive editor, Benjamin Bradlee, attributes the fraud to mental illness, explaining to an interviewer: "We're going to take care of her. We're going to see that she has professional help."19

The U.S. Supreme Court upholds the constitutionality of "a 40-year prison sentence imposed on a Virginia man for possession and distribution of nine ounces of marijuana worth about $200. The unsigned decision, which the Court reached by a vote of 6 to 3 . . . reverses ruling by two lower Federal courts that the sentence was so harsh in proportion to the crime as to violate the Eighth Amendment's prohibition against cruel and unusual punishment."20

In Tucson, Arizona, a 21-year-old man is sentenced to two years in prison for sniffing paint, under an Arizona law that reads: "A person shall not knowingly breathe, inhale, or drink a vapor-releasing substance containing a toxic substance." Police and prosecutors are said to favor the law because "in-toxicated sniffers can grow violent."21'

An editorial in the New York Post declares: "Drugs are now the scourge of our society. . . . [Parents] should ask their children this question: What did John Belushi have in com-mon with Elvis Presley, Freddie Prinze, Janis Joplin, Jimi Hendrix, Billie Holiday, Lenny Bruce, Frankie Lymon, Mi-guel Berrios, and Charlie Parker? Answer: They all took drugs and they all killed themselves doing so."22

1983 The Drug Enforcement Agency acknowledges using entrap-ment in fighting the war on drugs. "Federal drug agents seek-ing to draw out potential producers of hallucinogens and other illicit drugs have been operating bogus chemical companies that sell materials and instructions for the manufacture of such dangerous drugs. Then they arrest their customers. . . . The tactic . . . has already led to convictions."23
John V. Lindsay, Jr., son of former New York City Mayor John V. Lindsay, is sentenced to six months in prison for sell-ing three grams of cocaine to an undercover agent.24

1984 In Rapid City, South Dakota, Robert F. Kennedy, Jr., a for-mer assistant district attorney in New York City, pleads guilty to a felony charge of possessing heroin.25
Responding to David Kennedy's suicide (with an overdose of cocaine, Demerol, and Mellaril), New York City Mayor Edward Koch demands the death penalty for "drug dealers." Kennedy, Koch declares, " 'was killed by a drug pusher. I be-lieve the person who sold him those drugs is guilty of murder.'

. . . Koch said he wanted to see capital punishment for such crimes on a national level."26

School officials order the suspension of any Wilmington, Massachusetts, high school student "caught with drugs—in-cluding aspirin and over-the-counter medications." The rule, "written with the help of the U.S. Drug Enforcement Admin-istration . . . requires students to store drugs and pills in the school clinic." Robert Stutmant, head of the Boston office of the DEA, explained that the ruling was required because "a drop of LSD can be concealed in an aspirin tablet."27

Speaking in the House Rayburn Office Building, Demo-cratic presidential candidate Walter F. Mondale "accuses President Reagan of failing 'to match tough talk with tough action' in fighting illicit drug traffic." Mondale promises that, if elected, "he would direct the armed forces to join in the war on drugs. . . . will get tough on foreign countries that continue to produce the drugs that kill American kids,' he said. 'In my Administration, no country will receive foreign aid or military assistance unless it follows a plan to stop pro-ducing or peddling narcotics. 28

According to a survey conducted by the New York State Division of Substance Abuse Services, 31 percent of seventh grade students "reported using a drug before reaching that grade. About 60 percent of all students responding to the sur-vey said they had at least one experience with illicit drugs." At the same time, it was reported that New York City police and school officials agreed "to send undercover police offi-cers into city high schools in search of drug dealers. . . . [The officers would] impersonate teachers, custodians, or students.29

DRUG CONTROLS

As the evidence cited so far illustrates, and as I shall now try to demonstrate, it is a serious error to view currently fashionable drug controls as most people now view them and as their proponents want us to view them, namely, as if they were similar to measures aimed against the spread of, say, typhoid fever by contaminated water or food. Instead of resembling controls based on objective (technical, scientific) considerations, contemporary drug controls resemble the prohibition of countless substances whose control rests on religious (ritual, social) considerations. In this connection, we must not forget that there is hardly any object or behavior that has not been pro-hibited somewhere, some time, and whose prohibition was not viewed by those who believed in it and enforced it as rational, that is, as theologically or scientifically "valid." The following is but a brief and quite incomplete list of such prohibitions, with a few comments about them.

