History of drug misuse in the United States

Drug misuse in the United States has a long and complex history. The use of drugs has been present in the country since its founding, with the earliest settlers bringing over alcohol and opium. In the 19th century, the use of opium and opium-based products became increasingly prevalent, leading to the creation of laws regulating their sale and use.

One of the first federal drug laws, the Harrison Narcotics Tax Act of 1914, was passed. It placed federal taxes on the sale of opium and cocaine and imposed stricter regulations on their production, distribution and use. However, the law was primarily enforced against African American and Chinese immigrants who were disproportionately affected.

In the early 20th century, the use of marijuana and other drugs was not widespread. However, the passage of the Marihuana Tax Act of 1937 effectively criminalized the drug. This law was primarily enforced against Mexican immigrants, who were associated with marijuana use.

In the 1960s and 1970s, the use of marijuana, psychedelics, and prescription drugs became popular among young people, leading to a backlash and the creation of new laws and law enforcement efforts to combat drug use. In 1971, President Nixon declared a “war on drugs” and established the Drug Enforcement Administration (DEA) to combat drug use.

The “war on drugs” in the 1980s under President Reagan significantly increased funding for drug law enforcement and led to harsher sentences for drug offenses, disproportionately affecting communities of color. According to the American Civil Liberties Union (ACLU), the war on drugs has led to the mass incarceration of people of color, particularly Black Americans, for nonviolent drug offenses.

In the 1990s and 2000s, prescription drug misuse emerged as a major problem in the United States. The opioid epidemic began in the late 1990s, when pharmaceutical companies began aggressively marketing opioid painkillers to doctors and patients. This led to widespread misuse of the drugs and a significant increase in opioid-related overdose deaths.

Today, the United States continues to struggle with drug misuse, with opioid addiction and overdose being a particularly pressing issue. Many experts and advocates argue that a public health approach, rather than a criminal justice approach, is needed to address the issue effectively. For example, the National Institute on Drug Abuse (NIDA) recommends a comprehensive approach that includes increasing access to addiction treatment, reducing the availability of illicit drugs, and promoting prevention and education programs.


  • “The War on Drugs: A Failed Experiment” American Civil Liberties Union (ACLU)
  • “The opioid epidemic” National Institute on Drug Abuse (NIDA)
  • “The History of Drugs in America” History.com
  • “The Marihuana Tax Act of 1937” Erowid
  • “The Harrison Narcotics Tax Act” Drug Policy Alliance

History of Drug Misuse in England

Once upon a time, in the United Kingdom, drugs were not widely misused. However, as time passed, the use of drugs such as opium, cocaine, and heroin began to spread, particularly among the lower classes. These drugs were often used as a means of escape from the harsh realities of everyday life, such as poverty and unemployment.

As the use of these drugs became more prevalent, the government began to take notice. In the early 1900s, laws were passed to regulate and control the sale and distribution of certain drugs, including the Dangerous Drugs Act of 1920 and the Rolleston Committee in 1926, which aimed to control the use of morphine and heroin for medicinal purposes.

Despite these efforts, drug misuse continued to be a problem, and the number of drug-related deaths and crimes began to rise. With the arrival of World War II and post-war period, the use of drugs such as Benzedrine, which was prescribed to soldiers and civilians to help them stay alert, became more widespread.

In the 1960s and 1970s, a new wave of drug misuse emerged, as young people began experimenting with a variety of new drugs, including cannabis, LSD, and amphetamines. The government responded with even stricter laws, including the Misuse of Drugs Act of 1971, which classified drugs into different categories based on their potential for harm. This act still remains the main legislation in the UK for drug control.

Despite these efforts, drug misuse remained a significant problem in the UK, particularly in inner-city areas. In the 1980s and 1990s, the use of crack cocaine and heroin reached epidemic levels, leading to a surge in crime, poverty, and homelessness. The government response was to increase law enforcement efforts to combat drug trafficking and possession, as well as harsher penalties for drug offenses.

In recent years, the government has taken a more holistic approach to addressing drug misuse, including investing in education and treatment programs to help those who are struggling with addiction. The Advisory Council on the Misuse of Drugs, an independent body that advises the government on drug-related issues, has recommended a shift towards a health-based approach to drug policy, including the provision of harm reduction services, such as needle exchange programs and opioid substitution therapy.

