What is abuse? or, Why define abuse at all?
A question for future discussion and elaboration: What is drug abuse? And why should we care?
This is not so obvious as it may seem. A particular drug may be prescribed by a doctor, in which case it is assumed that, taken as directed, it is not abuse to use it. And the assumption is that any drug use — even of prescription drugs — outside of the prescription system is automatically abusive. This is transparently false, and is easily refuted by daily experience. These beliefs about abuse are totally beholden to a medico-political regime which is seen as objective, scientific, disinterested when in fact the complex network of institutions and practices which form it are inherently saturated with power, ideology, and interest.
Even addiction is a fuzzy concept, with no clear definition which is universally applicable. At least, none I’ve seen. It’s not enough to say that drug use becomes abuse when addiction becomes involved; otherwise I would be a drug abuser for my daily caffeine intake. I know some people would say that I am a caffeine abuser, but I do not receive the general approbrium of my fellows that I would if I were addicted to heroin instead. Even if I was just as effective at my job.
So it is relatively easy to destroy “addiction” and “drug abuse” as having objective scientific validity — after all, these are social diseases, and their definition, identification, treatment, and punishment are constituted of strategic social relations. But it is not so easy to create a useful definition for “drug abuse.” One questions the need for such a definition, which would seem to serve a (purely?) normative function within a system of control, identification, and segmentation.
But it may be that we need ethical concepts of self-abuse to help people manage their drug-body-mind interactions. For just as the falsity and interestedness of the medical/judicial stranglehold on processes of legitimation and approval/disapproval of drugs and their uses is made clear by only a modicum of lived experience, so I cannot deny the negative effects that drug use continues to have for many people. Alcoholism and drug abuse are distinct dangers for those who choose to consciously alter their consciousness, even if we can’t define the danger scientifically.
It’s just that too often the questions we ask are, “Who is addicted? What are they addicted to? Who is prone to addiction? How do we prevent drug abuse?” We should be asking, “What forms of use and methods of self-control can be created and learned?What social harm can come from my drug use, and how can I minimize or avoid that harm?”
It’s not enough for a drug to be legal or illegal. It’s not enough to define “good” drugs and “bad” drugs, or “good” people and “bad” abusers. We must work out methods of behavioural self-control and social practices of encouragement and discouragement which lead to a saner, more interesting, and less fucked-up world. How do we help people avoid abusive relationships with drugs? vs. How do we define and control “addicts”?
We will have to be open to ideas from abnormal and sometimes dubious quarters. Drugs are too important to be left to the doctors. We may find that we have lesson to be learned from those we have forced underground, those on the fringes, those who have been dealing with these issues without the watchful eye of the clinician.