by Dr Ann Dalley
(Extracted from "Addiction Controversies", Edited by David M.
Warburton,1992,Harwood Academic Publishers)


I am uneasy about two words that are used increasingly by those who
wish, or who do not wish, to liberalise the drug laws. They are
manipulated to the point of absurdity or meaninglessness by Drugspeak,
the language that distorts thought about drugs and prevents rational

  The activities of drug traffickers damage most of us because they
endanger young people and make our country less attractive. But, for
modern governments, they reveal the success of their drug policies. Drugs
are an ideal medium for campaigns whose real aim is to divert the
attention and anger of voters from what is happening elsewhere. Drugs
have become the modern equivalent of a medieval crusade, a skirmish
with a neighbouring state, or a Falklands War. Drugs can be used in this
way only by increasing existing prejudices and by avoiding the truth.
Better still, make the truth virtually impossible to reach. This is done by
the subtle and often unconscious corruption of language. 

Drugspeak, of course, is descended from Newspeak, the language through
which George Orwell's fictitious government of Oceania controlled its
citizens and prevented them from seeing what was happening (Orwell,
1949). To some extent the manipulation of language by those in power
occurs in any process aimed at a particular end other than finding the
truth. It happens automatically and unconsciously and not necessarily as
part of a "conspiracy". It is often the result of people pursuing their own
ends while pretending to do something else which is always part of
politics, including medical politics. Once you become aware of how
language is manipulated to suit those who use it, you see it all around. 

Like Newspeak, the purpose of Drugspeak is not only to provide a medium
of expression for those in power but also to make all other modes of
thought impossible. It aims to make heretical thought literally unthinkable.
This is achieved by inventing new words, eliminating words thought to be
undesirable and stripping words of unorthodox and secondary meanings. 

Drugspeak developed only during the last half century. It may have begun
with the change in meaning of the word "narcotic" when drugs were first
banned (Musto, 1973). A narcotic is a drug that induces the state of
lowered consciousness known as narcosis. But, when drugs which alter
mood and level of consciousness were made illegal in the United States,
the FBI called them all "narcotics". For example, cocaine and
amphetamines are stimulants, the very opposite of "narcotics". It all helps
to confuse the issue. Confused and imprecise thinking is essential to
Drugspeak and to modern drug policies. 

  Another word which has entered Drugspeak is "addiction". As Berridge
and Edwards ( 1987) have pointed out the term has acquired its present
connotations with the medical elaboration of a disease view of drug use.
As they phrase it:-- 

"Disease theory was perceived by the medical profession as a move to
throw the light of scientific theory into an area characterized by
outmoded moral judgements. Their medical ideology retained more than
a trace of its moral ancestry. It excluded social in favour of individualistic
and biologically deterministic explanations; yet in its operation and in the
thinking of addiction specialists, it resolutely emphasized social values. It
acted not simply as an agency of social control, but as one of social
assimilation, in which symptoms were defined in terms of deviations from
the norm and treatment involved inculcation in the values of conformity
and self-help". 
     (Berridge and Edwards, 1987; pp 170).


"Addiction is now defined as an illness because doctors have characterised
it thus ... "
     (Berridge and Edwards, 1987; pp 150)

  More words and restrictions appeared about fifteen years ago, after the
Drugspeakers had transformed the phrase drug abuse into a medical
diagnosis and Drugspeak really took over. Other "diseases" with pejorative
connotations include "psychopath", "hysteria", "syphilis" and "AIDS", but I
know of no other moral judgments that are used as medical diagnoses in
themselves. It corrupted the doctors and, perhaps, was engineered by
corrupt doctors. 

In spite of this abuse of language, there were few protests. Even people
who see the absurdity and the dishonesty of the drug dependence lobby
and who approve of more just laws do not press for clearer language. 

The term "drug use" has no place in Drugspeak. You cannot use illegal
drugs or even think of using them: you can only abuse or misuse them.
You cannot be a drug user: you can only be an addict. Moral judgment is
pronounced every time you mention the subject and you know
immediately that you are dealing with crime and wickedness. It also
suggests what society should do about it. It makes it difficult and often
virtually impossible to suggest that there might be some degree of
liberalization. It is part of the function of Drugspeak to promote
misconceptions, for instance, that all drugs are terribly dangerous and
that one puff of cannabis is likely to lead to destruction and death. You
can of course use alcohol and drink every day of the week. You can die of
heart disease or cirrhosis of the liver as a result. But only cranks and
weirdos think of this as abuse. After all, it is legal and widely advertised ...

