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Manky Stuff

Quick Fixes: Drugs in America from Prohibition to the 21st Century Binge, Benjamin Yen-Yi Fong, Verso Books, pp. 272, $24.95

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When I was a student, we used to play a boasting game. The rules were simple: all you had to do was list every drug you’d ever taken. The person who’d snuffled up the second-highest number of mind-altering substances would then, unofficially, win. Taking drugs is, after all, cool. Taking drugs makes you an adventurer. It means you’re open to the world, both the geographical outer world and the neurochemical inner world, in all its shades of weirdness. Lightly, sexily contemptuous of danger. A good person to know. But there is a limit. The person with the longest list would usually get some slightly concerned looks. There are other ways of taking drugs that aren’t so sexy. There are futures waiting for you. The hunched-over people under bridges with their frantic eyes.

I’m pretty sure the person with the longest list was, more often than not, me. That didn’t stop me running through the whole thing; I suppose I was secretly proud of myself. Maybe I still am. My list went something like this:

  • The boring, legal, socially acceptable drugs, which everyone would list very quickly to get them out of the way: Caffeine, Alcohol, Tobacco
  • The illegal but more or less socially acceptable drugs for having fun on weekends: Marijuana, M.D.M.A., Psilocybin, Cocaine
  • The drugs that were perfectly legal with a prescription, just not when I did them: Valium, Xanax, Amphetamines, Oxycontin
  • As above, but legal use was, at the time, mostly limited to horses: Ketamine
  • The drugs that were legal only because nobody had gotten around to banning them yet (or at least not when I first took them), which had awkward uncomfortable names and awkward uncomfortable effects, and which were sold online in small plastic sachets as “fish food,” or “plant fertilizer,” or most notoriously as “bath salts,” but sometimes simply as “research chemicals,” supposedly so independent chemists could play around with their methyls and ethers in test tubes and flasks, but really for the scientific experiments I was conducting inside my own body: Mephedrone, Dextromethorphan, Desoxypipradrol, Salvia, 2C-B, MT-45, K2
  • The drug whose name, when mentioned, would make everyone suddenly go ashen-faced and serious as they contemplated for a moment the wider oceans of human misery and desperation and utter all-silencing numbness that stretched far outside the fun pharmacological kiddie pool in which we were happy to play: Heroin
  • Unknown but worth mentioning: Whatever shavings and filings of psychoactive trash—rat poison, prescription opiates, bashed-up speed, benzocaine to make you bleary, phenacetin to numb your gums—actually accounted for most of the volume of the pills and powders I took
  • The drug that might have actually come closest to killing me: S.S.R.I. antidepressants.

There’s a story behind that last one. One summer when I was twenty years old, an old school friend and I decided to tour the disputed territories of Europe. So on one trip, we backpacked through Bosnia, Serbia, and Kosovo. For another, we flew to Ukraine, made our way through Moldova and the tiny self-declared ribbon of Transnistria, then Bucharest, then home to London. (Back then, Ukraine was just a mildly interesting place to visit; nobody contested Crimea, and Donetsk was about to host the Euros.) We had vague plans for what to do after that—Northern Cyprus, obviously, with its creepy abandoned beach resorts, stuck in an eternal, decaying 1970s; maybe Abkhazia, South Ossetia, Nagorno-Karabakh; maybe Palestine. Maybe, if we were feeling brave, Chechnya. And then finally, when we had exhausted every conceivable alternative, we would go to Gibraltar.

Anyway, we very swiftly made one important discovery about the post-Soviet world that had absolutely nothing to do with its geopolitics, which was that pharmacies in eastern Europe were much more lax when it came to handing out prescription medications than the ones back in the U.K. were. You could go into a tidy little shop on Khreschatyk Street, ask for speed or benzos, and they would simply give them to you. No prescription, no obligatory small talk in some drug dealer’s Fiat Punto with its smell of instant noodles and sour sweat—you just hand over a piddling sum of money and the deal is done. I think I spent the next few weeks constantly alternating between a teeth-grinding mania—frantic in Chernobyl, chattering crazily at the Golden Gate, firing a Kalashnikov from the hip on maybe an hour and a half of sleep and a brain full of chemically induced scurrying—and a total soporism. Nodding off in restaurants. Numb at Babi Yar. We popped benzos in the mornings, to take the edge off the sunlight. We gobbled up amphetamines at night. The transition between those two states would be eased with large volumes of cheap, good vodka. We drank a lot; we drank enough that some Russian tourists told us to slow down. We had a lot of bizarre conversations with bizarre people. One man, who called himself Konstantin, very genially explained that he was going to cut out my eyeball. It was all fun. I was on holiday. I was having a great time.

