No bad drugs: the arbitrary distinctions at the root of prohibition.

• Author: Sullum, Jacob
• Position: High Society: How Substance Abuse Ravages America and What to Do About It; The Cult of Pharmacology: How America Became the World's Most Troubled Drug Culture - Book review

High Society: How Substance Abuse Ravages America and What to Do About It, by Joseph A. Califano Jr., New York: Public Affairs, 270 pages, $26.95

The Cult of Pharmacology: How America Became the World's Most Troubled Drug Culture, by Richard DeGrandpre, Durham, N. C. : Duke University Press, 294 pages, $24.95

ON THE OPENING page of High Society, which aims to explain "how substance abuse ravages America," Joseph Califano declares that "chemistry is chasing Christianity as the nation's largest religion." Although it is not always easy to decipher Califano's meaning in this overwrought, carelessly written, weakly documented, self-contradictory, and deeply misleading anti-drug screed, here he seems to be saying that opiates are the religion of the masses. Americans, he implies, are seeking from psychoactive substances the solace they used to obtain from faith in God, and better living through chemistry is nearly as popular as better living through Christ.

That claim, like many Califano makes, is unverifiable, and it does not seem very plausible. Americans may be less religious than they used to be, but large majorities still say they believe in God and identify with specific faiths, making the U.S. much more religious than other Western countries, which tend to have substantially lower drug use rates. Although Americans have a bewildering array of psychiatric medications to choose from nowadays (with permission from a doctor), they smoke a lot less than they did in the 1960s and drink less than they did a century ago, when they also could freely purchase patent medicines containing opium, cocaine, and cannabis. If the devout are less inclined than the doubters to use mood-altering drugs, how is it that mostly Mormon Utah leads the country in antidepressant prescriptions? And if chemistry and Christianity are locked in competition, what are we to make of Jesus' water-into-wine miracle, or of the Native American Church, Uniao do Vegetal, and other groups that combine Christianity with psychedelic sacraments?

Already I have put more thought to the alleged connection between faithlessness and drug use than Califano did. And so it is with the rest of the book. A proper debunking would require more than the 186 pages of text that Califano, a domestic policy adviser to Lyndon Johnson and secretary of health, education, and welfare in the Carter administration, squeezes out of conversations with politicians and old reports from the Center on Addiction and Substance Abuse (CASA), the prohibitionist propaganda mill he founded and heads. Although CASA brags about its affiliation with Columbia University, the school has less cause to be proud of that relationship, given the center's sloppy research and hyperbolic rhetoric. In a 2002 report that attracted wide publicity, CASA issued "a clarion call for national mobilization" against "America's underage drinking epidemic," claiming that "Children Drink 25 Percent of Alcohol Consumed in the U.S." Not only did these "children" include 18-to-20-year-olds (a.k.a."adults"), but it turned out CASA's estimate was off by a factor of more than two.

Yet Califano is worth taking seriously. He is a leading exemplar of the moralistic pseudoscience that Richard DeGrandpre dissects in The Cult of Pharmacology, an insightful, historically informed critique of the ideas that guide the war on drugs. DeGrandpre, an independent scholar with a Ph.D. in psychopharmacology and a former fellow at the National Institute on Drug Abuse, decries "the modern mythologizing of drugs as angels and demons" that underlies our "bewildering and often brutal differential system of prohibition." Califano, by contrast, is committed to defending the arbitrary distinctions built into our drug laws.

Califano, who since his time in the Carter administration has railed against cigarettes with all the zeal you'd expect from a former three-pack-a-day smoker, is perceptive enough to recognize that legal drugs are not necessarily angels. When he talks about the promiscuous use of stimulants to control inattentive, unruly schoolchildren or the routine prescription of mood-altering drugs to smooth "the changing moods that mark human nature," he sounds a bit like DeGrandpre, who wrote a book called Ritalin Nation and is unsparing in his criticism of the psychiatric profession and the pharmaceutical industry.

What Califano fails to understated is that every drug, regardless of its current legal status, is potentially an angel or a demon. DeGrandpre builds upon the insights of the alternative medicine guru Andrew Weil, who first made his name with books about drugs and altered states of consciousness. "Any drug can be used successfully, no matter how bad its reputation, and any drug can be abused, no matter how accepted it is" Weil wrote in his 1983 book From Chocolate to Morphine (co-authored by Winifred Rosen). "There are no good or bad drugs; there are only good and bad relationships with drugs." While Califano acknowledges the importance of context in determining what constitutes abuse of alcohol and prescription drugs, he insists that any use of currently illegal drugs is abuse by definition. "Drugs are not dangerous because they...