a philosophical review of the new book by Jeffrey A. Singer
by Brian Ballard Quass, the Drug War Philosopher
June 9, 2025
In "Your Body, Your Health Care,1" Jeffrey Singer highlights many of the ways in which drug prohibition denies us our right to self-medication2, and I appreciate that. The author however signs off (contra Thomas Szasz3) on the existence of mental illness 4 (at least he uses the term 'illness' uncritically in reference to mental conditions) -- and this is problematic. This belief in the existence of a literal 'mental illness' is the assumption that placed materialist doctors in charge of mind medicine in the first place: the idea that human beings are biochemical widgets responsive to one-size-fits-all medical interventions -- not just for 'physical' diseases like cancer, but for erstwhile spiritual or moral diseases like depression, anxiety and existential angst.
This is a western-biased approach toward psychoactive medicine, biased by puritanism and materialism 5. This is not how drugs are conceived by indigenous peoples. No indigenous shaman would ever maintain that one has to be a materialist in order to understand mind and mood medicine. Indeed, they might even maintain that materialists had no role in talking about such medicines, except perhaps to point out potential purely physical downsides to a given substance, and only then in a largely acontextual manner.
The problem with Singer's materialist-friendly outlook can be seen in considering the following sentence from chapter 11 of his book:
"Much evidence confirms that long-term treatment with the opioid agonists methadone and buprenorphine is the most effective treatment for OUD [Opioid Use Disorder]." --Jeffrey A. Singer, from Your Body, Your Health Care, p. 1436
ANALYSIS
It sounds to me like victim blaming to posit the existence of a discrete illness called 'Opioid Use Disorder.' Opioids themselves came about as a result of the outlawing of naturally occurring opiates as well as all opium alternatives -- so the problems that we ascribe to the use of opioids should be called "Prohibition Disorders." This "disorder" only exists because of our failure to educate and our failure to provide a wide array of alternatives. In a free world, one with choice and education, OUD would be just a synonym for pathological masochism, there being so many common-sense ways to avoid it.
And what about the statement that two agonists (methadone and buprenorphine) are the most effective treatments for OUD? That is certainly not true -- unless we pretend that drug prohibition does not exist. The fact is that there are a vast array of drugs (like phenethylamines, coca, laughing gas 7 , and even opium) that could be used in wise protocols (alone or in combination) in such a way as to take the user's mind off of an unwanted opioid entirely. The user reports in books like "Pihkal"8 by chemist Alexander Shulgin cry out for sensible use of drugs for this purpose:"
"The feeling was one of great camaraderie, and it was very easy to talk to people."
"It was a glorious feeling, and beauty was everywhere enhanced."
"I acknowledged a rapture in the very act of breathing."
The opioid "abuser" could be offered a wide variety of drugs in common sense protocols to steer them away from unwanted opioids. But in fighting for such outcomes, we first have to be able to recognize success. We have to acknowledge that a successful treatment for opioid dependency for some people would be to allow them to smoke opium nightly in the privacy of their homes, as millions of Americans were doing before 1914. This is no worse an outcome than nightly drinking, or nightly smoking, or the daily use of Big Pharma 910 drugs as practiced by 1 in 4 American women. Indeed, an argument could be made that nightly opium smoking has benefits that these other popular "escapes" do not possess.
This is why I have an ambivalent philosophical reaction to drugs like Naloxone. Naloxone makes obvious sense in emergency situations to reverse the effects of the overdosing that prohibition renders likely. And yet Naloxone becomes a biochemical weapon for prohibitionists when they use it to turn Americans "off" of opium use entirely, to render them chemically unable to benefit from opiates at all. Let us be clear: that is a political use of Naloxone, not a scientific or medical one. In a sane world, our efforts would go toward helping users benefit wisely from nature's panacea, rather than simply rendering them biochemically incapable of benefitting from the drug.
Unfortunately, Singer falls into the habit of almost all non-fiction authors these days, in reckoning without the Drug War. And so he makes claims that only make sense if we assume that outlawed substances, like those described in "Pihkal," do not exist.
