Psychoactive substances and the political ecology of mental distress

'Substance' is a shorthand term used in common parlance for 'psychoactive substance', a pharmacologically active, consumable material, usually self-administered, that can reliably have, among other physiological effects, a discernible impact on one's mood, emotions, feelings, sensations, perceptions, and/or thinking. For the last century, consumption of a select group of psychoactive substances has been a matter of pressing political concern for modern State bureaucracies, and in that time all manner of popular conceptions concerning substance use, abuse, dependence, and addiction have had ample opportunity to be race-baited, red-baited, even gay-baited, chauvinistically slanted, politicized, inflated, and conflated due to a variety of cultural-historical reasons such as scapegoating, xenophobia, and 'culture wars' over the years, which an extensive literature has documented (see, for example:[1-3]). Nosology and diagnostics for substance-related mental disorders developed in health professional social circles and codified in standard psychiatry manuals have similarly shifted over time, with earnest attempts made in recent years at their summary de-politicization by mental health professionals and 'drugabuseologists'. But notwithstanding these efforts at putative 'scientific sanitization', this paper argues that long-hardened commitments to the normalized ideology of pharmacologicalism, eloquently described by DeGrandpre [4] as providing "a scientific foundation for the moral ordering of drugs" (p. 27), as in the good vs. bad/angel vs. demon/legal vs. illegal psychoactive substance dichotomies enshrined in high-level public policy, have uncritically been allowed to take root in medical diagnostic screening criteria for substance-related mental disorders. Under the current official diagnostic nosology, codified in the internationally used fourth edition of the American Psychiatric Association's Diagnostic and Statistical Manual for Mental Disorders (DSM-IV) [5], when