Few people’s views on drugs have changed so starkly as those of Aldous Huxley. Born in 1894 to a high-society English family, Huxley witnessed the early 20th-century ‘war on drugs’, when two extremely popular narcotics were banned within years of one another: cocaine, which had been sold by the German pharmaceutical company Merck as a treatment for morphine addiction; and heroin, which had been sold for the same purpose by the German pharmaceutical company Bayer.

The timing of these twin bans was not coincidental. Ahead of the First World War, politicians and newspapers had created a hysteria surrounding the ‘dope fiends’ whose use of cocaine, heroin and certain amphetamines allegedly showed that they had been ‘enslaved by the German invention’, as noted in Thom Metzer’s book The Birth of Heroin and the Demonization of the Dope Fiend (1998).

As the rhetoric of eugenics flourished during the interwar years – both from the mouth of Adolf Hitler and from Huxley’s older brother, Julian, the first director of the Paris-based UNESCO and a notorious eugenicist, Aldous Huxley imagined the use of drugs by government entities as a nefarious means of dictatorial control. In Brave New World (1932), the fictitious drug soma is doled out to the populace as a means to keep them dumbly happy and sated (‘All the advantages of Christianity and alcohol; none of their defects,’ Huxley wrote), and the book makes multiple mentions of mescaline (which at that point he had not tried but clearly did not approve of), which renders his character Linda stupid and prone to vomiting.

‘The dictatorships of tomorrow will deprive men of their freedom, but will give them in exchange a happiness none the less real, as a subjective experience, for being chemically induced,’ Huxley later wrote in The Saturday Evening Post. ‘The pursuit of happiness is one of the traditional rights of man; unfortunately, the achievement of happiness may turn out to be incompatible with another of man’s rights – liberty.’ Hard drugs were inherently tied up with politics in Huxley’s early years, and to be a proponent of cocaine or heroin was, in many ways, to be aligned with Nazi Germany in the eyes of politicians and leading newspapers.

But then, on Christmas Eve 1955 – 23 years after the publication of Brave New World – Huxley took his first dose of LSD and everything changed. He loved it. It inspired him to write Heaven and Hell (1956), and he introduced the drug to Timothy Leary, a vocal political advocate for the therapeutic benefits of mind-altering drugs. Eventually, Huxley would align himself with Leary’s hippie politics – in ideological opposition to Richard Nixon’s presidential campaign and the Vietnam War – in large part due to his now-positive experience with such drugs.

In his novel Island (1962), Huxley’s characters inhabit a utopia (rather than Brave New World’s dystopia) and gain serenity and understanding by taking psychoactive drugs. Whereas in Brave New World drugs are a means of political control, in Island, they are ‘medicine’.

What explains Huxley’s changed perspective – from seeing drugs as an instrument of dictatorial control to a way to escape from political-cultural repression? Indeed, in the grander picture, why are drugs universally despised at one time, then embraced by intellectuals and cultural influencers at another? Why do we have an almost decadal vogue for one drug or another, with popular drugs such as cocaine all but disappearing only to pop up again decades later? Above all, how are drugs used to affirm or tear down cultural boundaries? The answers colour nearly every aspect of modern history.

Drug use offers a starkly efficient window into the cultures in which we live. Over the past century, popularity has shifted between certain drugs – from cocaine and heroin in the 1920s and ’30s, to LSD and barbiturates in the 1950s and ’60s, to ecstasy and (more) cocaine in the 1980s, to today’s cognitive- and productivity-enhancing drugs, such as Adderall, Modafinil and their more serious kin. If Huxley’s progression is to be followed, the drugs we take at a given time can largely be ascribed to an era’s culture. We use – and invent – the drugs that suit our culture’s needs.

The drugs chosen to pattern our culture over the past century have simultaneously helped to define what each generation has most desired and found most lacking in itself. The drugs du jour thus point towards a cultural question that needs an answer, whether that’s a thirst for spiritual transcendence, or for productivity, fun, exceptionalism or freedom. In this way, the drugs we take act as a reflection of our deepest desires and our inadequacies, the very feelings that create the cultures in which we live.

To be clear, this historical investigation predominately concerns psychoactive drugs. It accounts for a large family of drugs embracing LSD, cocaine, heroin, ecstasy, barbiturates, anti-anxiety medications, opiates, Adderall and the like, but not anti-inflammatories such as ibuprofen (Advil) or pain relievers such as acetaminophen (Tylenol). These pharmaceuticals are not drugs that alter one’s state of mind and are consequently of little use when making sociocultural analyses.

