What their comparison tells us about American drug attitudes
by Brian Ballard Quass, the Drug War Philosopher
March 30, 2026
I have yet to hear any drug pundit have a kind word to say about heroin. And yet they'd surely change their tune if they shared my backstory. As a chronic depressive, I was placed on a Big Pharma drug 30 years ago, one that turned out to be far harder to kick than heroin. Far harder. When I mentioned my desire to get off the drug, a former psychiatrist of mine told me of an NIH study that found there was a 95% recidivism rate 1 for long-term users who attempted to kick the drug. 95%. Compare this to the Lee Robins study of American soldiers in Vietnam, where heroin use was rife among the rank and file. Robins found that only 5% of those soldiers sought help getting off the drug when they returned to the States. 5%. 2
Incidentally, I found that the psychiatrist in question had been replaced on my next visit to the "mental health clinic," making me strongly suspect that he had been fired for his candor about that ostensible "miracle drug." He violated the party line by talking about dependency. Even the Mayo Clinic doesn't commit that heresy. In fact, there is no mention of the nasty dependence-causing propensity of Effexor on the Clinic's website, not even in the side effects section! 3
But then I suppose from a doctor's point of view, the dependence-causing nature of their drugs is not a downside. To the contrary, it assures them of a patient for life!
This makes me ask the following heretical question: If I have to use a drug every day of my life, why can't it be heroin instead of antidepressants? Drug propaganda aside, heroin users can live completely normal lives, even when the government is spending literally billions of dollars to do everything they can to destroy those lives, including disrupting drug supply and refusing to regulate product as to quality and dosage.
Through the 1980s, investigators repeatedly found heroin addicts leading ordinary lives while steadily employed at middle-class jobs.
Richard Lawrence Miller, Drug Warriors and Their Prey: From Police Power to Police State 5
And yet many of our seemingly progressive drug pundits demonize heroin while failing to find any problem whatsoever with antidepressants. Worse yet, many of them actually praise antidepressants to various degrees. Carl Hart tells us in the opening to his otherwise informative book ("Drug Use for Grown-Ups") that the depressed like myself should be going to doctors and not using the kinds of drugs that could cheer us up in a trice.6 Imagine that: going to a doctor to see what's the best option for me. Does Carl not realize that the best option for the doctor is the exact opposite of the best option for me? I have no desire to become a ward of the healthcare state and to see a doctor half my age every three months of my life to answer humiliating questions, all for the privilege of receiving yet another prescription for an expensive, underperforming, and highly dependence-causing med. I have no desire to be treated like a child like that to my very dying day.
Of course, in a world where I was actually free to take care of my own health, I would use a wide variety of substances on a strategically intermittent basis (smoking an opium pipe today, using a little cocaine tomorrow, then a variety of phenethylamines, the huachuma cactus, etc.), just like wise users have always done, in order to avoid unwanted dependencies. I would do this both for my depression, for religious insight, and to follow-up on the philosophical speculations of William James with respect to the nature of consciousness. But if I could only choose between heroin and antidepressants, I would definitely choose heroin, first and foremost because I would much rather get my drug from a drug dealer that treats me like an adult than an RN that treats me like a child. Nor will the drug dealer require me to visit him every three months of my life to tell him how I'm feeling and whether I have considered suicide in the last three weeks. 7
It really seems that no one but myself has ever stopped to think of drug-related issues with med-dependent patients in mind, or else they assume that we are all just going to "shut up and take our meds." Libertarian Jeffrey Singer seldom has anything positive to say about outlawed drugs, and yet he champions government-administered drugs to help people get off substances like heroin. 8 This, of course, begs the question: why are we trying to get them off heroin in the first place? Could it be that we are just trying to fill the beds at the rehab clinics? Addiction treatment is a $35 billion industry, after all, according to Colleen Cowles, author of "War on Us." 9 And yet Cowles herself champions the power of pharmaceutical company drugs while also condemning outlawed drugs with faint (and rare) praise.
If we are going to insist on people getting off of heroin, we should also be insisting that they get off of antidepressants. But I will not hold my breath waiting for the pharmaceutical companies to create a drug that will help me with achieving that goal.