Taboo and Avoidance: Some Examples of Ritual Prohibitions

The dietary laws set forth in the Old Testament, which form one of the pillars of Judaism, prohibit the ingestion of numerous edible things. Although conformity to these rules is now often rationalized on historical-hygienic grounds, they have nothing whatever to do with health; instead, they have to do with holiness, that is, with being dutiful toward God, in an effort to gain His favor. By glorifying what one may or may not eat as a matter of the gravest concern to an all-caring deity, true believers elevate ordinary events—say, eating a shrimp cocktail—to acts that are, spiritually speaking, matters of life and death. Similar proscriptions of food characterize other re-ligions—for example, Muslims are forbidden to eat pork, Hindus to eat beef.

Most religious codes also proscribe, as well as prescribe, certain drinks. Jewish and Christian religious ceremonies require the use of alcohol, which, in turn, is forbidden in the Koran. When secular alcohol-prohibition is superimposed on Judeo-Christian customs, the result is the banning of a substance that, at the same time, is rec-ognized to be indispensable for religious (and, usually, medical) purposes.

Like eating and drinking, sexual activity is a basic human urge whose free exercise, with some exceptions, has also been closely con-trolled by custom, religion, and law. Among the forms of sexual activity that have been, or are still, forbidden, the following spring quickly to mind: masturbation; homosexuality; heterosexual inter-course outside of marriage; heterosexual intercourse with the sole purpose of sexual enjoyment; heterosexual intercourse with the use of condoms, diaphragms, or other "artificial" birth control devices; nongenital heterosexual intercourse; incest; and prostitution. For about two hundred years—well into the twentieth century—self-abuse (as masturbation was then called) was thought to be the greatest threat to the medical and moral well-being of mankind. Preoccupation with self-abuse, both popular and professional, has since been displaced by a similar preoccupation with drug abuse.

Verbal and pictorial representation of certain ideas or images are perhaps the prime products of human inventiveness prohibited by human inventiveness. This behavior, too, has its roots in religious ritual, exemplified by the Jewish prohibition against graven images, that is, making pictures of God and hence of man, created in His image. This is why, prior to the modern era, there were no Jewish painters or sculptors. With the development of literacy among the laity, the Catholic church quickly "criminalized" translating the Bi-ble into the "vulgar" tongues. Thus, in the fifteenth century, pos-sessing an English Bible was an offense much like possessing heroin is today, except that the penalty for it was death by burning at the stake. Since then, there followed an almost limitless variety of pro-hibitions against the printed word and the painted picture, such as prohibitions of blasphemy, heresy, subversion, sedition, obscenity, pornography, and so forth; these prohibitions have been imple-mented by such institutionalized interventions as the Roman Cath-olic Index of Prohibited Books, the Comstock laws (in the United States), the Nazi book burnings, and the censorship policies of the various communist countries.

Money, as precious metal or paper, is another product of human. inventiveness widely prohibited throughout history. Although the United States is regarded as the very pillar of the Western capitalist world, owning gold was, until recently, prohibited in this country. Private ownership of this metal (in forms other than personal or-naments) is, of course, prohibited in all communist countries; and so, too, is the free movement, across national boundaries, of paper money. Prohibitions against lending money at interest are deeply in-grained in the Christian and Mohammedan religions. Charging any interest was sometimes viewed as an evil that must be proscribed; at other times, only charging "excessive" interest, called "usury," was prohibited. Interest rates charged or paid by American banks today would, of course, have been considered usurious in the Middle Ages.

Although gambling was prevalent and permitted in antiquity, in the Christian world-view it, too, came to be seen as a sin and was generally prohibited. Conducted as a private enterprise, gambling is still treated as a criminal offense in most parts of the United States; however, if it is conducted by the state—offering much poorer odds for the gambler than do private gaming establishments—it is re-garded as a positively virtuous undertaking, aggressively promoted by the government.

Since the modern state has a monopoly on coercion, it is not sur-prising that individuals are prohibited from possessing powerful weapons, such as tanks, warships, or bombs. However, even in the politically most tightly controlled countries, individuals can own knives, sticks, ropes, automobiles, poisons, and other means useful for inflicting harm on others or oneself. Yet, it is illegal to own an empty hypodermic syringe.

