Chocolate to Morphine - What is a Drug?

Chocolate to Morphine: Understanding Mind Active Drugs
Andrew Weil, MD and Winifred Rosen
1983 Houghton-Mifflin Company

2.What Is a Drug?

MOST PEOPLE WOULD AGREE that heroin is a drug. 1t is a white powder that produces striking changes in the body and mind in tiny doses. But is sugar a drug? Sugar is also a white powder that strongly affects the body, and some experts say it affects mental function and mood as well. Like heroin, it can be addicting. How about chocolate? Most people think of it as a food or flavor, but it contains a chemical related to caffeine, is a stimulant, and can also be addicting. Is salt a drug? Many people think they cannot live without it, and it has dramatic effects on the body. A common definition of the word drug is any substance that in small amounts produces significant changes in the body, mind, or both. This definition does not clearly distinguish drugs from some foods. The difference between a drug and a poison is also unclear. All drugs become poisons in high enough doses, and many poisons are useful drugs in low enough doses. Is alcohol a food, a drug, or a poison? The body can burn it as a fuel, just like sugar or starch, but it causes intoxication and can kill in overdose. Many people who drink alcohol crusade against drug abuse, never acknowledging that they themselves are involved with a powerful drug. In the same way, many cigarette addicts have no idea that tobacco is a very strong drug, and few people who drink coffee realize the true nature of that beverage. The decision to call some substances drugs and others not is often arbitrary. In the case of medical drugs - substances such as penicillin, used only to treat physical illness - the distinction may be easier to make. But talking about psychoactive drugs - substances that affect mood, perception, and thought - is tricky. In the first place, foods, drugs, and poisons are not clear-cut categories. Second, people have strong emotional reactions to them. Food is good. Poison is bad. Drugs may be good or bad, and whether they are seen as good or bad depends on who is looking at them. Many people agree that drugs are good when doctors give them to patients in order to make them better. Some religious groups, such as Christian Scientists, do not share that view, however. They believe that God intends us to deal with illness without drugs. When people take psychoactive drugs on their own, in order to change their mood or feel pleasure, the question of good or bad gets even thornier. The whole subject of pleasure triggers intense controversy. Should pleasure come as a reward for work or suffering? Should people feel guilty if they experience pleasure without suffering for it in some way? Should work itself be unpleasant? These questions are very important to us, but they do not have easy answers. Different people and different cultures answer them in different ways. Drug use is universal. Every human culture in every age of history has used one or more psychoactive drugs. (The one exception is the Eskimos, who were unable to grow drug plants and had to wait for white men to bring them alcohol.) In fact, drug-taking is so common that it seems to be a basic human activity. Societies must come to terms with people's fascination with drugs. Usually the use of certain drugs is approved and integrated into the life of a tribe, community, or nation, sometimes in formal rituals and ceremonies. The approval of some drugs for some purposes usually goes hand in hand with the disapproval of other drugs for other purposes. For example, some early Muslim sects encouraged the use of coffee in religious rites, but had strict prohibitions against alcohol. On the other hand, when coffee came to Europe in the seventeenth century, the Roman Catholic Church opposed it as an evil drug but continued to regard wine as a traditional sacrament. Everybody is willing to call certain drugs bad, but there is little agreement from one culture to the next as to which these are. In our own society, all nonmedical drugs other than alcohol, tobacco, and caffeine are viewed with suspicion by the majority There are subgroups within our society, however, that hold very different opinions. Many North American Indians who use peyote and tobacco in religious rituals consider alcohol a curse. The most fervent members of the counterculture that arose in the 1960s regard marijuana and psychedelics as beneficial while rejecting not only alcohol, tobacco, and coffee but most other legal and illegal drugs as well. Classic heroin addicts, or junkies, may reject psychedelics and marijuana as dangerous but think of narcotics as desirable and necessary. Some yogis in India use marijuana ritually, but teach that opiates and alcohol are harmful. Muslims may tolerate the use of opium, marijuana, and qat (a strongly stimulating leaf), but are very strict in their exclusion of alcohol. Furthermore, attitudes about which drugs are good or bad tend to change over time within a given culture. When tobacco first came to Europe from the New World it provoked such strong opposition that authorities in some countries tried to stamp it out by imposing the death penalty for users. But within a century its use was accepted and even encouraged in the belief that it made people work more efficiently. In this century Americans' attitudes toward alcohol have shifted from nonchalant tolerance to antagonism strong enough to result in national prohibition, and back to near-universal acceptance. The current bitter debate over marijuana is mostly a conflict between an older generation that views the drug as evil and a younger generation that finds it preferable to alcohol. Students of behavior tell us that dividing the world into good and evil is a fundamental human need. The existence of evil provokes fear and demands explanation. Why is there sickness? Why is there death? Why do crops fail? Why is there war? And, most important, how should we act to contain evil and avoid disaster? One attempt at a solution is to attribute evil to external things, and then prohibit, avoid, or try to destroy them. This is how taboos arise. People tend to create taboos about the activities and substances that are most important to them. Food, sex, and pleasure are very important, and many taboos surround them although, again, there is little agreement from culture to culture as to what is good and what is bad. Muslims and Jews eat beef but not pork; some groups in India eat pork but not beef. Homosexuality is taboo in most modern Western cultures, but has been fully accepted in the past and is still accepted today in certain parts of the world. People who adhere to taboos justify them with logical reasons. Jews like to think they do not eat pork because pigs are unclean and may have carried disease in former times. Christians argue that homosexuality is a sin because it perverts God's intended use of sex for procreation. Actually, reasons for taboos are secondary; the basic process is the dividing of important things into good and evil - a form of magical thinking that tries to gain control over sources of fear. The reasons and justifications come later. Because psychoactive drugs can give pleasure and can change the ways people think" perceive the world, behave, and relate to each other, they invite magical thinking and taboos. When you hear arguments on the merits or dangers of drugs, even by scientific experts, remember that these may be secondary justifications of pre-existing views that are deep-seated and rooted in emotion. (It is always easy for both sides to produce statistics and "scientific evidence" to support opposing views.) Because drugs are so connected with people's fears and desires, it is very hard to find neutral information on them. In this book we try to give unbiased facts about all psychoactive drugs people are likely to encounter today. We cannot say that we have no biases about drugs, but we think we know what they are. Our strongest conviction is that drugs themselves are neither good nor bad; rather, they are powerful substances that can be put to good or bad uses. We are concerned with the relationships people form with drugs, whether legal or illegal, approved or unapproved. We believe that by presenting neutral information about these substances, we can help people, especially young people, come to terms with drugs. Our purpose is not to encourage or discourage the use of any drug, but rather to help people learn to live in a world where drugs exist and not get hurt by them. Suggested Reading The best book on the subject of how societies classify drugs as good and evil is Ceremonial Chemistry: The Ritual Persecution of Drugs, Addicts, and Pushers by Thomas Szasz (Garden City, New York: Doubleday/Anchor, 1975). Szasz is a psychiatrist interested in the assumptions that lead people to call some kinds of behavior sick or wrong. His discussion of drugs and drug users as scapegoats is excellent. A book written for junior-high and high-school students that gives a good overview of the subject is Mind Drugs (third edition) edited by Margaret 0. Hyde (New York: McGraw-Hill, 1974).