Why does American law allow the recreational use of some drugs, such as alcohol, tobacco, and caffeine, but not others, such as marijuana, cocaine, and heroin? The answer lies not simply in the harm the use of these drugs might cause, but in the perceived morality—or lack thereof—of their recreational use. Despite strong rhetoric from moral critics of recreational drug use, however, it is surprisingly difficult to discern the reasons they have for deeming the (...) class='Hi'>recreational use of (some) drugs morally wrong. In this book, Rob Lovering lays out and dissects various arguments for the immorality of using marijuana, cocaine, heroin, and other drugs recreationally. He contends that, by and large, these arguments do not succeed. Lovering's book represents one of the first works to systematically present, analyze, and critique arguments for the moral wrongness of recreational drug use. Given this, as well as the popularity of the morality-based defense of the United States' drug laws, this book is an important and timely contribution to the debate on the recreational use of drugs. (shrink)

There is a wide array of arguments for the immorality of recreational drug use, ranging from the philosophically rudimentary to the philosophically sophisticated. But the vast majority of these arguments are unsuccessful, and those that succeed are quite limited in scope. In this article, I present and evaluate a few examples of such arguments.

Recreational Drugs European Network (ReDNet) project aims to use the Psychonaut Web Mapping Project database (Psychonaut Web Mapping Group, 2009) containing novel psychoactive compounds usually not mentioned in the scientific literature and thus unknown to clinicians as a unique source of information. The database will be used to develop an integrated ICT prevention approach targeted at vulnerable individuals and focused on novel synthetic and herbal compounds and combinations. Particular care will be taken in keeping the health professionals working (...) directly with young people showing problematic behaviors regularly updated in terms of novel compounds and combinations as well. A user-friendly project website will be developed aimed primarily at delivering the information/prevention approaches, but will also be a way of communicating with project partners and relevant stakeholders (e.g. thematic forum facilities, instant messages, blogs, video chat, wikiblog, newsletters distributed via mailing list). The website will support various ICT prevention tools, including an SMS alert service. Different areas and sections will be aimed specifically at the different target groups. -/- . (shrink)

In this paper, I identify an argument derived from the commitments of John Rawls’s liberalism for restricting the consumption of recreational drugs in a liberal society, but not because of a great passion for restriction at present. The argument can also be used to respond to Jonathan Quong’s example of an unresolvable disagreement between liberal citizens.

Historically, laws and policies to criminalize drug use or possession were rooted in explicit racism, and they continue to wreak havoc on certain racialized communities. We are a group of bioethicists, drug experts, legal scholars, criminal justice researchers, sociologists, psychologists, and other allied professionals who have come together in support of a policy proposal that is evidence-based and ethically recommended. We call for the immediate decriminalization of all so-called recreational drugs and, ultimately, for their timely and appropriate legal (...) regulation. We also call for criminal convictions for nonviolent offenses pertaining to the use or possession of small quantities of such drugs to be expunged, and for those currently serving time for these offenses to be released. In effect, we call for an end to the “war on drugs.”. (shrink)

In our recent article, together with more than 60 of our colleagues, we outlined a proposal for drug policy reform consisting of four specific yet interrelated strategies: (1) de jure decriminalization of all psychoactive substances currently deemed illicit for personal use or possession (so-called “recreational” drugs), accompanied by harm reduction policies and initiatives akin to the Portugal model; (2) expunging criminal convictions for nonviolent offenses pertaining to the use or possession of small quantities of such drugs (and (...) releasing those serving time for these offenses), while delivering retroactive ameliorative relief; (3) the ultimate legalization and careful regulation of currently illicit drugs; and (4) the delivery of a new “Marshall Plan” focused on community-building initiatives, expanded harm reduction programs, and social and health care support efforts (Earp et al. 2021). We were gratified to see so many thoughtful commentaries on our proposal, and we respond to them in part in this reply. (shrink)

Programs of drug testing welfare recipients are increasingly common in US states and have been considered elsewhere. Though often intensely debated, such programs are complicated to evaluate because their aims are ambiguous – aims like saving money may be in tension with aims like referring people to treatment. We assess such programs using a proportionality approach, which requires that for ethical acceptability a practice must be: reasonably likely to meet its aims, sufficiently important in purpose as to outweigh harms incurred, (...) and lower in costs than feasible alternatives. In the light of empirical findings, we argue that the programs fail the three requirements. Pursuing recreational drug users is not important in the light of costs incurred, while dependent users who may require referral are usually identifiable without testing and typically need a broader approach than one focussing on drugs. Drug testing of welfare recipients is therefore not ethically acceptable policy. (shrink)