In short, there is virtually no material object or human behavior that has not been found to be "dangerous" or "harmful"—to God, king, the public interest, national security, bodily health, or mental health—and thus prohibited by religious, legal, medical, or psychi-atric authorities. In every case of such prohibition, we are con-fronted with certain ceremonial-ritual rules rationalized and justified on pragmatic-scientific grounds: Typically, we are told that such pro-hibitions protect the health or well-being of particularly vulnerable individuals or groups; actually, the rules protect the well-being—that is, the integrity—of the community as a whole (which is what is meant by saying that certain behavioral rules have a ceremonial function).

The Danger in "Dangerous Drugs"

In what way are drugs a danger to Americans individually or to the United States as a nation? What do the officially persecuted drugs—especially heroin, cocaine, and marijuana—do that is so different from what other drugs do? And if these drugs are such a grave dan-ger to Americans, why were they not a danger to them in, say, 1940 or 1900? Anyone who reflects on these matters must realize that our culturally accepted drugs—in particular, alcohol, tobacco, and "mind-altering" drugs legitimated as "psychotherapeutic"—pose a much graver threat, and cause much more demonstrable harm, to people than do the prohibited or so-called dangerous drugs.

There are, of course, complex religious, historical, and economic reasons, which we cannot consider here, that play a part in deter-mining which drugs people use and which they avoid. But regardless of such cultural-historical determinants, and regardless of the pharmacological properties of the "dangerous drugs" in question, one simple fact remains—namely, that no one has to ingest, inject, or smoke any of these substances unless he or she wants to do so. This simple fact compels one to see the "drug problem" in a light totally different from that in which it is now officially portrayed. The official line is that "dangerous drugs" pose an "external" threat to people—that is, a threat like a natural disaster, such as an erupting volcano or a hurricane. The inference drawn from this image is that it is the duty of a modern, scientifically enlightened state to protect its citizens from such dangers, and it is the duty of the citizens to submit to the protections so imposed on them for the benefit of the community as a whole.

But "dangerous drugs" pose no such threat. Obviously the danger posed by so-called dangerous drugs is quite unlike that posed by hur-ricanes or plagues, but is rather like the danger posed (to some peo-ple) by, say, eating pork or masturbating. The point is that certain threats—so-called natural disasters, in particular—strike us down as "passive victims," whereas certain other threats—for example, "forbidden" foods or sexual acts—strike us down as "active vic-tims," that is, only if we succumb to their temptation. Thus, an Or-thodox Jew may be tempted to eat a ham sandwich and a Catholic may be tempted to use artificial contraception, but that does not make most of us view pork products or birth-control devices as "dangers" from which the state should protect us. On the contrary, we believe that free access to such foods and devices is our right (or "constitutional right," as Americans put it).

In actuality—that is, at the present time, and especially in the United States—the so-called "drug problem" has several distinct di-mensions. First, there is the problem posed by the pharmacological properties of the drugs in question. This problem is technical: All new scientific or practical inventions not only offer us certain so-lutions for old problems, but also create new problems for us. Drugs are no exception. Secondly, there is the problem posed to the indi-vidual by the temptation certain drugs present, especially those be-lieved to possess the power to "give" pleasure. This problem is moral and psychological: Some drugs offer us certain new temptations that we must learn to resist or enjoy in moderation. They, too, are no exception. Thirdly, there is the problem posed by the prohibition of certain drugs. This problem is partly political and economic, and partly moral and psychological. Drug prohibition and persecution constitute a type of scapegoating, as discussed earlier.

Moreover, the drug prohibition itself generates a wide range of otherwise unavailable economic and existential options and oppor-tunities. Thus, for members of the upper and middle classes, the war on drugs provides opportunities for gaining self-esteem, public rec-ognition for benevolence, life meaning, jobs, and money. For ex-ample, it enables First Ladies (of both major parties) to play a combination of Santa Claus and Doctor Schweitzer vis-a-vis their involuntary beneficiaries, who, without the compassion and largesse of these ladies, are ostensibly unable to abstain from illegal drugs. Similarly, it enables physicians, especially psychiatrists, to claim spe-cial skills in treating the mythical disease of drug abuse, a claim pol-iticians and others are only too eager to authenticate. These examples are, of course, only the tip of the proverbial iceberg: There is no need to list the numerous jobs in the "drug rehabilitation" racket, and their ripple effects on the economy, with which everyone is only too familiar. For members of lowest and lower classes, the war on drugs is perhaps only slightly less useful. For example, for unem-ployed and perhaps unemployable youngsters, the war provides an opportunity for making a living as drug dealers and, after they have recovered from "drug abuse," as drug abuse counselors; for un-skilled but employable persons, it provides countless opportunities for staffing and running the infrastructure of the drug abuse empire. Last but not least, for persons at all levels of society, the war on drugs offers a ready-made opportunity for dramatizing their lives and aggrandizing their individuality by defying certain modern "medical" taboos.

