Grad Student Humanist

80% of the time I smoke marijuana alone; the other 20% of the time I'm smoking in a group with other people. I don't pull out a joint and light up in a restaurant or at my desk. Thus nobody is being harmed or exposed to marijuana against their will.

Similarly, I only smoke in my own home, my own car, outside and in places where it's allowed by law.

scigirl

Fatherphil, you have sparked an interesting and fairly civil debate. Too bad I didn't see it earlier. This topic is always a fascinating one for me, since I am going to become a drug pusher, and a pretty substantial one at that (aka MD - and if I do geriatrics, my patients will be on a lot of drugs!)

I have a few questions for you. Earlier you stated this:
I'm sure you are aware that many medications that doctors prescribe can risk damage to our bodies and our minds. Does your wish apply to these situations as well? If so, how do you propose we proceed as a society to begin to carry out such a wish?

Also, I note that you said no need...to alter his state of conciousness. Did you really mean no need? Surely you are ok with certain altered states of conciousness induced by drugs (surgery, extreme pain from a broken bone or from cancer)? Also, are you aware that most drugs that treat mental illnesses such as depression or schizophrenia work by altering someone's state of mind? Are these valid reasons? More importantly, if you do concede that there are some situations that deem narcotics or other mind-altering drugs necessary or even moral, who gets to make that list? You? Medical professionals? Politicians?

In addition, do you see a clear moral difference between using illegal drugs that harm our bodies and minds for some benefit we'll call X, and using legal drugs prescribed by physicians for a similar benefit X?

From my point of view, the drugs we deem "illegal" (and that you deem immoral) and the drugs we advertize in the Journal of the AMA are not that different. Chemicals that we put into our bodies all have side effects - some worse than others. Is it wrong for me to take Benadryl for my sniffly nose, even though it means I might be drowsy later on (and not able to help my neighbor to the hospital)? Is it wrong for a teen to take accutaine for acne even though it might cause liver damage (and thus harm society by draining resources used to treat liver disease)? And so on - I could bore you to tears with more examples of legal drugs which could harm society in some way.

Yet we must not forget a key reason that we even take drugs in the first place. To avoid pain and suffering. Clearly, pharmaceuticals have helped improve society in countless ways, such as helping cure cancer, kill deadly bacteria, and treat mental illness. Drugs have even helped in drug addictions - methadone for heroin addiction. And of course alleviate the pains of surgery and disease.

My main problem with the criminalization of some drugs is not necessarily because I think the drugs are ok. It's that 1) scientific criterion are not used to classify drugs - everyone and their dog agrees that pot is not as dangerous to society as alcohol, yet the laws do not reflect that fact. 2) Drug addiction is defined as an illness by the medical establishment that should be treated, yet it is defined as a crime by the state that should be punished. Despite the war on drugs, we continue to be the largest consumer of nearly every drug manufactured on earth (legal and illegal - correct me if I'm wrong on this statistic). I would like the millions and billions of dollars we spend on the trials and prison housing of drug addicts on better ways to treat addictions.
That's my hope for my fellow man and woman. I'd be interested to hear your thoughts...

scigirl

fatherphil

i limited my opening statement to recreational drug use. the use of drugs to get high or even the act of getting high is what i'd like the morality question to focus on since that is really at the crux of the drug debate.

i do not see pot as benign a thing as you claim it is. we failed as a society to abandon the use of alcohol and it seems sad to me to proceed as a society exhibiting such a lack of moral resolve.

from my experience with drug addiction, it seems a person needs to hit a bottom of sorts before they turn things around. i think the more relaxed our stance on drug use becomes, the more folks will find themselves struggling with its negative affects.

as a drug dealer, you will have a responsibility to avoid creating addicts by prescribing an easy out for patients. i have had dealings with seconal & Ritalin addicts. i did feel i was fighting a losing battle as the drug use was somehow legitimized by the medical profession. there must be better ways to cope with a condition than throwing a magic pill at it for the entirety of a person's life.

Buddrow_Wilson

Why must there be? How else do you propose that someone be helped that has exhausted all other options and likely has genetically imbalanced brain chemistry? Would you rather they be institutionalized?

But, like you said, the conversation was intended to revolve around recreational drug use. Let's imagine we have drugX. DrugX has no physically damaging side-effects and is shown to not have a high potential for dependency. DrugX is used because it is relaxing and feels good.

