01-Coomber-Chapters.indd 1 31/01/2013 3:06:29 PM 01-Coomber-Chapters.indd 2 31/01/2013 3:06:29 PM 1 what is a drug/medicine? 3 31/01/2013 3:06:29 PM drugs are those whose sale, possession or use constitutes an drugs are those whose sale, MEDICO-LEGAL DEFINITIONS OF DRUGS controlled drugs are those that can be legally sold, possessed and used, albeit often possessed and used, drugs are those that can be legally sold, or

offence under the Misuse of Drugs Act 1971 in the UK, the Comprehensive the Act 1971 in the UK, offence under the Misuse of Drugs leg- Act 1970 in the USA and equivalent Abuse Prevention and Control Drug illegal use of controlled drugs is defined In the UK, islation in other countries. ‘non-medical usage of the drugs controlled under the Misuse of Drugs as the legal sanction of specific drugs can also relate to their Furthermore, Act’. with certain restrictions. They include tobacco, alcohol, caffeine, volatile sub- caffeine, alcohol, include tobacco, They with certain restrictions. and prescription medicines. and over-the-counter stances, A drug is any psychoactive substance that can alter the way the mind or body works, substance that can alter the way A drug is any psychoactive or produced from status or medical approval. It can be synthetic regardless of legal rec- variety of reasons including medicinal, and can be used for a natural sources reational and spiritual. There are two main ways to define drugs. First, a distinction may be drawn a distinction may be drawn First, define drugs. to There are two main ways Illegal Legal 2 The perceived benefits of natural botanical substances have led almost all societies led almost all societies botanical substances have The perceived benefits of natural minerals the desired active ingredients from plants, throughout history to extract or spiritual prop- therapeutic preventative, and fungi for their perceived curative, drugs can also be world, from the natural Along with these drugs extracted erties. The effects of produced within the human body. and synthesised in laboratories feels or a person thinks, greatly and can alter the way psychoactive substances vary perception of themselves and the world along with changes in a person’s behaves, around them. psychoactive substances used which are medically sanctioned between medicines, are controlled substances whose use is not which drugs, and for clinical purposes, drugs can be classi- Second, or by medical practitioners. sanctioned either by law make up and attributed psychoactive fied according to their pharmacological and the distinctions between the definition of what is a drug, However, effects. substances and medicines are disputed. drugs, First, in terms of the medico-legal definition, drugs can refer to psychoactive sub- in terms of the medico-legal definition, First, illegal and quasi- including legal, of different legal statuses, stances with a range legal drugs: 1 01-Coomber-Chapters.indd 3 01-Coomber-Chapters.indd 4