Even the term "illegal drug use" is seldom used in Drugspeak. All contact
with illegal drugs must be seen as dangerous and damaging. Any idea that
these drugs might be used as well as abused would make drug use an
imaginative, or even a practical, possibility. Then people would see that
this alternative, though not desirable, might be infinitely preferable to
the increasingly terribly effects of prohibition. Drugspeak would not
tolerate such thoughts. So it must be impossible even to think of using
illegal drugs. Even official bodies now use the Drugspeak distortions. In
Britain there is now a Minister's group on Drug Abuse and an Advisory
Council on the Misuse of Drugs. Another official body is called SCODA or
The Standing Conference on Drug Abuse. "The War on Drugs" is another
Drugspeak phase. It conjures up a vision of battle and conquest, of a
drug-free world, of politicians leading a crusade for our benefit when it
really only conceals some of their dirty tricks. It generates a new
vocabulary of battle, conquest and control. The "War on Drugs" is a
political manoeuvre that creates certain enemies and then pretends to
fight them. While boasting of conquests over the drug barons, politicians
secretly support them. They boast of seizures, a word beloved by
drugspeakers and usually described in superlative terms, usually as the
biggest. They do not point out that more drugs seized means that more
drugs are being smuggled. They do not question the sense of "The War on
Drugs" or ask whether it might be lost already, or do more damage than
it prevents. They never look at the effect of the policies and they do not
want you or me to doubt them. Few people notice the discrepancies
between what is said and what actually happens. For instance, they
repeatedly announce intentions of keeping drugs out of the country but
cannot even keep them out of prisons or the White House! 

There are, I think, a number of reasons why few people protest, or even
notice. First, the shock-horror of drugs satisfies the widespread need of
many who need shock-horror in order to feel comfortable. During the last
century it was the shock-horror of sex, especially masturbation (Szasz,
1974). Today, it is drugs. Tomorrow, it will be food additives, AIDS or
something as yet unheard of. Building on the present penchant for
shockhorror about drugs, most people are now so deeply misinformed
and so profoundly prejudiced about drugs that they willingly believe the
politicians (including the medical politicians), who put out further
misinformation. Many people channel powerful prejudices, fears and
fantasies into drugs and believe that they or their children are seriously
threatened by them. 

Drug use need not lower the quality of life, but politicians have created
a situation in which they suggest that inevitably does. At the same time,
it gives us the appearance that we need Daddy Bush or Mother Thatcher
to protect us from them. By slipping into this frame of mind, people are
manipulated into bringing about the very situation they fear. They cling
to their beliefs and prejudices, even when they have incontrovertibly
evidence of their falsity. 

This is the essence of Drugspeak. It tends to create the situation it
purports to cure. One of the first words to be changed by Newspeak was
"freedom". In Drugspeak, "drug-free" usually means not actually receiving
drugs from a doctor and it is impossible to think of being free in thought
or action about drugs. Drugspeak reduces general ideas about drugs and
about the treatment of those dependent on them to a few simple ideas.
It reinforces them by simplifying certain terms and giving them strong
moral connotations, positive or negative. 

For example, the word "injection" became part of drug language in the
middle of the nineteenth century when the hypodermic syringe was
invented (Berridge and Edwards, 1987). It described a particular way of
taking drugs. It was even believed that drugs taken by injection could not
result in dependence and that it was a safer route of use. As recently as
15 years ago, before Drugspeak really got going, injection was an
important and common treatment option for drug user in Britain. Now
it is a dirty word, suggesting at the worst, drug abuser, or a wicked
doctor. Drugspeaking doctors are expected to ignore the fact that their
patients are injecting, however much this may affect or harm them. They
are supposed to ignore their patient's "track marks" and their relationship
with the black market and only what happens in the clinic. 

At the time, when injection was anathema to the drug use establishment,
which it still is, some doctors and clinics were deceiving themselves and
others by saying that it was never helpful to prescribe injections and that
to do so was wicked, while at the same time many doctors were
prescribing injectables in secret. I have known doctors give evidence in
court to affirm that it was never justified to prescribe injectables yet,
when cross-examined, admit that they themselves prescribed them! I have
known a doctor preach openly that injectables were never necessary
when he was prescribing them for selected patients and so secretly that
he kept it (or tried to) even from his own nurses. Of course, his staff knew
of his hypocrisy but it did not make any difference, because if people who
worked in the system were to criticise such a doctor, their jobs and
promotion would be at risk. 

Other Drugspeak words include reduction and detoxification. In the
treatment of drug use doctors and others are expected to organise
continual reduction in the dose, being used. Regardless of the patient's
needs, the dose of drugs must be reduced at a standard rate until he is
theoretically drug-free and can be recorded as an official "success". In
Drugspeak, there is one standard schedule of treatment with perhaps two
or three minor variations. The user is made to sign a contract agreeing to
the method of treatment and promising to be drug-free by a certain
date, before starting treatment. Users sign because of the desire to get
drugs, but they know how phoney it is and they despise the doctor or
social worker who forces it on them. How can one guarantee to be cured
of any problem by a certain date? 

