May 4, 2021
What Is a Drug: The Stigma Behind Psychedelics
As the global mental health crisis calls for more effective treatment options, the definitions, classing system, and stigma behind drugs are being challenged.
Context is key, but when someone mentions “drugs,” you might imagine “Just Say No” ads, those teenagers melting away on the couch, tye-dye and withdrawals.
But really, aren’t we all on drugs? — whether caffeine, alcohol, cannabis, Xanax or other. Pharmaceuticals, controlled substances, and some nootropics may be synonymous with “drugs,” but they don’t define one another. Heroin does not define drugs any more than caffeine does.
With anything, we generalize according to the worst case scenario. In terms of drugs, we call this the likelihood for harm and abuse.
How much of what we rely on — from our drug classing system to the definition of “harm” — do we take for granted based on stigma, things we’ve heard and worst case scenarios? These things affect us beyond casual conversation. In fact, they can empower as much as our definitions and government regulations.
So, what’s a drug? It depends on who you ask.
Who Gets to Define Drugs?
The governments that control them? The public who needs, uses or fears them? The scientists who discover and research them?
Definitions online tend to agree that a drug is a substance that alters the body's function physically, psychologically, or both. Some draw the line between legal and illegal drugs.
The World Health Organization defines “psychoactive drugs,” which “affect mental processes, e.g. perception, consciousness, cognition or mood and emotions.” The WHO’s World Drug Report 2019 includes stats on depressants, stimulants, and cannabis and hallucinogens. It states that 270 million people have used drugs in the last year.
The Australian Government defines drugs as “substances that change a person's mental or physical state.”
The Canadian Government is careful not to define drugs in general. Health Canada provides context around drugs as “prescription and non-prescription pharmaceuticals, disinfectants, and sanitizers with disinfectant claims.” Aside from these, the Controlled Drugs and Substances Act states that a “controlled substance means a substance included in Schedule I, II, III, IV or V.” Canada takes after the UN’s drug classification system, in which “schedules” are used to class substances based on potential abuse, as well as potential harm to oneself and to others.
Defining Drugs & Harm
What is harm?
The Lancet, an online peer-reviewed journal, published a chart categorizing 14 the “Most Dangerous Drugs” — from alcohol to mushrooms, with cannabis smack in the middle. Each has its own “drug harm score,” which meshes a number of factors based on harm to self and harm to others. Impairment, dependence, and loss of tangibles and relationships are in the “harm to self” category. Community, economic and environmental costs, crime and injury, and family adversaries are in the “harm to others” category.
While we’re on the topic of definitions, let’s talk about impairment and dependence. Impairment means diminished functionality, rather than harm. In contrast, there is no mention of the cognitive functions that some drugs promote.
Dependence also has negative connotations. Yet, many people depend on legal pharmaceuticals: blood pressure medication, insulin, blood thinners, pain killers, diarrhetics, heart medication, puffers and even laxatives. These drugs provide functions that the body is lacking. And of course, as with anything else, overuse can cause harm.
But not everything makes the chart — certainly not laxatives. Despite landing last place, psilocybin (or magic mushrooms) is currently categorized by Health Canada as a schedule III (3) drug, making “sale, possession, production, etc. ... prohibited unless authorized for clinical trial or research purposes.” That mushrooms are classed as the least harmful does not let them off the hook. Until we can prove the medical necessity for psilocybin, we can’t risk the potential for “harm,” whatever that entails. See here for the effects and risks associated with psilocybin, according to Health Canada.
When we ask “what is a drug,” what we really want is to answer “what makes certain drugs illegal?” And when we’re met again with the harmful factors mentioned in the drug chart, you’ll note that the most harmful drug is legal: alcohol.
The Stigma Plaguing Psychedelics
Definitions have much to do with stigma. Related to our exploration of the definition of drugs, the stigma behind psychedelics is being challenged in an attempt to obtain medical recognition for psilocybin.
The journey of psychedelics, from research to criminalization, seems to have been influenced by misdirected panic. Despite promising psychedelic research in the 1950s, cultural stigma formed against “delinquents” and “hippies.” These notions threatened the society and way of life at the time. Where did this stigma come from?
Rather than being promoted for their therapeutic potential, psychedelics like LSD, psilocybin, DMT, and mescaline took on negative associations due in part by messages of anarchy and protests. Psychedelic drugs became largely connected to insanity, self-harm, and rebellious attitudes against war and police. These factors did not play well for psychedelics, regardless of the suggested effects on cancer, addiction, depression, anxiety, and trauma.
Psychedelics & the Future of Mental Health Care
The revival of psychedelics for therapeutic purposes is changing how we look at psychedelics. We’re seeing a shift in attitudes due to the focus on mental health care. Science is challenging the psychedelic stigma by consciously disrupting the status quo for the benefit of wellness.
The cannabis industry’s ability to overcome stigma and reenter the market, both medically and recreationally, is enough to question the practicality of our drug rankings. After all, alcohol, too, was once illegal. Yet, that changed without an inkling of medical or therapeutic basis.
Is it possible that psychedelics just got a bad rap?
Of course, alcohol’s legality is not the reason for this article, nor should it infer that anything else should be legal. Instead, we must look to the research into the benefits of psychedelics to achieve medical recognition and inform therapeutic uses of such drugs.