Governments across the globe have squandered treasure and imprisoned millions of their own citizens by criminalising the use and sale of recreational drugs. But use of these drugs has remained relatively constant, and the primary victims are the users themselves. Meanwhile, antimicrobial drugs that once had the power to cure infections are losing their ability to do so, compromising the health of people around the world. The thesis of this essay is that policymakers should stop wasting (...) resources trying to fight an unwinnable and morally dubious war against recreational drug users, and start shifting their attention to the serious threat posed by our collective misuse of antibiotics. (shrink)

Public health policy often limits people’s liberty for their own good. The very point of many types of public health measures is to restrict people’s options in order to stop them from doing unhealthy things, for example use harmful recreational drugs or drive without a seatbelt. While such restrictive public health policies enjoy widespread support, so does the traditional liberal idea that liberty (or autonomy) is a higher value, to be given priority in most, if not all, circumstances. (...) In this text, I will defend the thesis that liberty is an important value, but with no claim to priority. (shrink)

Despite analgesic and emetogenic benefits, cannabis has been banned from prescription in a number of western countries. Although some benefits are shared by drugs already available, the options of prescription are limited to the physician. The negative side-effects of cannabis do not justify this limitation on freedom and autonomy. Recreational use warrants limitations, as the search for euphoria is regularly believed to be a non-autonomous behavior. Medical prescriptions serve an analgesic and emetogenic purpose comparable to other prescribed (...) class='Hi'>drugs. This vindicates the right for a physician to prescribe cannabis to qualified patients. For a patient to be considered qualified, they must be an adult that does not drive often, is not pregnant, and not at risk of schizophrenia or cardiovascular disease. If possible, cannabis should be eaten in an effort to avoid smoke irritation in the lungs and aerodigestive tract. In the end, the question is not whether cannabis use is efficable, but rather is the limitation of medical treatments to patients in need ethical? In light of the medical benefits, the banning of cannabis is simply immoral. Keywords: cannabis, banned substance, prescription, analgesic, emetogenic Note. Authors did not receive any external funding, nor display conflict of interest. (shrink)

Despite their centrality to medicine, drugs are not easily defined. We introduce two desiderata for a basic definition of medical drugs. It should: (a) capture everything considered to be a drug in medical contexts and (b) rule out anything that is not considered to be a drug. After canvassing a range of options, we find that no single definition of drugs can satisfy both desiderata. We conclude with three responses to our exploration of the drug concept: maintain (...) a monistic concept, or choose one of two pluralistic outcomes. Notably, the distinction between drugs and other substances is placed under pressure by the most plausible of the options available. (shrink)

Does intersectionality divide marginalized groups (e.g., women) along identity lines (e.g., race, class, and sexuality)? In response to the criticism that intersectional approaches to feminist and critical race theories lead to fragmentation and division, this paper notes that it relies on an ontological (mis)understanding of identity as a fixed entity. I argue against this notion of identity by engaging in a detailed case study of how Asian American women experience their Asian identity. The case study demonstrates that identity is lived (...) not as a pre-given static object but rather as a fluid and flexible process: what Asian identity means varies according to how this identity is related to the dynamics of power. I propose a tripartite taxonomy of identity-power relationships exhibited in Asian American women’s lives, in which identities are 1) constructed by and 2) used to reproduce power as oppression, as well as 3) used to build power as resistance. In particular, I explore Black and Asian feminist solidarities to show that those at the margins recreate their identities and, in doing so, build positive forms of power such as resistance and solidarity. The criticism that intersectionality leads to fragmentation does not hold, as it is grounded in a flawed notion of identity that fails to consider how identities are actually lived in their changing relationships to power—especially how marginalized groups, such as women of color, build solidarity to resist oppression by recreating their identities, rather than being fragmented into smaller and mutually exclusive subgroups. (shrink)

We often get evidence concerning the reliability of our own thinking about some particular matter. This “higher-order evidence” can come from the disagreement of others, or from information about our being subject to the effects of drugs, fatigue, emotional ties, implicit biases, etc. This paper examines some pros and cons of two fairly general models for accommodating higher-order evidence. The one that currently seems most promising also turns out to have the consequence that epistemic akrasia should occur more frequently (...) than is sometimes supposed. But it also helps us see why this might not be a bad thing. (shrink)

Promotion of prescription drugs may appear to be severely limited in some jurisdictions due to restrictions on direct-to-consumer advertising. However, in most jurisdictions, strategies exist to raise consumer awareness about prescription drugs, notably through the deployment of direct-to-consumer information campaigns that encourage patients to seek help for particular medical conditions. In Canada, DTCI is presented by industry and regulated by Health Canada as being purely informational activities, but their design and integration in broader promotional campaigns raise very similar (...) ethical concerns as those associated with DTCA. Specifically, DTCI can be an effective means of familiarizing the public with the scope and benefits of a particular prescription drug and so, like DTCA, can promote increased patient-consumer demand and thus a problematic rise in the prescribing and use of medications that may be neither the most appropriate nor the most cost-effective. Yet, with DTCI the industry is playing within the existing rules and regulations set by health regulators. To respond appropriately to this regulatory incoherence, we argue that DTCI should be regulated as a type of direct-to-consumer indirect advertising. Even if the case and specific regulations presented here are Canadian, the implications extend to every country that has a partial or total prohibition on DTCA. (shrink)