  So the user begins his so-called treatment in a dishonest relationship
with the doctor. When he breaks the contract, as nearly always happens,
either the fact is concealed and he is recorded as "cured" (a "success" for
the clinic), or else he is blamed for not having kept his promises. I cannot
think of a more absurd situation in medical treatment, yet it has
happened to thousands of drug users. Only very rarely does the "contract"
method lead to real success, although I know of many cases where it was
recorded, and even published as having been successful. Since you can no
longer use drugs but can only abuse them or misuse them, it is obviously
morally bad so you must be stopped, and perhaps treated, for the whole
subject is now medicalised. Of course, many of those in authority do not
bother with treatment or, at most, it's a standard treatment for all. One
of Britain's leading drug dependency doctors often insists that it must be
"the same for all", regardless of the circumstances or how long the person
has been a user. Not many doctors actually promote that attitude and
many reject it in theory, but many of them practice it. 

Then, if you do not respond (another weasel word) to the standard
treatment you must be punished or turned into a criminal. You have to
use the black market. If you are an opiate addict and, in order just to keep
yourself normal, look after your family and to do a normal day's work, you
take enough of the drug to which you are addicted to enable you to
function normally, then that is drug abuse, and you can be sent to jail for
it. The idea that an addict might have a "maintenance" or "stabilization"
dose until such time as he can reduce his dose, used to be part of the
humane "British system" outlined in the Rolleston Report of 1926 (Rolles-
ton, 1926). Not any more. In Drugspeak, "maintenance" is reduced to
absurdity as a dirty word meaning "drugs on demand, whatever patients
ask for", although I have never met, or heard of, a doctor who believed
or practised this. Drugspeak even holds that the "British system" never
existed or that it failed--when it was never actually put to the test. 

Drugspeak is a powerful influence on thinking, not only of those who
work to uphold official drug policies, but also of ordinary people who do
not take illegal drugs or know anyone who does, but are probably scared
that their children may be led into "drug abuse"--which they may think
starts with smoking cannabis. Some feel physically sick at the very thought
of drugs. Since all drugs, including "hard" drugs, are relatively harmless if
taken responsibly and with quality control, this is a real triumph for
Drugspeak. Drugspeak is so powerful that many honest people use the
phrase "drug abuse" and refer to working with "drug misusers", even
when their hearts and minds are bitterly opposed to the standard "War
on Drugs" and when they know the harm that the official policies are
doing. By cutting down the words, you cut down the range of thought
and ideas. I would label this language abuse. So far, I have heard no voice
raised against it. Drugspeak leads to other forms of dishonesty and
hypocrisy. When the absurdities of Drugspeak suggest a method of
treatment, then it became necessary for those in power to make some
changes. However, "change" means support of system, but gives the
appearance of change. Thus, a new word was invented--flexibility. In
practice, Drugspeak has turned this into choice between a narrow range
of options, for example whether the person "contracts" to be drug-free
in three weeks or three months. In this endeavour, the person is often
helped by "carers". In Drugspeak "care" usually means "control". 

Drugspeak encourages research which shows that users under the present
system decrease their intake of drugs and become drugfree. It ignores the
fact that most of them, including nearly all the long-term users, return to
the black market when their doses are reduced. One particular treatment
claimed a 95 percent success. Yet many of these "successes" soon became
my patients. One of them said to me "If they only have 5% failures, then
I know them all twenty times over". (See Dally, 1990.) 

Some users have the same course of treatment over and over again, each
time counted as a "success". One had the same course of treatment 27
times--yet was still offered only the same again. Twenty seven recorded
"successes" in achieving the "drug-free" state! 

To return to "decriminalization" and "legalization": some people believe,
and others would have us believe, that these are dangerous suggestions
meaning, respectively, allowing anyone to possess drugs without let or
hindrance and to buy them freely, perhaps even in the supermarket. This
increases the shock-horror and is intended to do so. 

"Illegal" drugs are already legal in Britain and in most countries and always
have been. Heroin is banned from the United States, but in Britain any
doctor may prescribe it, or any other drug, to someone who is in severe
pain or dying and may prescribe almost any drug under everyday circum-
stances. He may prescribe the exceptions, heroin, cocaine and a few
others, if he holds a special licence from the DHSS. So what exactly does
"legalization" mean? 

We also have some degree of "decriminalization" in that not everyone
found with illegal drugs is prosecuted. Who is and who is not is arbitrary,
often dependent on the whim of an individual policeman. Should it be
mandatory for policemen to ignore or to pursue small amounts of drugs
and, if so, does this mean all drugs? Who decides?

The reason for this discrepancy is the existence, encouragement and
power of Drugspeak. Drugspeak reinforces prohibition, brings untold
wealth to traffickers and is a convenient excuse for governments to wage
"The War on Drugs". 

I believe that, at least in Britain, the speciality of drug dependency is more
dishonest and hypocritical than any other branch of medicine partly
because it has given way to Drugspeak. It is difficult now to find a
structure for alternative attitudes, because the language about any drug
use is now designed to prevent discussion and, unless you can structure
things in language, you are powerless. 

This, of course, testifies to the success of Drugspeak and reveals one of its
saddest results. Let us learn and let us remember: Drugspeak, the language
of Western drug policies, makes it difficult to think in any other ways
about a drug. Drugspeak and the policies behind it are liable to corrupt
even the best people.
Bluntly, Drugspeak makes drugs seem dangerous.