Our prescription-drug binge only ended once we reached Bucharest. My friend, who knew more than I did about this sort of thing, said that there was one commonly available prescription drug that, when taken at a sufficiently high dose, functioned as a hallucinogen. In its legitimate guise, it was an anti-epileptic medication. So late one morning, he went off to get some. That was the last I heard of him for most of the rest of the day. He didn’t pick up his phone. He didn’t return to the hostel. In the end I found him shambling, shellshocked, down the Bulevardul Libertății. What a day, he kept saying. God, what a day. Eventually he explained that he’d tried to get our drugs, but things hadn’t really gone according to plan. This place was not like Ukraine. They wanted paperwork. So he decided that obviously the best way to fix the situation was to pretend to have a seizure, right there in the pharmacy. This had some of the desired effect: everyone in the shop suddenly became very concerned. But for some reason they did not just immediately supply the drugs he’d been asking for. Instead, they gave him a sedative. He said he’d heard voices in the haze, speaking, in slow and very deliberate English, about an ambulance, a hospital, and a mental health unit. Somehow, our fun holiday had culminated in the very real possibility of his being involuntarily committed to a Romanian psychiatric ward. Visions of squeaking iron beds in cold mildewed halls, where the bodies that once belonged to some of Ceaușescu’s forgotten dissidents might still shiver, tapping fingers, mumbling the beginnings of words and then giving up. He started insisting that he was actually perfectly sane, which is very difficult to do convincingly once the issue’s in doubt. But it worked, well enough at least to convince them that it wasn’t worth the bother of getting involved when he bolted for the door. After that, he just sort of wandered at random. Walked through the center of Bucharest, still half-sedated, not really looking at anything in particular. Trying to work out how it had all come to this.

But before that, there was the morning I woke up in my room in the Hotel Aist in Tiraspol with something very wrong with my head.

Tiraspol is the capital of Transnistria, an unrecognized breakaway republic within Moldova, with a large population of ethnic Russians. In the early 1990s, its secession was the occasion for one of the briefer, less-remembered post-Soviet wars, in which maybe a thousand people died; since then, Transnistria has been a functionally independent state, although it’s not clear what, if anything, the Transnistrians are getting from their functional independence. The country still has a hammer and sickle in its flag, even though the leaders of its tiny Communist Party keep getting arrested. The coins, which also feature the hammer and sickle, are made of plastic. The Hotel Aist was a Soviet behemoth; vast, grand, and practically ruined. Its wide, well-tiled lobby was magnificently empty, except for four old men tucked away in one corner, playing a game of cards on a rickety plastic table. They wore string vests and smoked cigarettes inside and spat sunflower seeds on the floor. In Transnistria, spitting sunflower seeds seemed to be the only entertainment going, and possibly the only economic activity too. But the booze was very, very cheap, so we drank a lot of it. I’m not really sure how the rest of the night panned out. I remember being told that our bank cards wouldn’t work in Transnistria, which isn’t connected to the global payments system. I remember going to the city’s sole A.T.M. to discover that it only dispensed U.S. dollars, in one-hundred-dollar increments. I’d never seen a Benjamin before. I remember bellowing something along the Dniester at night. And then the void.

