Reviewing an assumption I hold: Is Recreational Drug Use Inherently Bad?

My one anecdotal data point - my cousin. She did recreational drugs, hooked and stole to support her habit, so was in and out of prison, cleaned up briefly, then died of an opioid overdose. She was maybe 50? She left behind some kids, one who my uncle raised, but I don’t know about the others.

I’d consider her drug use bad.

Then there was a former classmate as well as an ex-brother-in-law who were said to have OD’d, but I have no direct knowledge of either.

As someone who rarely drinks and has never tried recreational substances of any sort, I honestly don’t get the appeal of getting drunk or getting high or hallucinating, or whatever people use drugs for. But I’m OK with legalized marijuana, assuming any impairment is treated similarly to drunkenness as far as public safety. On the other hand, stuff that clogs our emergency rooms and hospitals with users who go to far - I count that as bad.

This sounds great in principle: do bad things, face the consequences. The problem is the negative impacts on everybody else around the user, especially when such impacts can’t easily be undone. Example, we can imprison a user after he murders a homeowner during a robbery, but the homeowner will remain murdered.

Drugs that sometimes cause problems of varying severity for people around the user (e.g. alcohol, weed) can reasonably be regulated. Drugs that reliably cause severe problems for people around the user probably should remain illegal.

This is actually a topic I’ve thought about way more than is likely helpful. But y’all will get the fruits of my musings…

I think drugs can be usefully classified along 4 axes:

A: How addictive is it?
B: How physically damaging is it to the user under ordinary use, both casual and addicted use?
C: How directly damaging/annoying to others is is its use? For instance, someone smoking a joint in a public place makes it stink, and might give someone else a contact high. Someone shooting up in a public place doesn’t have any direct impact on others.
D: How indirectly damaging is it? This encompasses drunk driving, getting into fights at bars, etc. It also overlaps a little with “addictive” because it also includes the likelihood that a user will commit crimes to feed their habit, but to a large extent that can mitigated by making the drug more available.

So, for instance, take caffiene.
A: 4 It’s moderately addictive. Most users who want to quit can do so, but maybe suffer headaches, tiredness, and other physical problems if they try to do so.
B: 2 There’s very little harm to the user under ordinary circumstances. Even those who drink a dozen cups of coffee a day rarely suffer more than shaky hands and perhaps small increase in the risk of heart problems.
C: 0 Under ordinary circumstances, it is harmless to others directly
D: 0 Under ordinary circumstances, it is probably helpful to others (people get more work done when they use caffeine) and rarely causes any societal problems.

So, it seems completely appropriate that caffeine is fully legal and easy to get.

How about Pot? I’m going to guess
A: 1-2 Everyone I know who wanted to quit pot did, without much trouble.
B: 3-4? This is pretty murky. But the damage is surely not huge.
C: 8 when smoked, 0 otherwise.
D: 2-3? Recreational users, who are common, generally don’t harm others at all, but people who smoke pot and operate heavy machinery, or who smoke all day and can no longer work effectively, cause harm to others.

A: 9-10 this is the poster child of addiction
B: 2-3? People sometimes drop dead of an overdose, but you don’t hear about a lot of physical harm, except from mis-use, like using dirty needles or hooking, which probably belong in D
C: 0
D: 7? People drop out of society, lose the ability to work, and where it’s illegal, they commit dangerous and illegal acts to get it.

You get the picture. I feel like B mostly matters for addictive drugs. C determines whether we should regulate public use, and D is a driver of public policy. But if D without A, we could rely on non-drug laws (punish those who steal, don’t pay those who don’t show up at work) and it’s only the presence of A that makes D really important.

I find, as I usually do, that many people seem reluctant to recognize/include alcohol as a recreational drug. Which it is.

