You sit down to watch the recently released short revival of that much-loved early 2000s sitcom, Malcolm in the Middle. Suddenly you're swept up in a weird storyline where the dad, Hal (played by Bryan Cranston), suffering from depression, takes a mega-dose of magic mushrooms and runs through a wild therapy trip in the dingy back room of a local 'shaman'.

This dispatch I take a look at a strange episode of psychedelic TV. But first, I dive into an idea that pops up quite often: the morality of recreational drug use. Why is non-medical use of drugs so frowned upon in our modern world? And how arbitrary are our conceptions of recreational drug use?

An article last week by freelance writer Ed Prideaux lodged itself into the back of my mind. It was a critical dive into the idea that recreational drug use is immoral. Prideaux framed his article around a dissection of a pretty influential paper by controversial Christian philosopher Tim Hsiao. 

Is Recreational Drug Use Immoral? A Critical Look at Tim Hsiao’s Argument | Psychedelics-Community
Philosopher Tim Hsiao argues that recreational drug use is immoral because it deliberately impairs reason, our core human faculty. Ed Prideaux argues that his natural law framework is shaky, riddled with inconsistencies, and overlooks how altered states can sometimes serve, rather than undermine, human flourishing.
Psychedelics-CommunityEd Prideaux

Hsaio’s paper, titled ‘Why Recreational Drug Use Is Immoral’, summed up some pretty long-standing perspectives on the morality of intoxicated states. The ideas weren’t especially new, but they were succinctly put; highlighting that classic idealised notion of sobriety as the optimal state for a rational mind and suggesting any intentional act of drug taking that compromises one’s rational thoughts is an act that must be considered immoral.

Prideaux’s article countering Hsaio’s argument is wonderfully thoughtful, and I recommend you read the whole thing if you have a chance.

However, after reading both Hsaio and Prideaux’s arguments, one idea in the discourse really leapt out at me. It’s an idea that I discuss a little in Trip Reports so I thought I’d lead off with a short excerpt from the book; before moving into some hyperbolic opinionating.

Here is a short except from late in Trip Reports.

Medicines and drugs

For most of this book I have, perhaps flippantly, used the words ‘medicine’ and ‘drug’ in interchangeable ways. Of course not all medicines are drugs, and not all drugs are medicines. Our binary frameworks tend to perceive medicines as good and drugs as bad. I know that it’s easy to pull that idea apart (I’m looking at you, caffeine and alcohol) but in terms of the way value judgments are apportioned to uses of substances, it’s certainly socially preferable to call something a medicine over a drug. 
Consider yourself not a psychedelic drug user but a psychedelic medicine user.
So how, then, do we make whole the idea of psychedelics if these substances are both drugs (bad) and medicines (good)?
We need to grapple with semantics for a second, and I promise I won’t fall into the triteness of writing something like, ‘As defined by the Oxford English Dictionary, a medicine is …’ Nevertheless, we do need to consider what exactly the word ‘medicine’ means when we consider it in the context of the phrase ‘psychedelic medicine’.
In the province of Western thought, we generally operate in a binary between sick and well. When you’re sick, you visit a doctor. The doctor diagnoses the illness and prescribes medicine to cure or relieve your symptoms. 
Thus, the pathway of medicalising psychedelics is one by which scientists work to understand what diseases these drugs can treat, and establish processes by which clinicians can use those drugs as medicines to make people better. 
Although there are plenty of exceptions (again, I’ll never forget you, caffeine and alcohol), in modern Western societies we generally don’t look kindly on drug use when it’s taken outside of a formal medical container. Drug use that isn’t explicitly considered medicinal is framed as ‘recreational’, and considered poor behaviour. Outside of the socially allowed ‘vices’ (which are not considered ‘drugs’ in the conventional sense), we shun drug use that isn’t prescribed to a patient by a clinician.
In fact, once a drug has been explicitly categorised as a medicine, its uses outside of that medical container become especially illicit, loaded with social or morally punitive outcomes. Psilocybin, for example, may now be acceptable as a medicine for treatment-resistant depression, but if you take magic mushrooms in any other context, even with an intent to heal, you are fundamentally engaging in drug abuse.
As anthropologist Tehseen Noorani puts it, ‘In providing frameworks for “proper use,” medicalisation delineates the conditions of “abuse.”’ Noorani suggests most modern psychedelic clinical trials are so narrowly focused on specific doses and diseases they contribute to the ongoing idea that any uses beyond this frame are illicit.

