Dear reader,
We humans have a peculiar relationship with psychoactive substances. A kind of dualism marks this bonding. As a friend told me some time ago: “I hate drugs but I love the way they make me feel.”
Clearly, humans both revere and revile intoxicants. It’s a kind of a Freudian love-hate equation. This duality is evident in how we attach these elements to some of our most sacred rituals. History books tell us that the ancient Greeks consumed kykeon during the Eleusinian Mysteries, which are some sacred rites dedicated to the goddesses Demeter and Persephone. Kykeon, the ritual beverage, was made from water, barley, honey, and various herbs. It was central to the annual ceremonies held in Eleusis, near Athens.
Similarly, Americans in the pre-Columbian period used a kind of psychoactive cactus called peyote in their ceremonial practices. This contains a hallucinogenic compound—mescaline. It has been integral to indigenous Mexican tribal rituals for thousands of years. Such examples of “sacred substance use” span cultures and continents. Many continue even day.
Few themes have captured the literary imagination quite like our relationship with mind-altering substances. Thomas De Quincey’s vivid opium dreams in Confessions of an English Opium-Eater is my favourite. Then there is the not-so-well-known, vodka-soaked Moscow-Petushki by the Russian writer Venedikt Yerofeyev. And of course, we all remember Gabriel García Márquez’s portrayal of alcoholic haze in One Hundred Years of Solitude. There is also William S. Burroughs’ Junky, which offers a bare-all look at addiction’s raw reality.
Several writers, from Ernest Hemingway and Hunter S. Thompson to Jorge Luis Borges and Carlos Fuentes wrote about intoxicants, but the Russians had a particular fascination with this theme. In Crime and Punishment, Dostoevsky’s Semyon Marmeladov becomes an embodiment of both personal tragedy and societal metaphor through his alcoholism. Another striking example comes from Mikhail Bulgakov. He drew from his experience as a morphine-addicted country doctor to write Morphine. The book captured the medical profession’s complex ties with drugs. Conversely, Bulgakov’s influence extends to modern literature. His masterpiece The Master and Margarita inspired, hold our breath, Salman Rushdie’s The Satanic Verses.
These literary works provide valuable cultural context while often serving as cautionary tales. Though Bulgakov eventually overcame his morphine addiction, others like Edgar Allan Poe and Dylan Thomas met tragic ends. Their works illustrated the thin line between artistic inspiration and self-destruction.
As is evident in these works and the societies they depicted, the modern world maintains a conflicted stance towards intoxicants. It demonises recreational drug use while carefully regulating pharmaceuticals and sanctioning alcohol consumption. This contradiction has turned even casual drinking into a guilt trip for many.
As is to be expected, multiple factors drive the substance control policies that exist today. They range from social and economic concerns to medical and political imperatives. Paramount among these is the impact of addiction on public health. Substance abuse exacts an enormous toll, which includes trillions in global economic costs, billions in healthcare expenses, and countless shattered families. “In wine there is wisdom, in beer there is freedom, in water there is bacteria,” is a (probably made up) quote popularly attributed to Benjamin Franklin, but research tells us of a darker reality—roughly 65 per cent of violent crimes have some links to alcohol consumption. The economic impact is alarmingly evident in the US, which ranks among the world’s largest alcohol consumers (China leads the pack). In the US, lost productivity from substance abuse costs over $740 billion annually.
If substance control has historically been a tool for social control, then nowhere is it more evident than in the clear racial motivation behind the criminalisation of cannabis in the early 20th century, which went on to influence international drug policies. The conflict, while multilayered, plays off at essence as one between naturally occurring psychoactive leaves and fruits consumed by traditional communities over centuries and chemically formulated psychotropic substances that are underpinned by enormous underground financial and political rings.
With modern drug policies, societies face a paradox: balancing legitimate public health concerns with personal freedoms and cultural traditions. Many countries have begun to recognise and embrace “harm reduction approaches” rather than strict prohibition, recognising that complete suppression proves both impossible and counterproductive. As anthropologist Ronald K. Siegel notes in Intoxication: The Universal Drive for Mind-Altering Substances: “Outlawing drugs in order to solve drug problems is much like outlawing sex in order to win the war against AIDS.”
As neuropsychological research deepens our understanding of addiction and social science refines our grasp of effective interventions, policy approaches will continue to evolve. The path forward likely lies in nuanced, evidence-based policies that merge robust public health measures with respect for individual autonomy.
The landscape is already shifting. Sweden has a regulated alcohol monopoly while Canada has legalised cannabis. Medical cannabis programmes are expanding globally, showing a growing ability to separate medical benefits from moral panic. Research into psychedelic-assisted therapy, which was restricted earlier for political rather than scientific concerns, is now undergoing a renaissance that could transform mental health treatment.
The future relationship between humans and drugs will likely be guided by sophisticated regulatory frameworks based on actual risk profiles and potential benefits, rather than blanket prohibition or unrestricted access. This requires moving beyond simplistic good-versus-evil narratives towards a nuanced understanding of how substances interact with human biology, psychology, and society.
There is good news on those fronts too. Evidence increasingly supports the medical potential of previously stigmatised substances. MDMA-assisted therapy has shown promising results for PTSD treatment. For instance, studies show that psilocybin therapy has considerably reduced depression and anxiety in cancer patients. The benefits lasted six months or longer in some patients.
Perhaps the most crucial shift needed isn’t in laws or policies but in our ability to discuss these issues rationally. To develop a healthy relationship with drugs, society must first cultivate an honest relationship with the truth about them—uncomfortable as that truth may be.
In this context, Frontline examines India’s complex relationship with cannabis—a substance deeply woven into our history. While cannabis features prominently in our religions, traditions, cultural texts, and medicinal literature, current public policy remains driven more by moral panic than realism. In his lead essay, Karan Madhok explores cannabis as a multifaceted cultural gift that India continues to vilify. Perhaps it’s time to reclaim this herb’s true significance, he says.
Post Script. Two Aprils ago, my uncle—my father’s older brother, to whom I was close—met with a devastating accident. An out-of-control autorickshaw left him with broken ribs and a fractured skull. Despite our best efforts and skilled medical care, he soon slipped into what we believed was a coma. The doctors told us he was “aware of everything”. We felt helpless. We knew he was in tremendous pain, but that he was unable to express it.
When I discussed his condition with the doctor, he explained that the most humane approach would be to administer opioids to relieve the pain and allow my uncle to “exit in peace”. “But,” he added softly, “our country isn’t there yet, my dear.” The doctor confided to us that many physicians provide this comfort informally, and added, “A day will come when the medical use of these substances will become legal here.” I am convinced that people like my uncle, who finally passed away after months of suffering, deserve this dignity—the right to relief from unbearable pain.
What are your thoughts? Read Madhok’s piece and share your comments on this nuanced issue with us.
For Frontline,
Jinoy Jose P.
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