For Singer to say that methadone and buprenorphine are the most effective treatments for OUD is just like NIDA 11 telling us that SSRIs are the best way to treat depression. Both statements are obviously false -- UNLESS we assume that outlawed substances do not exist. Otherwise, in NIDA's case, we would point out that drugs exist which can end depression "in a trice" -- albeit in a politically incorrect way, one in which we did not doff the cap to materialists who profess to be the experts in such undertakings.
Malcolm X saw through this attempt on the part of materialist doctors to become the experts about psychoactive drug use12. He knew that ending unwanted drug use was all about changing motivations -- not about following the time-consuming, expensive, and uncertain materialist protocols that serve to enrich the medical establishment.
And what about drugs like Naloxone? Once again, it makes all the difference in the world whether we discuss this topic in light of America's unprecedented wholesale drug prohibition -- or if we discuss it in practical terms without acknowledging prohibition.
In practical terms, I say nothing against Naloxone and much good may it do the user in this imperfect world of ours. However, in philosophical terms, Naloxone is a very strange beast indeed. Just imagine. America first demonized opium based on racist and xenophobic fearmongering and managed to have it essentially outlawed around the world. And yet our hatred of "oriental" opium was still not sated. Now our laboratories had to come up with drugs that make it impossible to benefit from opiates! To be sure, we do so in the name of the seemingly lofty goal of fighting OUD, but that very condition exists because of our paleolithic fearmongering about substance use in general: a world in which we say things like "Fentanyl 13 kills!" and "Crack kills!" -- failing to realize that such statements are on a philosophical par with saying "Fire bad!" All such statements suggest that the best way to deal with harmful substances is to fear them and demonize them, rather than to use them as wisely as possible for the benefit of humanity.
We may as well advertise our opium-scorning agonists as follows:
This government-supplied drug will keep you from becoming a lazy Chinese a la the racist picture painted for us by mendacious missionaries in the 19th century, whose Big Lies about opium use in China taught us to mistrust and hate the drug in the first place, even though opium smoking in the west would cut down on alcohol use and so bring wife beating to an end.
What follows are a list of quotations from Jeffrey A. Singer's book entitled "Your Body, Your Health Care," each followed by my own comments on the issues raised.
"Sadly, staff at a London, Ontario, OPC experienced their first overdose fatality in early October 2024 after being unable to resuscitate an overdose victim." --Jeffrey A. Singer, from Your Body, Your Health Care, p. 14214
This quotation illustrates how Westerners are simply incapable of sanely evaluating risks in the age of the Drug War. One single death in such a fraught area of public endeavor should be considered as the merest drop in a bucket -- given that aspirin use kills thousands in the UK alone every year15 and that every risky activity on earth has a death toll, from horseback riding to parachuting to car driving to drinking alcohol16. And yet, as Singer's phraseology all too accurately suggests, a single death in the field is considered to be a potential mortal blow when it comes to marshalling public support for harm prevention.
It took only one death at a stateside ayahuasca ceremony to make ayahuasca advocates and prohibitionists alike recoil in terror17 . How many of them were smoking cigarettes and throwing back a cold one when they read about that incident? But no one is ever on the edge of their seat, just waiting to learn about a new death by cigarettes or alcohol. We are only wound up in that way by drug deaths. We are, in short, enormously predisposed to fixate lopsidedly on drug-related health issues. As long as we play by this rule of "One strike, you're out" when it comes to drug-related fatalities, then the prohibitionists will always have their way.
This is why I keep saying that the Drug War represents a wrong way of looking at the world. Speaking of which, I am glad to see that Singer refers to both a Drug War I and a Drug War II, the latter being the Drug War officially launched by Richard Nixon in the early 1970s. Singer thus makes it clear that the drug-war mindset was alive and well long before Nixon ever had the corrupt epiphany to use drug law to oppress his opponents.
"The DEA added MDMA to Schedule I in 1985, after the drug became popular among rave concertgoers who called the drug 'ecstasy.'" --Jeffrey A. Singer, from Your Body, Your Health Care, p. 9618
This sad truth reminds us why it is important to talk about benefit promotion as well as harm reduction. Prohibitionists talk like there was no upside to Ecstasy use at concerts. And yet the use of Ecstasy brought about unprecedented peace, love and understanding on British dance floors in the 1990s19. This is an enormous health benefit, especially in a world in which our propensity for hatred has our species on the brink of self-annihilation. But Drug Warriors do not see any benefits in peace, love and understanding. And so they cracked down on both Summers of Love in the anglophone world, first the psychedelic-fueled love-fest in the States in the 1960s and then the Ecstasy-fueled love-fest in the UK in the 1990s.
