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Antidepressant Vending Machines

some thoughts on pharmacology in the age of AI and drug prohibition

by Brian Ballard Quass, the Drug War Philosopher (Substack version)

August 1, 2026



Thanks for sharing those articles with me. Such papers are helping to fill in the many blanks in my knowledge about American pharmaceutical policy and history.

I find the current prescription system highly problematic, both for the reasons that you have highlighted and for some of my own that it seems that no one has ever highlighted. The striking thing to me about the system, given my backstory as a psychiatric patient, is that there is no distinction made between a doctor deciding on the propriety of use of a "physically" acting drug and a doctor deciding on the propriety of the use of a "psychologically" acting drug. The two situations, however, are entirely different. I could easily admit that a doctor would be more knowledgeable than I am about the former kind of medicine, about whether to take a certain pill to combat the growth of a tumor, for instance, but the doctor (or pharmacist) is completely unqualified to decide for me whether it is safe and wise for me to use a psychoactive substance for any non-medical purpose. He or she can certainly tell me the risks of such use in the abstract, but in order to tell me if the use were worth it in my case, they would have to be God him or herself, given the endless variables involved, including the idea of what constitutes what philosophers would call "the good life." The opium-loving Avicenna is quoted as saying that he desired a wide life, not a long one. The doctor can tell him that he is wrong to do so, but that is not a scientific verdict, that is just the expression of either a metaphysical preference or, which is far more likely, the doctor's fears about lawsuits and license revocation that might ensue from acting contrary to America's drug-hating mindset.

I feel we have to reexamine the assumption that scientists (including doctors and pharmacists) can, even in theory, objectively decide on the "genuine danger" of a psychoactive medicine when viewed in the abstract, without reference to any usage protocol or user. There is inherent subjectivity here. To see this, we have only to consider antidepressants. I would argue that antidepressants are far more dangerous than cocaine and even heroin, insofar as lifetime dependency for antidepressants is a feature of such "meds" and not a mere bug as is the case with most outlawed medicines. When our scientists say otherwise, they are not being scientific but prudent. They know that their job depends on adopting the prejudices of the majority when it comes to opining on such substances. Yet how am I supposed to honor their verdicts on drug safety when they simply "look the other way" when it comes to the fact that 1 in 4 American women have been turned into wards of the healthcare state thanks to drug prohibition 1 -- the drug prohibition which has shunted those women off onto underperforming antidepressants that I have found harder to kick than heroin? This is why GK Chesterton said, in connection with liquor prohibition, that the state would have to become God in order to decide what is beneficial for an individual in any specific case -- they would have to know all of the endless factors that we choose to ignore when we send ourselves on the fool's errand of trying to decide if a psychoactive drug is good or bad in the abstract. 2

Let us suppose, however, that our scientists found a psychoactive drug that has to be used particularly wisely, especially by drug-naive Americans -- drugs like ayahuasca, for instance -- else there could indeed be physiological problems for the user, especially for a gringo whose body is not accustomed to the very different diets of the curanderos of the Andes. It might be argued that here, at least, is a case in which we should supply the drug by prescription only. And yet the appropriate use of that drug (or in this case that drug compound) could inspire the creation of entire new religious sects, even in America. With that possibility in mind, why would we give a doctor the ability to veto such an eventuality by insisting that the would-be user forebear? In fact, the use of ayahuasca has indeed inspired the creation of new religions in the last few decades, both in South America and now even in the States. The stateside church was fought tooth and nail by the DEA until a rare 9-0 ruling in the church's favor by the Supreme Court. But that has not stopped the DEA from imposing onerous bureaucratic and logistical controls on the use of the drug for religious purposes at the UDV, the União do Vegetal.3 The drug could indeed pose a risk to the unwary. But in saying this, we must remember that we are spending over $50 billion a year to arrest drug users and zero dollars to educate them. With this backstory in mind, should we really be blaming ayahuasca for being dangerous -- or should we not rather be blaming our society for making ayahuasca dangerous by taking the superstitious view that drugs are bad in and of themselves and that education about safe use is therefore superfluous and even immoral?

