ABSTRACT: The author maintains that the origin of the moralistic attitudes toward drugs lies in the denial of the positive value of the quest for pleasure, the rejection of pleasure and of all that is exotic and new. He then analyses the project for the controlled distribution of drugs in health structures advanced by the Minister of Health, Renato Altissimo.

(Radical News N.146 of 29 September 1979)

As a consequence of the urgency of the problems concerning "drugs", more and more rarely do we wonder at the meaning and the deep reasons for certain attitudes which have a fundamental influence not only on the legislation and on the judicial praxis, but also on certain scientific approaches, on research, or at least on mass scientific information on this subject.

For example, why are heroin and marijuana considered "drugs", whereas alcohol is not? Why are some medicines which have relevant effects on the psyche and are capable of causing addiction not considered "drugs", whereas substances that are acknowledged to be "drugs" are not used in medicine, despite the fact that they are capable of engendering similar or better therapeutical results compared to many "medicines" and have far less contraindications and negative effects?

One explanation might be that it is the fact that they are "prohibited" which associates all "drugs" in a single category and subjects them to a single moral judgement. This is partly true, especially for that which concerns certain conditions of diffusion, of approach to use, of permanence in a state of addiction, etc.

However, I believe that there are two components at the origin of the moral (and not only moral) attitudes toward "drugs": the denial of the positive value of the quest for pleasure and of the manipulation of the psyche by means of the body, an attitude which is of ancient Christian and puritan origin; the other component is the refusal, the fear of all that is exotic, new and unknown (for example, think of the equation drugs = East, which prevailed for a long time in certain cultural milieus and which is not void of a historical basis). Also, looking further back in the past, think of the attitude toward magic, drugs, alchemy, etc.

I believe this interpretation can explain why prohibiting alcohol, for example, can only be the objective of extremist puritan groups, in that the production and use of alcohol belong to ancient traditions of countries that are presently predominant from a cultural point of view (apart from the obvious economic implications linked to its production and distribution). And this can also explain the fury with which the use of substances far less dangerous than alcohol is persecuted, and the hope to prove that they are on the contrary dangerous, and the moralistic attitude which is often much sterner toward people who indulge the habit of smoking a few joints than toward heroin addicts, who at least represent, with their self-destructive drive, a healthy example against the morals of the quest for pleasure. This reminds me of a priest, a religion teacher, who seemed to me almost enthusiastic (albeit generically) in describing the horrible venereal diseases which "luckily" affected sinners against chastity.

At a moment in which the failure of a policy which is roughly and occasionally repressive toward drugs leads even milieus which are traditionally little inclined to novelties and any form of broad-mindedness to take into consideration equally generic, approximate and occasional hypotheses of a legalization of the use of drugs or of specific drugs, I believe it is necessary to oppose the fundamental logic of these hypotheses, represented by the safeguard of health exclusively from the effects of addiction by means of a specific and direct public intervention, while observing such changes of attitude with deep attention and consideration.

At this point, we cannot but recall the not too enlightening history of the law on abortion, and of the trap into which practically all the forces that had raised and conducted this battle fell into, albeit to different degrees and with different responsibilities. "Drugs in hospital", with the logical appendix "drugs for free" is something that still shocks someone more than "legalized drugs", and convinces those who are already convinced of the uselessness or insufficiency of repressive systems more than other hypotheses based on the establishment of conditions of liberalization. At least at a first analysis, and owing to undeniable suggestiveness of such proposal. "Legalized, free and medically assisted" abortion also convinced (and possibly still convinces even now) more than the complete or partial depenalization of abortion, no longer linked to procedures of any kind and especially conditions of any kind, such as those relative to the public facilities to carry out the operation; the latter should repre

sent the means to ensure the medical assistance and the gratuitousness. However, because they are posed as the condition of the legalization subordinated to the respect of such requirements they have necessarily become the limit, the filter, and in practice the barrier that neutralizes legalization and with it, as a consequence, gratuitousness and medical assistance, which clearly do not exist in the situation of clandestinity in which most women still practice abortion. It would be too easy, tomorrow, to attribute the responsibility of the failure of the project developed by Minister Altissimo to the bad will of the hospital physicians, or of the administrators, with the usual conclusion that it is necessary to adapt the structures, etc. This does not mean that it is not too easy to proclaim that the problem of heroin addicts must be tackled in the "broader context" of the achievement of the reform of the health system, etc.

The fact is that the distribution of heroin to heroin addicts in hospitals cannot but be a therapeutical treatment, whereby the responsibility, the different evaluations and therefore necessarily the discretionary nature of the physicians' choices will end up by having too much space. Not to mention the incongruities, the deficiencies, the sluggishness of the Italian hospital system.

No one will ever force a doctor who should administer heroin to a heroin addict, to carry out controls, examinations, with the objective difficulty of establishing the extent of the habit (not to mention checking the real state of addiction), especially in the presence of a vast diffusion on the clandestine market of products that are "diluted" in countless ways.

Likewise, no one can avoid the fact that heroin addicts will have to be put on some sort of record, precisely so as not to make the whole operation more complicated and slow, while the secrecy concerning such records will not be and will not be considered leakproof. The result: heroin in hospitals won't be too different, in many respects, from "traditional" detoxication procedures, with the same type of resistance on the part of drug addicts.

Until the day I convince myself that there is no other alternative to the current situation, I, who am not an advocate of legalized drugs (whereas I was and am an advocate of legalized abortion and of legalized non-drugs) cannot understand the reason for all this commotion, for all these false references and deceptions and alibis, about the establishment of a "State drug" which, if it contradicts the morals both of those who advocate it and of those who are against the freedom of drugs and the freedom of administration of one's health, would also represent a bad implementation of the criterion of the "lesser harm".

This does not change the fact that in the current situation of stalemate of any initiative, this proposal has at least had the merit of rekindling a discussion which seemed to be concluded. Likewise, it cannot be ruled out that in the near future, and provided we are clearly aware of the provisional and emergency nature of the problem, so as to avoid any regression, deceptions and further temptations toward false solutions, the administration of heroin in hospitals can - possibly with a flexible implementation of the norms that must regulate it - represent a means to at least temporarily check the increase in power of heroin traders on drug addicts, and thus the diffusion of the distribution of heroin to new consumers on the part of those who are already addicted. Likewise, such measure could prevent a number of deaths from lethal "dilutions" or robberies committed out of the "necessity" to get money for drugs. This is not an irrelevant result, provided it is not a reason to avoid doing what it is necessary

to do.