While the problem of drug misuse in the UK is still ongoing, progress is being made to combat it. The government also invest in more research and development to find new ways to help those who are struggling with addiction. The UK is also a signatory of the United Nations conventions on narcotic drugs and psychotropic substances, which sets global standards for drug control, and aims to promote cooperation among countries to combat drug misuse.

However, there is still a long way to go. According to the Office for National Statistics (ONS), in 2020, drug-related deaths in England and Wales reached a record high, with 4,393 deaths registered, the highest number since comparable records began in 1993.

photo of opened bible book on brown table

Overview of Drugs Usage in the Scriptures (Bible)

Note: This is an abridged, text version of the Podcast episode on Drugs and the Bible. I have a lot of friends who have an interest in this particular topic. To make it easier for them, I am publishing this alongside the full podcast. It follows on from the Podcast episode on Drugs in Babylon and Assyria.

About the Bible

The Bible is a collection of sixty-six books. Some, or all of these are regarded as sacred text by followers of Judaism, Christianity, Islam, Rastafarianism, Samaritanism, and other faiths. While the internet is full of debates over the authorship of some of the books, such discussions are beyond the scope of this podcast. Our interest is in what the Bible reveals about the historical use of drugs in the Near East. We shall take the Bible at face value since the stories it presents tell us something about the beliefs and lifestyles of the authors and the communities in which they were based.

Connection with Babylon and Assyria

Assyrian statue

We find the first connection between the Bible and Babylon or Assyria in the book of Genesis[1]. This identifies Abram (later Abraham[2]) as having been born and brought up in Ur of the Chaldeans. Abraham is estimated to have lived around the second millennium BC[3]. He is the acknowledged forebear of Jews[4], Muslims[5] and Christians[6], whether in a physical or spiritual sense.

Chaldea was a region of the Persian Gulf, around the second millennium BC, that overlapped what was to later become Assyria and Babylon[7]. Abraham left the land of Chaldea and settled in the region around modern Palestine and Israel[8]. The rest of his family only made a partial journey and settled in Haran[9], which was likely part of the Assyrian empire[10].

Abraham had a monotheistic religion, which appears to have been a strong driving force behind the departure from Mesopotamia in the first place[12]. However, those who remained in Haran retained some polytheistic beliefs[13]. Interestingly, both Abraham’s son, Isaac, and his grandson, Jacob, got their wives from Haran[11]. We can therefore reasonably ask if Assyrian culture influenced the culture and medical practices of Abraham’s descendants.

Plants with drug-like effects


As we look at plants with drug-like effects in the Bible, we come across two unusual examples: the trees of life and of knowledge of good and evil[14]. The first of these is said to have possessed remarkable repair and regenerative powers, to the effect that it would make humans live forever[15]. The book of Revelation also references its unparalleled healing properties[16]. This is also likely the same tree referenced by Ezekiel in his vision in Ezekiel 47:12.

It appears that eating the fruit of the second tree results in massive harm, not so much from the tree itself but from the act of disobedience. Sadly neither plant is currently available for science to evaluate the secrets behind its properties.

The next plant we come across, used as a drug, are mandrakes. They are mentioned in Genesis 30:14-16 as well as in Song of Solomon 7:13. They were believed to be aphrodisiacs, fertility drugs as well as used for their fragrance. It appears that the Jacob’s wives and his descendants, many years later, shared this view of mandrakes held by other cultures[17].

Other examples of drug use

The 30th Chapter of Genesis also reveals what may either be seen as a misinformed attempt at drug therapy or as another superstitious belief in plants[18]. Jacob tries to use fresh sticks from the poplar, almond and plane trees to change the coat colour of livestock. He later learns the true reasons behind the outcomes, in terms of homozygous or heterozygous genotypes and phenotypes[19].

Other examples of drugs used in healing, diagnosis or otherwise include the following:

  1. Moses using a branch from an unnamed tree to purify some drinking water (Exodus 15:24-25)
  2. Use of hyssop as a cleansing an antiseptic agent. (Leviticus 14:4-6, Psalm 51:7).
  3. Holy water and dust as a diagnostic test (Numbers 5:11-31).
  4. Using a poultice of figs to heal a cancerous boil on a terminally ill king (2 Kings 20:1-11).
  5. Using ashes, containing charcoal, to alleviate the pain from painful sores (Job 2:7-8).
  6. The positive presentation of the benefits of medicine[20].
  7. The many references to the use of “balms” in the Old Testament. You can find these in Genesis 37:25, 43:11; Jeremiah 8:22, 46:11, 51:8 and Ezekiel 27:17. The ancients used balms in trade as well as for a variety of medical conditions, including pain management. They also gave them as gifts [21]. Furthermore, we derive the word, “embalm”, from the word, “balm,” thus acknowledging the chemical properties of the drugs in the embalming agents. (Genesis 50:2, 3 and 26).
  8. Jeremiah gives a figurative reference to ineffective medicines (Jeremiah 30:13, 46:11).
  9. Jesus uses clay made with his saliva alongside one of his healing miracles (John 9:1-7); which is perhaps an acknowledgement of the poultices that were sometimes used in healings.