Is your argument that drug use is immoral merely because it is used to alter your mood? How would that be any different than anything else done as a pasttime. You can take anything to an extreme. DrugX users could be likened to someone who masturbates a couple times a day. Would that be immoral? If done while driving, probably. As would be the drug use.

Recreational drug use as a concept is neither immoral or moral, its neutral. What comes into play is the setting that the drug is taken in and a person's reactions to the drug.

scigirl

Hmmm, I still think you are looking at the whole issue much too simplistically.

Huh? What is "lack of moral resolve?" This sounds like a 700 club sound byte, but not an actual argument.

Do you think that every single person is exactly like you? Again, lots of rhetoric, not much substance here.

Do you have proof of this assertion?

Ahh, if only it were that easy. I agree that some drugs are over-prescribed. This does not change the fact that some people need to be on medications in order to function, and these medications can have adverse effects and be addictive.

Is that the reason? Could another reason be that those drugs are just addictive by nature, irrespective of what the medical establishment "says" about them?

Again with the rhetoric. Of course I agree - ever hear of doctors telling their patients to eat right, quit smoking, and exercise more? Fatherphil, we probably just weren't meant to live as long as we do (whether you believe in creationsm or evolution) - but as a society, we have decided to use pharmacologic agents to stave off microbes, some aspects of aging (i.e. cardiovascular disease and cancer) and pain of course. If you think this is a bad approach to life - by all means, move to a country where drugs are unheard of (and the life expectancy is 40).

scigirl

fatherphil

coming off a bit condescending scigirl. just discount what i say as rhetoric and don't concern yourself further.

buddrow, i think the shear escapist nature of your "harmless" drug would cause me to question the morality of its indulgence.
i question the morality of the need to use a substance just to get through a weekend.

Grad Student Humanist

And I question the morality of telling another person what they can and can't do with their bodies, and what substances they can and cannot ingest.

yguy

As someone pretty much on your side of the issue, I think this is a bit of a cop-out. Whatever condescension scigirl may display isn't so offensive as to impede communication in my mind; and she's intelligent enough to help you sharpen your arguments.

scigirl

Heh, I do sincerely apologize - I was being condescending. I'l try to stick to science and anecdotal evidence this time!

Part 1: It’s not bad to want to feel good
Let’s address your statement here: “i limited my opening statement to recreational drug use. the use of drugs to get high or even the act of getting high is what i'd like the morality question to focus on since that is really at the crux of the drug debate.”

Getting high? I think we all know what you mean by the phrase. But let’s specifically define it. Euphoria = “a feeling of well-being, commonly exaggerated and not necessarily well-founded.” So people should only feel good when they are supposed to feel good. What does this really mean, though? This argument taken to an extreme would condemn orgasms from masturbation (an exaggerated sexual feeling, not necessarily well founded – evolution gave us those feelings so we would procreate, not jerk off! ) eating really good food that wasn’t good for us, etc. I fail to see how a person who smokes pot now and then for his sole pleasure is acting immoral, yet a person who is masturbating, or eating a yummy fattening dinner every now and then is NOT immoral. In other words – why are you picking on the poor cannabis and not Emeril’s diet?

More generally, I wonder: should we evaluate the morality of drug use based on the intent of the user? Or should it be based on the side effects (including on society)? Or some combination of both? I maintain it should be more of the latter, less of the former.

Why? Well, I think that wanting to feel good is a normal, healthy human condition. My father takes nexium so his esophagus feels better and so he can sing. Other friends of mine are on drugs (accutaine or tetracycline) for acne. No other reason but pure vanity. Both of these drugs no doubt have short- and long-term side effects. Is it wrong for my father to want a better voice, or my friends to want more pure complexion?

You may think these examples are irrelevant to your discussion about human behavior - but I don't. The brain is certainly an organ in the body that follows the same biological rules as our esophagus. If our esophagus is not healthy - we should be able to recognize this, make lifestyle changes (for instance, alter the diet) and then add pharmacologic agents as necessary. If our brain is not healthy - same thing.

Another part of feeling good is not feeling bad. In other words - treating our aches and pains and diseases. You stated, “there must be better ways to cope with a condition than throwing a magic pill at it for the entirety of a person's life.” I agree. But what are these better ways?

