HJAR Mar/Apr 2022

26 MAR / APR 2022 I  HEALTHCARE JOURNAL OF ARKANSAS   ABSTRACT Our taste for addictive psychoactive substances is attested to in the earliest human records. Historically, psychoactive substances have been used by (i) priests in religious ceremonies (eg, amanitamuscaria); (ii) healers for medicinal purposes (eg, opium); or (iii) the general population in a socially approved way (eg, alcohol, nicotine, and caffeine). Our forebears refined more potent compounds and devised faster routes of administration, which contributed to abuse. Pathological use was described as early as classical Antiquity. The issue of loss of control of the substance, heralding today’s concept of addiction, was already being discussed in the 17th century. The complex etiology of addiction is reflected in the frequent pendulum swings between opposing attitudes on issues that are still currently being debated, such as: is addiction a sin or a disease; should treatment be moral or medical; is addiction caused by the substance; the individual’s vulnerability and psychology, or social factors; should substances be regulated or freely available. on their flocks. Tradition has it that Ethio- pian priests started roasting and boiling coffee beans to stay awake through nights of prayer after a shepherd noticed how his goats were frolicking after feeding on cof- fee shrubs. ADDICTIVE SUBSTANCES AND CULTURAL PATTERNS OF USE Schematically, psychoactive substances have been used (i) in religious ceremonies by priests; (ii) for medicinal purposes; or (iii) massively, as staple commodities, by large segments of the population in a socially approved way. Dominant patterns of use varied according to epochs and places. An important parameter was the degree of a drug’s acculturation. For instance, New World plants such as tobacco (nicotine) and coca (cocaine) are relative newcom- ers to the Old World. Conversely, poppy (opium) and hemp (cannabis) originated in Eurasia. 1 In contrast, alcohol can eas- ily be produced by the action of yeast on a variety of plants containing starch or sugar, and has been used by virtually all cultures. 2 Surprisingly, however, alcohol was largely unknown throughout much of North America before the arrival of Euro- peans. The sudden destructive impact of alcohol on North American native cultures might be explained by the fact that tradi- tional patterns of use had not been estab- lished; another possible factor may be the lack of previous genetic selection operat- ing on vulnerable subjects over millennia. Religious use Priests or shamans have ingested plants for millennia to induce states of dissocia- tive trance. Such substances are sometimes termed “entheogenic”(from the Greek roots “en” [inside], “theo” [god], and “gen” [cre- ate]). The mushroom Amanita muscaria, commonly known as fly agaric, has been at the center of religious rituals in Central Asia for at least 4000 years. Children know this beautiful white-spotted redmushroom from the illustrations of fairy tales and Christmas cards. Amanita muscaria had a religious significance in ancient India, and travelers recorded its use as late as the 18th century in Northeastern Siberia. It was an ingredient of Soma, a sacred beverage in the Rigveda in Part I: Historical and Cultural Aspects of Man’s Relationship with Addictive Drugs © 2007 LLS. Printed with permssion. Crocq, Marc-Antoine. “Historical and cultural aspects of man's relationship with addictive drugs.” Dialogues in Clinical Neuroscience vol. 9, no. 4 (2007): 355-61. doi:10.31887/DCNS.2007.9.4/macrocq This paper endeavors to discuss (i) the cultural history of man’s relationship with addictive drugs; and (ii) the historical roots of the science of addiction. The first part deals with addictive substances and their “normal” patterns of use across differ- ent epochs. The second part is about the recognition of pathological use and the appearance of the science of addiction, the definition of drug use as a disease and its inclusion in the medical constituency, and the evolution of views on etiology and intervention. Our early ancestors lived as hunter- gatherers and—as shown by the culture of human groups who retained this lifestyle (eg, Australian aborigines, Amazon Indi- ans, or Kalahari desert Bushmen)—they undoubtedly collected considerable infor- mation on pharmacological plants. Ötzi, the man whose frozen body was recovered in theAlps in 1991, lived about 3300 years BC, and carried in his pouch a travel pharmacy including a polypore fungus with antibacte- rial and hemostatic properties. After adopt- ing a pastoral lifestyle, humans may have observed the effects of psychoactive plants