Alcohol in the Bible

Alcoholic drinks

Having gone through the list above, it would be remiss of us to not mention another drug that appears several times in the Bible, right through from Genesis to Revelation. This, you might have guessed, is alcohol. In fact, one can argue that this appears more than any other drug in the Bible. A rudimentary count of the number of occurrences of the word, “wine,” in the King James Version shows that it appears a minimum of 267 times. As such, we would need a whole series to look at the subject of wine and the Bible.

If you search online, you will also find many sites dedicated to either the condemnation or support of alcohol consumption based on selected Bible references. However, it appears that many of these sites give arguments based on a superficial reading of the texts, mainly based on the English translations of the original languages. Scholarly research suggests that the term “wine” in the Bible was used both for alcoholic beverages and for unfermented grape juice[22]. In general, it appears that the favourable references relate to the unfermented juice, while the unfavourable references relate to the alcoholic beverages.

Among the deleterious effects highlighted as caused by alcohol are drunkenness, poor decision-making, poor behaviour, numbing of the mind, alcohol addiction and being a symbol for apostasy, spiritual confusion and slavery.

However, there are positive references to (unfermented) wine as being useful for pleasurable consumption and treatment of some medical conditions.

There is also a reference in the Book of Proverbs[23] to the use of strong wine for those who are perishing, most likely referring to the pain-numbing properties of alcohol in an age when there were no general anaesthetics or palliative drugs for those in terminal pain. Having said all this, one may note that many Jews and Christians seem to enjoy a tipple or more every now and then. We may, in future, return to the discussion of the use of alcohol in the Bible.

However, it is useful to remember the current recommendation of the National Health Service[24] and a Medscape review[25] that argue that “there is no safe level of alcohol consumption,” with alcohol being associated with higher risks of various cancers, neurotoxicity and cognitive decline such as with dementia. We shall cover this in a future episode looking at the history of alcohol.

[1] Genesis 11:27,28,31

[2] Genesis 17:5

[3] https://christianity.stackexchange.com/questions/3603/when-was-abraham-alive

[4] John 8:33


[6] Romans 4:12

[7] https://jewishencyclopedia.com/articles/4213-chaldea

[8] Genesis 12:1

[9] Genesis 11:31, 12:4

[10] https://www.britannica.com/place/Assyria

[11] Genesis 24; 27:43; 28:1-5; 29:1-29

[12] Genesis 18:17-19

[13] Genesis 31:30-35

[14] Genesis 2:9

[15] Genesis 3:22

[16] Revelation 22:2

[17] https://www.gotquestions.org/mandrakes-Bible.html

[18] Genesis 30:37-43

[19] Genesis 31:10-11

[20] Proverbs 17:22

[21] Genesis 43:11

[22] Bacchiochi, S (1989). Wine in the Bible: A Biblical Study on the Use of Alcoholic Beverages, An Abridged Edition. Signal Press & Biblical Perspectives

[23] Proverbs 31:6

[24] https://www.nhs.uk/live-well/alcohol-support/the-risks-of-drinking-too-much/

[25] https://www.medscape.com/viewarticle/965387?uac=166631AR&faf=1&sso=true&impID=3911689&src=WNL_infoc_211229_MSCPEDIT_Alcohol.Brain#vp_1

What is a drug?


The mention of the word, “drug” evokes different images in different people. For many ordinary people, the word is associated with illicit drugs used outside the boundaries of conventional medicine. Hence the first images that pop into their minds are those of street heroin or cocaine, speed or ecstasy. For clinicians, depending on where they practice, the word also means something negative or positive. The context in which it is used also plays a role in fully understanding what is meant.

Finding a comprehensive medical definition of the term, “drug” is an interesting challenge. The National Cancer Institute defines a drug as,

“Any substance (other than food) that is used to prevent, diagnose, treat, or relieve symptoms of a disease or abnormal condition.”

