Good Drug, Bad Drug– Same Drug

  Last month NPR had an interesting bit about how drugs change from good to bad and back again:

It reminded me of a drug education book I saw that was aimed at middle school kids. It tried to explain that “medicine” was good while “drugs” were bad. And it’s a goal to teach kids critical thinking in the same classroom? Considering that the latest National Survey on Drug Use and Health (NSDUH) shows that 12-13 year olds are more likely to raid the medicine cabinet than smoke a joint– that it makes the whole spiel about “drugs” versus “medicine” even more lame.

de: Struktur von Morphin; en: Structure of mor...

de: Struktur von Morphin; en: Structure of morphine (Photo credit: Wikipedia)

Let’s have a show of hands here. Is there anyone who DOESN’T want to be dosed with a bunch of morphine if you get busted up in a car accident, say 10-15 broken bones? I didn’t see a lot of hands go up there.  Second show of hands: how many people think it’s a REALLY GOOD IDEA to self-inject with morphine on a regular basis as a form of recreation? Again, we don’t see too many hands going up.

Let’s acknowledge that drugs are tools that we use in our lives. Like a lot of tools, they can be dangerous. Fire is a tool– it can help you keep warm, it can cook your dinner. It can burn your house down and it can kill you. You can have fun barbecuing in your back yard, which is a strictly optional and recreational use of fire. And so on. Fire doesn’t care. It is neither good nor bad; it’s just fire. Likewise with the various substances we put in our bodies. They are neither good nor bad; they’re just substances. “Good” and “bad” are labels and attitudes. And when attitudes change, labels change.

The NPR story points out that patent medicines of the 19th century had strong drugs in them, especially opiates. One estimate is that up to 80% of 19th century opiate addicts were women– some of them using because it was less stigmatized than using alcohol in their social circle. They obtained their opiates largely from patent medicines, but some directly from their doctors– remember that in those days “prescription” merely meant that the doctor told you how to use it. There were no legal bars to getting opiates on your own. That wheel has certainly turned. Likewise with cannabis, which has had its ups and downs. When it was outlawed in 1937, it had to be removed from the U.S. pharmacopeia, where it was indicated for a number of medical uses. Now that wheel is turning again, while the controversy over recreational use continues. The ups and downs in the reputation of beverage alcohol are well known, while its only medical use is to kill germs. But the drugs themselves are the same– neither good nor bad. Only our attitudes have changed.

 Medicine Drug Pills on Plate


About jamesmatter

Marriage and Family Therapist (MFT) in private practice in San Francisco. I work with adults, adolescents, and couples, with focus on substance use and abuse and co-occurring disorders (having both a mental illness and an addiction).
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