The semantics of prohibition
Author and founder member of the International Anti-prohibition League
The basic premise of the drug control system is the proscription of a number of substances, whose supposed effects on humans are either intrinsically bad, or intrinsically different from the effects of other substances. The difference between legal and illegal substances is couched in a terminology which is seemingly objective, scientific and descriptive, but whose actual meaning is subjective and ideological. This contradiction is highlighted in the text of the United Nations Single Conventions. In the 1961 Single Convention, the main targets of international drug control were 'addiction to narcotic drugs' and 'abuse of narcotic drugs'. These introductory considerations were followed by a 'Glossary' giving the definitions of all the terms used within the text. But in this glossary the words 'addiction', 'abuse' and 'narcotic' do not appear. In the most recent Single Convention (1988), the term 'addiction' disappears from the text and the word 'abuse' is again ignored by the glossary. These terms are, however, keywords in the prohibition of certain drugs.
Narcotics and drugs
We know very well that, pharmacologically, the term 'narcotic' refers to the sedative effect produced by a definite group of substances, mainly opiates and alcohol. Given that the Single Convention also implicitly considers as 'narcotics' such substances as cannabis, cocaine, stimulants and psychedelics (but not alcohol), it would be the case to give its own operational definition. But, as we have seen, this didn't happen. In fact, the seemingly scientific word 'narcotics' became a legal-bureaucratic term which defines these substances according to their legal status. According to the US National Commission, "the word 'narcotics' had been purged of its scientific meaning and became, instead, a symbol of socially disapproved drugs" (1973).The term 'drug' is defined by the Glossary of the 1961 Single Convention as "any of the substances in the Schedules I and II, whether natural or synthetic". However, by 1988 the glossary of the Single Convention defined the term 'narcotic drug' as "any ... substances ... in Schedules I and II". That means that the 'drugs' are defined not by their objective qualities, but by their classification into a subjectively sanctioned category.
From a strictly logical point of view, the term 'abuse' has a relative meaning, insofar as it is related to the concept of 'use', i.e. 'abuse' is defined as a type of 'use' that has negative effects. In its XVI Report, The Expert Committee on Drug Dependence of the WHO adopted a definition of 'drug abuse' as "persistent or sporadic excessive drug use, inconsistent with or unrelated to acceptable medical practice" (1969). This definition therefore considers 'drug abuse' to be any kind of non-medical use. The same concept was expressed by the American Psychiatric Association in 1972: " as a general rule, we reserve the term drug abuse to apply to the illegal, non-medical use of a limited number of substances, most of them drugs, which have properties of altering the mental state in ways that are considered by social norm and defined by statute to be inappropriate, undesirable, harmful, threatening or, at minimum, culturealien" (Glasscote et al). This definition is more overtly bound to evaluations that are not scientific, such as legality and conformity to the mainstream culture.
In 1975 the WHO itself recognised that the term 'abuse' had been used within an arbitrary and non-scientific approach: "Drug abuse is a term in need of some clarification.... The term is really a convenient, but not very precise way of indicating that (1) an unspecified drug is being used in an unspecified manner and amount ... and (2) such use has been judged by some person or group to be wrong (illegal or immoral) and/or harmful to the user or society, or both. What might be called "drug abuse" by some would not necessarily be considered so by others.... For these reasons, the term "drug abuse" is avoided here" (Kramer & Cameron 1975).
Nevertheless, the term 'drug abuse' has been used ever since in most WHO publications. A testament to the WHO's conceptual schizophrenia is a document issued in 1980, under the title 'DrugAbuse Reporting System': 'The term and, as noted in another WHO publication, there is no universal agreement on its definition. Nevertheless, the term is used here ... for referring to the adverse consequences of non-medical drug use" (Rootman - Hughes, 1980).