The role of defiance in so-called drug abuse is, indeed, quite obvious. It is clearly displayed in the various contemporary subcul-tures' righteous rejection of conventional or legal drugs and its passionate embrace of the use of unconventional or illegal drugs. The perennial confrontation between authority and autonomy, the permanent tension between behavior based on submission to coer-cion and the free choice of one's own course in life—these basic themes of human morality and psychology are now enacted on a stage on which the principal props are drugs and laws against drugs. In this connection, the following tragedy, typical of countless similar stories reported in the press, is especially revealing.

A young couple about to be sentenced on drug charges [possessing mar-ijuana and cocaine] horrified a packed courtroom when they swallowed cyanide and fell dying to the floor. After the probation judge refused to grant probation, William Melton, 27, put a white powder in his mouth and collapsed seconds later. His wife, Tracey Lee, 21, walked over to her husband and patted him softly on the head and then put some cy-anide powder in her own mouth. . . . They died in a local hospital. "It was crazy. It was as if they were going to the gas chamber," said court clerk Howard Smith. "They weren't even going to get a long sentence.30

THE POLITICS OF DRUG CONTROL

We Americans regard freedom of speech and religion as fundamental rights. Until 1914, we also regarded the freedom of choosing our diets and drugs as fundamental rights. Obviously, this is no longer true today. What is behind this fateful moral and political transfor-mation, which has resulted in the rejection, by the overwhelming majority of Americans, of their right to self-control over their diets and drugs? How could it have come about in view of the obvious parallels between the freedom to put things into one's mind and its restriction by the state by means of censorship of the press, and the freedom to put things into one's body and its restriction by the state by means of drug controls?

The answer to these questions lies basically in the fact that our society is therapeutic in much the same sense in which medieval Spanish society was theocratic. Just as the men and women living in a theocratic society did not believe in the separation of church and state but, on the contrary, fervently embraced their union, so we, living in a therapeutic society, do not believe in the separation of medicine and the state but fervently embrace their union. The cen-sorship of drugs follows from the latter ideology as inexorably as the censorship of books followed from the former. That explains why liberals and conservatives—and people in that imaginary center as well—all favor drug controls. In fact, persons of all political and religious convictions (save libertarians) now favor drug controls.

Viewed as a political issue, drugs, books, and religious practices all present the same problem to a people and its rulers. The state, as the representative of a particular class or dominant ethic, may choose to embrace some drugs, some books, and some religious practices and reject the others as dangerous, depraved, demented, or devilish. Throughout history, such an arrangement has charac-terized most societies. Or the state, as the representative of a con-stitution ceremonializing the supremacy of individual choice over collective comfort, may ensure a free trade in drugs, books, and re-ligious practices. Such an arrangement has traditionally characterized the United States. Its Constitution explicitly guarantees the right to freedom of religion and the press and it can with some justification be argued that it also implicitly guarantees the right to free-dom of self-determination with respect to what we put into our bodies.

The Right to Drugs

The framers of the Constitution did not explicitly guarantee the right to take drugs for a variety of reasons, but for our purposes, two are particularly worthy of note. First, two hundred years ago medical science was not even in its infancy; medical practice was socially un-organized and therapeutically worthless. Second, there was then no conceivable danger of an alliance between medicine and the state. The very idea that the government should lend its police power to physicians to deprive people of their free choice to ingest certain substances would have seemed absurd to the drafters of the Bill of Rights.