When I woke up, my head felt awful. My teeth were chattering, and when I tried to clamp my jaw shut the muscles on either side of my face trembled like dying hummingbirds. My heart chattered away at a similarly frantic rate. But the rest of my body was numb, and when I dragged myself into the Hotel Aist’s decaying Soviet-vintage bathroom, I saw that my pupils were huge, deep, lightless pools. My mouth was dry. I had difficulty swallowing. All of these are common side effects of M.D.M.A., which you might also know as ecstasy, molly, or mandy. I’d gulped down plenty of the stuff in my time: little dabs of brownish powder, wrapped up in cigarette paper, swallowed in the clammy trench of a smoking area outside a student rave. But Tiraspol was not a very ecstatic city, and it was hard to imagine that I’d been out clubbing the previous night. In fact, it was hard to imagine anything. M.D.M.A. also induces an intense, superabundant energy. You start to really enjoy the sensation of moving your body and touching different surfaces. You experience a glowing euphoria and a profound, universal love. I didn’t have any superabundant energy. I wasn’t feeling any euphoria or universal love. In fact, I wasn’t feeling anything at all. I tried to think through the situation, and soon discovered that thinking was also suddenly not available to me. I was still having conscious experiences; unpleasant ones, mostly. I could still pilot my animal body around in the world. But some switch buried deep in my brain had been flipped, and all my higher functions had simply turned themselves off.

We spent a very miserable day in Tiraspol. We looked at the big Lenin statue. We tramped around a supermarket full of unfamiliar Russian products. My friend confirmed that no, we had not been clubbing the previous night. I don’t know what’s wrong with me, I kept saying. Maybe you’re just hungover, he said. I was sweaty, saucer-eyed, hollow-cheeked, gulping and shuddering like a broken android. Maybe, I said.

Eventually, though, he remembered the previous night. Here is what had happened. At the end of the night, as my friend was popping his daily dose of antidepressants out of their blister pack, I had asked what would happen if I took them, since I wasn’t depressed. Which was a lie. Of course I was depressed: maybe not in the clinical sense, but still very, very unhappy. I was twenty years old and lonely. I knew that I was living wrong, that I was doing everything in the wrong way. It’s normal for a twenty-year-old to go to Europe in the summer and take drugs, but you’re supposed to be doing cocaine on a Greek island, not prescription speed in a country that doesn’t exist, with a T-34 on a plinth outside its parliament. I didn’t know who I was. I didn’t even know who I was trying to be. I kept having daydreams in which I’d abandon my entire life, move to somewhere like Transnistria and simply start again, do it right this time. Maybe the drugs were part of the same impulse. I wanted to edit myself; I thought that with the combination of modern pharmacology and sheer force of will, I could actively reshape the raw material of my personality. But every time, it just kept yielding the same basic guy, just as misshapen as ever, but sweatier.

My friend, meanwhile, was also not depressed in the clinical sense: he’d been prescribed the S.S.R.I.s as part of his recovery from heroin. Quite a few people at our school—a nice, fee-paying school for smarmy intellectuals—had been dabbling in heroin. At house parties, there would usually be one or two people sprawled out insensate in the corners. I’d tried it once or twice and wasn’t massively impressed. It just felt like nothing. Not even a cosmic void: on heroin, all your ordinary thoughts and sensations are replaced with a very mild lightheadedness. It’s not really all that fun. I had no real urge to do it again. But I hadn’t considered what it would mean for someone to be addicted to the absence of all ordinary sensations. I didn’t really understand that there were ways of being unhappy that were much more serious than mine. And now I was enjoying our boozy, druggy adventure in eastern Europe, without thinking too much about whether any of this was a particularly good idea for someone who was trying to stay off the stuff. We were having fun. It didn’t occur to me that with my constant hunger for more and different pills to fill up the gap in me I didn’t know how to name, I was also quite badly failing in my duties as a friend.