Some have argued that heroin causes addiction whereas antidepressants "merely" cause dependence, but this is a distinction without a difference, at least from the depressed person's point of view. Attempting to get off of Effexor put me in hell. How are we going to compare that with heroin withdrawal? Are we going to start comparing different kinds of hell? 10 That's a subject for an eye-catching philosophy paper, perhaps, but it has nothing to do with the price of tea in China as far as actual users are concerned. It will be argued perhaps that Effexor is not habit-forming, but that again is a distinction without a difference from the user's point of view. Heroin may send more pronounced signals to the brain that, "Hey, it's time to take your meds," but Effexor sends the same message, only in a more sinister way, by letting one's mood lower imperceptibly over time. This may not make you want to run to the prescription bottle, but it will eventually make you want to die, so I don't personally see that as a great improvement over heroin.
Some may still argue that antidepressants are "scientific," that they fix a chemical imbalance in the brain, but this has always been a myth, albeit one that was encouraged by the well-paid talking heads for the pharmaceutical companies on network television. Richard Whitaker not only debunked the "chemical imbalance" theory in his groundbreaking book of 2011, "Mad in America," 11 but he went on to provide evidence that antidepressants may actually cause the imbalances that they purport to fix. If this is true, it could go a long way toward explaining why antidepressants are so difficult to kick. Even the Science gods have finally come clean on this topic. In 2022, Psychology Today published an article by Dr. Noam Shpancer entitled "Depression Is Not Caused by Chemical Imbalance in the Brain," in which the clinical psychologist began by dropping the following trio of platitude-busting bombshells:
"There is no convincing evidence that depression is caused by serotonin abnormalities.
Many people take antidepressants believing their depression has a biochemical cause. Research does not support this belief.
The notion that antidepressants work by elevating serotonin levels is not supported by the evidence."
Wow! Dr. Shpancer did everything but tell the tens of millions of chemically dependent patients in America that there is no such thing as Santa Claus. Not only do their "meds" not correct a chemical imbalance in the brain, but, says Noam, "We don’t know how antidepressants work," to which I would add that we don't even know that they DO work, if by "work" we mean that they help the user to achieve self-actualization in life rather than to merely keep them from killing themselves. This has got to be disappointing news for the millions of Americans who prided themselves on being scientific every time they took their meds. I can hear them now: "Do you mean that all we've been doing all this time is helping to buy new Maseratis for pharmaceutical company execs?!"
I write this essay because it is very instructive to compare the typical reaction of Americans to heroin use with their reaction to the use of antidepressants. It reminds us that drug prohibition is not really about health and safety but about the kinds of lives that we think people should be living. This is why we have no problems with prime-time ads for Jim Beam bourbon that are targeted at young people.13 This is why we never even notice that the toy shelves at Walmart are full of so-called "hydration games" that encourage young people to drink irresponsibly.14 We are not worried at all about public health; we are simply insecure. We are worried that people might be choosing lifestyles other than our own, thereby implicitly calling into question our own traditionalist convictions about what life is all about.
Of course, there is one objective reason why one would choose antidepressants over heroin if those were the only two drugs available for treating depression. That is the fact that our government is spending billions of dollars to make heroin use as dangerous as possible and to ruin our lives in countless ways should you or I make such a choice 15.
It's disgusting that folks like Paul Stamets need a DEA license to work with mushrooms.
There are plenty of "prima facie" reasons for believing that we could eliminate most problems with drug and alcohol withdrawal by chemically aided sleep cures combined with using "drugs" to fight "drugs." But drug warriors don't want a fix, they WANT drug use to be a problem.
Most people think that drugs like cocaine, MDMA, LSD and amphetamines can only be used recreationally. WRONG ! This represents a very naive understanding of human psychology. We deny common sense in order to cater to the drug war orthodoxy that "drugs have no benefits."
"My faith votes and strives to outlaw religions that use substances of which politicians disapprove."
The media called out Trump for fearmongering about immigrants, but the media engages in fearmongering when it comes to drugs. The latest TV plot line: "white teenage girl forced to use fentanyl!" America loves to feel morally superior about "drugs."
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.
There are endless creative ways to ward off addiction if all psychoactive medicines were at our disposal. The use of the drugs synthesized by Alexander Shulgin could combat the psychological downsides of withdrawal by providing strategic "as-needed" relief.
Wonder how America got to the point where we let the Executive Branch arrest judges? Look no further than the Drug War, which, since the 1970s, has demonized Constitutional protections as impediments to justice.
By reading "Drug Warriors and Their Prey," I begin to understand why I encounter a wall of silence when I write to authors and professors on the subject of "drugs." The mere fact that the drug war inspires such self-censorship should be grounds for its immediate termination.
The formula is easy: pick a substance that folks are predisposed to hate anyway, then keep hounding the public with stories about tragedies somehow related to that substance. Show it ruining lives in movies and on TV. Don't lie. Just keep showing all the negatives.
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