Pharmaceuticals and performance self-management
from Part 2 - Drugs, health and the medicalisation of addiction
Psychoactive drugs have a complex and unstable status in contemporary culture. On one hand illicit drugs are believed to possess a unique ability to disable the user's self-control and thereby destroy physical, psychological and social well-being. On the other hand, the development, marketing and supply of a growing array of commodified psychoactive pharmaceuticals is a central activity of biomedicine and one of the most profitable sectors of global capitalism. As pharmaceutical consumers we rely on chemical effects to maintain our functioning as productive and healthy citizens, usually without being stigmatised as dependent drug users. This is despite the fact that substances on opposite sides of the dangerous drugs/beneficial medication divide frequently share common chemical structures, modes of action and psychoactive effects.
At the same time as the use of a wide range of pharmaceuticals has become normalised and domesticated, anxiety about the reliance of modern societies on chemical solutions has grown. Within the general unease about the over-medication of society, psychoactive pharmaceutical drugs are the focus of particular anxiety. Publicity about problems of abuse and addiction seem almost inevitably to follow the adoption of a new medication. In addition, the mood-altering, cognitive and behavioural effects of psycho-pharmaceuticals are seen as potentially altering the self, raising ethical and personal questions about enhancement and identity. As Emily Martin has observed, psychotropic pills are a pharmakon, a Greek term that means both ‘remedy’ and ‘poison’. The meanings attached to their effects are both positive and negative, but this ambivalence does not prevent their consumption on a massive scale.
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