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One of the most important aspects of ceremonial drug use is that the desire for the drug is experienced as issuing from the very depth of the user; whereas, in the case of the therapeutic use of drugs, the user experiences
external necessity, or even compulsion, as the motive for drug taking. It is precisely this experience of an inner need or "craving" that justifies our placing this behavior in the same class with other patterns of religious conduct and observance: what all these behaviors--that is, drug use recognized as religious, drug "addiction," and habitual "drug abuse"--share with other kinds of religious behaviors is the experience of a profound inner desire or
urge, whose satisfaction gratifies the user's deepest sense of existence or being in the world. And herein, too, lies the reason why both the religious fanatic and the "dope fiend" go to such great lengths to satisfy their desires;
and why each feels fully justified in the moral righteousness of his conduct. This "call" or "craving"--which to the observer seems to come from without, from the voice of God or the lure of a drug, but which to the subject comes from within, from the recognition of the ubject's "calling" or from the conviction that only with the drug is he "whole"--must, moreover, be contrasted, if we are to appreciate its real import, with the universal human experience it opposes, and indeed tries to annihilate; namely, the experience of helplessness and powerlessness and of being manipulated by external agents and their hostile interests.
In the countless ceremonial uses of drugs and in the oppositions to them, a fundamental polarity and "problem" inherent in human nature is dramatized and ritualized: namely, the struggle between man controlling himself, and man controlled by alien powers, between autonomy and heteronymy.
Thomas Szasz
from Ceremonial Chemistry
The Ritual Persecution of Drugs, Addicts, and Pushers