‘Angels and demons’: the politics of psychoactive drugs

Joanna Moncrieff

The FIAT (Financial Incentives for Adherence Trial) study, published last year, highlights the paradoxical nature of our current attitude to the use mind-altering drugs. In this randomised controlled trial people with ‘psychotic disorders’ were paid £15 a time to take an injection of an ‘antipsychotic’ drug (1). The payment increased rates of compliance only marginally, and had no effect on clinical outcomes, so the accompanying editorial suggested we need to pay people more (2).

We are now paying people to take drugs they don’t like and don’t want, while we continue to invest vast sums of public money in efforts to curb the use of drugs that people do like and do want. Prescription drugs like antidepressants, antipsychotics and so-called ‘mood stabilisers’ are widely promoted as good for your health. But the history of prescription and recreational drug use is more intimately intertwined than most people recognise. Attempts to disentangle…

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