This conjecture is strongly supported by a casual remark by Thomas Jefferson, clearly indicating that he regarded our freedom to put into our bodies whatever we want as essentially similar to our freedom to put into our minds whatever we want. "Was the gov-ernment to prescribe to us our medicine and diet," wrote Jefferson in 1782, "our bodies would be in such keeping as our souls are now. Thus in France the emetic was once forbidden as a medicine, the potato as an article of food."31

Jefferson poked fun at the French for their pioneering efforts to prohibit drugs and diets. What, then, would he think of the state that now forbids the use of harmless sweeteners while encouraging the use of dangerous contraceptives? That labels marijuana a nar-cotic and prohibits it while calling tobacco an agricultural product and promoting it? That defines the voluntary use of heroin as a dis-ease and the legally coerced use of methadone as a treatment for it?

Freedom of religion is indeed a political idea of transcendent im-portance. As that idea has been understood in the United States, it does not mean that members of the traditional churches—that is, Christians, Jews, and Muslims—may practice their faith unmolested by the government but that others—for example, Jehovah's Wit-nesses—may not. American religious freedom is effectively uncon-ditional; it is not contingent on any particular church proving, to the satisfaction of the state, that its principles or practices possess "re-ligious efficacy." The requirement that the supporters of a religion establish its theological credentials in order to be tolerated is the hall-mark of a theological state. The fact that we accept the requirement that the supporters of a drug establish its therapeutic credentials be-fore we tolerate its sale or use shows that we live in a therapeutic state.

The argument that people need the protection of the state from dangerous drugs but not from dangerous ideas is unpersuasive. No one has to ingest any drug he does not want, just as no one has to read a book he does not want. Insofar as the state assumes control over such matters, it can only be in order to subjugate its citizens—by protecting them from temptation, as befits children, and by pre-venting them from assuming self-determination over their lives, as befits an enslaved population.

The Fear of Drugs

Conventional wisdom now approves—indeed, assumes as obvious—that it is the legitimate business of the state to control certain sub-stances we take into our bodies, especially so-called psychoactive drugs. According to this view, as the state must, for the benefit of society, control dangerous persons, so it must also control dangerous drugs. The obvious fallacy in this analogy is obscured by the riveting together of the notions of dangerous drugs and dangerous acts: As a result, people now "know" that dangerous drugs cause people to behave dangerously and that it is just as much the duty of the state to protect its citizens from dope as it is to protect them from murder and theft. The trouble is that all these supposed facts are false.

Today, the average person does not want to keep an open mind about drug controls. Instead of thinking about the problem, he tends to dismiss it with some cliche such as, "Don't tell me that heroin is not a dangerous drug!" He thus implies or indeed asserts, "Don't tell me that it doesn't make good sense to prohibit its production, sale, and possession!"

What is wrong with this argument? Quite simply, everything. In the first place, the proposition that heroin is dangerous must be qual-ified and placed in relation to the dangerousness of other drugs and other artifacts that are not drugs. Second, the social policy that her-oin should be prohibited does not follow, as a matter of logic, from the proposition that it is dangerous (even if it is "dangerous").

Admittedly, heroin is more dangerous than aspirin, in the sense that it gives more pleasure to its users than does aspirin; heroin is therefore more likely than aspirin to be taken for the self-induction of euphoria. Heroin is also more dangerous than aspirin in the sense that it is easier to kill oneself with it; heroin is therefore more likely to be used for committing suicide.

The fact that people take heroin to make themselves feel happy or high—and use other psychoactive drugs for their mind-altering effects—raises a simple but basic issue that the drug-prohibitionists like to avoid, namely: What is wrong with people using drugs for that purpose? Why shouldn't people make themselves happy by means of self-medication? Let me say at once that I believe these are questions to which honest and reasonable men may offer different answers. For example, some people say that individuals should not take heroin because it diverts them from doing productive work, making those who use the drugs, as well as those economically de-pendent on them, burdens on society. Others say that whether in-dividuals use, abuse, or avoid heroin is, unless they harm others, their private business. And still others opt for a compromise between the total prohibition of heroin and a free trade in it.

There is, however, more to the prohibitionist's position than his concern that hedonic drugs seduce people from hard labor to happy leisure. Actually, the objects we now call "dangerous drugs" are metaphors for all that we consider sinful and wicked; that is why they are prohibited, rather than because they are demonstrably more harmful than countless other objects in the environment that do not now symbolize sin for us. In this connection, it is instructive to consider the cultural metamorphosis we have undergone during the past
half-century, shifting our symbols of sin from sexuality to chemistry.