This is why I am always a little dissatisfied with the harm reduction approach. It makes sense in itself, of course. It is an important way to help clean up the mess that drug prohibition has left us with. There are real heroes out there in the field of harm reduction20. However, almost all those who write about harm reduction fail to make it sufficiently clear that drug use can have benefits as well. In the absence of such an acknowledgement, the use of the term "harm reduction" yields ground to the Drug Warriors by focusing the debate on drug-use downsides, thereby implying to the brainwashed public that drug use, indeed, has no upsides.
"[Ketamine] creates a dissociative state by disconnecting patients' mental processes from their pain perception." --Jeffrey A. Singer, from Your Body, Your Health Care, p. 9521
True. And those feelings are marvelous. But let me add here that opium can do the exact same thing. Opium can help one externalize pain as well. As Jim Hogshire writes in "Opium for the Masses":
"This feeling of detachment is the most important feature of opiate analgesia. As a deadening agent, opium has almost no effect. If measured purely for its ability to alleviate the sensation of pain, morphine 22 , opium, or any of the others would score no better than aspirin. It is the perception of pain that opium alters, and that makes all the difference in the world." --Jim Hogshire, from Opium for the Masses: Harvesting Nature's Best Pain Medication23
Consider also this quote from Andrew Weil about opiates:
"The strong craving that characterizes opiate addiction has inspired many critics of the drugs to suggest that narcotics destroy the will and moral sense, turning normal people into fiends and degenerates. Actually, cravings for opiates are no different from cravings for alcohol among alcoholics, and they are less strong than cravings for cigarettes, a more addictive drug." --Andrew Weil, from From Chocolate to morphine 24 : Everything You Need to Know About Mind-Altering Drugs25
Americans are simply trying to re-invent the wheel in a politically correct way when it comes to the time-honored benefits of opium. For two centuries now, they have been bashing this panacea, and so they now find that they have to sanctify new drugs like ketamine to take opium's place -- new and more dangerous drugs, of course: in this case, a substance which, unlike opium, causes urinary problems in long-term or high-dose users. But then the Drug War is all about controlling the narrative around drug use, and if those with a financial interest in marketing ketamine can brand their intervention successfully, that intervention can become the lamb's milk of mental health therapies. After all, the Drug War has nothing to do with the facts about drugs, merely with how we feel about them.
But isn't this what capitalism 26 is all about: selling us on things based on a PR-generated impression of those things? The Coca-Cola company does not try to win customers by pointing out the technical benefits of ingesting caffeine or the coca leaf -- they instead work to create a Pavlovian association in the consumer's mind between Coca-Cola and youth and spontaneity and joy and optimism.
I do not mean to imply that ketamine has no uses, by the way. That is the whole problem with the Drug Warrior mindset: that it encourages us to vote drugs "up" or "down" without regard for context. I myself have benefited from ketamine, but only briefly (for several months), as I wished to avoid the potential urinary downsides -- that, plus the fact that it was enormously expensive to acquire a prescription for home use. It was the kind of therapy that non-millionaires like myself could financially justify only as a once-in-a-lifetime experiment in psychological healthcare.
"Journalists, commentators, and lawmakers should use terminology more accurately and precisely, and resist the temptation to confer legitimacy on an unproven addiction." --Jeffrey A. Singer, from Your Body, Your Health Care, p. 11827
In discussing so-called 'social media addiction,' Singer brings up the highly fraught topic of the difference between addiction and dependency. Many psychiatrists see no problem with SSRIs because they "merely" render a user dependent and not addicted. But why is it okay for me to feel like hell when I am withdrawing from a highly dependence-causing drug? The real 'benefit' of my dependency is a benefit for doctors, not for myself, because if I am merely dependent, I will not pester my doctor for more and better drugs: I will simply stay silently at home and wish that I were dead. But if I were "addicted," then I would demand the drugs that I needed and so become a problem for psychiatrists.
