Self-medication refers to any course of treatment that is not prescribed by a recognised medical practitioner. Buying non-prescription medicines from a pharmacy or supermarket constitutes self-medication. We all self-medicate. Indeed our self-medication goes well beyond over-the-counter drugs peddled by Big Pharma. It goes beyond herbal or homeopathic remedies. It is endemic to all cultures.
Alcohol is a form of self-medication. Like most self-medication it treats the symptoms. The underlying problem remains and may even be exacerbated. Alcohol is a legal drug. Many illegal substances constitute self-medication. When viewed as self-medication then the whole approach to such substances seems quite ridiculous. Why are some forms of self-medication criminalised? All treat symptoms and addictiveness is not limited to the illegal forms. Addictiveness is less about the relief given by imbibing than about avoiding the pain of withdrawal. This pain is in part connected to the chemical consequences of the self-medication but also the result of the fact that the underlying condition is not treated, only the symptoms. This is true of many prescribed drugs also. The US has an opiate addiction epidemic and it arises out of legally prescribed opiates for pain relief. Similar problems exist with antidepressants.
The only material difference between self-medication with legal drugs and illegal drugs is the amount of knowledge we have about the legal ones and quality control. Big Pharma sells lots of over the counter medicine. They have been researched and comes with clear usage guidelines. The contents are known and pure. The drugs are not safe in all doses. Supermarkets have clear limits on how many pain killers they will sell at any one time. Illegal drugs are poorly researched and come with no authoritative health or usage guidelines. The quality control is non-existent and the content is often unclear. Adulteration is common. Dose size is unclear. There is no packet with a list of possible side effects. The only known consequences is that self-medication with illegal drugs could land you in prison.
Presenting illegal substance consumption as self-medication, analogous to cough medicine, may seem odd but it is not illogical. That it seems odd is a consequence of the generic disregard for mental health issues. Antidepressants and alcohol alter the state of consciousness. So do illegal substances. One can infer that the purpose of imbibing any is to alter one’s state of consciousness. The desire to actively alter one’s state of consciousness implies one is unhappy with the non-medicated state of consciousness. There is potentially an underlying mental health issue. Our society criminalises mentally ill people who resort to illegal substances for self-medication.
The source of this anomaly is that our society does not understand mental health and does not prioritize its treatment. Indeed large sections of the population regard mental ill-health in very simplistic terms. Either you are ‘mad’ (and should be sectioned) or you are conning people. The idea that people might have mental infirmities, just as they might have physical infirmities, that can be treated and enable them to lead ‘normal’ lives (whatever this might mean) is only now gaining traction. It may eventually lead to a better drug policy as well.
Not all mental health therapies involve substances of course. We also have the talking therapies or counselling. These come in many shapes and sizes depending on the particular line of psychology to which the therapist subscribes. Cognitive Behavioural Therapy is very popular but this might be because it is cheap rather than effective. Generally, talking therapies are expensive and the inclination to self-medicate naturally very strong. But how do you self-medicate a talking therapy? You could try talking to your friends and family but this is quite dangerous. So many turn to religion.
Religion has been the self-medication talking therapy since religion was invented. Indeed, maybe this is why it was invented. When Marx famously described religion as the opiate of the masses he was closer to the mark than many understood. Religion is to mental health what opium is to pain relief. It offers effective relief, it is addictive, and it does nothing to help the underlying condition. It can take over your life and ultimately it can kill you. Nevertheless, religion, like opiates, can be a useful medicine, which is why someone as non-spiritual as I am is so tolerant of religion. However, as with opiates it needs to be controlled and dished out in safe doses and not allowed to overwhelm the patient’s life.
The confessional serves many of the functions of a talking therapy as well as observing the same confidentiality ( I assume, as a I have never been to a confession). The Church provides a naturally supportive community, a sense of discipline, and purpose. Prayer can generate hope and help overcome a sense of fear and hopelessness. If one has an urge to talk to someone in one’s head there are plenty of candidates. In the Christian church the concept of forgiveness can help people ‘move on’. Jesus Christ, it seems to me, was an outstanding group therapist, and if it helps you think of him as a the son of God that was resurrected from death, why not? I am all for religion as a personal form of self-medication. However, I draw the line at pushing this particular form of self-medication much as I draw the line at drug pushers.
Drug pushers engage in aggressive marketing. They get people hooked and once hooked they have a ready market. There is no quality control and no after sales service. There are no side effect warnings. Of course many legal substances are aggressively marketed as well, notably alcohol, gambling, sugar products etc. These are materially no different to drug pushing. But the biggest danger of all is in pushing religion. Telling people your way is the only way and damnation or salvation is the binary choice you must make. It is the pious self-righteous religion pushers, that impose arbitrary and anachronistic values on society, that are the real villains.