Is alcohol a “drug”? Why the question matters

Mark Kleiman offers a commentary about alcohol’s cultural status as something other than a drug. I think he’s guilty of a little hyperbole and condescension, but I find his point to be on the mark.

“In terms of its effects on the human body and psyche, alcohol is simply another psychoactive substance.” That sentence, with which Cook and Reuter begin their very able essay, embodies a proposition that will be taken as a truism by most readers of this journal, but would be regarded as a fallacy, an outrage, and an insult by many, if not most, ordinary citizens.

Why is that claim controversial, and why does the rejection of that claim matter?

It is controversial, I would submit, because the mood in which the public, its elected representatives, and their appointed officials consider drugs, drug-taking, and drug policy has little to do with the calm, evidence-based, policy-analytic tone taken by Cook and Reuter. The two scholars do not recite, because they do not believe, the basic credo underlying the international drug control regime, as well as the drug policies of most countries: outside a strictly medical context, drugs are fundamentally evil, drug-taking is both harmful and morally culpable, and drug-takers require some mixture of treatment and punishment. It is this credo that is threatened by any attempt to treat alcohol as a “drug.”

By contrast with any of the controlled drugs, alcohol use is neither statistically”

n particular, those who discuss drug policy (outside Islamic societies) have no obligation to pretend that they themselves are, nor any right to assume that their audiences are, abstinent from alcohol. Thus courtesy forbids even those who themselves do not drink, and disapprove of drinking, from referring to alcohol users generically as “drunkards” or “degenerates” or “slaves of the Demon Rum.” Problems with alcohol must therefore be treated, in Abraham Lincoln’s formulation, as “the abuse of a good thing,” not “the use of a bad thing.”

But if alcohol is a drug, then “drug use” is normal, and not all drug use is abuse. That undercuts the entire project of stigmatization underlying much of what passes for “drug abuse prevention.” If smoking cannabis, snorting cocaine, swallowing MDMA (“ecstasy”), or even injecting heroin, are not different in principle from having a glass of wine, then the moral basis for treating cannabis-smokers, cocaine-snorters, rave-goers, and heroin-injectors as carriers of a deadly plague is called into question, and even suppliers of those drugs might be seen as regulatory violators rather than hostes humani generis (enemies of humankind) the modern incarnation of a legal category that used to cover pirates and slave-traders.

Conversely, labeling alcohol a “drug,” given the nasty connotations that word has been so carefully given, calls into question the presumptive innocence and innocuousness of drinking by responsible, non-alcoholic adults, and of the industry that supplies them, as it also supplies children, alcoholics, and those who become violent and imprudent under the influence of drink. To the analytically-minded it seems perverse that the one-eighth or so of diagnosable substance abuse disorder (other than nicotine dependency) that relates to the controlled drugs should receive much more attention (whether measured by rhetoric or control resources) than the seven-eighths in which the problem substance is alcohol.