Moreover, this kneejerk assumption that opium leads to cravings in sensible users is problematic in itself and based on a lot of self-serving lies by anti-opium missionaries of the 19th-century. The Anti-Opium Society of England was itself created in response to the lies of an American missionary who promoted the Big lie that Indian opium use had killed millions of Chinese. Remember that protestant missionaries had an obvious reason for hating opium: they wanted the Chinese to put down their opium pipes and pick up a Christian Bible instead.
In the words of Dr. Ayres, the Surgeon-General of Hong Kong in the early 19th century:
"No China resident believes in the terrible frequency of the dull, sodden-witted, debilitated opium smoker met with in print. " --William H. Brereton, from The Truth About Opium, quote from Dr. Ayers, the Surgeon General of Hong Kong in the early 19th century28
Speaking of China, Singer reports that:
"The government forces thousands of Chinese whom it labels 'internet addicts' into psychiatric boot camps. It subjects them to forced medication and, sometimes, electroshock therapy." --Jeffrey A. Singer, from Your Body, Your Health Care, p. 11729
And so we see that "addiction" is not just the golden goose of the Drug Warrior, it is the bugbear by which totalitarian governments can justify dictatorial measures of all kinds. It is interesting, however, that no Drug Warriors ever wish to spend lavishly on ending addiction. Or if they do, they want to spend that money on scientific research which will ignore all common sense and thus proceed at a snail's pace. The fact is that drug education combined with the re-legalization 30 of drugs would provide us with endless common-sense ways to avoid and/or overcome addictions. The Drug War practically created addiction out of whole cloth in 1914 by outlawing opium, turning habitues into "addicts" and "junkies" overnight.
The poor Chinese cannot win, by the way. If they avoid the Internet entirely, they are singled out as rebels who are probably "up to something.31" If they embrace the Internet too thoroughly, however, they are again singled out as troublemakers. Like baby bear in the fairy tale, they have to find an Internet usage pattern that is "just right"... according to the paranoid sensibilities of their freedom-fearing government.
"It is much less harmful to consume cannabis than it is to consume alcohol. There is no lethal dose of cannabis, and no history of anyone dying from consuming too much of it. Cannabis is also less likely to lead to violent behavior than alcohol." --Jeffrey A. Singer, from Your Body, Your Health Care, p. 9332
Yes. But we should also add that opium, at least when smoked, is much less harmful to consume than alcohol. As William H. Brereton points out in The Truth about Opium, nightly opium smokers in China do not beat their wives as do some nightly beer drinkers in England.
This is the whole problem with drug prohibition: it quickly devolves into a game about who can control the branding of psychoactive substances. If you can control the narrative, you can control the people. Almost no one even realizes that aspirin kills thousands a year (since it is in no one's financial interest to point that out in billboards, ads, and movies 3334 , etc.), and yet members of the Drug War generation are made aware of every death related to opiate use and are essentially told that each death constitutes a knock-down argument in favor of substance prohibition. And so the Drug War is just one big PR campaign to cast drugs in a bad light.
This is what happens when we put the government in charge of the health of the individual.
As GK Chesterton wrote:
"It is said that the Government must safeguard the health of the community. And the moment that is said, there ceases to be the shadow of a difference between beer and tea. People can certainly spoil their health with tea or with tobacco or with twenty other things. And there is no escape for the hygienic logician except to restrain and regulate them all. If he is to control the health of the community, he must necessarily control all the habits of all the citizens...." --GK Chesterton, from Eugenics and Other Evils35
Author's Follow-up:
November 04, 2025
Singer's book is excellent, by the way. I say that explicitly here for those who might misinterpret my philosophical observations as carping. He is one of the least bamboozled of all our Drug War pundits. He is one of the few writers who acknowledges the fact that the Drug War represents the outlawing of a fundamental right -- namely, our right to take care of our own health as we see fit.