4 key concepts in drugs and society of ‘drugs’. posedly ‘objective’ measuresofharmwhichformthebasisforlegalclassification (Nutt etal., 2010), raising concernsabouttherelativearbitrariness ofsuchsup- clas ules 1–5inaccordancewitheaseofaccess. Otherjurisdictionshave similar classified intoclasses A-C inaccordancewithperceivedlevelsofharm, andsched- intent tosupply, import/export, production)ofcontrolled drugs. These drugsare the tion, pharmacy andgeneral sales), whereastheMisuseofDrugs Act 1971 covers banned. the firstdrugtobe(briefly)placedinthisnewcategoryalthoughsubsequently ture, sale, supplyandadvertising. (BZPor ‘party pills’)was which therewereregulationssurroundingminimumpurchaseage, manufac- to thethreepre-existingclassifications(A-C), creatingacategoryofdrugsfor example, anamendment in2005totheMisuseofDrugs Act 1975addedClassD 3 Illicit In theUK, theMedicines Act 1968coversthe Some countrieshave formalisedthisquasi-legalstatus. InNewZealand, for situations. therefore itwouldbeunacceptabletoingest ‘legal highs’inmanysocial when theyfirstappear, buttheiruseis notlegallyorsociallysanctionedand sidered illicitinthattheyarenotformallycontrolledbylegislation, atleast in itsfreshlypickedform. Second, the mushrooms’ forconsumptionthatmadeitillegalbutwas notcontrolled forms ofpsilocinundercontrol, itwas thepreparation ofpsilocinor ‘magic in termsof their preparation, saleoruse. Three Britishexamplesaregivenhere. First, legally controlledbutmayfacecertainformalorinformalrestrictionson ‘grey area’betweenlegalandillegaldrugssuchasthosethatarenot choactive substances(see (sildenafil) (see tional’ purposesforexample, theerectiledysfunctionmedication Viagra intended purpose, such asthe ‘misuse’ ofprescriptionmedicinesfor ‘recrea- the Internet), butarenotsociallysanctionedifusedotherthanfortheir can alsobepurchasedillicitlyandwithoutaprescription(forexample, on as anindustrialcleaner. Certaindrugs maybeavailable onprescriptionbut (gamma-butyrolactone) ifintendedforhumanconsumptionbutnot 16s andtobaccotoover18sintheUK. Third, itsisillegaltopossessGBL control topsilocininallforms. the MisuseofDrugs Act 1971, priortotheDrugs Act 2005whichextended illegal andthedrugwas classifiedinthemostharmfulcategory(Class A) under prepared forconsumptioninanyway (suchasdriedorboiled), possessionwas ‘magic’ mushroomscontainingpsilocinintheirfreshstatewas legal, butif physical state, sothatinthe UKpriorto2005possessionofpsychedelicor sification systems. Recentlytheseclassificationshave beensubjecttodispute non-medical or quasi-legal useofdrugs, criminalisingthepossessionandtrafficking (supply, preparation 8

typologies ofdruguse drugsisalessclearlydefinedterm, whichincludesthe , intheUKbeforeDrugs Act 2005broughtall novel

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psychoactive substances sale ). Mostrecently, somenovelpsy- ofsolventsisrestrictedtoover medical useofdrugs, (prescrip- ) couldbecon- use 31/01/2013 3:06:29PM

1 what is a drug/medicine? 5 31/01/2013 3:06:29 PM vents, vents, typologies of typologies of

8 example, sol example, the patient. For For the patient. ), daily or problem use of drugs such as daily or problem use of drugs such ), 4 addiction (psychedelics) are drugs that distort the senses and one’s aware- the senses and one’s (psychedelics) are drugs that distort , the physical and psychological characteristics of the individual the physical and psychological characteristics ,

(‘downers’) are drugs that slow down the functions of the central of the central that slow down the functions (‘downers’) are drugs PHYSICAL/PSYCHOACTIVE DEFINITIONS OF DRUGS DEFINITIONS OF PHYSICAL/PSYCHOACTIVE

(‘uppers’) are drugs that speed up the central nervous system, make system, nervous that speed up the central (‘uppers’) are drugs

is a fourth category, sometimes submerged into depressants, which which sometimes submerged into depressants, is a fourth category, ). ‘Hard’ drugs usually include those drugs which are seen as more likely ‘Hard’ ). between ‘hard’ and ‘soft’ drugs is integral to their drug policy, with an to their drug policy, ‘soft’ drugs is integral ‘hard’ and between Nordic countries between ‘hard’ drugs and ‘soft’ drugs (see ‘hard’ drugs and Nordic countries between ketamine. the user feel more alert and energetic, causing people to stay awake for long people to stay awake causing alert and energetic, the user feel more exam- For and make the user feel euphoric. decrease appetite periods of time, caffeine. nicotine, , , ple, For of the events around them. make the user less aware nervous system and , , , for example, opiates (painkillers, alcohol, example, (for example, sedatives/hypnotics Percodan), Demerol, , , such as tranquilisers medications, sleeping such as Seconal, , and ). Librium Valium, possibly resulting in hallucinations events, ness or perception of people and PCP (angel LSD, example, For not exist). (seeing or hearing things that do ‘magic’ mushrooms). (contained in (buttons), dust), Deliriants effect between the mind and body, includes drugs that result in a dissociative This has led some drugs in this category to be ‘out-of-body’ experience. or with children for example, and animals, used as anaesthetics with humans be consid- anaesthetics may general when traditional and on the battlefield, too risky for or ered to be either impractical Other typologies of drugs include a distinction favoured in mainland European in mainland Other typologies of drugs include a distinction favoured polydrug use)