The drugs up for discussion also cut across boundaries of law (just because a drug is illegal does not preclude it from being central to a cultural moment) and class (a drug used by the lower class is no less culturally relevant than drugs favoured by the upper class, although the latter tend to be better recorded and retrospectively viewed as of ‘greater cultural importance’). Finally, the category of drugs under scrutiny cuts across therapeutic, medical and recreational usage.

To understand the way we create and popularise drugs to match the culture we have, consider cocaine. Readily available at the turn of the 20th century, cocaine was outlawed in 1920 with the passing of The Dangerous Drugs Act in the United Kingdom (and in 1922 in the United States under the Narcotic Drugs Import and Export Act). Cocaine’s initial popularity in the late-19th-century was in large part due to ‘its potent euphoric effects’, according to Stuart Walton, an ‘intoxication theorist’ and author of Out of It: A Cultural History of Intoxication (2001). Cocaine, Walton told me, ‘helped potentiate a culture of resistance to Victorian norms, the abandonment of rigorous civility in favour of an emergent “anything goes” social libertarianism in the era of the Jugendstil, and the rise of social-democratic politics’.

Once Victorian moralism had been overcome, social libertarianism had vogued, and secularism had its sharp uptick in the period after the Second World War, cocaine generally fell out of style with white European-American culture. Until, that is, the 1980s, when cocaine had new cultural questions to answer. As Walton explained to me: ‘Its return in the 1980s was predicated on precisely the opposite social tendency: iron conformism to the dictates of finance capital and stock-trading, which underscored the resurgence of entrepreneurial selfishness in the Reagan and Thatcher period.’

Another instance of drugs answering cultural questions (or problems) concerns women who became addicted to barbiturates in 1950s suburban America. This was a population that faced a bleak, oppressive culture, now infamous through the works of Richard Yates and Betty Friedan. As Friedan wrote in The Feminine Mystique (1963), such women were expected to have no ‘commitment outside the home’ and to ‘find fulfilment only in sexual passivity, male domination, and nurturing maternal love’. Frustrated, depressed, neurotic, they numbed themselves with barbiturates so as to fulfil norms there was as yet no licence to buck against. In Jacqueline Susann’s novel Valley of the Dolls (1966), the three female protagonists dangerously come to rely on stimulants, depressants and sleeping pills – their ‘dolls’ – in order to cope with personal decisions and, especially, sociocultural boundaries.

But the solution provided by prescription drugs was not the hoped-for solve-all. When drugs are unable to fully answer the cultural questions at hand – in this case, how suburban American women might escape the crippling dullness that so often characterised their lives – alternative drugs, often seemingly irrelevant to the situation at hand, tend to present themselves as potential solutions.

LSD spoke to unmet needs that affected not only suburban housewives, but also gay, or sexually confused, men too

Judy Balaban began taking LSD in the 1950s when she was still in her 20s, under the supervision of a medical doctor. She had a seemingly perfect life: the daughter of the affluent and respected president of Paramount Pictures, Barney Balaban, she had two daughters, a sprawling home in Los Angeles, and a successful film-agent husband who represented and befriended Marlon Brando, Gregory Peck and Marilyn Monroe. She counted Grace Kelly as a close friend, and became a bridesmaid at her royal wedding in Monaco. It would have seemed crazy for her to admit it but, beneath it all, Balaban felt deeply dissatisfied with her life. Her equally privileged friends felt the same. Polly Bergen, Linda Lawson, Marion Marshall – all actresses married to famous film agents or directors – complained of a similar, underlying dissatisfaction with life.

With limited options for fulfilment, clear cultural expectations, and the dreary outlook of living life on antidepressants, Balaban, Bergen, Lawson and Marshall all began regimens of LSD therapy. Bergen told Balaban in Vanity Fair in 2010: ‘I wanted to be the person, not the persona.’ LSD, Balaban wrote, afforded the ‘possibility of a magic wand’. It was a more effective ‘answer drug’ to the problems at hand than antidepressants had been. Many of Balaban’s culturally disenfranchised peers felt the same way: between 1950 and 1965, a reported 40,000 people were treated with LSD therapies. It was legal, but unregulated, and nearly everyone who tried it swore to its efficacy.

LSD spoke to unmet needs that affected not only suburban housewives, but also gay or sexually confused men too. The actor Cary Grant, who was housemates with the handsome Randolph Scott for several years and was married to five different women for an average of five years each (often while living with Scott), likewise found release through therapeutic LSD. Grant’s film career would have been destroyed had he been seen publicly as homosexual; like many of the suburban women of his time, he found that LSD afforded a much-needed escape valve, a way of sublimating sexual anguish. ‘I wanted to rid myself of all my hypocrisies,’ he said, somewhat subtly, in an interview in 1959. After going to more than a dozen LSD therapy sessions administered by his psychiatrist, Grant admitted, ‘at last, I am close to happiness’.

