By David Herzberg
As a historian of psychoactive pharmaceuticals in the 20th century U.S., I see history rhyming in potentially dangerous ways in the current psychedelic boom. After decades of being associated with insanity, violence, and social disorder, psychedelics are now being embraced as potential wonder drugs. What appears to be a radical, 180-degree shift in reputation, however, masks an underlying similarity: both of these mirror-image stories belong to the mythologies of the consumer culture, which attribute broad transformational power to individual acts of consumption. Seeing drugs through this mythological lens prevents us from accessing their potential benefits, while exposing us to the real possibility that they could make things worse.
We are all familiar with the “wonder drug” story. This is before-and-after consumer magic, in which buying the right product—very much including pharmaceuticals—unlocks deep-seated human dreams of acceptance, love, happiness, authority, etc. Traditionally, this story is set in white contexts: consumerist technological advances are understood to serve presumptively white consumers.
Consumer culture stories can also be dystopian, however. Critics have often warned that consumerism produces a “mass culture” that erases individuality and spreads mindless conformity. In a drug context, this can be seen in condemnations of the inauthentic selfhood produced by mass use of psychiatric medicines, or more brutally, in the belief that so-called “addicts” lack all meaningful selfhood. These stories have been set in both white contexts (as with psychiatric medicines) and in racialized contexts (as with addiction).
Both sunny and dystopian consumer culture stories invest magical properties in consumer goods, including drugs. On closer inspection, these supposed magical properties share one defining element: the power to render social context irrelevant by working directly on the individual psyche.
This is an alluring idea. “Social context” is complicated, encompassing a labyrinthine tangle of social hierarchies of class, race, and gender that reproduce devastating injustices, entrenched interests, and divisive politics. However complicated the brain may be, changing it by taking drugs looks much easier than almost any social intervention. Yet history shows that social context cannot be separated from our individual and collective wellbeing. When boosters promote a drug as a simple solution to complex problems with deep social and political roots, it usually ends up making things worse. If we want drugs’ magic, we have to understand them within social context rather than hoping they will free us from it.
Social context 1: The consumerist nightmare tradition
Psychedelic boosterism is an example of the positive style of magical drug thinking, but its operations become clearer if we place them in relation to their dystopian cousins. Seeing the similarities between these seemingly opposite stories helps us recognize the deeper patterns at work in both.
One classic version of dark consumerism can be found in the way that heroin, and later “crack” cocaine, were blamed for the late 20th century’s urban crisis.
In fact, the crisis had been produced by decades of racist disinvestment and over-policing in predominately Black and brown cities. To fix this crisis would require acknowledging and reforming those policies, and repairing the damage. It would be a long and difficult project, and one actively opposed by many politically powerful constituencies.
In part for this reason, an alternate explanation became prominent: that the crisis had been caused by its most dramatic manifestation, i.e., addiction. This was a simpler story, an easier fit for brief news reports, and—moreover—suggested a much simpler (if ineffective) solution. In a kind of reverse pharmacotherapy, if drugs were causing the problem, eliminating drugs would solve the crisis.
Of course, this “drug war” approach didn’t end the urban crisis, it just added a new layer to it: racially disparate mass incarceration.
Social context 2: Pre-psychedelic consumer utopias
Today’s psychedelic boom, of course, is part of the sunny story, where goods magically transform their (presumptively white) consumers in beneficial ways. (As Lizabeth Cohen and others have shown, the post-WWII policies that placed consumerism at the heart of U.S. institutions and the economy were designed to build a resilient white middle class; those categorized as non-white were both explicitly and implicitly excluded.) It’s worth taking a deeper dive into the long history of this tradition.
A good starting point is cocaine, first introduced in the U.S. by the pharmaceutical company Parke, Davis in 1883. The new drug rocketed to what we would today call “blockbuster” status thanks to widespread marketing campaigns, which promised that cocaine could revive white, middle-class Americans suffering from nervous depletion (“neurasthenia”) because of the rapid pace of industrial-age life. Brand-name cocaine products were briefly everywhere—until it became clear that the miracle drug seemed to exacerbate the problems it was supposed to solve.
For the sake of brevity, I’ll skip over a parade of other wonder drugs, including Bayer’s Heroin, barbiturate sleeping pills, and amphetamine, and draw from my book Happy Pills in America to get to a more immediately relevant precedent: late 20th century psychiatric medicines such as Valium and Prozac.
