(Article for International Journal on Drug Policy - apr 90)

PART 1

SEMANTICS OF ILLEGAL DRUGS

PREMISES

The postulate of the drug control system is the qualification of a number of substances, whose effects on the humans are;

1) intrinsically bad,

2) intrinsically different from the ones of other substances.

The difference between legal and illegal substances is enacted by a terminology, who has the following features:

A) the terms are seemingly objective, scientific, descriptive

B) their actual meaning is subjective, ideological.

This contradiction is pointed out by the text of the Single Convention (SC).

In the 1961 SC, the main targets of drug international control were worded as "addiction to narcotic drugs" and "abuse of narcotic drugs".

The introductory considerations were followed by a "Glossary", giving the definitions of all the terms used wtihin the text. But in this glossary the words "addiction","abuse", and "narcotic" do not appear.

In the new 1988 SC, the term "addiction" disappears from the text; the word "abuse" is again ignored by the glossary.

These terms are, however, the key-words of the prohibition of illegal drugs.

NARCOTICS AND DRUGS

We know very well that the pharmacological meaning of the term "narcotic" refers to a definite group of substances, that roughly coincides with the opiates and alcohol. Given that the Single Convention implicitely considers as "narcotics" also cannabis, cocaine, stimulants and psychedelics (but not alcohol), it would be the case to give its own operational definition. But, as we have seen, this didn't happen. In fact, the seemimgly scientific word "narcotics" became a legal-burocratic term to define the substances according to their legal status.

Accoding to the US National Commission,

"the word "narcotics" had been purged of its scientific meaning and became, instead, a symbol of socially disapproved drugs" (National Commission on Marijuana and Drug Abuse: "Drug use in America; problem in perspective", Washington 1973,p. 17)

The term "drug" is defined by the Glossary of the 1961 Single Convention as follows:

"any of the substances in the Schedules I and II, whether natural or synthetic"

In the 1988 SC the term "narcotic drug" is defined in the Glossary as "any [...] substances [...] in Schedules I and II"

That means that the "drugs" are defined not by their objective qualities, but by their classification into a subjectively sanctioned category.

ABUSE

From a strictly logical point of view, the term "abuse" has a relative meaning, insofar as it is related to the concept of "use": we define as "abuse" a type of "use" that has negative effects.

The Expert Committee od Drug Dependence of the WHO, in its XVI Report in 1969 adopted a definition of "drug abuse" as "persistent or sporadic eccessive drug use inconsistent with or unrelated to acceptable medical practice" (e.a.).

This definition considers therefore as "drug abuse" any kind of non-medical use.

The same concept is expressed by the American Psychiatric Association in 1972:

"...as a general rule, we reserve the term drug abuse to apply to the illegal, nonmedical use of a limited number of substances, most of them drugs, which have properties of altering the mental state in ways that are considered by social norm and defined by statute to be inappropriate, undesirable, harmful, threatening or. at minimum, culture-alien" (Glasscote et al.: "The Treatment of Drug Abuse, Washington 1972, e.a.).

This definition is more overtly bound to evaluations that are not scientific, like legality and conformity to the mainstream culture.

The WHO itself recognized in 1975 that the term "abuse" had been used within an arbitrary and non-scientific approach:

""Drug abuse" is a term in need of some clarification. [...] The term is really a convenient, but not very precise, way of indicating that (1) an unspecified drug is being used in an uspecified manner and amount [...] and (2) such use has been judged by some person or group to be wrong (illegal or immoral) and/or harmful to the user or society, or both. What might be called "drug abuse" by some would not necessarily be considered so by others. [...] For these reasons, the term "drug abuse" is avoided here" (Kramer - Cameron (eds.): "A Manual on Drug Dependence", WHO 1975, p. 16, e.a.).