Indeed, our present views on drugs, especially psychoactive drugs, are strikingly similar to our former views on sex, especially mastur-bation. Until relatively recently, masturbation—or self-abuse, as it used to be called—was professionally declared, and popularly ac-cepted, as both the cause and the symptom of a variety of illnesses, especially insanity. Today no medical authority accepts, much less supports, this concept of self-abuse. However, no medical authority now questions, much less rejects, the concept of drug abuse. On the contrary, expert medical opinion now holds that drug abuse is a ma-jor medical, psychiatric, and public-health problem. Conventional wisdom maintains that (1) drug addiction is a disease similar to di-abetes, requiring prolonged (or lifelong) and medically carefully su-pervised treatment; (2) taking or not taking drugs is primarily a matter of medical concern and responsibility; and (3) doctors cannot discharge their responsibility for controlling and "curing" drug abuse unless the state empowers them to use fraud and force to combat this worldwide "plague."

A CRITIQUE OF DRUG CONTROLS
Like any social policy, drug controls, or antidrug laws, may be examined from two entirely different points of view: technical and moral. Our present inclination is either to ignore the moral perspective or to mistake the technical for the moral.

Illustrative of our misplaced overreliance on a technical approach to the so-called drug problem is the professionalized mendacity about the dangerousness of certain types of drugs. Since most propagandists against drug abuse seek to justify their repressive policies by ap-peals to the alleged dangerousness of various drugs, they falsify the facts about the pharmacological properties of the drugs they seek to prohibit. They do so for two reasons: first, because many substances in daily use are just as harmful as the substances they want to prohibit; second, because they realize that dangerousness alone is never a sufficiently persuasive argument to justify the prohibition of any drug, substance, or artifact. Accordingly, the more they ignore the moral dimensions of the problem, the more they must escalate their fraudulent claims about the dangers of drugs.

To be sure, some drugs are more dangerous than others. It is easier to kill oneself with heroin than with aspirin, just as it is easier to kill oneself by jumping off a high building than a low one. In the case of drugs, we regard their potentiality for self-injury as a justification for their prohibition; in the case of buildings, we do not. Further-more, we systematically blur and confuse the two quite different ways in which narcotics can cause death: by a deliberate act of suicide and by accidental overdose.

Suicide is an act, not a disease. In other words, suicide resembles other acts of killing persons, such as murder and execution, and differs from diseases, such as cancer or diabetes. The now fashionable argument that suicide, say self-poisoning with a barbiturate, is a medical matter because it results in the subject's ("patient's") death is no more and no less valid than would be the argument that exe-cuting a convicted murderer, say by poisoning him with cyanide, is a medical matter because it results in the subject's ("patient's") death. Neither the suicidal person nor the person condemned to death are patients (in the conventional sense of that word), though either or both may be so treated by medical or political authorities. This is why I maintain that it is morally absurd—and, in a free society, it is also politically illegitimate—to deprive a particular adult of cer-tain drugs because he might use them to kill himself; and it is even more absurd and illegitimate to deprive all adults of certain drugs because some adults might use them to kill themselves. Indeed, to do so is tantamount to treating people as if they were suicidal pa-tients, and politicians as if they were psychiatrists whose job was to prevent suicide.

Death by accidental overdose is an altogether different matter. But can anyone doubt that this danger now looms so large precisely be-cause the sale of narcotics and many other drugs is illegal? Persons buying illicit drugs cannot be sure what they are getting or how much of it. Free trade in drugs, with governmental action at most limited to safeguarding the purity of the product and the veracity of label-ing, would reduce the risk of accidental overdose with so-called dan-gerous drugs to the same levels that prevail, and that we find acceptable, with respect to other chemical agents and physical arti-facts that abound in our complex technological society.

In my view, regardless of their dangerousness, all drugs should be "legalized" (a misleading term that I employ reluctantly as a conces-sion to common usage). Although I realize that the use of some drugs—notably heroin, among those now in vogue—may have dan-gerous consequences, I favor free trade in drugs for the same reason the Founding Fathers favored free trade in ideas: In a free society it is none of the government's business what ideas a man puts into his mind; likewise, it should be none of its business what drugs he puts into his body.