He’d given me something like four times his already hefty daily dose. These antidepressants were, like M.D.M.A., serotonin re-uptake inhibitors. What I was experiencing were the effects of swamping my brain in serotonin, a neurotransmitter whose precise function is still mostly unknown. Most brain chemicals have a single, obvious function: dopamine activates the reward system; adrenaline charges your body in a crisis. Serotonin was originally thought to be connected to happiness, but in fact it seems to be connected to everything the brain does: it’s necessary for memory formation and retrieval, for regulating blood pressure, for moving food through the intestinal tract, and possibly for consciousness itself. But it does seem to be the case that increasing serotonin levels in the brain makes it harder to be utterly miserable, so this is how most modern antidepressants work. Serotonin is, of course, a very blunt instrument for something as subtle as unhappiness, especially since there’s no real evidence to suggest depression has anything to do with a deficit of the stuff. Treating depression with S.S.R.I.s is only slightly less haphazard than trying to dislodge the sad parts of the brain with bullets. The ordinary side effects of antidepressants—weight gain, dizziness, fatigue, impotence, apathy, loss of libido—are well known. There are others, though: it’s also possible to end up with too much serotonin sloshing around in your brain. This is very rare, because what kind of idiot overdoses on antidepressants?

Should you happen to be one such idiot, you risk something called serotonin syndrome, which is exactly what I was experiencing. Shivering, spasms, fever, seizures. And without the proper medical treatment—usually, an antiserotonergic drug like cyproheptadine—serotonin syndrome can very easily be fatal.

I did not seek the proper medical treatment. But as you may have surmised, I did not die. Instead, I sat utterly numb on a bus back to Chișinău. At the border crossing between Transnistria and the rest of Moldova, a man with deep dirty yellow nicotine stains in his beard glimpsed my British passport and spent much of the rest of the trip yelling that I was a Western spy. I didn’t have any thoughts on the matter. But the next day I felt a little more like I existed, and the day after that I was almost entirely human again, and the day after that I was looking forward to taking some hallucinogenic anti-epileptic pills.

That brush with death didn’t do much to quell my interest in drugs. Death is built in; death is always part of the deal. Philip K. Dick dedicated his novel A Scanner Darkly to his friends who had died, or who were left brain-damaged or permanently psychotic, after their adventures with drugs. “This is a novel about some people who were punished entirely too much for what they did. They wanted to have a good time, but they were like children playing in the street; they could see one after another of them being killed—run over, maimed, destroyed—but they continued to play anyhow. We really were all very happy for a while, sitting around not toiling but just bullshitting and playing, but it was for such a terribly brief time, and then the punishment was beyond belief.” But in Philip K. Dick’s world, drugs keep opening doorways into shared psychic universes of collective hallucination, and in our world, where every psychonaut goes out alone, I think the line from drugs to death is much clearer than he thought.

There’s a kind of heroic myth of drug-taking: you can find it in Dick, in Aldous Huxley’s Doors of Perception, in the whole long tradition of psychedelic counterculture. It says that when you play around with drugs, it’s because you’re looking for some transformative private experience; you’re prodding and poking at the raw stuff of your own subjectivity just to see what it can do. So your self is the thing you’re putting at stake, and there’s always a chance your adventures will bring you to the threshold of the most transformative and the most private experience there is, which is dying. There might be fentanyl in your coke. You might speedball into eternity. Your heart might simply stop. This is what anti-drug advocates constantly shriek about, but there’s almost nobody on the other side who even disagrees. Yes, death is joining you on your trip. No epic without catabasis. This is the pact you made.

But it wasn’t just death that I’d glimpsed in Transnistria. My S.S.R.I. overdose was an encounter with something much grimmer and much less glamorous. For weeks, I’d been trying to have some kind of meaningful encounter with myself through medicines to treat other people’s insomnia and other people’s narcolepsy. Yes, these substances came with the wonderful promise of customizing your own consciousness, but at root they were fairly blunt chemical instruments for sending people who can’t sleep to sleep and keeping people who can’t stay awake awake. This worked for a while, but eventually it got to the point that I was trying to act out the heroic, self-exploratory mode of drug-taking with antidepressants. What would it be like? What strange new vistas of experience would open themselves before me if I swallowed an entire blister pack of S.S.R.I.s? The answer, of course, was nothing. I had reached the limit. This drug did not exist to open my mind or introduce me to the mystic core of my being. It was not here to mess up my mind in new and excitingly nihilistic ways. It was not about me. It was something very functional. It had been developed by a large company to enable people with crippling depression to lead a more or less ordinary life. There was no way of taking this drug that would make me interesting or unique. Its only function was to make me either normal, or dead.

