I seldom try to refute critics in long-form because they're usually so wrongheaded that I feel a single reply tweet of mine can demolish their feeble pretentions to truth, at least when the subject is drug prohibition and its endless downsides. But occasionally I get some pushback that calls for a little more effort on my part.
Take Frank S., for instance. I maintain that "addiction" is a problematic and political diagnosis because it ignores the fact that prohibition helps cause addiction. But Frank S. demurs. He tells me that we often make diagnoses without regard for one's personal life, their lack of education, lack of food, etc. So why should we not label a problem user as an "addict" without regard for the existence of a Drug War?
My answer is as follows:
The fact that we fail to highlight things such as poor diet and poor education in our diagnoses should be seen as a shortcoming of the whole categorization system of the west, rather than an excuse to add drug prohibition to the list of causes that we already ignore. If huge problems are being caused, say, by poor diet, it would be misleading to diagnose the starving with all sorts of maladies attendant upon malnutrition -- depression, fatigue, and so forth - without simultaneously stressing the outsize role that malnutrition played in causing those subsequent disorders. If we simply label all victims of a lack of food as depressed and anxious, etc. - however true those diagnoses may be "in and of themselves" -- we are helping to divert attention from tragically bad social policies. This is the whole thesis of Ivan Illich's book "Medical Nemesis," in which he shows how medical diagnoses help to justify and normalize bad social policies and, indeed, the failures of the capitalist system as a whole.
But diagnosing someone as an "addict" without referencing prohibition is especially problematic. This is so because "addict" is a wildly subjective term as used in Drug War America. As Richard L. Miller writes in Drug Warriors and Their Prey:
'As used by politicians and law-enforcement agencies today, the term "addict" often becomes synonymous with... a person who has had only one or two contacts with the substance.'
In fact, the term "addiction" is subjective, even as it is defined in Webster's Dictionary:
addiction: "The quality or state of being addicted -- specifically : the compulsive uncontrolled use of habit-forming drugs beyond the period of medical need or under conditions harmful to society."
Here are at least four problems with that definition:
It's a little "rich" to pathologize the "compulsive uncontrolled use" of drugs with the pejorative label of "addiction," given that we live in a world where multibillion-dollar agencies are tasked with the job of making drug use as unsafe as possible. If, on the other hand, drugs were re-legalized and users had a smorgasbord of psychoactive options from which they could choose freely and were taught to use them safely, this "compulsive uncontrolled use" would arguably not exist. A drug that caused undue compulsion would be replaced by other less compulsion-causing drugs. (Obsessive use of a contaminated Fentanyl 1 supply could be replaced, for instance, with a relaxing nightly session of uncontaminated opium smoking.) But this is something that the Drug Warrior cannot imagine, of course, because their puritanical presumptions make it unthinkable to fight drugs with drugs.
"beyond the period of medical need." This qualification ignores the whole reason for USING psychoactive drugs in the first place: they are not used for medical purposes but rather for the very human purpose of attaining self-transcendence in life. By defining addiction in terms of "medical need," we put scientists and doctors in judgment of a decision about drug use that only the user is competent to make. Only the user can decide if use of a certain psychoactive drug can be justified by a cost-benefit analysis given the user's own priorities in life, given what they personally consider to be the "summum bonum," a good life. The scientists and researchers may advise the would-be user about physical risks of a given drug, but they cannot decide whether that risk is worth taking because they do not know what the user most values in life. (Perhaps the user is like the opium -loving Avicenna, who was said to have valued "a short life with width to a narrow one with length.") Sure, the scientists and doctors can say that such illegal use would be wrong, morally speaking, as most would probably do these days, but that is not medical advice, that is legal and/or religious advice.
"under conditions harmful to society"? Who decides what is harmful to society? This is a subjective judgment. The Christian Scientist believes that any drug use is harmful to society, as do most politicians. The typical politician will also point to open-air drug markets and the miss-called "opioid crisis" as signs of harm, but this is a mere political charge in a world in which the harms of prohibition are never acknowledged, let alone discussed. The Drug Warriors use the downsides of prohibition as a scapegoat and a red herring to divert attention from the real culprit: prohibition itself, which limits choices, contaminates the drug supply, and refuses to even speak about safe use.
The definition implies that there's something wrong with habit-forming drugs. But this is not an obvious truth. Coffee is habit-forming and use is encouraged. Alcohol is habit-forming, cigarettes are habit-forming. 1 in 4 American women use SSRIs every day of their life. Of course, we don't call that a habit, we call that "taking care of one's mental health!"