It outlines that drugs can also affect how the brain and the rest of the body work and cause changes in mood, awareness, thoughts, feelings, or behaviour.

Another definition of the word acknowledges the murky history of the term “drug” in Western societies. Under this definition,

“A drug is any psychoactive substance that can alter the way the mind or body works, regardless of legal status or medical approval. It can be synthetic or produced from natural sources and can be used for a variety of reasons including medicinal, recreational and spiritual.”

This definition, taken from a Sage publication on “Key Concepts in Drugs and Society,” is part of a discussion that acknowledges that drugs are used in a variety of contexts, including outside the medical setting. The publication goes on to highlight the cultural influences on the understanding of the word (as compared to, for instance, the word, “medicine”); and the medico-legal status of drugs as legal, controlled, illegal, illicit, or quasi-legal. Despite the breadth of coverage of the contextual understanding of the term, the weakness with the second definition is that it limits the definition to “psychoactive” substances i.e., drugs that act principally on the brain.

On this podcast, we adopt a definition that encompasses both above definitions. We define a drug as,

“Any substance (other than food) that can alter the way the mind or body works, regardless of legal status or medical approval. It can be used to prevent, diagnose, treat, or relieve symptoms of a disease or abnormal condition; be synthetic or produced from natural sources and can be used for a variety of reasons including medicinal, recreational and spiritual.”

This is in recognition of the rather arbitrary differentiation between a “drug” and a “medicine”. We shall look at practical examples of this shortly. However, at this point it is important to introduce a term that we will try to use for most of our podcasts where relevant.

In the past, when drugs were seen to have been used inappropriately, this was referred to as “drug abuse” and the individuals who were known to be involved were referred to as “drug addicts”. The term “drug addict” is loaded with negative connotations based on stereotypes. In recognition of this, we prefer to use the term, “drug misuser”, which is a more holistic description of problematic drug use.

The National Library of Medicine, quoting the World Health Organisation and the UK Department for Health (2006), defines drug misuse in the following terms,

Drug misuse is defined as the use of a substance for a purpose not consistent with legal or medical guidelines. It has a negative impact on health or functioning and may take the form of drug dependence or be part of a wider spectrum of problematic or harmful behaviour.

For instance, when a patient goes into a pharmacy and buys paracetamol with codeine (co-codamol) for the short-term management of a headache, that is a legitimate use of the medicine. However, if the same patient starts to use the co-codamol inappropriately on a long-term basis, resulting in drug-induced headaches, then the patient becomes dependent on the medicine. That patient has become a “drug misuser.” The legal status of the co-codamol has not changed. It is the conditions under which it is being used that have changed.

Other examples can be cited to illustrate this point. Clinicians will be familiar with patients who have become dependent on prescription and over the counter “drugs” such as opioids, benzodiazepines, other analgesics, and sedatives. Many such patients are otherwise fully functional members of the community and do not regard themselves as “drug misusers.” On the other hand, the deaths of some well-known music stars have been linked with addiction to and overdosages from licenced prescription medication.

Furthermore, consideration must be given to such socially acceptable “drugs” as alcohol and tobacco. Though they are widely consumed and shared in social settings, providing pleasure to millions, only confirmed problem drinkers are regarded as “alcoholics,” a short term for “alcohol-dependent drug misuser”. This is in recognition of the deleterious effects of such misuse on health, social life, and economic well-being; in much the same way as other well-recognised “drugs”. However, rarely do we find, in everyday conversation, people referring to the purchase and consumption of alcoholic beverages as trade in “drugs”. Similarly, it is thanks to the changes in societal perception of tobacco misuse that there is now widespread appreciation of tobacco dependence as a form of addiction to the drug nicotine.

In addition, we also acknowledge that the legal status of many “drugs” is fluid depending on use, culture, geography, and politics. At the time of writing this post, the recreational use of cannabis, for instance, is legal in 18 US states; whereas its medical use is legal in 37. Across the world, there are varying levels of control affecting anything from the whole plant to cannabinoids derived from it.

Finally, we consider that some people like to distinguish between synthetic drugs and naturally derived substances used in a state as close to raw as possible. They regard the former as bad and the latter as more acceptable. This is not justified by an understanding of the underlying mechanisms of action at a molecular level; at which it is observed that the active components are similar, if not identical, and generally have identical mechanisms of action. The natural substances are therefore ‘drugs’ in the same way as the synthetic formulations.

In this podcast, therefore, we trace the history of drugs across social, religious, political and moral boundaries, irrespective of type and origin.