I think most drugs are more like those S.S.R.I.s than we want to admit. The effects of nearly dying from serotonin syndrome were, after all, eerily similar to the effects of having a fantastic weekend on M.D.M.A. Pharmacologically, there’s not that much difference between them. There’s no drug so enjoyable that it can’t be appropriated for utility. Around the time of my visit to Transnistria, we were all doing a lot of ketamine, which was supremely scaggy, manky stuff. It was, after all, a horse tranquilizer. A low dose of ketamine loosens your limbs and your inhibitions; it’s a bit like alcohol without the hangover. On a large dose of the stuff you may lose all sense of space, time, and self. From the outside, a person on ketamine looks like a zombie: silent, shuffling, eyes unfocused, sometimes drooling. It’s hard to imagine that this person will be an ordinary speaking human being the next day. We used to take ketamine to smooth over our comedowns: the clubs would close around six in the morning, at which point we’d all stumble into someone’s filthy student house to snort ketamine for another five hours, and then I’d walk into campus to sit in a seminar room and talk about poetry. Once, during one of those sessions, someone racked up twenty or so small lines of ketamine on the back of a book; the first person she passed it to then proceeded to methodically snort up every single one. He spent the rest of the afterparty standing in one corner, not moving, not speaking, as white gunk slowly collected around the corners of his lips. Like I said: manky stuff.

In the last few years, you might have noticed that ketamine is suddenly everywhere. It’s good for depression, it’s good for anxiety, it can even treat alcoholism and other substance abuse issues; it’s the wonder drug we’ve all been waiting for. A few years ago, a friend was asked to try out a “psychedelic therapy” treatment for a glossy fashion magazine; the psychedelic in question was ketamine. The ketamine tablet was supplied by a licensed pharmacy, and came with a branded eyemask, a blood-pressure monitor, and a one-hour pre-trip Zoom session with a dedicated psychedelic integration coach. The point of this therapy is to help you attain your goals. The wellness industry, with its tasteful colorways and its sans serif fonts, had taken the chemical sludge in which I spent some of the most fetid years of my life and made it something useful and wholesome and clean. I’m not sure why, but that made me strangely upset.

I read a story about someone who paid to go on an ayahuasca retreat deep in the Peruvian Amazon. Cabins in the jungle, shamans performing ancient rites, communion with the spirit world, union with the mystical forces of the universe itself: the whole package. So he drank down the sacred brew and waited for the visions to come, and they came. He saw the figure, wreathed in mystic light, of his own car. And from the depths of the spirit world, his car spoke to him. It told him he ought to take better care of it, to go easier on the suspension and stop stuffing empty crisp packets down the side of the seat.

Benjamin Yen-Yi Fong’s Quick Fixes is less a book about drugs and more of a book about the car. Which is to say, this is a book that refuses to pretend that drugs aren’t ultimately very ordinary. They do not exist outside the ordinary operations of society. They do not belong to the private realm of the isolated self. They are not some alien menace that’s come to disturb our world from the outside: “Though we often think psychoactive drug use is about sociability or mind expansion or simple fun, much of the time we are taking drugs for more boring reasons: either to be better at (or, at least, tolerate) work, or to quickly and temporarily unwind after work to prepare for the next day of work.” If drugs are at all special, it’s because the regimen of drugs—both legal and illegal—that structure the working week mark the point where economic abstractions come closest to actual bodily human life: increasing or decreasing our heart rate, making us wake up or fall asleep, reaching into our brains and changing the way we think. Which means that to understand how things worked in any given era, it helps to understand its drugs. Fong points out that in post-war America, helpful substances—chiefly, the amphetamines and benzodiazepines I had so much fun with in eastern Europe—fueled the slightly manic, rictus-grinned optimism of the age. In the twenty-first century, we’re popping more pills than ever before, but the pills in question are increasingly some form of painkiller. We just want to suffer as little as possible: “Postwar polydrug use reflected a fundamental belief, however coerced and driven by an underlying anxiety, that America was worth it. Today it paints a portrait of the country as a giant palliative care unit.”

