Intended for healthcare professionals

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 …

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