Nevertheless, the term "drug abuse" has been since used by most WHO publications. A testimony of the WHOs conceptual schizofreny is a document issued in 1980, under the title "Drug-abuse Reporting System":

"The term "drug abuse" is a rather imprecise term and, as noted in another WHO publication, there is no universal agreement on its definition. Nevertheless, the term is used here [...] for referring to the adverse consequences of nonmedical drug use" (Rootman - Hughes: "Drug-abuse reporting System", WHO 1980,p.9)

Moreover, an extensive reading of the UN and WHO literature clearly indicates that, whenever illegal substances are concerned, they are always referred to in terms of "abuse" instead of "use". This semantic attitude seems to postulate the equivalence between "abuse" and "use of illegal substances", and therefore the idea that the consequences of the use of illegal substances are necessarily pathologic - an idea which suites the phylosophy of other UN agencies:

"The UN discourages the use of all the following terms and concepts: "recreational use" of drugs, "responsible use" of drugs[...]" (UN DND: "The UN and Drug Abuse Control", NY 1987,p.49).

Summing up, along with Goode:

"As "abuse" is used in context, [...] it conveys the distinct impression that something quite measurable is being referred to, something very much like [...] a sickness in need of a cure. Thus the term simultaneously serves two functions: it claims clinical objectivity, and it discredits the phenomenon it categorizes" (Goode: "Drugs in American Society", Knopf 1972,p.26)

According to the US National Commission,

"the term drug abuse must be deleted from official pronouncements and public policy dialogue. The term has no functional utility and has become no more than an arbitrary codeword for that drug use which is presently considered wrong" (op.cit., p.13)

ADDICTION / DEPENDENCE

In 1957, the WHO classified two types of drug dependence:

1) "addiction", that is qualified by physical dependence and tolerance;

2) "habituation", that is qualified by psychic dependence and no tolerance (WHO Expert Committee, cit. by Young: "The Drugtakers", London 1971,p. 42)

This definition was replaced in 1965 by a new general definition, worded as follows:

"Drug dependence is a state , psychic and sometimes also physical, resulting from the interaction between a living organism and a drug, characterized by a behavioural and other responses that always include a compulsion to take the drug on a continuous or periodic basis in order to experience its psychic effects and sometimes to avoid the discomfort of its absence. Tolerance may or may not be present" (WHO Bull.,no32,1965)

This generic definition was supplied with separate definitions of "specific dependences", related to nine different types of substances: (1) alcohol, (2) amphetamine, (3) barbiturate, (4) cannabis, (5) cocaine, (6)hallucinogen, (7) khat, (8) opiate, (9) solvent.

Now, the general definition can be stretched until any condition "characterized by a behavioural [...] response that always include a compulsion to take the drug on a [...] periodic basis in order to experience its psychich effects" : this concept is so wide and vague, that can be attached also to an almost universal habit like drinking coffee or tea after waking up in the morning.

On the other hand, the WHO classification doesn't explain according to which criteria the concept of "specific dependence" was attributedto some substances and not to other ones. For example, it is not clear why the label of dependence was attached to hallucinogens (that are almost universally used occasionally) and not to tobacco. In fact, it seems that the WHO classification of "drug dependence" is void of any scientific meaning. According to Goode,

"the new definition [...] is without any utility and confuses more than it clarifies. Its intent is patently ideological in nature: to make sure that a discrediting label is attached to as many widely used (or "abused") drugs as possible" (Goode, cit., p.23)

Moreover, the 1965 WHO definition of dependence is contradicted by the "diagnostic guidelines" of the "dependence syndrome" indicated by another official WHO publication, issued in 1987: the "I.C.D. - 10". According to this document,

"a diagnosis of dependence can only be made if three or more of the following have been experienced [...]:

i) A strong desire or compulsion to take drugs.

ii) Subjective awareness of an impaired capacity to control drug taking behaviour [...].

iii) Substance use with the intention of relieving withdrawal [...].

iv) A physiological withdrawal state [...].

v) Evidence of tolerance [...]

vi) A narrowing of the personal repertoire of patterns of drug use.

vii) Progressive neglect of alternative pleasures or interests in favour of substance use.

viii) Persisting with drug use despite clear evidence of overtly harmful consequences [...].

ix) Evidence that return to substance use after a period of abstinence leads to a more rapid reinstatement of other features of the syndrome than occurs with non-dependent individuals"

(ICD - 10, WHO, Geneva 1987)

This definition has much more strict criteria than the 1965 one.