The book is structured as a series of short essays, each using one particular drug to peer into some of the pathologies of the present. We spend quite a lot of time with the boring drugs, the ones I’d jabber out quickly when I was reeling off my list, because these are not nearly as boring as they seem. So, coffee. This was the first new drug the Western world had encountered for a very long time: centuries in which all we had to molest our psyches with was alcohol, and some of the weirder mushrooms growing in cowpats in the fields. (Before coffee, an ordinary breakfast mostly consisted of beer soup, “a mixture of beer, eggs and butter responsible for the portly figures of Jordaens and Rubens.”) But unlike alcohol, caffeine makes you sober, alert, and industrious: when it arrived in Europe in the late sixteenth century—around the same time as tobacco—it was as if the values of the rising bourgeois class had been distilled into chemical form. In that era, coffee was a revolution. In England, coffee houses were where strange, radical new ideas were thought. In America, they were where the Boston Tea Party was planned; in France, the mob that stormed the Bastille began in a coffee house. But of course, the bourgeois revolution had a dirty secret. Its heroic project—the liberation of man from all the arbitrary social ties of the past—could also mean exploitation on a scale never imagined before: masses of people torn out of their irrational, bucolic, ordinary lives and transformed into expendable units, to be worked until all their value had been sucked dry. By the eighteenth century, most of the world’s coffee was being produced in the French colony of Saint-Domingue, which is now Haiti. Even in the context of transatlantic slavery, Saint-Domingue was Hell. A young, fit, enslaved African who survived the passage to the colony could expect to be worked to death within three years.

But coffee didn’t stay revolutionary for long. Today, it’s the second-most-traded commodity on the international markets, right after crude oil. Which makes sense; the two are basically the same stuff. One dark liquid to power the machines and engines that keep the global economy running, another to power the human workers. And just like oil, coffee became a central feature of American imperial policy. At the height of the Cold War, the U.S. set up a coffee cartel in South America that aimed to prevent a communist revolution by setting a minimum price per bag of beans. (One Colombian senator had warned: “Pay us good prices for our coffee or—God help us all—the masses will become one great Marxist revolutionary army that will sweep us all into the sea.”) At one point, those bags of coffee accounted for nearly a tenth of all American imports: ground up, freeze-dried, sold in unimaginable bulk by huge faceless firms, often to keep their own workers going through long, grueling shifts. Coffee powered the entire finely tuned Fordist machine, but that system only worked as long as there was still the very real fear that the masses would become one great Marxist revolutionary army and sweep their exploiters into the sea. U.S. coffee consumption peaked in 1946: that year, the average American drank more than forty-five gallons of the stuff. It declined slowly at first and then, from the 1970s, very rapidly, as the factories closed, as the unions withered, as the solid ground started to dissolve and a few cups of brown liquid every day were no longer enough to hold everything together. No point in being industrious when there’s no work to be industrious at. The new workplace stimulant was cocaine: to make you maniacally personable, to clear a path for you in the people-powered, network-oriented economy of the unreal.

In 1989, the coffee cartel collapsed, and the price of coffee plummeted by seventy-five percent—“the functional equivalent of the United States halving its world aid budget.” In Latin America, immiserated coffee farmers turned to paramilitary violence, or started growing coca and opium poppies instead. In Rwanda, where coffee accounted for eighty percent of all exports, the collapse in prices set off a series of shocks that ended with ordinary people hacking eight hundred thousand of their neighbors to death with knives and machetes. But the breakup of Big Standardized Coffee had stranger, subtler effects at home. Consumers started caring about their coffee. They started talking in autistic detail about particular soils, varieties of beans, types of roast. They wanted to buy from small, cool, specialty providers. Coffee fetishism seeped into the pop culture of the End of History era: David Lynch, Quentin Tarantino. Obviously, most of this was a posture and a fraud. As Fong relates, “In 1996, it was discovered that Central American beans were being routed through Hawaii so their producers could brand them as Hawaiian Kona coffee, even though professional cuppers recognized the imitation coffee as better than Kona itself.” But something had changed: people were trying to turn an indifferently efficacious drug into some kind of statement about themselves and their identity. I prefer the Sumatran highlands. I take mine black. I’m not sure they actually did manage to wrest themselves out of the mass production of human subjectivity, though. Consider that one of the success stories from the big boom in specialty roasters was a little chain of coffee shops called Starbucks.