Depressants Hallucinogens Stimulants It should be noted, however, that the above categories based on psychoactive that however, It should be noted, effects as some drugs fall into more than one effect can be modified by overlapping So for user and other variables. the individual category depending on the dosage, some stimulant ketamine and alcohol are all perceived to have , example, but become predominantly sedative at higher doses. properties at lower doses, the although the specific drug and strength of dosage is important, Furthermore, simultaneous use (see existence and amount of other additives or adulterants, 6 2 3 4 that a user and the wider environment can also influence the psychoactive effects upon the user. drug can have and Second, in terms of defining drugs by their attributed physical or psychoactive drugs by their attributed in terms of defining Second, pharmacological categories of drugs: there are four broad effects, 1 drug use ‘addiction’ (see to result in heroin and crack cocaine. A ‘soft’ drug primarily relates to cannabis but may also ‘soft’ drug primarily A cocaine. heroin and crack ‘recreation- include other drugs such as those which are used occasionally and/or In the Netherlands the dis- ally’ and may also include hallucinogens and MDMA. tinction 01-Coomber-Chapters.indd 5 01-Coomber-Chapters.indd 6

6 key concepts in drugs and society such substanceshasbeencontestedleadingtoaquestioningofthetermitself. have beendescribedasdrugs, althoughthisexpansionofthetermtoinclude by psychoactivedrugs. Given sugarandchocolate’s effectsonthebody, theytoo mood andperformance, regulated bythebodyaswellpotentiallystimulated tonin andcreatine, forexample, areallnaturally occurringsubstancesthatalter occurring substancesaltertheway themindandbodyworks. Dopamine, sero- describe theconceptofaddiction. Additionally, MacGregorhasnotedthatsomeculturesdonothave aword to need thereforetobeseenassocial, cultural andpolitical categories’(2011: 11). people shouldavoid, andwant to avoid …theterms “addiction” and “drugs” substances societydisapprovesofatagiventime, andwhichsocietysaysnormal gested that ‘the categoryofdrugsisanentirelypoliticalone…itcontainsall pliers (see may accesstheirdrugswithoutmakingcontactwithnetworksof ‘hard’ drugsup- dents indesignated ‘cannabis cafes’orcoffeeshopsinorderthatcannabisusers official tolerance of addictive (see ‘misuse’ wherethedrugtakingisjudgedtobeinappropriate, dangerousand norms. constructed andbasedonhistoricalcultural context, value judgementsand concept ofdrugs, likethe conceptofaddiction, canbeconsideredtosocially moral orpoliticalevaluations’ (1993, inFraser andMoore, 2011: 10). Thus the concept ofdrugsisnotascientificconcept, butisrather institutedonthebasisof Black harm andmoretoissuesofregulationsocialcontrol(Ruggiero, 1999; tion between ‘drugs’ and ‘medicines’ relateslesstotheirrelativephysicalorsocial which isinthewrongplaceattime’. Ithasbeenarguedthatthedistinc- mal acceptability. As MaryDouglas(1978)expressed it, ‘a drugisachemical distinction betweenadrugandmedicineisthedifferenceinitsformalorinfor- tioned ‘medicines’ andsociallydisapprovedorillicit ‘drugs’. not have awordfor ‘drugs’ anddonotmakeadistinctionbetweensociallysanc- as epitomisedintheterm ‘drug store’rather thanpharmacy. Othercountriesdo all psychoactivesubstancesregardlessoflegalstatusormedicalsanctionas ‘drugs’, of insomeway andknownas ‘drugs’. Bycontrast countriessuchastheUSAterm and legallysanctionedknownas ‘medicines’, andsubstancesthataredisapproved countries (forexample, theUK)distinguishbetweensubstancesthataremedically The term ‘drug’ isbothsociallycontestedandculturally context-specific. Some Drugs arenotnecessarilyexternalsubstances. Within thebodytoo, naturally A distinctionissometimesdrawn betweenlegitimatedrug ‘use’ anddrug For manyresearchersandcommentators, particularlyin Western societies, the man, 2004). As Derridafamouslynoted, ‘there arenodrugsin “nature” …the 19 thegatewayhypothesis 8 typologiesofdruguse the saleanduseofsmallamountscannabisbyDutchresi- The debatebetween‘drug’and‘medicine’ CRITIQUES OFTHETERM‘DRUG’ ). ). IndeedFraser andMoorehave sug- 31/01/2013 3:06:29PM 1 what is a drug/medicine? 