Furthermore, an extensive reading of the UN and WHO literature clearly indicates that, whenever illegal substances are concerned, they are always referred to in terms of 'abuse' instead of 'use'. This semantic attitude seems to postulate the equivalence between 'abuse' and 'use of illegal substances' and, therefore, the idea that the consequences of the use of illegal substances are necessarily pathologic an idea which suits the philosophy of other UN agencies: 'The UN discourages the use of all the following terms and concepts: 'recreational use' of drugs, 'responsible use' of drugs ..." (UN 1987).
As Goode stated, "As 'abuse' is used in context, ... it conveys the distinct impression that something quite measurable is being referred to, something very much like ... a sickness in need of a cure. Thus, the term simultaneously serves two functions: it claims clinical objectivity and it discredits the phenomenon it categorizes" (1972).
According to the US National Commission, "the term drug abuse must be deleted from official pronouncements and public policy dialogue. The term has no functional utility and has become no more than an arbitrary codeword for that drug use which is presently considered wrong" (op.cit., p.l3).
Addiction and dependence
In 1957, the WHO classified two types of drug dependence: 1) 'addiction', that is qualified by physical dependence and tolerance; and 2) 'habituation', that is qualified by psychic dependence and no tolerance (Young 1971).
This definition was replaced in 1965 by a new general definition worded as follows: "Drug dependence is a state, psychic and sometimes also physical, resulting from the interaction between a living organism and a drug, characterised by behavioural and other responses that always include a compulsion to take the drug on a continuous or periodic basis in order to experience its psychic effects and sometimes to avoid the discomfort of its absence. Tolerance may or may not be present" (WHO. 19fiS) This generic definition was supplied with separate definitions of 'specific dependencies', related to nine different types of substances: alcohol; amphetamines; barbiturates; cannabis; cocaine; hallucinogens; khat; opiates; and solvents.
Now, the general definition can be stretched until any condition "characterised by a behavioural .. response that always includes a compulsion to take the drug on a ... periodic basis in order to experience its psychic effects". This concept is so wid~ and so vague, that it can also be attached to an almost universal habit like drinking coffee or tea after waking up in the morning.
On the other hand, the WHO classification doesn't explain why, or according to which criteria, the concept of "specific dependence" was attributed to some substances and not to others. For example, it is not clear why the label of dependence was attached to hallucinogens (which are almost universally used occasionally) and not t tobacco. In fact, it seems that the WHO classification of 'drug dependence' is void of any scientific meaning. According to Goode, "the new definition ... is without any utility and confuses more than it clarifies. Its intent is patently ideological in nature: to make sure that discrediting label is attached to as many widely used (or 'abused') drugs as possible" (Goode, cit.,p.23).
Moreover, the 1965 WHO definition of dependence is contradicted by the 'diagnostic guidelines' of the 'dependence syndrome' indicated by another official WHO publication, the I.C.D. - 10, issued in 1987. According to this document, "a diagnosis of dependence can only be made if three o more of the following have been experienced:
i) A strong desire or compulsion to take drugs.
ii) Subjective awareness of an impaired capacity to control drug taking behaviour ....
iii) Substance use with the intention of relieving withdrawal ....
iv) A physiological withdrawal state ....
v) Evidence of tolerance ....
vi) A narrowing of the personal repertoire of patterns of drug use.
vii) Progressive neglect of alternative pleasures or interests in favour of substance use.
viii) Persisting with drug use despite clear evidence of overtly harmful consequences ....
ix) Evidence that return to substance use after a period of abstinence leads to a more rapid reinstatement of other features of the syndrome than occurs with non-dependent individuals". (WHO, 1987)
This definition has much stricter criteria than that of 1965.
As we have seen, the concept of 'abuse' is strictly related to the discrimination between 'medical use' and 'non-medical use'. The WHO defines 'non-medical use' as: "The use of dependence-producing drugs...except when... medically indicated" (Kramer-Cameron:op.cit.,p.15, e.a.). That is, that there are two criteria to define the 'non-medical use': 1) the substance must be "dependence producing", and 2) it must be used "other than medically indicated".