If I’m spending so much time with coffee, it’s because a lot of the discourse around this book has focused on the sexier, more thrilling, and more illegal drugs; the ones we talk about when drug war becomes culture war. The line goes like this: while millions of people are suffering from the truly debilitating effects of drug addiction, there’s a strange dogma that’s sprung up in some left-wing circles, in which taking drugs is simply a question of personal preference. It’s not for us to tell the hollow-eyed and shuffling how they should or shouldn’t enjoy their free time. After all, drugs are fun. It certainly shouldn’t be a matter for the police. All we should do is destigmatize drug use: lean in close to the people shivering on street corners, and say, you are valid; I affirm your choices. According to a critical review in Compact, Fong is part of this tendency: he “clearly favors libertarian policies over the prohibitionist ones,” and it’s thanks to people like him that “we are currently engaged in a massive social experiment of expanding access to cannabis and other substances, while treating widespread addiction to deadly substances like fentanyl as the inevitable cost of individual freedom.” In other words: people who choose to take drugs are choosing wrong, and society at large should compel them to choose otherwise. Fong responded that the reviewer had massively misinterpreted his point, which was that the choice between prohibiting and decriminalizing these drugs is a false choice. People take drugs because they are unhappy, stressed, or suffering, and much of that suffering has a social cause. If you don’t address the suffering with something more effective than drugs, then prohibition will simply not work—but legalization will also not work; if anything, it’ll make things worse.

To be honest, the culture war over drugs strikes me as fairly pointless. Even if state policy could resolve the ancient problems of human suffering, and the monsters that are born whenever we try to escape it, this is not where policy is made. The real question this book poses isn’t whether drug-taking is a legitimate personal choice, but how we ended up using that kind of category at all.

After all, if drugs modify the way we think, then who, exactly, is the person making the choice? Habitual drug users aren’t choosing whether to have a cup of coffee or a bowl of crystal meth every morning. They don’t have that freedom; they’ve signed it over to a power beyond ordinary human will, and now the substance will do the choosing for them. But for some reason, we keep on identifying this process with some kind of freedom. Maybe it’s notable that the idea of drug use as a personal choice was first advanced by the legal team representing three tobacco companies who had been sued by one of their dying customers.

A lot of Fong’s chapters have a similar shape. Amphetamines, for instance, were first manufactured in industrial quantities by the competing powers of World War II. The Nazis produced prodigious amounts of speed, and stuffed their soldiers with as much of it as they could take. “During the siege of Leningrad,” Fong writes, “an entire S.S. infantry company surrendered to the Soviets without a fight, having fired all their ammunition the night before in a collective amphetamine psychosis.” The Allies, meanwhile, produced some two hundred fifty million speed pills in the last three years of the war. But after the war, the amphetamine boom continued. People took speed to stay slim and active and peppy, to do their jobs, to fit in. This new postw-ar world, sunny and regimented, was still in some deep chemical sense the same as the years of total, global, frenzied bloodshed. Pharmacologically, the war never ended. But while we’re still popping a lot of speed today, its present-day guise is Ritalin or Adderall, the accouterments to a host of boutique and increasingly fuzzy diagnoses. Autism, A.D.H.D., undifferentiated neurodivergence. Sometimes these names describe actually existing disabilities, but often a diagnosis is just a name for the universal idea that everyone secretly holds: that you are different, that your mind works in strange and interesting ways, and that other people should make special concessions because you have the freak experience of being yourself.