The illegal drug trade is a world phenomenon, which has had some adverse impact on societies. Significantly, the impact is damning in developing economies in Africa and Ghana in particular. This paper therefore seeks to address the causes and effects of the use and peddle of these illegal drugs in three communities in the capital city of the Asante Region of Ghana. It further ascertains the extent to which these drugs burden the security agencies in the communities and (...) the country in general. We have used documentary and non-documentary sources to arrive at some postulations on this important social question which has wider ramifications on Kumase, Asante, Ghana and Africa in general. (shrink)

Every day the news shows us provoking stories about what's going on in the world, about events which raise moral questions and problems. In Philosophers Take On the World a team of philosophers get to grips with a variety of these controversial issues, from the amusing to the shocking, in short, engaging, often controversial pieces. This chapter covers drug use, making you think again about the judgements we make on a daily basis and the ways in which we choose to (...) conduct our lives. (shrink)

In this paper, I present and criticize several historical arguments in favour of prohibition and criminalization of illicit psychoactive substances. I consider several versions of Charles Brent’s argument from drug harms and an argument from addiction based on Kantian view on autonomy. My criticism will mainly rely on empirical evidence on drugs, drug use, and addiction. I think that in light of this evidence, all of the arguments lose their cogency or can be refuted altogether. Moreover, the evidence reveals (...) an inconsistency in the international drug law framework. In conclusion, I therefore provide a general argument challenging the legitimacy of the existing distinction between licit and illicit drugs based on the inconsistency. (shrink)

Drug regulation is fraught with inductive risk. Regulators must make a prediction about whether or not an experimental pharmaceutical will be effective and relatively safe when used by typical patients, and such predictions are based on a complex, indeterminate, and incomplete evidential basis. Such inductive risk has important practical consequences. If regulators reject an experimental drug when it in fact has a favourable benefit/harm profile, then a valuable intervention is denied to the public and a company’s material interests are needlessly (...) thwarted. Conversely, if regulators approve an experimental drug when it in fact has an unfavourable benefit/harm profile, then resources are wasted, people are needlessly harmed, and other potentially more effective treatments are underutilized. Given that such regulatory decisions have these practical consequences, non-epistemic values about the relative importance of these consequences impact the way such regulatory decisions are made (similar to the analysis of laboratory studies on the toxic effects of dioxins presented in Douglas [2000]). To balance the competing demands of the pertinent non-epistemic values, regulators must perform what I call an “inductive risk calculus.” At least in the American context this inductive risk calculus is not well-managed. (shrink)

In recent years, a debate has emerged on whether bodily sensations are typically accompanied by a sense of body ownership, namely a distinctive experience of one's body or body part as one's own. Realists about the sense of body ownership heavily rely on evidence from experimentally-induced bodily illusions (e.g., the rubber hand illusion) and pathological disownership syndromes (e.g. somatoparaphrenia). In this chapter, I will introduce novel evidence regarding body disownership syndromes induced by psychoactive drugs rather than pathological conditions, and (...) discuss its relevance to the debate on the sense of body ownership. (shrink)

While the Value-Free Ideal of science has suffered compelling criticism, some advocates like Gregor Betz continue to argue that science policy advisors should avoid value judgments by hedging their hypotheses. This approach depends on a mistaken understanding of the relations between facts and values in regulatory science. My case study involves the morning-after pill Plan B and the “Drug Fact” that it “may” prevent implantation. I analyze the operative values, which I call zygote-centrism, responsible for this hedged drug label. Then, (...) I explain my twofold account of value-ladenness, involving the constitutive role of value judgments in science and the social function of facts as political tools. Because this drug fact is ineliminably value-laden in both senses, I conclude that hedged hypotheses are not necessarily value-free. (shrink)

In many jurisdictions, an offender’s remorse is considered to be a relevant factor to take into account in mitigation at sentencing. The growing philosophical interest in the use of neurointerventions in criminal justice raises an important question about such remorse-based mitigation: to what extent should technologically facilitated remorse be honoured such that it is permitted the same penal significance as standard instances of remorse? To motivate this question, we begin by sketching a tripartite account of remorse that distinguishes cognitive, affective (...) and motivational elements of remorse. We then describe a number of neurointerventions that might plausibly be used to enhance abilities that are relevant to these different elements of remorse. Having described what we term the ‘moral value’ view of the justification of remorse-based mitigation, we then consider whether using neurointerventions to facilitate remorse would undermine its moral value, and thus make it inappropriate to honour such remorse in the criminal justice system. We respond to this question by claiming that the form of moral understanding that is incorporated into a genuinely remorseful response grounds remorse’s moral value. In view of this claim, we conclude by arguing that neurointerventions need not undermine remorse’s moral value on this approach, and that the remorse that such interventions might facilitate could also be authentic to the recipient of the neurointerventions that we discuss. (shrink)