Finally, Botox is one of the most toxic substances on the planet, and yet it has recently been found to have benefits, at the proper dosage, for fighting migraines.4 If we had obsessed about the abstract danger of Botox on the grounds of its toxicity, then those beneficial uses might never have been discovered. This is the problem for those who seek to enlist fighters in the war against drug prohibition, by the way: most of the downsides of that policy are inherently invisible to us. We cannot miss the medical treatments that we never even knew were possible thanks to our drug-hating propensities. We cannot see the millions of chronic depressives who are suffering unnecessarily behind closed doors. But we cannot help but see the handful of young people who manage to spectacularly misuse a drug on a film clip on the Six O'Clock News. And so we draw the rash conclusion that the only stakeholders in the drugs debate are white American suburban mothers.

But I digress.

What I'm really saying here is that drug prohibition is the big problem with the current prescription system. It has deprived the pharmacists and doctors of all credibility when it comes to their role in safeguarding us against dangerous substances. And the problem here is enormous, though it is still off the radar of almost all Americans. We have always assumed as a country that we could have a sane medical system while yet imposing an unprecedented wholesale ban on psychoactive medicines. It turns out that the two are incompatible. And until we recognize this fact, the problems with the prescription system will continue to appear to be inexplicable to us: just as inexplicable as inner-city gun violence, school shootings, and our inability to give powerful relief to autism and dementia patients, all of which problems could be ameliorated by what we have been falsely told to believe is the oxymoronic expedient of beneficial drug use. We demand our world to be both healthy and drug free, and we cannot have both. We will eventually have to choose between our current policy of Christian Science Sharia and the kind of healthcare progress that one can only expect in a free world.

Finally, some thoughts about which drugs, if any, should be classified as "prescription-only" (noting here that the first step in making this determination is to remove self-interested parties from the committees that decide such things).

Now, I am not a doctor, and I do not even play one on TV. But I cannot think of many drugs that I believe should require a prescription. I have already stated some of my concerns about requiring prescriptions for psychoactive drugs based on the naive assumption that "doctor knows best" when it comes to that category; as for physically-acting drugs, I assume that most people would not think of buying them unless the doctor asked them to do so and therefore there should be no need for a prescription. Perhaps one could argue for the use of a prescription to purchase pills that fight cancer on a radiological basis, the justification being that cancer victims might use too many of those pills under the misguided belief that dosage increase can only improve results.

I end this section with a pertinent quotation from Thomas Szasz, which speaks to the folly of turning to doctors and pharmacists for 'scientific' (i.e., objective) judgments about psychoactive substances:

'Drug policy,' Judge [Pamela] Alexander concluded, 'should not be set according to anything less than scientific evidence.' Unfortunately, this is a very naive statement. There is no scientific basis for any of our 'drug policies' -- a term that, in this context, is a euphemism for prohibiting pharmaceutical and recreational drugs. Warning people about the risks a particular drug poses is the most that science can be made to justify. 5
Thomas Szasz -- Our Right to Drugs

There is another downside of the prescription system in the States that I have never heard mentioned, and that is the cavalier way in which prescription holders are treated, especially in the behavioral health field. I have learned from long experience that if I run out of dependence-causing meds on a weekend, no one is going to move one muscle to help me, notwithstanding the fact that the drug literature itself cautions against the sudden cessation of the drugs in question. I have had this situation arise at least a half-dozen times over the past 40 years. In one instance, I had driven 50 miles on a Saturday night only to find that a doctor had not followed through as promised on a refill. The answering service gave me the usual spiel about calling back at 9 a.m. on Monday morning. I finally told the lady that I was contemplating suicide. This was a complete lie, of course, but I realized that it was the only way that I could get them to actually bother the doctor who had cost me this fruitless two-hour round trip to the distant pharmacy in Harrisonburg, Virginia. (The head of the clinic called me back shortly and phoned in the refill after I brought him up to date on "the facts on the ground.") Nor has this problem just been mine alone. About 15 years ago, I was trying to get a weekend refill for my elderly mother on a med without which she was panicking. The staff spoke to me like they were sitting on a raft in a local swimming pool eating corn chips. Their very tone made it clear to me that this was not their problem, as far as they were concerned, not on a Saturday. They would be delighted to talk to me on Monday morning, but until then, they were sorry, but they had some swimming to do.

