A table published in the Lancet in 2007 ranked substances for harmfulness, and it made headlines when it placed alcohol ahead of crack cocaine and ketamine (“Special K”, to those who enjoy administering a horse tranquiliser on themselves). Tobacco was judged to be worse than cannabis, glue and solvents, LSD and ecstasy. Bar-room philosophers all over the land almost spilled their pints at the notion that they were hard-drug users.
It was, perhaps, meant to be provocative in that unworldly way scientists sometimes like to affect. They did not stray all that far away from public opinion, however: the most harmful drug by some margin was said to be heroin, followed by cocaine, and the least bad, amyl nitrate and khat, then just emerging as a feature among the Somali community. Had the table been produced a couple of centuries before, heroin’s opiate predecessors would not even have been eligible for inclusion: alcohol, specifically gin, would have topped the charts.
Virginia Berridge’s book is an entertaining – I hesitate to use the term addictive – account of our changing attitudes towards, and use of, all manner of substances, with a focus on the most durable pair, tobacco and alcohol. Her account reminds us of how what is now illicit used to be commonplace. Thus, William Wilberforce is revealed as an opium addict, one of many at the time who apparently functioned well into old age. He had a lot to choose from. As with the myriad legal highs today, numerous opium preparations were available, from pills, lozenges, tincture (the romantically named laudanum) through to – goodness me – opium enemas.
The question that is always asked, of course, is why alcohol and tobacco survived, albeit heavily taxed and regulated, while other drugs became demonised. Much of it seems to be fashion and culture. Snuff and pipe-smoking have long been out of fashion, while tobacco is ghettoised. “Rave” drugs and “legal highs” emerged to replace the treats of the hippie generation. Opium became associated with “low life” by about 1900, and infected with fear of “otherness” due to its popularity among Chinese seafarers in the east end of London.
The most rational drug choice today, as per Lancet’s list, would probably be khat: organic, relatively harmless, with no links to organised crime or street violence. But how many of us want to sit around chewing leaves? Then again, not so long ago it was quite usual to see ashtrays in offices and smokers in restaurants. Maybe in 20 years they’ll passing round the khat at fashionable dinner parties or raves.