@Machine_Elf I think you may be underestimating the amount of damage done by alcohol in our society. It is not something you measure solely in OD’s. There are people who spend too much money on alcohol, people that alcohol makes more likely to act out in violent or unhealthy ways, people who drink enough to have a negative impact on their health, yet a person can be subject all of those ill effects and still hold down a job, keep their family (although their family may not be as happy or healthy as they be otherwise), and live for a remarkably long time despite physical damage done. Damage and negative effects don’t have to be huge to add up over time.

@FairyChatMom your statement about rarely drinking implies that you have, in fact, consumed alcohol at some point, so you have in fact tried a “recreational substance”. Alcohol is a drug, too, even if we don’t often think of it as one. Why did you take that drink? Whatever the reason, that’s one of the reasons people use recreational substances. It could be curiosity, or custom, or because everyone else in the room is doing it, or because you enjoy it once in awhile… doesn’t matter. So you do, in fact, have some idea, what you probably are puzzled about are why people keep imbibing long past the point you do. I’ve never seen the appeal to drinking until vomiting or passing out either - and because that appeals to neither of us we can exist as social drinkers, or social non-drinkers as the case may be.

For myself, I’ve long though that if I ever did into trouble with drugs it wouldn’t be sedatives - I don’t like that warm fuzzy blanket drifting off feeling, I like to be AWAKE. No, I think I’d have trouble with the stimulants. I mean, wow, I’d LOVE to be REALLY SUPER AWAKE!!! And knowing that about myself, and seeing people who couldn’t handle stimulant use, I’m pretty sure I’m going to steer clear of things like cocaine or amphetamines or meth or anything like that for the rest of my life. I don’t even want to try it once.

(Yes, I am a caffeine addict, why do you ask? I could quit any time I want to, but I don’t want to… I freely admit that. But my addiction does not impair my ability to be a functional adult in this world and does not put others at risk.)

I think it would help if people remembered that such items as alcohol and caffeine are also drugs. Almost everyone uses one or both of those, so almost everyone is, in fact, a recreational drug user of some sort, the difference is a matter of degree and chosen substance. The real questions are which drugs are we going to make legal for recreation and why.

@puzzlegal’s way of thinking about it is one way to consider these things, even if not perfect (there is not perfect method, just to be clear on that).

Another thing to consider is the potency/purity of the delivery method. It does make a difference. Coffee and tea deliver caffeine, but in small to moderate doses. If, on the other hand, you purified caffeine to its pure state, as we do coca leaf to make cocaine, and consumed it in that form, either orally or by injection, we’d have a lot more people dropping dead because they OD’ed on the stuff. Coca leaf tea allegedly is not so much a problem (I say allegedly because I have no direct experience of it and not a lot of confirmed information). The poppy seeds used in cooking contain trace amounts of opium, enough to trigger a positive on some drug tests, but not enough to cause anyone to get high. Get the latex out of the seed pod, though, it’s definitely concentrated enough to get high and caused a lot of problems in the past. Rinse and repeat for a lot of things. So I think another factor to consider is not just what @puzzlegal mentioned but also the purity/potency of the delivery method.

Yeah, the purity and potency matter for how addictive a substance is, as well as how likely you are to get in trouble with that one use. I know a couple of people who’ve had coca leaf tea in the Andes. I gather it’s a lot like ordinary tea, in that you maybe notice an effect but it’s not a big deal. Both mentioned that the people who drank the coca tea had less trouble with altitude sickness than the people who abstained, and if I am ever in the Andes and offered coca tea, I would drink it, based on the experiences of two friends.

But cocaine scares the shit out of me.

An amazing number of patients were legally prescribed alcohol for “debility” and “La Grippe” during Prohibition, as documented in Daniel Okrent’s “Last Call”.

And of course there was a major boom in “religious” uses of wine.

Oh, absolutely. I would consider someone who drinks wine to relax or to get a buzz a recreational drug user. But probably not someone who drinks wine strictly for the taste.

Caffeine is of course a drug, but what makes it (or anything else) count as a recreational drug? Yes, people who use caffeine do so because it makes them feel better or function better, but the same could be said of allergy medication or aspirin for a headache.

