Social aspects

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The enormous social importance of this subject warrants discussion here.

All the naturally occurring sedatives, narcotics, euphoriants, hallucinogens and excitants were discovered thousands of years ago, before the dawn of civilisation ... By the late Stone Age man was systematically poisoning himself. The presence of poppy heads in the kitchen middens of the Swiss Lake Dwellers shows how early in his history man discovered the techniques of self-transcendence through drugs. There were dope addicts long before there were farmers.1

The drives that induce a person more or less mentally healthy to resort to drugs to obtain chemical vacations from intolerable selfhood will be briefly considered here, as well as some account of the pharmacological aspects of drug dependence.

The dividing-line between legitimate use of drugs for social purposes and their abuse is indistinct for it is not only a matter of which drug, but of amount of drug and of whether the effect is directed antisocially or not. 'Normal' people seem to be able to use alcohol for their occasional purposes without harm but, given the appropriate personality and/or environmental adversity, many may turn to it for relief and

1 Huxley A1957 Annals of the New York Academy of Sciences 67: 677.

become dependent on it, both psychologically and physically. But drug abuse is not primarily a pharmacological problem, it is a social problem with important pharmacological aspects.

A further issue is whether a boundary can be drawn between the therapeutic and nontherapeutic use of a therapeutic drug and, some would argue, if it can be drawn, should it be? The matter has been highlighted by the use of SSRI antidepressants, e.g. fluoxetine (Prozac), not to treat depression but to elevate mood — make a person feel 'better than well' (see nonmedical use, below).

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