Like so many topics (human consciousness, human perception, the nature of ultimate reality, etc.), our definition of "addiction" cannot be meaningfully discussed until we end the Drug War and the many anti-scientific premises upon which it is waged. It would be like trying to discuss the supposed intransigency of depression without mentioning the fact that we outlaw and/or marginalize drugs whose wise use could end most depression overnight: the coca leaf, laughing gas 2 , and MDMA 3 , for starters. American science journalists like Laura Sanders can pretend to write authoritatively about the supposed intransigence of depression only because they assume that the drugs that we outlaw today do not exist - and they expect that their readers will not even notice the omission, let alone care about it, because like the author, the readers too have been indoctrinated from childhood in the drug-hating ideology of the Drug War - thanks in part to the endless TV shows 4 they watch in which Christian Science messages have been inserted into the action thanks to pressure from the White House.
The authors of the DSM may wish to rise above the fray of politics by being "totally scientific," but they cannot escape the political implications of their work.
Let's take a real-life example.
Several decades ago, I complained to my psychiatrists about the fact that they could not give me something more. I had read about shrooms, opium , coca, etc. etc. and felt that the meds I was receiving were shabby replacements for drugs that could REALLY help me.
I was warned that if I kept up such talk, I might be diagnosed as an "addictive personality."
But had they followed through with this threat - for "threat" it certainly was - that would have been a political diagnosis, not a medical one. Why? Because it would have been based on a variety of unspoken premises such as: "it is wrong to use Mother Nature's psychoactive substances; it is wrong to seek too keenly for self-transcendence and spiritual insight." In fact, such premises would typically include the Christian Science idea that Mother Nature's drugs can offer no spiritual insights in any case, a proposition with which I heartily disagree. (I guess I'm old school, but then I can cite God himself in support of my view, for He told us in the Book of Genesis that his creation was good. Now, you can tell me that God misspoke, but please don't try to convince me that it has been scientifically proven that God was in error on this point!)
This is why I can't back down on this subject with a clear conscience. It's 30 years since the shrinks threatened to diagnose me as an "addictive personality," and my subsequent reading about the tremendous untapped potential of criminalized medicines has only strengthened my belief that such a threat was based on politics, not science. Had I been diagnosed as an "addictive personality," it would have just been another attempt by society to blame the victim for the downsides of America's war on self-transcendence, AKA the War on Drugs.
We should remember moreover that the DSM is basically written so that insurance companies and doctors can be "on the same page," both literally and figuratively speaking, when it comes to assigning costs for treatments. This has led to endless disease mongering since a condition cannot be treated in a remunerative manner unless it ticks some box in the paperwork of the insurance companies. But the DSM has political ramifications nonetheless, as its authors discovered in 1952 when they defined homosexuality as a disorder. In fact, one could almost say that, "those who define the illnesses control the society." That's what the above-referenced Ivan Illich says, in so many words, in "Medical Nemesis." And that is why I'm leery of diagnoses that help shield Drug Warriors from responsibility for the endless evils that they are inflicting upon society.
My suspicions of the diagnostic labeling systems are only heightened by the fact that scientists are almost universally silent about the Drug War. They pretend that it does not exist. Meanwhile, they write endless articles about abuse and misuse, but almost never about positive use: how the coca leaf can inspire and invigorate; how morphine 5 can give one a supernatural appreciation of Mother Nature; how "mindful" opium 6 smoking can re-cast one's problems as a metaphorical dream from which one can learn; how psychedelics can provide a new way of seeing one's world, etc. etc. And when I write to the authors and politely ask them to speak up, they almost never respond, because they are terrified by the Drug War and want to say nothing against it.
What's the answer?
In place of diagnoses like "substance misuse disorder" and "addictive personality," I propose that we use the diagnosis of "Prohibition Spectrum Disorder," which would include all of the mal-adaptive behaviors that prohibition helps bring about. The fact that scientists would never even consider this proposal is proof of my thesis that the labeling system today serves a political purpose: to normalize prohibition by pretending that it has no consequences in the real world. It's as if a country were to outlaw almost all food, only for its doctors to discover that the people were experiencing a raft of diet-related disorders. The scientists know that the ban on food is causing the problems, but they ignore that fact on the "scientific" ground that "dietary problems are dietary problems." Maybe so, but it's still cowardice on the part of those scientists when they fail to mention the gorilla in the room: namely, the fact that their government has caused these problems by outlawing almost all food.