Eh…Mostly because we don’t prescribe alcohol because you can get it “over the counter” and we don’t see it as medication. But we could. I get really bad headaches. My doctor asked what I did about them “two advil and a bourbon coke” - pain killer, muscle relaxant, vascular dilator. He said “that’s pretty much what I’d prescribe, if that works for you, and you aren’t doing it more than once or twice a month, that’s safer than anything I’d give you.” Heck, when I was pregnant (21 years ago) I had a panic attack and my OB said “drink a glass of wine and sit in a warm - not hot! - tub…any medication I can give you for a panic attack will be less understood and potentially more harmful than a glass of wine.”

But a LOT of people self medicate with alcohol. And a lot of them become alcoholics because they use it to treat pain, muscle issues, anxiety, etc.

Lots of prescription medications can be abused. Lots of them aren’t really safe, they are just safer than living with what you are treating. That’s why they are prescriptions.

I have come to believe that legalizing weed is a good thing - in part because its always been “legal” for white people, but a way to put people of color into the legal system. You’d have a hard time convincing me to legalize meth or opiates (although I so wish we’d go back to OTC codeine, selfishly because I have chronic bronchitis, and codeine is about the only thing that lets me sleep through the night - and now I can’t even get a prescription for it - suck it up, buttercup - don’t want those opiates on the street). And if alcohol would be invented today, rather than being invented right after fire and before the wheel, we would control it much more than we do.

Weed is a hell of a lot safer than alcohol. I’ve never treated anyone for life-threatening consequences of THC intoxication or its chronic use (outside of consequences of driving impaired which can be deadly all around), but I’ve treated thousands for alcohol-related stuff like potentially fatal levels of of blood alcohol, end-stage alcoholic liver disease, alcoholic cardiomyopathy, acute alcohol withdrawal, alcoholic pancreatitis, alcohol-induced esophageal and gastric hemorrhage, alcoholic dementia, liver and pancreas cancer related to chronic alcohol use, etc etc etc.

Biggest problem with weed (assuming one doesn’t toke and drive, etc) is that chronic daily use leaves a significant number of users with significant microdeckia. But there are worse things than that.

That may be the biggest problem in adults, but I’ve seen reports that it can damage the developing brains of adolescents.

I like the idea of a framework to discuss the potential harms and potential benefits of different drugs, but I also suspect classification of drugs into these categories would vary widely depending on the user. For example, I’m in relatively close agreement on the effects of caffeine, but would consider heroin much more harmful with the overdose death rates.

Some - not all - heroin OD deaths are due to the inability to get a truly reliable potency of the drug. One scenario is that a user gets ahold of smack that is stronger than what they usually use, they use their regular dose, but in this case it’s enough to kill them. If - and I’ll add I’m not on board with this, it’s strictly hypothetical - if heroin (or other opiate) was legalized user could get a standardized and reliable strength, which would cut down on such accidental deaths.

Which, of course, would not eliminate all problems with that substance, just one of them.

Yeah, frankly weed use is a concern for those with brains not yet done fully developing (ie those under age 30 or thereabouts).

Unless your dog gets into the chocolate bar you brought back from Massachusetts. Even then, the chocolate is more dangerous than the weed, but dogs have really sensitive THC receptors and a slightly paranoid, confused very very high dog is no fun.

And yeah, twelve year olds smoking weed is not good. Still better than twelve year olds drinking.

I read a surprisingly (though not entirely) positive review of this book (by another mental health professional in today’s Wall St. Journal.

For every person who insists that a hard drug “hobby” is no problem or makes them a better person, I wonder how many of their family members, acquaintances and coworkers have noticed deleterious changes of which the user is unaware or in denial about.

Me too. “Back in the day” I loved to smoke weed and drink alcohol until I was ready to fall asleep, then I’d do a couple lines and be wide awake and ready to party some more.

But cocaine is so expensive and is sold in single use packages (regardless of package size). I haven’t touched la coca in a long time.