From Psychology Today:
Mood modification through drugs—intoxication—is a standard cultural reality in American history; it's possibly even more so today. Rather than hopelessly pursuing a drug-free country or world, a more mature response might ask: How can we successfully manage this reality?
The World Health Organization announced last year that the ideal amount of alcohol a human being should consume is...none. Somehow, I doubt that alcohol producers are panicking or anti-alcohol epidemiologists rejoicing in the wake of this pronouncement, which follows many similar ones. In all likelihood, Americans will continue to drink and use other drugs—perhaps even more so.
Drinking in America
Americans have a long and conflicted history with alcohol. Colonial America, for instance, was soaked in it. Protestant sects observed sacramental wine in church; the tavern was the center of family and community gatherings; alcohol was served during sessions of state legislatures.
Consider that drinks were doled out at the signing of the Declaration of Independence and throughout the Constitutional Convention—our founding national documents were written by inebriated men!
A picture of drinking in Colonial America was presented in the 2015 National Archives exhibit, Spirited Republic: Alcohol in American History. In an interview titled, “The time when Americans drank all day long,” Bruce Bustard, senior curator of the exhibit, commented:
Early Americans took a healthful dram for breakfast, whiskey was a typical lunchtime tipple, ale accompanied supper and the day ended with a nightcap. Continuous imbibing clearly built up a tolerance as most Americans in 1790 consumed an average 5.8 gallons of pure alcohol a year.
The framers of the Constitution organized a farewell party for Washington before signing off on the document; we still have the tavern tab. The 55 attendees drank 54 bottles of Madeira, 60 bottles of claret, eight of whiskey, 22 of porter, eight of hard cider, 12 of beer, and seven bowls of alcoholicpunch. That’s more than two bottles of fruit of the vine, plus a number of shots and a lot of punch and beer, for every delegate. It works out to perhaps 16-20 standard drinks each.
That was some party! How is such drinking humanly possible, let alone how our most prominent citizens actually behaved?
Bustard explains, as best as possible:
We think of that as an astounding amount—you would think people would be staggering around drunk, but most people were able to handle their alcohol because it was integrated into daily life.
This was also a period when most people were working in the fields which presumably didn’t require much focus. And living in a tight knit community meant people could keep an eye on each other and intervene if somebody was thought to be overdoing it. Even so, modern Americans look quite abstemious by comparison, consuming only two gallons of pure alcohol per year.
In 1830, on the eve of Temperance, consumption peaked at seven gallons per person per year, three and a half times as much as the average American drinks today. But the nineteenth century saw Americans curtail their drinking substantially, leading finally to national Prohibition in 1920–which was then repealed in 1933.
Then Came Opiates
In his classic book, Dark Paradise: A History of Opiate Addiction in America, David Courtwright details how 19th-century America was awash in opioids. Laudanum (tinctured opium) was sold in drug stores without prescription, hawked as a miracle cure on street corners, and given to teething babies. Morphine was widely introduced during the Civil War, and heroin was developed by the Bayer company by the end of the century.
Courtwright compellingly describes the prevalence of opioids in the 19th century, but the title of his book is misleading. Widespread addiction to opioids was not evident in America until (as he himself describes) heroin became a street drug, typically purveyed among disadvantaged populations, after the turn of the 20th century.
In other words, addiction is not inherent in the properties of the drugs themselves (as Carl Hart has shown in High Price), but is instead bound up in the difficult social and economic circumstances of people’s lives. Nonetheless, opiates, cocaine, and marijuana were banned in America by the Harrison Act of 1914.
Contemporary Trends in Psychoactive Substance Use
In contemporary America, alcohol is once again a normal part of the lives of Americans (although not in the quantities typical for Washington and other Colonial Americans): According to the National Survey on Drug Use and Health, nearly 90 percent of us have drunk in our adult lives, and 56 percent of us have done so within the past month (although rates in many European countries are higher).
Drinking rates are highest among well-off, educated Americans. Indeed, beverage alcohol is most often a high-end product, including prestige wines, local and imported small-batch spirits, and craft beers. When Elizabeth Warren appeared on Instagram Live in her run-up to seeking the Presidency, she began by telling her audience, “I am going to get me a beer.”
It seems safe to say that America is not poised to return to the kind of widespread prohibition and individual abstinence sought so ardently by some, and resisted with as much urgency by others, in the past.
Meanwhile, marijuana is commercially legal in 10 states, while cannabis is legal for medical use in well over half the states. Meanwhile, a majority of Americans nationwide now support the legalization of the drug. It would be hypocritical if they didn’t: The National Survey showed that most (52 percent) of us have used marijuana, and 44 percent of those who have tried it still use it.
So Americans are fairly well accustomed to the idea of normal intoxication and in many cases the experience of it, with alcohol and now marijuana, even as they worry about it.
At the same time, since 2000, the number of Americans on long-term antidepressant therapy has tripled. Then, there are highly utilized drugs for other mental disorders: benzodiazepines (anti-anxiety drugs), antipsychotics, and stimulants (used for ADHD and ADD)—all of which are used in large and growing quantities.
And we still need to account, of course, for the use of opioids, consumed by many tens of millions of Americans—most of whom follow prescriptions and use the drugs safely, albeit with a small, high-risk minority who do not, creating our current opioid crisis.
This limited but significant trend in destructive opioid-painkiller use, typically in dangerous combinations with other drugs, is the source of great, understandable alarm. But how exactly are we to fight this phantom considering that reducing prescriptions doesn’t reduce the death rate—or even halt its growth.
Does it seem as though an awful lot of people are currently using a wide variety of substances to modify their feelings and consciousness? This is our past, present and future reality—even as we exude anxiety about it. So it seems that what would be most useful are sensible and largely safe ways for a society to accommodate the human penchant for intoxication.
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