The first of the Valium-like “minor tranquilizers,” Miltown, was introduced in the 1950s as a miraculous cure for anxiety. In the Freud-influenced psychiatry of that era, anxiety was widely seen as underlying almost all mental illness. The consumerist promise of magically eradicating this bedrock human experience made some people nervous. Could progress be achieved, and the Cold War be won, if everyone took the pills and (as one critic said) floated in their own tub of butter?
These were gendered and racialized arguments. According to stereotypes being aggressively encouraged at that time, white men were supposed to be assertive, pioneering leaders—the opposite of the tranquility promised by pills. White women, on the other hand, were supposed to be calm, cooperative, and cheerful. Unsurprisingly, women ended up being prescribed and taking the pills at twice the rate of men. And initially, at least, no one seemed overly curious about why so many seemingly privileged white women were so miserable that they needed “happy pills.”
By the 1960s, however, one wing of the diverse second-wave feminist movement had begun to think quite a lot about that question. Perhaps white, middle-class women were miserable not because something was wrong with them, but because something was wrong with their circumstances. Instead of fixing their minds with pills, maybe they should organize politically to fix injustices. Notably, feminists did not claim that “happy pills” were ineffective. Instead, they argued that the magical power to calm was actually harmful when it was delivered through the social context of sexism.
Thanks in large part to feminists’ successful campaign, Valium’s days as a wonder drug were numbered. But it did not take long for a new wonder drug to replace it: the SSRI antidepressant Prozac. In the late 1980s, Prozac’s boosters hailed it specifically as a “feminist drug” because, unlike tranquilizers, it made its (mostly women) users less compliant and more assertive. Who needed feminism, or political organizing, when adjusting serotonin levels gave women the power to make freer choices?
Of course, some feminists noted that more energy and a better attitude would not eliminate structural problems women faced, such as sexist workplaces, lower pay, and the “double workday.” But such critiques were drowned out amid the marketing and cultural hoopla driving Prozac to blockbuster status.
Similar dynamics on an even grander and more devastating scale helped produce the early 21st century’s opioid crisis. Here too, a new generation of pharmaceuticals promised a magical solution to a serious, widely prevalent problem: chronic pain. As Keith Wailoo has argued, opioid boosters promised their products could free America from wrenching political debates over how to care for people suffering from chronic pain. Did they deserve social services or did they need “tough love” to restore their independence? After decades of struggle over different versions of this question, a miracle pill to treat pain could be portrayed by boosters as a godsend way to cut through politics and solve a major public health crisis. As we know, that’s not how it worked out.
Learning from history
Each of these histories follows a similar pattern. They start with a complex problem deeply enmeshed in social and political determinants of health: the psychic toll of industrialization; racism and the urban crisis; sexism; poverty and chronic pain. Then drug boosters (usually an informal coalition of scientists, marketers, health care providers, and cultural crusaders), for a mixture of idealistic and self-interested reasons, promote a simple, magical drug solution. When implemented, the supposed solution only intensifies the problem.
This is not to say that drugs have no value, any more than a critique of housing discrimination debunks the value of having a home. All of these drugs truly do have real power and can bring real benefits. The trick is that those benefits cannot be extricated from the social structures through which they circulate, and within which people encounter and consume them.
Remembering this trick is especially important for psychedelics, whose boosters promise a particularly strong version of consumerist transformation.
Yet the history of other drugs and consumer products warns that if psychedelics are provided through the same social structures as everything else we encounter, they will become a part of those structures and will tend to reinforce them rather than enabling consumers to transcend them. If those structures are racist and profit-oriented—as they are—psychedelics will reinforce inequality and injustice. The most privileged will get real benefits, because their encounters with psychedelics will be the most favorable and well-regulated. Less privileged people will be excluded by cost, barriers to access, and more. Or they will be included in ways that serve others’ interests (and profit) rather than their own, disproportionately exposing them to psychedelics’ also-real risks. This could mean, for example, being provided a treatment regimen only studied in and developed for the psychological problems of the whiter and better off, which may not be as effective—or which could be actively harmful—for people whose suffering has been shaped by very different life experiences. Or it could mean only being able to access lower quality treatment, including, perhaps, poorly trained or even abusive “guides”. (For examples of recent work wrestling with these issues, see these special issues.)
In short: drugs are part of the world, not a shortcut freeing us from it. If we want to harness their real power, we must resist boosters’ promises that they are magic. Instead, we have to accept a more pedestrian reality: Drugs are like everything else. To reduce suffering and make the world a better place, we have to use drugs as parts of—not replacements for—our broader efforts to make justice, opportunity, and safety available to all.