Yes, for many conditions – both mental, and non-mental, there are usually lifestyle changes that would improve the patient’s health and make them feel better. Health care professionals do their best to encourage these changes, but it’s not always easy. One of my patients – an older gentleman born and raised in Greece – was just diagnosed with Type II Diabetes. He has eaten figs, and sugary foods, and 40 servings of bread every day of his life for 50 years. (Ok I exaggerate a bit!) Food is an important part of his culture, and it’s not exactly easy for him to scrap the diet he was born and raised with. So – we compromise. We encourage him to make reasonable changes, AND we prescribe him a blood-sugar lowering drug. Do I think this is immoral? No, I do not. What would be immoral would be to say “you just need to change your diet,” shove him out of the office with a hemoglobin H1C of 9 (trust me this is really bad), knowing full well that he probably won’t change his diet enough and thus go blind or lose a leg. I know that’s not at all what you meant when you made that comment above – but I just want you to realize how difficult it is for people to make changes to their lifestyle, and the consequences of ignoring that fact.

Let’s get back to the drug issue. You don’t like seeing kids popped full of Ritalin, or adults popped full of Zoloft. Well I don’t either. But we know even less about how to keep the brain healthy than we do about all the other organs. And until we make drastic improvements on our mental health knowledge (which is not likely to occur under the USA’s current administration – Colorado recently rejected a bill to help improve mental health facilities yet increased the funding for prisons – oh the irony), I will be an avid supporter of Zoloft, Ritalin, lithium and other mind-altering substances. I don’t think it’s bad to want to feel good (is that a Van Halen song – it should be!)

Part 2: There is no such thing as recreational drug users.

Another point I wish to make is that your hypothetical population of normal healthy people who do drugs just to feel even better than normal – may not be as high as you think. In other words, people start doing drugs for a variety of reasons, only one of which is to elevate a current good feeling.

Stats on depression from webmd:

It is likely that there is an intersection between drug users and this population. If some people are doing drugs to improve a current bad state, this is no longer recreational drug use.
Here’s some studies I did find on why people even do drugs:
Substance abuse: an overview.
The drug abuse problem in Peninsular Malaysia: parent and child differences in knowledge, attitudes and perceptions.
I just read a report in JAMA that stated the following:
According to one study – a general inpatient population in the USA (Seattle to be exact) had a pain prevalence of 17% (2 fold lower than the methadone population above). Also – the study was able to distinguish withdrawal pain from chronic pain.

Some comments in the study:
“The prevalence of chronic pain in these chemically dependent patients also compares with that in surveys of cancer patients undergoing active therapy, approximately a third of whom have pain severe enough to warrant opiod therapy”

”Inpatients with chronic pain visited physicians and received pain medications no more frequently than those without pain, raising the possibility that undertreatment or inability to access appropriate medical care may be a factor in the decision to use illicit drugs for pain.”

So since I went off on a number of tangents, let me summarize my points:

1) Doing a drug for “sheer pleasure” is not inherently immoral for the following reasons:

A. We do lots of other behaviors, including take certain pharmacologic agents, for sheer pleasure or vanity that are not considered by society as immoral.

B. It is likely that a large percentage of people who do these drugs are doing them not for “recreational pleasure” but rather for other reasons including depression, chronic pain, or addiction. This calls into question the claim that doing drugs is immoral (and also whether it's criminal).

C. Addiction is a real and important facet of drug abuse, and certainly complicates the issue of whether or not it is moral or immoral to continue using drugs (which I didn’t talk about but I think it goes without saying).

2) Doing a drug instead of completely altering lifestyle is also not immoral for the following reasons:

A. The brain is inherently an organ of the body, and like all other organs, can become unhealthy. Treating the brain, just like all the other organs of the body, will involve lifestyle and pharmacological interventions.

B. Making lifestyle changes is very difficult, and for certain conditions – mental or otherwise, pharmacologic intervention may be a necessary step to initiate changes.

scigirl

Gurdur

I'm not sure if this has been mentioned (because I'm not going to bother reading 8 pages to find out), but:

The Netherlands has a far more relaxed attitude to marijuana than does the USA.

In the Netherlands, not only can doctors routinely prescribe marijuana (and chemists fill the prescriptions), but there are also official coffee-houses to buy and smoke marijuana in for purely recreational (=non-medical) purposes.

Moreover, prostitution is legalized and regulated.

Results ?

The Netherlands has less problems with hard drug addiction than the USA does (heroin, other opiates, etc.); it has less prostitution-related crime (not counting the prostitution itself); it has less drug-related crime than the USA.

People who think legalizing pot would have a bad effect on society's morals may like to look at the evidence and reconsider.