Clearly, the argument that heroin or cocaine is prohibited because it is addictive or dangerous cannot be supported by facts. For one thing, there are many drugs, from insulin to penicillin, that are neither addictive nor dangerous but are nevertheless also prohibited: They can be obtained only through a physician's prescription. For another, there are many things, from poisons to guns, that are much more dangerous than narcotics (especially to others) but are not pro-hibited. As everyone knows, it is still possible in the United States to walk into a store and walk out with a shotgun. We enjoy that right, not because we do not believe that guns are dangerous, but because we believe even more strongly that civil liberties are pre-cious. At the same time, it is not possible in the United States to walk into a store and walk out with a bottle of barbiturates or codeine or, indeed, even with an empty hypodermic syringe. We are now deprived of that right because we have come to value medical paternalism more highly than the right to obtain and use drugs with-out recourse to medical intermediaries.

I submit, therefore, that our so-called drug-abuse problem is an integral part of our present social ethic that accepts "protections" and repressions justified by appeals to health similar to those which medieval societies accepted when they were justified by appeals to faith. Drug abuse (as we now know it) is one of the inevitable con-sequences of the medical monopoly over drugs—a monopoly whose value is daily acclaimed by science and law, state and church, the professions and the laity. As formerly the church regulated man's relations to God, so medicine now regulates his relations to his body. Deviation from the rules set forth by the church was then considered heresy and was punished by appropriate theological sanctions; de-viation from the rules set forth by medicine is now considered drug abuse (or some sort of "mental illness") and is punished by appro-priate medical sanctions, called treatment.

The problem of drug abuse will thus be with us as long as we live under medical tutelage. That is not to say that if all access to drugs were free, some people would not medicate themselves in ways that might upset us or harm them. That, of course, is precisely what hap-pened when religious practices became free. People proceeded to en-gage in all sorts of religious behaviors that true believers in traditional faiths found harmful and upsetting. Nevertheless, in the conflict be-tween freedom and coerced religion, the American political system has come down squarely for the former and against the latter.

THE ETHICS OF DRUG CONTROLS

I believe that just as we regard freedom of speech and religion as fundamental rights, so should we also regard freedom of self-medication as a fundamental right; and that, instead of menda-ciously opposing or mindlessly promoting illicit drugs, we should, paraphrasing Voltaire, make this maxim our rule: "I disapprove of what you take, but I will defend to the death your right to take it!"
Sooner or later we shall have to confront the basic moral dilemma underlying the so-called drug problem: Does a person have the right to take a drug, any drug, not because he needs it to cure an illness but because he wants to take it?

It is a fact that we Americans have a right to read a book—any book—not because we are uninformed and want to learn from it, nor because a government-supported educational authority claims that it will be good for us, but simply because we want to read it and because the government—as our servant rather than our mas-ter—does not have the right to meddle in our private reading affairs. I believe that we also have a right to eat, drink, or inject a sub-stance—any substance—not because we are sick and want it to cure us, nor because a government-supported medical authority claims that it will be good for us, but simply because we want to take it and because the government—as our servant rather than our master—does not have the right to meddle in our private dietary and drug affairs.

Of course, this belief is not universally shared. On the contrary, it is a minority view, held only by persons who support the moral and political principles of a free society, by which I here mean prin-cipally a society in which individuals are expected to control their own self-regarding behavior. The First Amendment's protection of religious freedom exemplifies this posture: Americans are not ex-pected to look to the government to provide them with those reli-gious beliefs and organizations that are good for them, while protecting them against those that are bad for them. Our system of drug controls exemplifies the opposite principle: Americans are ex-pected to look to the government to provide them with those drugs and drug-dispensing organizations that are good for them, while pro-tecting them from those that are bad for them. The results speak for themselves.

Sad to say, we Americans have collectively chosen to cast away our freedom to determine what we should eat, drink, or smoke. In this large and ever expanding area of our lives, we have rejected the principle that the state is our servant rather than our master. This proposition is painfully obvious when people plaintively insist that we need the government to protect us from the hazards of "dan-gerous" drugs. The demand for, and expectation of, governmental protection from what is, in effect, the temptation to take drugs is, in my opinion, emblematic of our collective belittling of ourselves as children unable to control themselves, and of our collective glor-ification of the state as our benevolent parent whose duty is to con-trol its childlike subjects.

To be sure, drugs are potentially potent influences, for good or ill, on our bodies and our health. Hence, we need private voluntary associations—or also, some might argue, the government—to warn us of the dangers of heroin, salt, or a high-fat diet. But it is one thing for our would-be protectors to inform us of what they regard as dangerous substances, and it is quite another thing for them to punish us if we disagree with them or defy their wishes.