The purpose of the study. This study aims to identify the prevalence of participants in physical activities, the motivation needed by the students to engage in the activity, challenges encountered by the implementors, health benefits, and recommendations and suggestions needed for the improvement of the implementation. -/- Materials and methods. A systematic analysis of the data from different articles was conducted using Arksey and O’Malley’s (2005) scoping review framework. -/- Results. It was found that the implementation of active recreational (...) activities offers different health benefits to the youth, physical literacy and orientation and motivation played a vital role in the implementation of the recreational activities. -/- Conclusions. Therefore, the implementation of active recreational activities must be strengthened in schools not just for the sake of participation but because they are motivated to. And engagement in these activities must not only be limited to school grounds but also engaged at home and in the community. (shrink)

Studies have shown that both serotonin and glutamate receptor systems play a crucial role in the mechanisms underlying drug-induced synesthesia. The specific nature of these mechanisms, however, continues to remain elusive. Here we propose two distinct hypotheses for how synesthesia triggered by hallucinogens in the serotonin-agonist family may occur. One hypothesis is that the drug-induced destabilization of thalamic projections via GABAergic neuronal circuits from sensory areas leads to a disruption of low-level, spontaneous integration of multisensory stimuli. This sort of integration (...) regularly occurs when spatial and temporal attributes match. Destabilization of feedback loops, however, can result in incongruent experiences or binding of random thalamus activation with sensory input in a particular sensory modality. The second hypothesis builds on embodied cognition, cases in which visual images of external stimuli activate task-related neural regions. On this proposal, binding processes that do not normally generate awareness become accessible to consciousness as a result of decreased attentional discrimination among incoming stimuli. (shrink)

Advocates of moral enhancement through pharmacological, genetic, or other direct interventions sometimes explicitly argue, or assume without argument, that traditional moral education and development is insufficient to bring about moral enhancement. Traditional moral education grounded in a Kohlbergian theory of moral development is indeed unsuitable for that task; however, the psychology of moral development and education has come a long way since then. Recent studies support the view that moral cognition is a higher-order process, unified at a functional level, and (...) that a specific moral faculty does not exist. It is more likely that moral cognition involves a number of different mechanisms, each connected to other cognitive and affective processes. Taking this evidence into account, we propose a novel, empirically informed approach to moral development and education, in children and adults, which is based on a cognitive-affective approach to moral dispositions. This is an interpretative approach that derives from the cognitive-affective personality system (Mischel and Shoda, 1995). This conception individuates moral dispositions by reference to the cognitive and affective processes that realise them. Conceived of in this way, moral dispositions influence an agent's behaviour when they interact with situational factors, such as mood or social context. Understanding moral dispositions in this way lays the groundwork for proposing a range of indirect methods of moral enhancement, techniques that promise similar results as direct interventions whilst posing fewer risks. (shrink)

Philosophical and empirical research on bodily awareness has mostly focused so far on bodily disorders – such as anorexia nervosa, somatoparaphrenia, or xenomelia (body integrity dysphoria) – and bodily illusions induced in an experimental setting – such as the rubber hand illusion, or the thermal grid illusion. Studying these conditions can be illuminating to investigate a broad range of issues about the nature, function, and etiology of bodily experience. However, a number of psychoactive compounds can also induce a remarkably wide (...) variety of bodily effects that have received little attention despite their relevance to these issues. Some of these effects are similar to those associated with bodily disorders or experimental bodily illusions, while others appear to be unique. The purpose of this chapter is to provide an overview of these lesser known bodily effects of psychoactive compounds, and outline some ways in which they can bear on recent debates regarding bodily awareness and bodily ownership. (shrink)

Gerald Dworkin provides an insightful starting point for determining acceptable paternalism through his commitment to protecting our future autonomy and health from lasting damage. Dworkin grounds his argument in an appeal to inherent goods, which this paper argues is best considered as a commitment to human flourishing. However, socialconnectedness is also fundamental to human flourishing and an important consideration when determining the just limits of paternalistic drug controls, a point missing from Dworkin’ essay. For British philosopher Thomas Hill Green, regulation (...) of alcohol sales emerged from the social ideal. Green argued that policy interventions, including restricted opening hours and locations, improved the conditions for humans to flourish. Green offers a compelling political vision but fails to account for the fact pleasure is also an inherent good. He focused excessively on our social nature, excluding our more pleasure-seeking and egoistic characteristics. In contrast, a more realistic and complete vision of human flourishing can be found in an amended version of Gerald’s Dworkin’s arguments. In conclusion, this paper argues drug policy makers should remain committed to the harm principle as applied to criminal law whereby a person should never be criminalized for self-harm. Such a limit on paternalistic interventions is deemed necessary when eudaimonia is the end of government action. In practical terms, this means that the criminalization of drug use, as opposed to drug production, is always unjust. (shrink)

