Rationing America's Medical Care: The Oregon Plan and Beyond Book

According to Szasz, health is the dominant good in our society. So, for example, medicating someone against their will is justified, because health trumps freedom from assault. This is part of what he calls the Therapeutic State. By contrast, in medieval society, religion was the dominant good. Szasz makes an analogy between those who misused religion then - witches - with those who misuse therapies now - drug dealers and users.

How is drug misuse officially defined? According to Szasz, the answer lies not in the drug, but the user. At the start of the 20th century opium was considered indispensable in medicine, and only became 'dangerous' when there were too many users of the wrong kind - notably, Chinese. In the same way, he says, that it's absurd to use lab analysis to detect kosherness in wine, a drug is labelled 'dangerous' not according to its pharmacology but rather its users.

He argues that addiction has only been defined as a disease since the early 20th century, and wrongly. Drugs are used by individuals for their own various reasons and, he says, this is no business of the medical establishment or the state. On opiates again, although Szasz doesn't mention it, the US expected a huge number of returning Vietnam veterans to be persistent users, but it didn't happen, because their main reason for opiate use ended with their participation in the war. Addictiveness is something ascribed to drugs used by the wrong kind of people. Hence, for example, until the 1980s cocaine was not considered addictive. In another of Szasz' pithy phrases, it is 'just as absurd to search for non-addictive drugs that produce euphoria as it would be to search for non-flammable liquids that are easy to ignite.'