DRUGS AND SELF-DETERMINATION

According to the formula made famous by the Caesars, the masses of mankind need only two things: panem et circenses, bread and circuses. This is still true. Today, farms and factories supply us with an abundance of "bread," while drugs and drug controls give us our "circuses." In other words, the contemporary preoccupation with the use and abuse of drugs, together with the persecution of (illicit) drugs, "addicts," and "pushers," is best understood as a secular ritual that now amuses, fascinates, terrorizes, and satisfies Ameri-cans, much as gladiatoral contests and Christian wonder-workings fascinated and satisfied the Romans.

As I noted earlier, this is, of course, not the way people see their own important rituals. Hence, it should not surprise us that the ritual nature of the war on drugs does not make people doubt the validity of their premises concerning our so-called drug problem or the le-gitimacy of the social policies ostensibly aimed at combating it. In-deed, why should it? If people want to deny that the danger in "dangerous drugs" lies not in the substances themselves but in the human propensity to take them and in the personal decisions of those who use them, then they will deny it. And, having denied it, they will proceed to lose sight of such old-fashioned but eternally valid ideas as temptation and self-control, and will end up denying the reality of personal freedom and responsibility as well. Finally, people will convince themselves, as most Americans have, that the "drug problem" is something historically novel, a new disease requiring new treatment. This is a costly illusion.

1. T. S. Szasz, The Manufacture of Madness: A Comparative Study of the Inquisition and the Mental Health Movement (New York: Harper & Row, 1970), esp. pp. 242-75.

2. R. Bourne, The Radical Will: Selected Writings, 1911-1918 (New York: Urizen Books, 1977), p. 360.

3. New York Post, 8 November 1980, p. 5.

4. New York Post, 26 September 1980, p. 10.

5. For more details, see T. S. Szasz, Ceremonial Chemistry: The Ritual Persecution of Drugs, Addicts, and Pushers (Garden City, N.Y.: Doubleday, 1974), pp. 183-212.

6. B. J. Albaugh and P. O. Anderson, "Peyote in the Treatment of Alcoholism Among American Indians," American Journal of Psychiatry 131 (1974): 1247.

7. New York Times, 5 June 1975, p. 38.

8. International Herald-Tribune, 20-21 December 1975, p. 3.

9. New York Times Magazine, 1 February 1976, p. 34.

10. International Herald-Tribune, 9 December 1976, p. 1.

11. J. T. M. Murphy-Ferris and L. Torrey, "The Apricot Connection," New Scientist (London), 30 June 1977, p. 766.

12. International Herald-Tribune, 7 June 1977, p. 4.

13. T. S. Szasz, The Therapeutic State: Psychiatry in the Mirror of Current Events (Buffalo, N.Y.: Prometheus Books, 1984), pp. 284-96.

14. International Herald-Tribune, 7 September 1979, p. 16.

15. International Herald-Tribune, 21 January 1980, p. 16.

16. Washington Post, 22 November 1980, p. C-1.

17. International Herald-Tribune, 17 December 1980, p. 16.

18. New York Times, 5 March 1981, p. B2.

19. T. S. Szasz, "The Protocols of the Learned Experts on Heroin," Libertarian Review, July 1981, p. 297; reprinted in Szasz, The Therapeutic State, p. 297.

20. New York Times, 13 January 1982, p. B-15.

21. Ithaca Journal, 11 February 1982, p. 29.

22. New York Post, 10 March 1982, p. 24.

23. New York Times, 11 August 1983, p. A-1.

24. Syracuse Herald-Journal, 1 October 1983, p. A-9.

25. New York Times, 18 February 1984, p. A-8.

26. Syracuse Herald-Journal, 1 May 1984, p. A-2.

27. Washington Post, 8 September 1984, p. A-16.

28. New York Times, 4 October 1984, p. B-17.

29. Ibid., 18 October 1984, pp. A-1, B-3, B-7.

30. New York Post, 8 November 1980, p. 4.

31. T. Jefferson, "Notes on the State of Virginia" (1781), in A. Koch and W. Peden, eds., The Life and Selected Writings of Thomas Jefferson (New York: Modern Library, 1944), p. 275.