But sometimes, instead of people finding drugs to answer their cultural questions, cultural problems are manufactured to sell pre-existing drugs.

In the case of today’s most popular drugs for attention deficit hyperactivity disorder (ADHD), Ritalin and Adderall, their wide availability has led to a significant increase in ADHD diagnoses: between 2003 and 2011, there was a 43 per cent rise in the number of schoolchildren in the US diagnosed with ADHD. It’s unlikely that those eight years coincided with a massive spike in US schoolchildren manifesting ADHD: it is much more plausible that the presence of Ritalin and Adderall – and their savvy marketing – grew in that period, leading to greater diagnosing.

HRT, first used to ease the menopause has been expanded to include transgender and androgen replacement therapies

‘[I]n the 21st century, diagnoses of depression have risen dramatically, as have those of post-traumatic stress disorder and attention hyperactivity disorder’, writes Lauren Slater in Opening Skinner’s Box: Great Psychological Experiments of the 20th Century (2004). ‘[I]ncidences of certain diagnoses rise and fall depending on public perception, but also the doctors who are giving these labels are still doing so with perhaps too little regard for the DSM [Diagnostic and Statistical Manual of Mental Disorders] criteria the field dictates.’

That is to say, today’s drug-makers have helped to create a culture in which people are perceived to be less attentive and more depressed in order to sell drugs that might answer the very problems they’ve manufactured.

Similarly, hormone replacement therapy (HRT), deployed to ease discomfort during the menopause, and in which oestrogens and, sometimes, progesterone used to be injected to artificially boost a woman’s hormone levels, has since been expanded to include therapies for transgender people and also as an androgen replacement, in which male ageing can theoretically be delayed via hormone treatment. This desire to constantly expand the uses and necessity of drugs speaks to the way in which culture is created (and bolstered) by the drugs at hand.

Clearly, the causal motion swings both ways. Cultural questions can popularise certain drugs; but sometimes popular drugs end up creating our culture. From rave culture booming on the back of ecstasy to a culture of hyper-productivity piggybacking on drugs initially meant to help with cognitive and attention deficits, the symbiosis between chemical and culture is evident.

But while drugs can both answer cultural questions and create entirely new cultures, there is no simple explanation for why one happens rather than the other. If rave culture is created by ecstasy, does that mean ecstasy is also ‘answering’ a cultural question; or was ecstasy simply there and rave culture blossomed around it? The line of causality is easily blurred.

A corollary can be found in the human sciences where it is extraordinarily difficult to categorise different types of people because, as soon as one starts ascribing properties to groups, people change and spill out of the parameters to which they were first assigned. The philosopher of science Ian Hacking coined the term for this: ‘the looping effect’. People ‘are moving targets because our investigations interact with them, and change them,’ Hacking wrote in the London Review of Books. ‘And since they are changed, they are not quite the same kind of people as before.’

This holds true for the relationship between drugs and culture as well. ‘Every time a drug is invented that interacts with the brains and minds of users, it changes the very object of the study: the people who are using,’ says Henry Cowles, assistant professor of the history of medicine at Yale. On this reading, the idea that drugs create culture is true, to an extent, but it is likewise true that cultures can shift and leave a vacuum of unresolved desires and questions that drugs are often able to fill.

Take the example of American housewives addicted to barbiturates and other drugs. The standard and aforementioned causal argument is that they were culturally repressed, had few freedoms, and so sought out the drugs as a way to overcome their anomie: LSD and later antidepressants were ‘answer drugs’ to the strict cultural codes, as well as a means to self-medicate emotional pain. But, Cowles argues, one might just as easily say that ‘these drugs were created with various sub-populations in mind and they end up making available a new kind of housewife or a new kind of working woman, who is medicated in order to enable this kind of lifestyle’. In short, Cowles says: ‘The very image of the depressed housewife emerges only as a result of the possibility of medicating that.’

Such an explanation puts drugs at the centre of the past century of cultural history for a simple reason: if drugs can create and underscore cultural limitations, then drugs and their makers can tailor-make entire socio-cultural demographics (eg, ‘the depressed housewife’ or ‘the hedonistic, cocaine-snorting Wall Street trader’). Crucially, this creation of cultural categories applies to everyone, meaning that even those not using the popularised drugs of a given era are beholden to their cultural effects. The causality is muddy, but what is clear is that it swings back and forth: drugs both ‘answer’ cultural questions and allow for cultures to be created around themselves.