Background: Multi Drug Therapy approved by WHO is the best treatment option for Leprosy. There is a significant decline of mortality and morbidity after the introduction of multi drug therapy. But the adverse effects causing changes in clinical and laboratory parameters to multi drug therapy are the main limiting obstacle for the treatment course completion. Objective: The aim of this study is to find out the effects on routine laboratory parameters including hematological and biochemical changes before, during and after the (...) treatment of multi drug therapy in leprosy. Methodology: A descriptive cohort hospital based study on 85 multi drug therapy treated leprosy patients using standard laboratory tools for routine investigations for 18 months. Results: During the one year multidrug treatment period, most of the routine laboratory parameters showed mild to moderate change from normal level during the first 3 months with gradual recovery in the following months. Complete blood count assessment revealed mild decline in Hb, PCV, MCH, MCHC, and moderate decline in WBC and Platelet count. A mild increase in liver function tests (Bilirubin, AST, ALT, Alkaline phosphatase) and renal function tests (S.Creatinine, b. Urea) was observed. A moderate decline in S. Sodium with mild increase in S. Potassium was found on investigating S. Electrolytes. Patients were fully recovered from all hemato-biochemical adverse effects after 6 months of completion of the multi drug therapy. Conclusion: Despite of mild to moderate hematological and biochemical adverse reactions with multi drug therapy, recovery was excellent after 6 months of completion of therapy. (shrink)

Mandatory minimum sentencing provisions have been a feature of the U.S. justice system since 1790. But they have expanded considerably under the war on drugs, and their use has expanded considerably under the Trump Administration; some states are also poised to expand drug-related mandatory minimums further in efforts to fight the current opioid epidemic. In this paper I outline and evaluate three prominent arguments for and against the use of mandatory minimums in the war on drugs—they appeal, respectively, (...) to proportionality, consistency, and efficiency. I ultimately defend the view that the use of mandatory minimums in the war on drugs is unjust. -/- . (shrink)

The War on Drugs has been waged primarily for cultural reasons, i.e., to enforce the Protestant Work Ethic. It does not serve a rational utilitarian function.

Modern science began as natural philosophy, an admixture of philosophy and science. It was then killed off by Newton, as a result of his claim to have derived his law of gravitation from the phenomena by induction. But this post-Newtonian conception of science, which holds that theories are accepted on the basis of evidence, is untenable, as the long-standing insolubility of the problem of induction indicates. Persistent acceptance of unified theories only in physics, when endless equally empirically successful disunified rivals (...) are available, means that physics makes a persistent, problematic metaphysical assumption about the universe: that all disunified theories are false. This assumption, precisely because it is problematic, needs to be explicitly articulated within physics, so that it can be critically assessed and, we may hope, improved. The outcome is a new conception of science—aim-oriented empiricism—that puts science and philosophy together again, and amounts to a modern version of natural philosophy. Furthermore, aim-oriented empiricism leads to the solution to the problem of induction. Natural philosophy pursued within the methodological framework of aim-oriented empiricism is shown to meet standards of intellectual rigour that science without metaphysics cannot meet. (shrink)

Unmanaged recreation presents a challenge to both researchers and managers of outdoor recreation in the United States because it is shrouded in uncertainty resulting from disagreement over the definition of the problem, the strategies for resolving the problem, and the outcomes of management. Incomplete knowledge about recreation visitors’ values and relationships with one another, other stakeholders, and the land further complicate the problem. Uncertainty and social complexity make the unmanaged recreation issue a wicked problem. We describe the wickedness inherent in (...) unmanaged recreation and some of the implications of wickedness for addressing the problem for the Front Range of the Rocky Mountains in Colorado. Conclusions about the nature of the problem are based on a problem appraisal that included a literature review and interviews of key informants. Addressing wickedness calls for institutional changes that allow for and reward the use of trust building, inclusive communication, and genuinely collaborative processes. (shrink)

Prescription Drug Monitoring Programs (PDMPs) contain detailed information about which controlled medications physicians prescribe individuals, including where, when, how much, by whom, and more. The programs allow physicians to glimpse into the life of each patient that visits them — sometimes before a single word is exchanged between them. Every state has a PDMP, and almost all states share the data they collect through it. In this paper, I argue that informed consent should be required for recording of prescriptions related (...) to addiction management into the PDMP. (shrink)

