The unruly pharmacy: expert opinion and the management of public debate over LSD.

• Author: Bost, Matthew
• Position: Report

Drugs are a perennial facet of human culture. From the use of cannabis discussed by Herodotus (73-74.5) to the millions spent worldwide on tobacco, coffee, and chocolate for daily and hourly consumption, we have a pronounced tendency to intoxicate ourselves to various degrees and in various contexts. Despite this tendency, however, consciousness-altering substances have also been severely proscribed throughout history. Ancient religious prohibitions against drug use are the ancestors to current drug prohibition in a variety of geopolitical contexts. This tension between frequent open use and taboo, as well as the interplay of scientific reasoning and religion in more recent public discussions of drugs, make debates over drug use an ideal case to study the limits of argumentation.

This article examines a key moment in the formation of contemporary attitudes toward drugs: the hearings held in 1966 by the United States Senate Committee on Government Operations to decide the fate of federally funded research on LSD. While they produced no legislation, they are a crucial moment in the history of debates over drug policy in the United States because they set the tone for subsequent state- and federal-level debates over criminalization and regulation. The results of these debates have had significant policy consequences: the federal government spent over $25 billion dollars on drug enforcement and treatment in 2012, and hundreds of thousands of people are in state and federal prisons for drug offenses (Fiscal Year 2013 Budget Summary). The medical model the FDA and other federal agencies applied to discussing LSD's fate is also a rhetorical precursor to the scheduling process set up by the 1970 Controlled Substances Act, which gave the FDA authority to schedule (make illegal) any substance as a dangerous drug without significant external oversight. I argue that the 1966 hearings exhibit three rhetorical strategies of interest to scholars of argument. First, while the legislators debating the LSD problem widely admitted they did not know how to deal with the drug, they asked specific types of experts--psychiatrists and public health researchers--for advice. The story these experts told about who uses LSD and why codified a medical model of drug use that saw control of drugs by physicians as legitimate and all other use as illegitimate. The definition of the problem as a medical one led to a second move: via their testimony, the doctors speaking in the hearings created a mythology of drug users as lazy and stupid that was taken for granted in subsequent legislative discourse about drug use, as well as establishing a specifically medical model for drug control that has since granted the FDA broad powers to decide what counts as a drug and which drugs should be controlled. Finally, narrative descriptions of LSD users were used to justify the inclusion of testimony on the part of concerned citizens. The few non-expert voices allowed in the hearings served as precursors for public debate, dramatizing the officially sanctioned opinion of LSD use as the one held by the public. These three strategies--the solicitation of experts, narrative description of LSD users, and the selection of citizen testimony "representative" of public discourse--conditioned subsequent debate about LSD and set the terms of future drug policy debate. Because the hearings were officially a fact-finding mission, they appeared to be an open solicitation of opinion and an effort to encourage public discourse on the issue; instead, they conditioned the outcome of public debate over drug use in advance. These strategies are of immediate political interest: they show how discourses in official fora, such as Congress, can foreclose or manage subsequent public debate on an issue by defining the terms of the problem and determining who is qualified to offer an opinion about it.

The strategies deployed in the 1966 hearings are also of interest to scholars of argument in that they contribute to debates over the relationship between expert knowledge and public deliberation. Scholarship in recent years has parsed this relationship in terms of the utility of expert knowledge for fostering public engagement and democratic action. Discussing the medical rhetoric of such fields as end-of-life care and gene counseling, Zoltan Majdik and William Keith have argued that expert knowledge, when placed in a dialogic relationship with a public "articulation of values and interests" (373) can create democratic "inventional capacities for the best possible resolution for a particular problem" (382) based on particular normative criteria for the problem in question. If a plurality of "stakes and interests" in given situations of technical debate are factored into the process of defining these criteria, Majdik and Keith argue, democratic involvement in such situations will be fostered (374). This conception of expert knowledge has been complicated by the argument that slippage between apparently neutral clinical "information" provided by a given scientific study, and the interpretive "meaning" of that information for decisions about individuals' lives, as well as the complexity of technical concepts, lack of corporate transparency regarding experiments, and other factors, mean that clinical facts and meanings alike are contested and potentially fraught with inaccuracies and barriers to public discussion (Lynch 370). The 1966 hearings provide insight into a situation where "normative issues are deeply intertwined with factual ones" (Majdik and Keith 374) in a way that clarifies the relationship between definitional debate, technical knowledge and normative criteria for issues of public policy, and that problematizes conceptions of expert knowledge as a site of democratic agency.