In the book I move this thought in a different direction than I am going to take it today. Here, I want to consider the way Hsaio frames ‘good’ or ‘moral’ drug use against immoral use.

Let’s look at a quote from Hsaio’s argument where he tries to carve out some exceptions for ‘moral’ drug use.

“Indeed, interventions to promote or restore our thinking to its normal function are good for us. This is no different than taking medication to restore health or taking multivitamins to improve dietary intake. Thus, it is permissible to take antidepressants, analgesics or sleeping medication, drink coffee, and undergo anesthesia, for these things all positively affect aspects of our cognition that are over- or under-stimulated or that interfere with some other part of our overall well-being. It is not wrong to repair, enhance, or promote our cognition, since in doing so we enable our cognitive faculties to function in the way they should.”

So, all this falls into a place where we picture a kind of optimal rational cognitive state. A mental place where our sense of reason is clear and uncorrupted. This is, according to thousands of years of moral philosophy, the rational mindset we must strive for in order to think clearly and act as moral human beings. Any 'drug' that clouds this ideal state is bad.

As Prideaux notes, religion has long deemed it immoral to intoxicate our rational mind.

“The Noble Eightfold Path of Buddhism regards intoxication as morally dangerous, conducive to heedlessness (pamada). The author of the First Epistle of Peter advised his readers “be sober minded, for your adversary the devil prowls like a lion looking for anyone whom he can devour”.”

The thing is, I’m not so sure an untainted 'sober' mind-state truly exists.

I don’t know about you, but this morning the first thing I did when I woke up was waddle to the kitchen, bleary-eyed, and brew up a cup of coffee. That jolt of caffeine certainly sharpened up my mental facilities and got me going. 

Was that an immoral act of drug use? 

Not exactly, according to Hsaio, because it helped “promote” my cognitive facilities. But maintaining some kind of rational equilibrium could involve a constant cocktail of drugs.

If someone uses too many stimulants (aka drinks too much coffee) over the course of a day would it be wrong for them take some depressant drugs to “come down”? Alcohol, or maybe even cannabis, could be useful?

Hsaio admits antidepressants and analgesics can sometimes be needed to positively affect an over- or under-stimulated mind. But every concession we carve out quickly begins to feel arbitrary when we try to delineate “good” drug use from “bad” drug use. 

A 5-minute GP visit declares a patient depressed allowing deeply mind-altering SSRI antidepressants to be prescribed; dramatically affecting their mood, personality and cognitive facilities.

An adult recently diagnosed with ADHD following a 60-minute psychiatrist consultation is now taking powerful amphetamine-like stimulants every day, subsequently buzzing with renewed focus and activity.

A student gets some modafinil illegally off a friend in order to do some multi-hour study sessions. Drug use as a cognitive booster.

How are your iron levels? Do you suffer from mid-afternoon mood slumps? Insomnia? Hormone-levels fluctuating leading to irritable fights with your partner? These all may require some kind of drug use for recalibration.

Sure, I might be suggesting examples where the drug use isn’t what one would technically refer to as ‘recreational’. So let me ask, where does ‘functional’ drug use end and ‘recreational’ drug use begin?

Does someone with ADHD feel good when they take their medicine? I certainly feel good when I have my morning coffee. A recreational amphetamine user will consume their drug of choice because it helps them feel clear, energetic, social. In fact, many people take drugs to help them socialise more comfortably, including alcohol.

Is that immoral?

I don’t want to be so reductive as to turn everything we think and feel into a chemical calculus. But I think it’s pretty important we are aware of how arbitrary our moral judgements over drug use can be, and remember there isn’t really an ideal “drug free” mindset. 

Psychedelic Pop Culture Corner

This psychedelic pop culture corner report looks at one of the weirdest trip storylines I’ve seen in a long time: Bryan Cranston embarking upon an expansive bout of psychedelic therapy in the reboot of Malcolm in the Middle.