Intended for healthcare professionals

Feature Christmas 2016: Being Well

Morality and non-medical drug use

BMJ 2016; 355 doi: https://doi.org/10.1136/bmj.i5850 (Published 09 December 2016) Cite this as: BMJ 2016;355:i5850
  1. A C Grayling, master
  1. New College of the Humanities, London WC1B 3HH, UK
  1. acgrayling{at}yahoo.co.uk

So long as others are not harmed, there are no moral grounds for restricting use of cannabis or heroin any more than alcohol or caffeine, argues A C Grayling

Conservative moral attitudes are fruitful in causing social problems. The question of the use of drugs such as cannabis and heroin is a prime illustration of this fact. Arguably, neither the use nor the misuse of mind altering substances is a moral problem, though both, and especially misuse, can cause practical problems. But if in addition their use is criminalised, those problems are exacerbated and the cost to society balloons.

By “drugs” in what follows I mean opium and its derivatives, cocaine, various forms of cannabis, LSD, “ecstasy,” amphetamines, solvents, tranquillisers, and anything else people use to alter their states of consciousness and emotion, whether or not they become addicted to them.

Moral inconsistency

The list should also therefore include alcohol, nicotine, and caffeine, but it usually does not. There are yet other substances in what we eat and drink that have narcotic, stimulant, or hallucinogenic effects—sugar, for example, in the stimulant class—but usually with milder immediate consequences (though perhaps with as great or greater longer term effects on health—again, as with sugar). But these too we do not outlaw.

The fact that only some drug use is regarded as morally opprobrious is a problem. Is it immoral to drink a glass of wine or put a lump of sugar in your tea? Hardly anyone would think so. If not, why is it immoral to put cannabis in your cake mix? Parity of reasoning says it is not.

The 19th century English philosopher John Stuart Mill argued that what …

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