THE CONTEXT of the HEARINGS

The first federal hearings on LSD use and research were held on May 24-26, 1966. Originally scheduled to deal with federal disability protection, the topic was changed after two articles appeared in Life magazine the week before the hearings. The articles themselves were sympathetic; editor George P. Hunt wrote in the introduction to the issue that "we wanted to show they [LSD users] weren't just the antisocial fringe" (2). However, the issue's characterization of LSD as a "threat" and "the mind drug that got out of control" sparked national controversy over LSD use (Hunt 1). More specifically, the articles' description of LSD's recreational use on college campuses prompted members of the subcommittee that held the hearings to propose that LSD be prioritized as a topic of discussion. Senator Robert Kennedy was invited to chair because of his legislative and familial experience with mental health issues; this was stated as the specific concern of the hearings. Personal possession and use of LSD was still legal at this point, but the drug could only be purchased for research purposes and had primarily been used experimentally to treat alcoholism and depression and as part of talk therapy. Distribution or sale independent of the FDA had already been made illegal

The only immediate policy effect of the hearings was a severe restriction of federal LSD research. Following the hearings, FDA and National Institute of Mental Health (NIMH) criteria for providing LSD for research were narrowed to investigation of a few medical problems, curtailing an incipient field of research into creativity, spiritual experience, and less conventionally therapeutic fields. The debate on the Senate floor also directly informed a wave of state criminalizations of the drug during the months following the hearings. California criminalized the drug in October 1966, and other states rapidly followed suit. Another round of congressional hearings in 1968 led to the passage of amendments to the Federal Food, Drug and Cosmetics Act to make personal possession of LSD a federal crime (Lee and Shlain; Stevens). The broad latitude granted the FDA and other agencies driven by medical expertise to weigh in as to how LSD should be regulated also harks forward to the 1970 Controlled Substances Act, which gave the FDA latitude to criminalize any substance with minimal congressional or judicial oversight (Courtwright 2004). The powers apportioned to the FDA in the act include the power to emergency schedule any substance it wants to make illegal with minimal Congressional or judicial oversight, pending a longer term DEA investigation into the effects of the drug in question. This power was most infamously used in the scheduling of 3,4-methylenedioxy-N-methamphetamine (MDMA, also known as ecstasy) in the 1980s and reaffirmed via an amendment to the act in 1987.

IMAGINATION AND ARGUMENTATIVE IDENTITY IN THE DEBATE OVER LSD

The 1966 hearings conditioned subsequent debates over drug policy in two ways. First, the image of LSD users featured in the hearings affects the images and emotional associations citizens and policymakers will use to assess future controversy. Second, this image, along with the medical criteria of expertise set up in the hearings, affect subsequent presumptions about which speakers can make a credible argument about drugs and what arguments are credible. The first point is illustrated by the concept of the national imaginary. In Visions of Poverty, Robert Asen argues that hearsay, media accounts, and official discourse allow voters and policymakers a way of envisioning the effects of a policy on people they may never meet. People use such narratives as "a method of coming to know others" indirectly, a way of viewing them (visually, but also morally and otherwise) through imagination (9). Using federal welfare policy as an example, Asen argues that such portrayals render disempowered groups affected by a policy both "subjected to and objectified in public debate": subjected because they are bound by the decisions of debate participants, objectified because their lived experiences become...