As we have seen, the 1965 WHO definition of 'dependence-producing drugs' has no clear scientific meaning. Therefore, once more we have a seemingly objective definition which is referred to a subjective criterion. On the other hand, the expression 'other than medically indicated' is clearly related to any kind of recreational use. But, as we know, the international control system has never included some recreational drugs, like alcohol and tobacco, in spite of their dependence-producing properties. The arbitrary code of 'non medical use' is, therefore, the semantic key to the discrimination between the so called 'drugs' and the traditional social intoxicants of western countries.
Semantics of the Single Convention
The use of terminology by the international drug agencies is meaningfully displayed by some historical details of the 1961 UN Single Convention. In fact, the Single Convention included cannabis in Schedule IV, along with heroin, with the following consideration: "particularly liable to abuse and to produce ill effects and ... such liability is not offset by substantial therapeutic advantages".
Though the term 'abuse' was quoted in the XVI Session of the UN Commission on Narcotic Drugs (which is the main UN political agency of the drug control system) in 1961 when the WHO representative stated that "cannabis abuse definitely comes under the terms of definition of addiction". However, he went on to explain that "it was ... not possible to assess qualitatively its addiction-producing properties" (Solomon, 1966). In other words, these properties could also be irrelevant.
The term 'addiction', by the 1957 WHO definition, was equivalent to 'physical dependence', but the further 1965 WHO definition of 'cannabis-type dependence' stated that there was "little, if any, physical dependence" (Kramer Cameron, op.cit., pp. 37-38). Paradoxically, the inclusion of cannabis in Schedule IV by the Single Convention was based on a WHO classification, which was latterly disproved by the WHO itself.
Furthermore, according to different sources (Bruun et al. 1975), the main argument for putting cannabis in Schedule IV was the fact that it had no medical use and it was widely used recreationally: "... the presence of cannabis in Schedule IV is to be explained by its wide abuse and its obsolescence in medical practice rather than by its intrinsic dangers" (Advisory Committee on Drug Dependence) .
On this subject, it is interesting to compare another popular drug, alcohol, which:
a) was officially included in the WHO classification of dependence producing drugs. In 1954, the WHO Expert Committee stated that alcohol dependence was in an intermediate position between habituation and addiction (cit. by Bruun et al, "The Gentlemen's Club", Chicago 1975, p. 176) moreover, by the 1965 WHO classification, the specific 'alcohol-type dependence' was described as far more severe than the 'cannabis-type'.
b)has no medical use;
c)is 'liable to produce ill effects' which, in fact, have (and had at the time) a severe impact on our society. Nevertheless, alcohol has never even been mentioned by the UN Single Convention.
The semantic system of the UN authorities, when examined critically, evinces a tautology that can be worded as follows Some substances are illegal because they are 'abused'/'abuse' equals 'non-medical use'/'non-medical use' is any use of illegal substances.
This situation was clearly defined by Apsler:
"Often the definitions essentially state that something is bad without clarifying what the something is, without specifying the criteria on which the negative judgement is based, and without stating the assumption from which the value is derived" (1978).
Advisory Committee on Drug Dependence 1968 Cannabis: Report HMSO London App.2, par.24
Apsler, R.,1978 Untangling the conceptual jungle of drug abuse in Contemporary Drug Problems 7:55-80
Bruun, K., Pan, L. & Rexed,1.,1975The Gentlemen's Club University of Chicago Press pp .2û 1 -202
Glasscote, R., et al 1972 The Treatment of Drug Abuse Joint Information Service:Washington
Goode, E.,1972 Drugs in American Society Knopf:New York p.26
Kramer & Cameron eds.1975 A Manual on Drug Dependence WHO p.16.
National Commission on Marijuana and Drug Abuse 1973 Drug use in America: problem in perspective Washington p.17
Rootman - Hughes 1980 Drug-Abuse Reporting System WHO p.9.
Solomon, D.(ed)1966 The Marijuana Papers Signet:New York p.87
UN DND 1987 The UN and Drug Abuse Control p.49.
WHO Bulletin No32 1965
WHO Expert Committee, cit. by Young, J. 1971 The Drugtakers Paladin:London p.42
WHO 1987 ICD-10 Geneva