I welcome with great enthusiasm Meling and Scheidegger’s (2023; henceforth “M&S”) timely contribution to advance an enactive approach to psychedelic therapy, especially to the complex causality involved. Their two main research questions concerned:(i) the causal interaction between the psychedelic molecule and brain activity; and (ii) the causal interaction between brain activity and the psychedelic experience. While I largely agree with and celebrate much of what is proposed by M&S, especially their employment of key enactive concepts to advance our understanding of (...) the first research question, in the following, I will present some worries regarding their answers to the second. Although I agree that there is probably a two-way reciprocal relationship between neural activity and experience, I have several points of contention regarding M&S’s proposal. My hope is to stimulate discussion on M&S’s important contribution, and to help advance a much-needed enactive science of psychedelics. (shrink)

Sex, Drug & Laruelle -/- - et nous errions, nourris du vin des cavernes et du biscuit de la route, moi pressé de trouver le lieu et la formule - A. Rimbaud.

In this contribution to the symposium on Quill Kukla's _City Living_, I argue that the "objective properties" invisibly built into playgrounds can limit children's development of their agency. Playgrounds may seem insignificant because play may seem insignificant. However, playgrounds are where children develop as agents: it is through play that they learn to make decisions about their own bodies, express their own values, and negotiate with others. Yet at the playground, there is co-dependence between social practice and material object: the (...) latent surveillance by adults enforces and reinforces the rules that have been built into equipment like slides. Social and spatial inequalities can constitute self-amplifying feedback loops that sustain oppressive systems. Playgrounds do not merely reflect the social fact that children’s autonomy is not always taken seriously, they also condition and constitute this social fact. (shrink)

There are a number of premises underlying much of the vigorous debate on pharmacological cognitive enhancement. Among these are claims in the enhancement literature that such drugs exist and are effective among the cognitively normal. These drugs are deemed to enhance cognition specifically, as opposed to other non-cognitive facets of our psychology, such as mood and motivation. The focus on these drugs as cognitive enhancers also suggests that they raise particular ethical questions, or perhaps more pressing ones, (...) compared to those raised by other kinds of neuroenhancement. Finally, the use of these drugs is often claimed to be significant and increasing. Taken together, these premises are at the heart of the flurry of debate on pharmacological cognitive enhancement. In this article, it is argued that these are presumptions for which the evidence does not hold up. Respectively, the evidence for the efficacy of these drugs is inconsistent; neurologically it makes little sense to distinguish the cognitive from non-cognitive as separate targets of pharmacological intervention; ethically, the questions raised by cognitive enhancement are in fact no different from those raised by other kinds of neuroenhancement; and finally the prevalence rates of these drugs are far from clear, with the bulk of the claims resting on poor or misrepresented data. Greater conceptual clarity along with a more tempered appreciation of the evidence can serve to deflate some of the hype in the associated literature, leading to a more realistic and sober assessment of these prospective technologies. (shrink)

From antiquity, Galenic physicians extensively discussed the active powers of simple and compound drugs. In their views, simple drugs, that is, single ingredients, acted according to their material qualities and the properties of their substance. As for compound drugs, their efficacy resulted from the mutual interaction of their ingredients and their modes of preparation. In the late Renaissance, Galenic physicians and naturalists, such as Leonhart Fuchs and Pietro Andrea Mattioli, attempted to explain these pharmacological properties or “faculties” (...) at the intersection of medicine, botany, and natural philosophy. This chapter examines the case of the Italian physician and botanist Andrea Cesalpino. His pharmacological treatise De medicamentorum facultatibus [On the Faculties of Drugs, 1593] was particularly significant for its reception of ancient and medieval texts on drug properties, materia medica, and the role of the senses in the knowledge of bodies. (shrink)

Understanding recreational experiences is a longstanding research tradition and key to effective management. Given the complexities of human experience, many approaches have been applied to study recreational experience. Two such approaches are the experiential approach (based in a positivistic paradigm) and emergent experience (based in an interpretive paradigm). While viewed as being complementary, researchers have not offered guidance for incorporating the approaches into a common model of recreational experience. This study utilized longitudinal, qualitative data to examine aspects (...) of recreational experience posited by these two approaches. Results provided a framework for synthesizing across the two approaches. Respondents had clear pre-activity expectations, and most respondents realized their expected outcomes. This supports the experiential approach. Of the 48 activity narratives, 27 experienced something unexpected, and 45 described process-oriented, intrinsic motivation, suggesting evidence of emergent and unique characteristics specific to an individual’s realization of recreational experience. This supports the application of the emergent experience approach to understand how individuals create meaning from recreational engagements. The paper proposes a model for integrating results of the two approaches. While not advocating for any specific approach, the findings can serve as an example of building a holistic model of the outdoor recreation experience. The purpose of the model is to allow for a more complete understanding of how individuals create recreation experiences, more complete documentation of the benefits of outdoor recreation for both researchers and managers, and better synthesis across studies. (shrink)