The most glaring instance of this process, though, is in hallucinogens. During the 1950s, the U.S. government ran notorious, horrific experiments to assess L.S.D. as a possible mind-control drug. The C.I.A. took psychiatric patients, many of whom had been seeking treatment for minor issues like anxiety or postpartum depression, and subjected them to months of psychological torture. People were locked in cells, dosed with L.S.D., and fed repeating phrases like “my mother hates me” through earphones. There were deaths; we might never know how many. But the C.I.A. did not manage to develop a working mind-control pill. Except—not long afterwards, the exact same drug was at the center of a new countercultural movement that promised to unshackle the mind from all forms of social control. Suddenly, L.S.D. was the gateway into a world of pure freedom, pure play, total innocence, a psychedelic revolution that would replace the cruelties of every existing society with pure and universal love. Fong tells a story about how that ended up working out. During a group L.S.D. trip among a Weatherman cell in Cincinnati, a police informant in the group tearfully admitted that he was a pig. The rest of the group assumed that he was talking about the policeman inside his head, his unconscious complicity with power. They accepted him as part of the group. It was a very crude kind of social control that tried to organize people’s behavior by locking them in a room and blaring slogans at them. The smart kind of control is the one that happens all by itself. People will surrender a portion of their minds to synthetic, inhuman agencies, and they’ll do it all in the name of liberation.

I don’t take many drugs these days. I stopped smoking weed not long after my trip to Transnistria. It was simply not good for me: every time I smoked, I’d have just a few minutes to wonder what I’d have a minor panic attack about this time, and then I’d find out. (Once, I spent an entire evening silently fretting that other people secretly hated me for only wearing black or gray shoes.) A few years later, I stopped drinking coffee. I’d noticed that my mornings all followed the same routine: I’d make a nice strong black Americano so I’d be able to focus on my work, and then I’d spend the next few hours too wired to do anything at all. Then eventually the coffee would wear off and I could write. It occurred to me that I might actually be better off skipping the first step.

My own brush with death from serotonin syndrome didn’t convince me to stop snorting or swallowing whatever I could get my hands on, but the death of a friend in 2018 did. I don’t regret my years of frequent social drug abuse, but I don’t miss them either. I still drink, sometimes, but it’s very rare that I’ll allow myself to come close to getting drunk. I gave up smoking one day before my last birthday. I expected it to be agony—for nearly two decades, I’d been dosing myself with nicotine, which is by all accounts about as addictive as heroin, every few minutes, every waking hour of the day. I warned friends that I might be unbearable, grouchy, miserable, that I might be retching, that I might convulse on the floor. But in fact it was completely fine. I didn’t want to smoke any more, so I stopped. Which means that I could have stopped at any point before, if I’d wanted to, but I hadn’t. I’d wanted to keep smoking. Maybe beneath the long histories of intoxication, the cigarette advertisers, the pharma firms, the cocaine cartels, the C.I.A. moving heroin in secret networks around the world, the socially imposed indignities that send us reaching for some kind of temporary relief—maybe beneath it all, there’s some small rebellious part of our psyche that does not want to be free.

A few months ago, I broke my streak: my girlfriend and I took some psilocybin mushrooms. Hallucinogens, we decided, were fine; they don’t count as real drugs. We went to a park in south London, where I started noticing all the tiny scraps of litter on the ground. Dozens of them, dotting every square foot of grass. What on earth was this stuff? Receipts? Labels? Cigarette papers? Who had left it all there? Why? Later, we looked at a tree, which was nice. We talked about God. My girlfriend believes in the Christian God and I’m agnostic about the Jewish one, but it turned out we were both using different terms for fundamentally the same thing. We watched dogs trotting on the path. Then, when the effects finally started wearing off, I felt a sudden and almost cosmic sense of relief. It felt wonderful to be sober. Once, I didn’t know who I was or who I wanted to be, and I was desperate to let something else do the work of being me. But I know who I am a little bit better now, and I’m not so upset with the result. Despite everything, I still don’t believe that drugs are inherently bad: maybe there really are ways of enjoying them that aren’t ultimately rooted in unhappiness; maybe there’s a lot I’m missing out on. But it felt incredibly good to be thinking in my own ordinary mind again. Not to be so concerned with small bits of paper in the grass. It felt like coming home.