Views & Reviews Review

Our chemical romance

BMJ 2010; 341 doi: (Published 08 December 2010) Cite this as: BMJ 2010;341:c7052
  1. Ike Iheanacho, editor, Drug and Therapeutics Bulletin
  1. iiheanacho{at}

Today the illicit drug trade is worth an estimated £200bn a year, but human beings have used substances recreationally since time immemorial. Ike Iheanacho marvels at an exhibition and book that consider our history of getting high

“Alcohol,” a professor of pharmacology used to declare, “is a food not a drug.” His argument was that the effects on the central nervous system occur only with high doses, which supposedly precluded classifying alcohol as anything other than a source of energy. This lame, unscientific reasoning buckles under its own contradictions. But in a sense far removed from that intended he was right.

Because of the ways that alcohol is marketed, bought, consumed, and cherished in Western society it is far closer to foodstuffs than to other substances taken primarily for their consciousness altering effects. Indeed it’s often not considered a drug at all, even in medical parlance. Who, for example, on hearing the term “drug addict” thinks immediately and spontaneously of the inveterate boozer? The risk of such oversight presumably accounts in part for the popularity of the phrase “drugs and alcohol,” a tautology that is both a helpful reminder and a nod to the special status afforded to one of society’s sacred cows.

The myriad consequences of culturally sanctioning or censuring substances that are (or that contain) psychoactive drugs are key themes in the book High Society and the Wellcome Collection exhibition of the same name. Arguably these couldn’t have come along at a better time. Too much of current debate about non-medicinal/recreational/illicit/illegal drug use is a stalemate slanging match between closed minds expounding from entrenched positions in the absence of context.

On the one hand are people in the extreme liberal/libertarian wing, who, in pushing for wholesale legalisation of currently controlled drugs, state unoriginally that, were alcohol to be discovered today, it would be instantly outlawed in light of its dangers. Occupying the opposite position are those who will brook no other solution than outright “bans” of any products even suspected as having potential for misuse.

High Society represents a gentle poke in these blinkered eyes through its straightforward and engaging storytelling and cool headed analysis of use of, and attitudes towards, mind altering drugs.

Early on the book makes and substantiates the key point that the tendency to use substances to produce desired (not necessarily pleasant) psychological effects is an intrinsic feature of the human condition, recognisable down the ages and across all cultures. The same message is conveyed simply and effectively in the exhibition, in which the very first display comprises 50 or so juxtaposed items that exemplify the wide diversity of psychoactive agents, the ways and means by which they are taken, and the social circumstances surrounding their use.

The sceptic could, of course, try to draw hard and fast distinctions between, say, the injecting drug user and the coffee junkie; the devotee of amyl nitrite and the chronic tobacco smoker; the ritual-observing drinker of the narcotic kava and the wine buff. But, in reality, many of the obvious differences are culturally determined rather than being reflections of immutable pharmacological fact. This is not to say that all drug taking is or should be regarded as equal or automatically deserving of toleration, acceptance, or endorsement. The book certainly doesn’t fall into this trap when detailing what it calls a “universal impulse” to use chemicals to change mental function. But neither does it shy away from highlighting the failures to understand or take account of common factors that have triggered or sustained the development, use, and trade of drugs of which mainstream society disapproves.

The book deserves high praise for rendering a complex, controversial topic with clarity and elegance. It’s also good looking: every double page spread in the main text has at least one illustration, and the content and sensitive placement of these enhance an already lively text. The exhibition is also excellent but suffers a tiny bit from direct comparison with the book. It covers the same ground, but the inevitably restricted amount of linking narrative makes for a slightly disjointed presentation, in which some of the book’s subtlety is lost.

And although the exhibition has potential advantages through incorporation of real life objects and installations, one or two of these are, frankly, duds. A particular offender is an overlong, dreary film in which an artist, having taken a dose of LSD, cycles tediously around Berlin, apparently in homage to a similar trip (in every sense of the word) taken by Albert Hofmann on discovering the drug 58 years before.

But this is a minor irritation, given the wealth of other illuminating exhibits. These include a breathtaking film of endless poppy fields that is both haunting and beautiful. And another gem is the snippet from a Panorama programme (recorded in 1955) in which a doctor called Humphrey Osmond interviews Christopher Mayhew, an MP, before and after Mayhew has taken a dose of mescaline. The hallucinogenic drug clearly scrambles Mayhew’s concentration, but he also reports his colour vision as becoming “quite marvellous.” Overall that’s a pretty fair summary of High Society too.


Cite this as: BMJ 2010;341:c7052


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