Factors influencing work-life balance are evolving at a very fast pace, thus creating a fecund ground for innovative work-life balance tools and techniques. The increasing significance of expatriates in the global workforce necessitates a targeted set of work-life balance initiatives to help expatriate workers contribute more effectively in the competitive work environment. Health and recreation are the two important life spheres which play a very important role in success or failure of an expatriate assignment. While work-life balance researches are being (...) conducted globally in plenty, yet research on expatriate adjustment and expatriate work-life balance is still in its nascent stage especially in an expatriate dominated work environment in the Gulf Cooperation Council (GCC) countries. This research paper investigates the health and recreation spheres of expatriate academicians working in private higher education institutes in Bahrain, Oman and the UAE. The research paper illustrates and evaluates the health and recreation spheres in relation to the demographic factors of the respondents and suggests ways to improve work-life balance of expatriate employees. (shrink)

Binding specificity is a centrally important concept in molecular biology, yet it has received little philosophical attention. Here I aim to remedy this by analyzing binding specificity as a causal property. I focus on the concept’s role in drug design, where it is highly prized and hence directly studied. From a causal perspective, understanding why binding specificity is a valuable property of drugs contributes to an understanding of causal selection—of how and why scientists distinguish between causes, not just causes (...) from noncauses. In particular, the specificity of drugs is precisely what underwrites their value as experimental interventions on biological processes. (shrink)

Stimulants have been shown to be safe and effective for reduction of the symptoms of attention deficit hyperactivity disorder. Despite much debate, however, there has been little empirical evidence as to whether stimulants affect authenticity and moral agency in children. Singh presents evidence that stimulants do not undercut children's' sense of self and increase their experience of agency. These findings are consistent with laboratory evidence that stimulant drugs in therapeutic doses improve cognitive control over thought and behavior.

The purpose of this essay is to make the case that the ethical issues raised by the current U.S. practice of direct-to-consumer prescription drug advertising are worthy of study in philosophy courses, and to provide instructors with some ideas for how they might approach teaching the topic, despite the current relative scarcity of philosophical literature published on it. This topic presents a unique opportunity to cover ground in ethics, critical thinking, and scientific literacy simultaneously. As a case study, the practice (...) of DTC advertising is both theoretically rich and universally relevant to students’ lives. The nature of these ads—numerous, diverse, visually and thematically entertaining—makes them delicious fodder for in-class activities, small group work, discussion-based learning, creative projects, and customizable essay topics. I offer a set of suggestions for approaching the study of DTC drug ads that is informed by my own experience doing so in bioethics courses. Ultimately, including this topic on your syllabus not only contributes to students’ philosophical skills and knowledge, but also helps them become better informed as citizens and potential “consumers” of health care. (shrink)

As a response to the opioid epidemic in the United States, the Centers for Disease Control and Prevention (CDC) published the CDC Guideline for Prescribing Opioids for Chronic Pain in 2016. This document served as a means to reduce risks and address harms of opioid use by recommending that clinicians conduct periodic urine drug testing for patients on chronic opioid therapy. As an unintended result of this recommendation, providers began using unexpected urine drug test results as a reason to dismiss (...) patients from practice, both out of concern for their patients’ wellbeing as well as their own legal risks. Using Husserl’s and Heidegger’s phenomenology, we argue that this science-based, black-and-white practice does not heed the patient as a whole person. Instead, we recommend a more contextual, patient-centered approach that can help us to better understand and manage patient needs in such contexts. (shrink)

The underreporting of suspected adverse drug reactions remains a primary issue for contemporary post-market drug surveillance or ‘pharmacovigilance.’ Pharmacovigilance pioneer W.H.W. Inman argued that ‘deadly sins’ committed by clinicians are to blame for underreporting. Of these ‘sins,’ ignorance and lethargy are the most obvious and impactful in causing underreporting. However, recent analyses show that diffidence, insecurity, and indifference additionally play a major role. I aim to augment our understanding of diffidence, insecurity, and indifference by arguing these sins are underwritten by (...) value judgments arising via epistemic risk. I contend that ‘evidence-based’ medicine codifies these sins. (shrink)

