Drug Use and Abuse

The use of psychoactive substances is a common feature of all human societies, and these drugs have been used throughout human history for medicinal purposes, pain control, religious rituals, and personal pleasure. Notwithstanding the “war on drugs” metaphor of recent decades, drug use and abuse are not problems of late modernity but rather problems from antiquity. Nevertheless, drug use and abuse take an immense economic and social toll on society in terms of society's criminalizing response to those who use and abuse these substances, the morbidities and mortalities associated with their usage, and the familial dysfunction and community disintegration common to those with addiction troubles. Drugs are viewed as a scourge on society, on morality, and on social order, and because of this viewpoint, there is a long history in the United States of battling this problem.

The terms drug abuse and drug use speak to very different concepts, although historically they [Page 386]have often been conflated in the policy and public rhetoric on illicit substances, especially around the use of marijuana. A drug user is not necessarily a drug abuser. Indeed, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, defines drug abuse by the following four markers: (1) the failure to maintain and discharge one's role requirements, (2) the frequent use of illicit drugs in settings that are dangerous or hazardous, (3) having multiple legal problems, and (4) experiencing recurring social and interpersonal crises. On the other hand, a drug user is someone who frequently or occasionally uses psychotropic substances but is not dependent on them. Ostensibly, a drug user can give up his or her use of illicit drugs, but addicted individuals (i.e., those who abuse drugs) cannot easily accomplish this. Throughout the history of laws on drug use and abuse in the United States, there have been few attempts to differentiate between the recreational user and the everyday, freewheeling addict; this is particularly acute in discourses on marijuana use, especially where federal and state laws treat both recreational users and addicted abusers as criminals.

History

Humans have a long storied history with psychoactive plants and synthetic chemicals. The fathers of Western medicine, Hippocrates and Galen, prescribed plants with medicinal properties such as Papaver somniferum, the poppy flower, for a host of physical and psychological ailments, from asthma to chronic sadness. During the Industrial Revolution in Europe, laudanum, which was a tincture of alcohol and opium, was widely prescribed and used for its painkilling and healing properties. Opium was so important to international commerce that the British fought two wars, the first from 1839 to 1842 and the second from 1856 to 1860, over China's efforts to enforce Prohibition and to end British monopoly of the trade.

In the Americas,Erythroxylum coca, or the coca leaf, from which the drug cocaine is derived, played an important role in Inca rituals and religious funeral rites and was used for medicinal purposes. Native Americans in the U.S. Southwest and indigenous groups in Mexico employed, and continue to use, the peyote cactus and a host of hallucinogenic mushrooms in sacred rituals and religious ceremonies. The Cannabis sativa plant, commonly known as marijuana, has been used throughout most cultures as a medicinal, ritual, and pleasure-producing substance. Almost all human societies, including those of India, China, Africa, the Middle East, and the Americas, have a recorded antiquity with the plant, dating back to 4000 B.C.E.

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