7 31/01/2013 3:06:29 PM London: London: . London: London: . Melbourne: Cambridge Cambridge Melbourne: . Vienna: UNODC. Vienna: . World Drug Report World . Basingstoke: Macmillan. Basingstoke: . Drugs: Cultures, Controls and Everyday Life Cultures, Drugs: SUMMARY REFERENCES The Drug Effect: Health, Crime and Society. Health, The Drug Effect: The debate between ‘drug’ and ‘substance’ between ‘drug’ The debate Chilling Out: The Cultural Politics of Substance Consumption, Youth and Drug Youth of Substance Consumption, The Cultural Politics Chilling Out: Purity and Danger: An Analysis of Concepts of Pollution and Taboo. and Pollution Analysis of Concepts of An Purity and Danger: Women and Substance Use Women , 376 (9752): 1558–65. 376 (9752): , . Maidenhead: Open University Press. Maidenhead: . The Lancet South (ed.), N. in illicit substances’, Policy Paul. Routledge and Kegan University Press. Sage. Given the contested nature of the term ‘drug’, some researchers have argued for argued some researchers have ‘drug’, nature of the term Given the contested Any substance, chemical or otherwise, that alters mood, perception or consciousness Any substance, chemical or otherwise, detriment of society and the individual. and/or is seen to be misused to the apparent discourses including new with ‘substance use’ we are explicitly use’ By replacing ‘drug … from the viewpoint of women, ‘substance on bodily management and regulation 7) use’ is a more illuminating notion. (1992: Ettorre, E. (1992) E. Ettorre, (2011) D. and Moore, S. Fraser, a multicriteria decision analysis’, ‘Drug harms in the UK: (2010) L. and Phillips, L. King, D., Nutt, discussing the legalisation of as a drug: and the law ‘Drugs as a password (1999) V. Ruggiero, United Nations Office on Drugs and Crime (1997) Blackman, S. (2004) S. Blackman, (1978) M. Douglas, A ‘drug’ is usually understood as a psychoactive substance which alters the which alters the ‘drug’ is usually understood as a psychoactive substance A synthe- from nature, and can be extracted mind or body works, that the way what However, within the human body. or produced sised in laboratories contexts and the term between historical and cultural ‘drug’ varies counts as a terms of which sub- in value-laden can be seen as politically and morally rather sanctioned or socially disapproved of, stances are legally and medically of the substance itself and its effects on than related to the intrinsic qualities the user. There is also a debate between the terms ‘drug’ and ‘substance’. The 1992 The 1992 ‘substance’. ‘drug’ and between the terms There is also a debate included both legal and illegal Health Organisation expert committee World the word drug – including within its definition of psychoactive substances Report made a distinc- Drug World the 1997 By contrast alcohol and tobacco. unau- ‘the and tobacco) and (which includes alcohol tion between substances of their potential for because use of drugs which, thorised or non-medical control’ (UNDCP, been brought under international have causing dependence, 10). 1997: In ‘drug use’. than use’ rather ‘substance such as term the use of a more neutral as: Ettorre defines substance use making the case, 01-Coomber-Chapters.indd 7