There is converging evidence that high doses of hallucinogenic drugs can produce significant alterations of self-experience, described as the dissolution of the sense of self and the loss of boundaries between self and world. This article discusses the relevance of this phenomenon, known as “drug-induced ego dissolution (DIED)”, for cognitive neuroscience, psychology and philosophy of mind. Data from self-report questionnaires suggest that three neuropharmacological classes of drugs can induce ego dissolution: classical psychedelics, dissociative anesthetics and agonists of the (...) kappa opioid receptor (KOR). While these substances act on different neurotransmitter receptors, they all produce strong subjective effects that can be compared to the symptoms of acute psychosis, including ego dissolution. It has been suggested that neuroimaging of DIED can indirectly shed light on the neural correlates of the self. While this line of inquiry is promising, its results must be interpreted with caution. First, neural correlates of ego dissolution might reveal the necessary neurophysiological conditions for the maintenance of the sense of self, but it is more doubtful that this method can reveal its minimally sufficient conditions. Second, it is necessary to define the relevant notion of self at play in the phenomenon of DIED. This article suggests that DIED consists in the disruption of subpersonal processes underlying the “minimal” or “embodied” self, i.e., the basic experience of being a self rooted in multimodal integration of self-related stimuli. This hypothesis is consistent with Bayesian models of phenomenal selfhood, according to which the subjective structure of conscious experience ultimately results from the optimization of predictions in perception and action. Finally, it is argued that DIED is also of particular interest for philosophy of mind. On the one hand, it challenges theories according to which consciousness always involves self-awareness. On the other hand, it suggests that ordinary conscious experience might involve a minimal kind of self-awareness rooted in multisensory processing, which is what appears to fade away during DIED. (shrink)

The primary responsibility of the US Food and Drug Administration is to protect public health by ensuring the safety of the food supply. To that end, it sometimes conducts risk assessments of novel food products, such as genetically modified food. The FDA describes its regulatory review of GM food as a purely scientific activity, untainted by any normative considerations. This paper provides evidence that the regulatory agency is not justified in making that claim. It is argued that the FDA’s policy (...) stance on GM food is shaped by neoliberal considerations. The agency’s review of a genetically engineered animal, the AquAdvantage salmon, is used as a case study to track the influence of neoliberalism on its regulatory review protocol. After that, an epistemic argument justifying public engagement in the risk assessment of new GM food is outlined. It is because risk evaluations involve normative judgments, in a democracy, layperson representatives of informal epistemic communities that could be affected by a new GM food should have the opportunity to decide the ethical, political or other normative questions that arise during the regulatory review of that entity. (shrink)

Objective: Primary care, which is often the first level of contact for patients with various communicable diseases (CDs) and noncommunicable diseases (NCDs), might exhibit patterns of injectable drug utilization different from hospitals. We aimed to examine injection prescribing to adults with CD or NCD in primary care. -/- Methods: In this retrospective study, single-diagnosis injectable drug-containing prescription data from Family Medicine Information System comprising 32 provinces of Turkey were analysed. The prescriptions were grouped by diagnosis as “CD” (n=3848) and “NCD” (...) (n=9338). Injectable drug utilization patterns in these groups were analysed by demographics, diagnoses, and drug subgroups. -/- Results: Out of 13186 prescriptions, 70.8% were issued for NCDs. NCD prescriptions were mostly generated for women and elderly (p<0.05 for both). About 63.3% (n=2948) of injectable drugs in CD prescriptions were antibiotics and 12.6% were analgesics. Cefazolin (15.2%) was the most commonly prescribed antibiotic for acute pharyngitis and acute sinusitis, and benzathine benzylpenicillin (12.8%) was the top-choice for acute tonsillitis and rheumatic fever. In NCD prescriptions, 34.0% (n=4214) of injectable agents were analgesics and 16.9% were muscle relaxants. The most frequently encountered drug in NCD prescriptions was thiocolchicoside (16.3%), which was the top-choice in all seven common musculoskeletal diagnoses. -/- Conclusion: Muscle relaxants and analgesics were the most commonly prescribed injectable drugs for NCDs, musculoskeletal diseases in particular. Antibiotics were frequently encountered in CD prescriptions, mostly as broad-spectrum for lower respiratory tract infections (RTIs) and narrow-spectrum for upper RTIs. These findings may elucidate the issues to especially focus on regarding excessive use of injections. (shrink)

In psychiatry, pharmacological drugs play an important experimental role in attempts to identify the neurobiological causes of mental disorders. Besides being developed in applied contexts as potential treatments for patients with mental disorders, pharmacological drugs play a crucial role in research contexts as experimental instruments that facilitate the formulation and revision of neurobiological theories of psychopathology. This paper examines the various epistemic functions that pharmacological drugs serve in the discovery, refinement, testing, and elaboration of neurobiological theories of (...) mental disorders. I articulate this thesis with reference to the history of antipsychotic drugs and the evolution of the dopamine hypothesis of schizophrenia in the second half of the twentieth century. I argue that interventions with psychiatric patients through the medium of antipsychotic drugs provide researchers with information and evidence about the neurobiological causes of schizophrenia. This analysis highlights the importance of pharmacological drugs as research tools in the generation of psychiatric knowledge and the dynamic relationship between practical and theoretical contexts in psychiatry. (shrink)