There is probably one thing, and one thing only, on which the leaders of all modern states agree; on which Catholics, Protestants, Jews, Mohammedans, and atheists agree; on which Democrats, Republicans, Socialists, Communists, Liberals, and Conservatives agree; on which medical and scientific authorities throughout the world agree; and on which the views, as expressed through opinion polls and voting records, of the large majority of individuals in all civilized countries agree. That thing is the “scientific fact” that certain substances which people like to ingest or inject are “dangerous” both to those who use them and to others; and that the use of such substances constitutes “drug abuse” or “drug addiction” — a disease whose control and eradication are the duty of the combined forces of the medical profession and the state. However, there is little agreement — from people to people, country to country, even decade to decade — on which substances are acceptable and their use therefore considered a popular pastime, and which substances are unacceptable and their use therefore considered “drug abuse” and “drug addiction.”

My aim in this book is at once simple and sweeping. First, I wish to identify the actual occurrences that constitute our so-called drug problem. I shall show that these phenomena in fact consist of the passionate promotion and panicky prohibition of various substances; the habitual use and the dreaded avoidance of certain drugs; and, most generally, the regulation — by language, law, custom, religion, and every other conceivable means of social and symbolic control — of certain kinds of ceremonial and sumptuary behaviors.

Second, I wish to identify the conceptual realm and logical class into which these phenomena belong. I shall show that they belong in the realm of religion and politics; that “dangerous drugs,” addicts, and pushers are the scapegoats of our modern, secular, therapeutically imbued societies; and that the ritual persecution of these pharmacological and human agents must be seen against the historical backdrop of the ritual persecution of other scapegoats, such as witches, Jews, and madmen.

And third, I wish to identify the moral and legal implications of the view that using and avoiding drugs are not matters of health and disease but matters of good and evil; that, in other words, drug abuse is not a regrettable medical disease but a repudiated religious observance. Accordingly, our options with respect to the “problem” of drugs are the same as our options with respect to the “problem” of religions: that is, we can practice various degrees of tolerance and intolerance toward those whose religions — whether theocratic or therapeutic — differ from our own.

For the past half-century the American people have engaged in one of the most ruthless wars — fought under the colors of drugs and doctors, diseases and treatments — that the world has ever seen. If a hundred years ago the American government had tried to regulate what substances its citizens could or could not ingest, the effort would have been ridiculed as absurd and rejected as unconstitutional. If fifty years ago the American government had tried to regulate what crops farmers in foreign countries could or could not cultivate, the effort would have been criticized as meddling and rejected as colonialism. Yet now the American government is deeply committed to imposing precisely such regulations — on its own citizens by means of criminal and mental health laws, and on those of other countries by means of economic threats and incentives; and these regulations — called “drug controls” or “narcotic controls” — are hailed and supported by countless individuals and institutions, both at home and abroad.

We have thus managed to replace racial, religious, and military coercions and and colonialisms, which now seem to us dishonorable, with medical and therapeutic coercions and colonialisms, which now seem to us honorable. Because these latter controls are ostensibly based on Science and aim to secure only Health, and because those who are so coerced and colonized often worship the idols of medical and therapeutic scientism as ardently as do the coercers and colonizers, the victims cannot even articulate their predicament and are therefore quite powerless to resist their victimizers. Perhaps such preying of people upon people — such symbolic cannibalism, providing meaning for one life by depriving another of meaning — is an inexorable part of the human condition and is therefore inevitable. But it is surely not inevitable for any one person to deceive himself or herself into believing that the ritual persecutions of scapegoats — in Crusades, Inquisitions, Final Socutions, or Wars on Drug Abuse — actually propitiate deities or prevent diseases.

—Thomas Szasz (1 September 1973)
Preface to Ceremonial Chemistry