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Drug Use and Abstinence: Two Routes to the Most You Can Be

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<i> David F. Musto is a professor of psychiatry in the Child Study Center and in the History of Medicine Department at the Yale Schoolof Medicine. </i>

America’s past and present involvement with drugs can be described as a series of waves separated by intervals of relative abstinence. We can view the same history, though, with reverse emphasis: plateaus of abstinence have been broken by shifts toward drugs.

The goal of both eras, although dominated by opposing assessments of the best way, has been the same: to be all that you can be--the traditional American aim to maximize mental and physical potential.

Looking at drugs in this way, as instruments to push the body and mind to achieve desirable conditions difficult or even impossible to attain without--so the argument runs--the aid of chemical assistance, we can appreciate why many turn to drugs. In fact, I would suggest that the beginning of an era of drug use is easier to understand than its ending--a process that may take our society, as a whole, 20, 30 or more years of experience before rejection is widespread and resolute.

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Cocaine appears a gift to the worker with brain or brawn. More productivity through longer hours and a confident euphoria is the promise that made cocaine the all-American tonic of the 1890s and again in the 1970s. Opium and its active ingredient morphine, and its derivative heroin, provide more than pain relief; they provide tranquility in the midst of life’s travails.

An occasional saint may have achieved an expansion of consciousness that put our human-centered world into a truer perspective, but that achievement is promised to the most earthbound consumer of LSD or marijuana. Productivity, serenity and transcendent perspective--the personal if somewhat contradictory goals so highly valued in our society--can be pursued on a chemical path as well as on the narrow road of toil and abstinence.

Every drug that I have listed was cheap and legal when first introduced to Americans. Why have we not floated higher and higher on an uninterrupted intake of cocaine, heroin and LSD? It is because the promise of chemical achievement is betrayed by addiction, mental distortion and the illusion of insight rather than true understanding. The self-preoccupation created by many chemicals after prolonged use blocks attainment of the high goals that stimulated use in the first place. To the observer, if not to the confirmed drug user, the failure of the chemical promise is evident.

American society takes quite a while before abandoning the promise of chemical fulfillment, just as later (and earlier) generations firmly cling to the safer alternative of abstinence. That drugs are only gradually rejected may be frustrating and disheartening, but the explanation is not obscure. The drugs mentioned bring pleasure to many, and initially appear to provide just the gifts that their claims suggested. The question is not so much why Americans start taking drugs as why they stop.

Not all drug users become casualties of drug-induced addiction, violence, paranoia and confusion. If that were the case, the drugs that we are discussing would be as popular as strychnine. For a variety of reasons--purity, frequency of use, biochemical variations among individuals and specific effects of particular drugs--the percentage of persons who ever use a drug and eventually get into serious trouble is conservatively estimated for cocaine at 3%. If this were the percentage of airline passengers who, for one reason or another, never reached the plane’s destination, commercial air travel would come to a halt, but in the looser and less closely observed world of drug users such a fraction of casualties is not a hindrance until after years of accumulation.

This gradual accumulation of victims is a major reason the span from drug introduction to broad social rejection may be measured in decades. Once that consensus against drugs is reached, however, the effect and duration are impressive. It may last the remaining lifetimes of those who are old enough to have learned the lesson of failed promises.

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Yet the desire to attain the very same goals is not extinguished; only the chemical path is rejected. Therefore, we enter an era equally American, seeking maximum personal achievement through abstinence that is safer, healthier and cheaper than drugs. Nevertheless, it is not a sure path to our highest cultural goals--particularly if those goals are so idealized that attainment is practically impossible.

Understood in this way, our goals taunt our best efforts at achieving productivity, tranquility and insight. In a way, our cultural ideals are like ever-receding stars that attract our best efforts to reach them. If, then, we owe our remarkable technological civilization to these high goals, the trade-off is that we must endure wide swings in life style as we search for the path to individual and national perfection.

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