Medicine And Multimedia

The Alchemy of Culture: Intoxicants in Society

BMJ 1998; 317 doi: (Published 28 November 1998) Cite this as: BMJ 1998;317:1532
  1. Colin Drummond, senior lecturer in psychiatry of addictive behaviour
  1. St George's Hospital Medical School, London

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    Richard Rudgley

    British Museum Press, £9.99, pp 160

    ISBN 0714127116

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    A recent resurgence in the debate over legalisation of illicit drugs, notably cannabis, has tended to generate more heat than light. At one extreme, protagonists argue in favour of libertarian values and eschew the interference of the “nanny state.” At the other extreme, a prohibitionist lobby espouses the evils of intoxication and the virtues of abstinence from psychoactive substances.

    The reasons for a resurgence in this debate are doubtless many and complex. Not least is the apparent powerlessness of governments, law enforcement agencies, customs, and the caring professions to stem the rising tide of drug misuse sweeping Western societies. The debate is unfortunately more influenced by political dogma and media hype than by sound reasoning and scientific evidence. The Alchemy of Culture contains elements likely to appeal to both sides of this debate as well as contributing to scientific understanding.

    Richard Rudgley applies data from archaeology, ethnology, and anthropology to take the reader on a fascinating journey from prehistory to the present to explore the role of intoxicants in societies, ancient and modern. Speculation about the use of hallucinogenic plants and opium by Stone Age cavemen and its influence on their art gives way to more direct observations of early anthropologists on psychoactive drug use in isolated tribal cultures. The academic research behind this book is impressive.

    Two principal themes emerge. Firstly, since prehistory, humans have experimented with naturally occurring substances for their psychoactive effects. Secondly, psychoactive drugs acquire a cultural importance that extends beyond the drugs' pharmacological effects and that influences the subjective experience.

    Rudgley's thesis seems to be that modern Western cultures arbitrarily condone some drugs (such as alcohol and tobacco) while outlawing others (cannabis, LSD, opium). His view is that the control of drugs by Western politicians is akin to the social control and conferment of social privilege exerted by tribal shamans (or priests) to maintain their elite social status. This comparison seems rather far fetched.

    Nevertheless, the fact that many of these psychoactive substances are highly poisonous or addictive is acknowledged. At the outset, readers are warned that “the book is not intended as a practical manual for the use of intoxicating substances. Details of certain plant preparations have been omitted to prevent its use as such.” From this perspective, the book is somewhat more responsible than recent television programmes on the same subject.

    Overall, this is a scholarly and very readable account of the history of psychoactive drugs and their role in diverse cultural contexts. It will be of interest to specialists in addiction, to anthropologists, and to anyone who wishes to develop a broader understanding of psychoactive drug use and misuse. It is reassuring, and at the same time troubling, to discover that, just as psychoactive drug use has a long history, so too does the debate about whether these substances should be controlled or freely available. This book will help to inform and extend that debate. However, one cannot help but fear that it will be quoted out of context in the service of protagonists of legalisation.

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