Before she found heroin, Allison could not get out of bed most mornings. She contemplated suicide. She saw herself as “a shitty lazy person who felt like crap all the time”. She was deeply depressed, and no wonder. As she explained in an interview with NPR last month, in slow, halting sentences, she’d been molested by three family members by the age of 15. One of the three was her father.

Listening to Allison recount the horrors of her young life, most of us feel great pity. If we were psychiatrists, we’d need little justification to prescribe any drug that might help alleviate her suffering. We’d probably start at one end of the long list of approved antidepressants – and keep going. But heroin?

Heroin, Allison explained, “made me feel as if I could get up and do something”. She could function. “I was great at my job ... and I was doing art on the side. I had energy for the first time in I don’t know how long.” In other words, she had vanquished her depression – with an illegal, highly addictive, “recreational” drug that she bought off the street.

It would be wrong to deny that many heroin users suffer great harm as a result of the position their addiction places them in. And I would advise anyone who experiences debilitating depression to seek professional help. But it would also be wrong to classify strong opioid drugs, and other substances currently disparaged by our society, as intrinsically “bad” or “evil”.

In some parts of the world, people seem to be getting smarter about recreational drugs. For a couple generations, “soft” drugs like marijuana and hashish have been increasingly tolerated, more broadly viewed as socially acceptable and, finally, in several European countries and a few American states, legalized.

And why not? These drugs help people relax, enjoy music and philosophize. In fact, pot is far safer than booze in every respect. It makes you silly but not aggressive, it has none of the well-documented health risks of alcohol, it’s far less likely to lead to accidents, and it’s not generally addictive, psychologically or otherwise. (Some people do end up with a cannabis habit that hampers clear thinking and short-term memory, but these effects disappear when they cut down or stop.)

Then come the psychedelic drugs: LSD, psilocybin mushrooms, mescaline and the currently stylish (in some circles) ayahuasca. There is ongoing debate about whether psychedelics are good, bad, safe or unsafe. But compare that dialogue to the tyrannical edicts of the 60s. When I was an 18-year-old in Berkeley, California, in 1969, my friends and I had wrenchingly beautiful interactions with forests, seascapes, music, and each other – on acid. Like Aldous Huxley and other intellectuals, we saw psychedelics as a gateway to a more inclusive, less self-centered sense of reality. We generally couldn’t share those views with our parents nor, certainly, with the police or the courts. Yet despite that, societal views were in flux.



In fact, the promise of psychedelic psychotherapy has intrigued scientists and clinicians for decades. A recent wave of research suggests that psychedelics can relieve psychological suffering, from depression, anxiety, PTSD and alcoholism to end-of-life fears. Presently, thousands of young people from North America and Europe are trying ayahuasca, a powerful psychedelic used for self-growth and healing by indigenous cultures in the Amazon region. Like their hippie predecessors, many of these “psychonauts” feel they’ve gained something essential from the experience: a broader vision of reality, connection with other people and cultures, a bond with the planet and a commitment to its wellbeing.

Well, maybe the soft drugs are better than booze, and psychedelics have greater potential for good than for harm. But what about drugs such as heroin, methamphetamine and cocaine? In keeping with the punitive policies of the DEA, and the battle cry of the “war on drugs”, most of us still see these drugs as unequivocally bad.

Indeed, heroin and meth lead to addiction – and to misbehaviours ranging from lying and petty theft to full on criminality. After years as an addiction expert and a one-time addict, I recognize how dangerous these drugs can be. And I know that the cycling of desire, acquisition and loss leads not only to compulsive drug seeking (and associated brain changes) but also to a narrowing spiral of social isolation, shame, and remorse. Can there be anything good about drugs that are often too attractive to resist?

For Allison, the good was undeniable. Heroin helped her overcome a depression that very likely arose from her history of sexual abuse, a trauma that left PTSD in its wake and drained her life of joy, functionality, and any semblance of normality. Allison represents the rule rather than the exception. PTSD often triggers anxiety and depression, and substance abuse is as high as 60–80% among those with PTSD. In fact, the largest epidemiological study ever conducted found an extremely strong correlation between the degree of childhood adversity and injection drug use.

When Allison got tired of heroin, she was able to quit, as most addicts eventually do. She found a psychiatrist and learned to live without it, though she reports that she continues to rely on antidepressants. The point is that, for her, heroin was an antidepressant – a very effective one.

It shouldn’t be surprising that a powerful opiate can help people overcome psychological pain. Opioids are critical neurochemicals, helping mammals to function in spite of pain, stress and panic. Rodents play and socialize far more easily after being given opiates. Opioids are even present in mother’s milk: they are nature’s way of ensuring an emotional bond between infant and mother. Opiates might be too attractive for some people some of the time; obviously addiction is a serious concern. But that doesn’t make opiates intrinsically bad.

I doubt whether there’s much to recommend meth for today’s youth, and clearly meth and coke can destroy lives. But coca leaves were used to overcome fatigue in Latin America for centuries before Europeans figured out how to turn them into cocaine. Like opiates, it seems that stimulants can be of benefit in particular contexts.

It becomes impossible to define the “goodness” or “badness” of drugs according to drug type – in the abstract. Rather, the balance between potential help and potential harm depends on the person and the circumstances.

The human nervous system is an incredibly complicated chemistry set, and we experiment with it continuously through our actions, our loves, the things we eat and drink, and, yes, the substances we ingest for that specific purpose. Tinkering with our nervous system is a direct expression of our ingenuity and our fundamental drive for self-improvement. We’re not likely to give those up.

The failure of the “war on drugs” should help us recognize that people will never willingly stop taking drugs and exploring their benefits and limitations. It’s ridiculous to deal with this human proclivity by labelling most or all drugs as “bad”. And it’s absurd to mete out punishment as a means for eliminating the drugs we don’t like. Instead, let’s expand our knowledge of drugs through research and subjective reports, let’s protect ourselves against the dangers of overdose and addiction, and let’s improve the lives of children raised in ghastly circumstances.

Then the problem of “bad drugs” will no longer be a problem.