Looking at the culture of today, perhaps the biggest question answered by drugs are issues of focus and productivity – a consequence of the modern ‘attention economy’, as termed by the Nobel Prize-winning economist Herbert Alexander Simon.

Modern drugs of choice permit users to stake more of their emotional worth and happiness on work

The use of Modafinil – intended for treating narcolepsy and misused to stay awake and work longer – and the abuse of other prolific, attention-deficit drugs such as Adderall and Ritalin for similar reasons reflects an attempt to answer these cultural questions. They’re widely used, too. In a Nature magazine survey in 2008, one in five people said they’d tried cognitive-enhancing drugs at some stage in their lifetime. And according to an informal poll in The Tab in 2015, the highest rates of abuse occur at the most academic institutions: students at Oxford University abuse cognitive-enhancing drugs more than students at any other university in the United Kingdom.

These cognitive-enhancing drugs help ‘disguise the banality of work in a double sense’, says Walton. ‘They goad the user into a distractive state of high excitement, and simultaneously persuade him that it must be his success at work that allows him to feel so elated.’

In this way, modern drugs of choice not only keep people at work and make them more productive, they also permit them to stake more of their emotional worth and happiness on work, thereby reifying its importance and justifying the time and effort spent. These drugs ‘answer’ the cultural prescription of more work and more productivity not just by allowing users to focus better and stay awake longer, but also by making them less miserable.

The flip side of the cultural productivity imperative is a demand for heightened convenience and ease of leisure in daily life (think of Uber, Deliveroo, etc) – a desire that is sated by dubiously efficacious drug-like experiences such as ‘binaural beats’ and other cognitive-altering sounds and ‘drugs’ that can be accessed easily via the internet. (In the case of binaural beats, one can listen to melodies that allegedly put the listener in ‘non-ordinary states of consciousness’.) But if today’s drugs mostly answer the cultural needs of the attention economy – focus, productivity; leisure, convenience – they also alter what it means to be oneself.

Critically, it is the way in which we now take drugs that shows the shift in the notion of the ‘self’. So-called ‘magic-bullet drugs’ – one-off, limited-course drugs designed to treat highly targeted problems – have given way to ‘maintenance drugs’ – eg, antidepressants and anti-anxiety pills that must be taken in perpetuity.

To be oneself is to be drugged. The future of drugs is likely an extension of this

‘This is a big shift from the old model,’ says Cowles. ‘It used to be: “I am Henry. I am ill in some way. A pill can help me get back to being Henry, and then I’m off it.” Whereas now: “I am only Henry when I’m on my meds.” Between 1980, 2000, and now, the proportion of people on that kind of maintenance pill with no end in sight is just going to keep going up and up.’

Might maintenance drugs then be the first step in drug use that permits a post-human state? Although they don’t necessarily fundamentally change who we are – as anyone who is on daily antidepressants or other neurological medications knows – there is a certain cloudy feeling or dullness that begins to redefine one’s most basic experiences. To be oneself is to be drugged. The future of drugs is likely to be an extension of this.

Here, it is worth stepping back. Over the past century there has been an intimate interaction between culture and drugs, each informing the other, exemplifying the cultural directions in which humans have wanted to go – be it rebelling, submitting or moving entirely outside of all systems and constraints. Taking a good look at what we want today’s drugs and the drugs of tomorrow to do provides an idea of the cultural questions we are looking to solve. ‘The traditional model of drugs that do something active to a passive user,’ says Walton, ‘will very possibly be superseded by substances that empower the user to be something else entirely.’

Surely, this possibility will come to pass in some form or another in a relatively short time – drugs allowing a total escape from the self – and with it we will see the new crop of cultural questions that are being raised, and potentially answered, by drugs.

Patterns of drug use over the past century gives us a surprisingly accurate insight into wide swaths of cultural history, with everyone from Wall Street bankers and depressed housewives to college students and literary scions taking drugs that reflect their desires and answer their culture’s issues. But the drugs have always reflected a simpler, consistent truism. Sometimes we have wanted out of ourselves, sometimes we’ve wanted out of society, sometimes out of boredom or out of poverty; but always, whatever the case, we have wanted out. In the past, this desire was always temporary – to recharge our batteries, to find a space away from our experiences and the demands of living pressed upon us. However, more recently, drug use has become about finding a durable, lengthier, existential escape – a desire that is awfully close to self-obliteration.