Author's Follow-up:
October 29, 2025
The use of cocaine 7 could end most people's depression in a trice! Sigmund Freud 8 knew this from personal experience. But the medical establishment does not want to end depression, they want to treat it. That's why doctors demonized the drug in op-ed pieces by focusing only on statistically rare misuse, thereby throwing HUNDREDS OF MILLIONS of depressed under the bus. Imagine now the chutzpah -- nay, the gall -- of medical doctors who want to pathologize all the problematic drug use that prohibition has brought about -- the same doctors who have shunted me off onto a Big Pharma drug that is FAR HARDER TO KICK THAN HEROIN -- and which, in fact, can NEVER be kicked. My own psychiatrist told me that an NIH study showed Effexor to have a 95% recidivism rate for long-term users after three years. And the 5% who get off the drug encounter cognitive impairment 9!
That is the mother of all addictions -- although psychiatrists will tell me that it's not addiction, it's just dependence, as if there's a huge difference from the user's point of view. The lack of cravings is a benefit only for the doctor, because that means the patient will suffer silently at home and not bother them for pharmacological relief while they are on the golf course.
Addiction is manufactured by drug prohibition and America's childish and superstitious approach to "drugs" -- and it really bothers me that the same people who profit from this system (with their unearned monopoly on providing mind and mood medicine) are now going to categorize the addicts as sick and in need of help. Drug prohibition is sick and these disease-mongers in the medical industry have a duty to say so loudly and clearly to the beer-bellied politicians who are denying hundreds of millions the right to heal with their Stone Age belief that "Drugs bad, Og! Drugs bad!" Yes, these people need help: they need help in ending drug prohibition which refuses to teach safe use, refuses to regulate product and refuses to offer real drug choice. First the government does all it can to make drug use end in disaster -- and then its scientists turn around and cry, "Aha! You have a disease because your drug use is problematic!"
They get us both coming and going, don't they?
Before the outlawing of opium thanks to hateful prejudice against the Chinese, Americans could smoke opium peaceably at home, knowing that the drug supply was regulated. They were then mere opium habitues. Then in 1914, they turned overnight into addicts because drug law made use highly problematic and essentially turned them into criminals.
The answer is to re-legalize Mother Nature's medicines which government never had a right to outlaw in the first place. Scientists now want to discover all sorts of scientific reasons why one would want to use opiates -- as if there is any mystery why one would want to use a godsend. It was not enough for the government to outlaw opium, their scientists now followed up on that outrage by pathologizing the very desire for such drugs.
The opium-loving Benjamin Franklin was no addict in the pejorative sense of that word. He was one of the most successful men on the planet. We need to relegalize drugs and let the vast majority of people use drugs wisely just like Ben -- just as the majority of drinkers now drink wisely. The medical industry should start standing up to politicians and begin protesting drug prohibition as the denial of our right to heal. Instead, they help normalize drug prohibition by blaming the problems it creates on our genes and biochemistry -- on anything except the real cause of drug problems in America: the politicians who think that ignorance and incarceration are the way to respond to people's attempts to heal themselves.
There would be little or no profiling of blacks if the Drug War did not exist.
In the Atomic Age Declassified, they tell us that we needed hundreds of thermonuclear tests so that scientists could understand the effects. That's science gone mad. Just like today's scientists who need more tests before they can say that laughing gas will help the depressed. Science today is all about ignoring the obvious.
Even when laudanum was legal in the UK, pharmacists were serving as moral adjudicators, deciding for whom they should fill such prescriptions. That's not a pharmacist's role. We need an ABC-like set-up in which the cashier does not pry into my motives for buying a substance.
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."
Using the billions now spent on caging users, we could end the whole phenomena of both physical and psychological addiction by using "drugs to fight drugs." But drug warriors do not want to end addiction, they want to keep using it as an excuse to ban drugs.
For most drugs, dependency is a bug. For Big Pharma antidepressants, it is a feature.
Our tolerance for freedom wanes in proportion as we consider "drugs" to be demonic. This is the dark side behind the new ostensibly comic genre about Cocaine Bears and such. It shows that Americans are superstitious about drugs in a way that Neanderthals would have understood.
When we place the FDA in charge of deciding whether a psychoactive drug should be re-legalized or not, we are asking them to decide on things like the relative importance of appreciating a sunset, a task for which the FDA has no expertise whatsoever.
If MAPS wants to make progress with MDMA they should start "calling out" the FDA for judging holistic medicines by materialist standards, which means ignoring all glaringly obvious benefits.
At best, antidepressants make depression bearable. We need not settle for such drugs, especially when they are notorious for causing dependence. There are many drugs that elate and inspire. It is both cruel and criminal to outlaw them.
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