NON-MEDICAL USE

As we have seen, the concept of "abuse" is strictly related to the discrimination between "medical use" and "non medical use". The WHO definition of "non medical use" is:

"The use of dependence-producing drugs [...] except when [...] medically indicated" (Kramer-Cameron:op.cit., p.15, e.a.)

That is, that there are two criteria to define the "non-medical use": 1) the substance must be "dependence-producing", 2) it must be used "other than medically indicated".

As we have seen, the 1965 WHO definiton of "dependence-producing drugs" has no clear scientific meaning. Therefore, once more we have a seemingly objective definition which is referred to a subjective criterion.

On the other hand, the expression "other than medically indicated" is clearly related to any kind of recreational use. But, as we know, the international control system did never care about some recreational drugs, like alcohol and tobacco, in spite of their dependence-producing properties. The arbitrary code of "non medical use" is therefore the semantic key of the discrimination between the so called "drugs" and the traditional social intoxicants of western countries.

SEMANTICS OF THE SINGLE CONVENTION

The use of terminology by the international drug agencies is meaningfully displayed by some historical details of the 1961 UN Single Convention (SC).

In fact, the SC inserted cannabis in the Schedule IV (along with heroin) with the following motivation:

"particularly liable to abuse and to produce ill effects and [...] such liability is not offset by substancial therapeutic advantages".

The term "abuse" was not defined by the SC, but we can assume, by the context, that its meaning was equivalent to "non medical use".

Though, the term "abuse" was quoted in the XVI Session of the UN Commission on Narcotic Drugs (main UN political agency of the drug control system) in 1961, when the WHO representative stated that "cannabis abuse comes definitely under the terms of definition of addiction", but explained that "it was [...] not possible to assess quantitatively its addiction-producing properties" (ACDD: "Cannabis", par.20, cit. by Solomon: "The Marijuana Papers", p. 87): that is, that these properties could also be irrelevant.

The term "addiction", by the 1957 WHO definition, was equivalent of "physical dependence"; but the further 1965 WHO definition of "cannabis-type dependence" stated that there was "little, if any, physical dependence" (Kramer-Cameron,op.cit., pp.37-38). Therefore, it is unquestionable that the inclusion of cannabis in Schedule IV by the SC was based on a WHO classification, which was lately disproved by the WHO itself.

Anyway, according to different sources (cfr. Bruun et al.: "The gentlmen's club", Chicago 1975,pp. 201-202), the main argument for putting cannabis in Schedule IV was the fact that it had no medical use and it was widely used recreationally:

"[...] the presence of cannabis in Schedule IV is to be explained by its wide abuse and its obsolescence in medical practice rather than by its intrinsic dangers" (Adivsory Committee on Drug Dependence: "Cannabis: Report", HMSO, London 1968, App. 2, par.24).

On this subject, it is interesting a comparison with another popular drug, like alcohol, which:

1) was officially included in the WHO classification of dependence producing drugs: already in 1954 the WHO Expert Committee stated that alcohol dependence was in an intermediate position between habituation and addiction (cit. by Bruun - Pan - Rexed: "The gentlemen's club", Chicago 1975,p. 176); moreover, by the 1965 WHO classification, the specific "alcohol-type dependence" was described as far more severe than the "cannabis- type";

2) has no medical use;

3) is "liable to produce ill effects", which in fact have (and had at the time) a severe impact on our society.

Nevertheless, alcohol has never been even mentioned by the UN Single Convention.

CONCLUSIONS

The semantic system of the UN authorities turns out into a tautology that can be worded as follows:

- some substances are illegal because they are "abused"

- "abuse" equals "non medical use"

- "non medical use" is any use of illegal substances.

A situation which was conveniently portrayed by Apsler:

"Often the definitions essentially state that something is bad without clarifying what the something is, without specifying the criteria on which the negative judgement is based, and without stating the assumption from which the value is derived" (Apsler: on Contemporary Drug Problems, 7:55-80, 1978)