"Imagine how many people would have benefited during the past half-century had the government respected their autonomy and their right to self-medicate." --Jeffrey A. Singer, Your Body, Your Health Care --p. 9736
THIS is the true evil of drug prohibition -- and yet most re-legalization pundits never even mention this fact. Instead, they argue on the backfoot 3738 , adducing statistics to show that, on the whole, legalization would help more people than it hurts 39. This is obviously true, of course, as anyone can see if they dare to drive through one of the endless urban communities that has been destroyed by the gangs and violence that drug prohibition has created out of whole cloth 40. But the best debating tactic is to argue from principles, not from statistics. A statistic can (and will) always be strategically gainsaid with the help of another statistic, however disingenuously deployed; and yet our opponent can only mutter and blush when we confront them with the fact that their prohibition is outlawing a basic human right, such as our right to heal.
This is why I refer so often to the condition of chronic depression in my essays, because as a chronic depressive myself, I am LIVING the pernicious effects of drug prohibition. I feel the effects of prohibition every day insofar as it has denied me my right to heal. If I were a debater, therefore, I would not waste my time trying to persuade a clearly disingenuous opponent with statistics about prohibition-fueled gun violence or the highly preventable drug overdoses that result from our failure to regulate the drug supply. Instead, I would bring the Drug War home. I would look the prohibitionist straight in the eyes and tell them "thus did thou!"
"You have taken away my right to heal by outlawing drugs like cocaine that could have cured my depression in a trice, and instead shunted me off onto Big Pharma drugs that can NEVER be kicked 41. Where is your concern for the Big Pharma patients who can never get off their "meds", you who have always made such a big fuss about the evils of drug dependency?! How can you sit there and support a policy that has turned me into a drug user for life -- meanwhile denying me the obvious cure for depression that was championed by Sigmund Freud himself 42-- until self-interested doctors ignored the interests of hundreds of millions of the depressed by focusing only on the rare downsides of use? You have outlawed my most fundamental human right: my right to heal! And how? By taking away another equally fundamental right: my right to benefit from the bounty of Mother Nature!"
Of course, the committed Drug Warrior will eventually stop spluttering in response to these unexpected home truths and cobble together some sort of response. The point is, however, that they will not be able to respond to such principled pushback merely by citing the usual cherry-picked statistics; they will now have to answer for the anti-democratic consequences of their policies in the real world. They will have to justify the fact that their drug prohibition outlaws the most basic of human rights. And this is sure to put the Drug Warrior at a disadvantage, a fact upon which any decent debater on the side of freedom can capitalize, thereby revealing the inconsistency, shallowness, and anti-democratic tendencies of the whole prohibitionist outlook.
We should no more arrest drug users than we arrest people for climbing sheer rock faces or for driving a car.
Irony of ironies, that the indignant 19th-century hatred of liquor should ultimately result in the outlawing of virtually every mind-affecting substance on the planet EXCEPT for liquor.
Drug War propaganda is all about convincing us that we will never be able to use drugs wisely. But the drug warriors are not taking any chances: they're doing all they can to make that a self-fulfilling prophecy.
Mad in America solicits personal stories about people trying to get off of antidepressants, but they will not publish your story if you want to use entheogenic medicines to help you. They're afraid their readers can't handle the truth.
The Drug War is a religion. The "addict" is a sinner who has to come home to the true faith of Christian Science. In reality, neither physical nor psychological addiction need be a problem if all drugs were legal and we used them creatively to counter problematic use.
Everyone's biggest concern is the economy? Is nobody concerned that Trump has promised to pardon insurrectionists and get revenge on critics? Is no one concerned that Trump taught Americans to doubt democracy by questioning our election fairness before one single vote was cast?
Opium could be a godsend for talk therapy. It can help the user step outside themselves and view their problems from novel viewpoints.
Getting off some drugs could actually be fun and instructive, by using a variety of other drugs to keep one's mind off the withdrawal process. But America believes that getting off a drug should be a big moral battle.
Here are some political terms that are extremely problematic in the age of the drug war:
"clean," "junk," "dope," "recreational"... and most of all the word "drugs" itself, which is as biased and loaded as the word "scab."
It's "convenient" for scientists that their "REAL" cures happen to be the ones that racist politicians will allow. Scientists thus normalize prohibition by pretending that outlawed substances have no therapeutic value. It's materialism collaborating with the drug war.
We should no more arrest drug users than we arrest people for climbing sheer rock faces or for driving a car.
