Vol 9, No 4 - Addictive Substances
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his 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 different 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 con- stituency, 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 Indians, or Kalahari desert Bushmen)—they undoubtedly collected considerable  information  on  pharmacological  plants. Ötzi, the man whose frozen body was recovered in the Alps in 1991, lived about 3300 years BC, and carried in his pouch a travel pharmacy including a polypore fungus with antibacterial and hemostatic properties.After adopt- ing a pastoral lifestyle, humans may have observed the effects of psychoactive plants on their flocks. Tradition has it that Ethiopian 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 coffee 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 approvedS t a t e  o f  t h e  a r t T Copyright © 2007 LLS SAS.  All rights reserved www.dialogues-cns.org Historical and cultural aspects of man’s relationship with addictive drugs Marc-Antoine Crocq, MD 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, amanita muscaria); (ii) healers for medicinal purposes (eg, opium); or (iii) the general population in a socially approved way (eg, alcohol, nico- tine, 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 cen- tury. 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 fac- tors; should substances be regulated or freely available.   © 2007, LLS SAS Dialogues Clin Neurosci. 2007;9:355-361. Keywords: addiction; dependence; drug; history; culture Author affiliations: Centre Hospitalier, Rouffach, France Address for correspondence: Centre Hospitalier, BP29, 68250 Rouffach, France (e-mail: ma.crocq@ch-rouffach.fr)