This is what happens when we give a monopoly to doctors on mind and mood medicine -- they know that they are the only game in town. So they do not bother to hire more staff, or to use the present staff, in a way that would meet the sudden urgent needs of their patients. There are no sudden urgent needs, as far as the staff are concerned when it comes to prescription refills. They only recognize needs that have been duly communicated to the office by phone at least 48 hours prior to the promised satisfaction of those needs. In other words, they have come to take their prescription-related monopoly as a right without responsibilities.

Finally, a few notes on points raised in specific papers:

RX Only as Definitional Capture



Note: I would tend to err on Szasz's side on the subject of drug dangers, not because of an abstract principle, but because drug prohibition implicitly controls how we can think and feel about the world around us -- and this is a fact that will become increasingly apparent to the extent that we study psychoactive drugs and new states of consciousness (things which indigenous people have investigated for ages). This gets into the very business of who I am as a person and who I am allowed to be. It is monstrous to think that the government or medical personnel get to decide this for me, who I am deep inside. This is why I call drug prohibition a meta injustice: it does not simply seek to control what I can think, as did the tyrants of yore, by burning books. It seeks to get into my very pores, as it were, and control how I can think about the world in which I live. It is, in fact, the ultimate government tyranny, worse in some ways than death itself.

Note 2: American drug policy is all about spending billions of dollars to make drug use as dangerous as possible, by failing to regulate product and by forcing buyers to consort with gangs and cartels. When we attribute that socially created danger to the drugs themselves, by blaming drugs as "hard" and as "dangerous," we are giving drug prohibition a Mulligan for the problems that it causes. We are helping to normalize drug prohibition, just as city leaders do when they fight against gun violence without ever mentioning the drug prohibition that brought guns to the city in the first place.

Pricing Their Own Work



Note: One wonders why "meds" could not be dispensed by a kind of modified soda machine. After verifying my identity, the machine could ask me the usual questions about whether I have considered killing myself lately and so forth. After receiving the correct responses, the machine could prompt me to enter my debit card and pin, after which it would place the appropriate refill in the product slot in front of me and wish me a great day.

The Surveillance State Did Not Arrive with the Internet

The issues raised in this latter paper deserve a separate essay. However, there is relevant overlap in subject matter. This paper gives us a new reason to limit the use of prescriptions: namely, the fact that the recipient of a prescription is added to a database and thereby subject to prejudicial future treatment based on the whims of the powers that be.









Notes for essay entitled Antidepressant Vending Machines: some thoughts on pharmacology in the age of AI and drug prohibition:

1: Richard Louis Miller. 2017. Psychedelic Medicine : The Healing Powers of LSD, MDMA, Psilocybin, and Ayahuasca. Rochester, Vermont: Park Street Press. (up)
2: “The Project Gutenberg eBook of Eugenics and Other Evils, by G.K. Chesterton..” 2019. Gutenberg.Org. https://www.gutenberg.org/files/25308/25308-h/25308-h.htm. (up)
3: Paradoxes of ayahuasca expansion: The UDV–DEA agreement and the limits of freedom of religion Labate, Beatriz Caiuba, Taylor & Francis Online, 2011 (up)
4: Reddy, Sashank. 2024. “Botulinum Toxin Injectables for Migraines.” Www.hopkinsmedicine.org. 2024. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/botulinum-toxin-injectables-for-migraines. (up)
5: Szasz, Thomas. 1992. Our Right to Drugs. Praeger. (up)




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I should have added to that last post: "I in no way want to glorify or condone drug demonization."

If there is an epidemic of "self-harm," prohibitionists never think of outlawing razor blades. They ask: "Why the self-harm?" But if there is an epidemic of drug use which they CLAIM is self-harm, they never ask "Why the self-harm?" They say: "Let's prohibit and punish!"

In the 19th century, poets got together to use opium "in a series of magnificent quarterly carouses" (as per author Richard Middleton). When we outlaw drugs, we outlaw free expression.

All uplifting drugs are potential antidepressants. Science denies that fact by claiming that drug efficacy must be proven quantitatively. And so they ignore anecdote, history and psychological common sense.

My cousin says we should punish drug dealers. I say we should punish those politicians who created those drug dealers out of whole cloth by passing unprecedented laws against the use of Mother Nature's bounty.

Med-dependent patients of the world, unite -- to end drug prohibition, that is. You have nothing to lose but your prescription bottles and your status as a ward of the healthcare state.

One merely has to look at any issue of Psychology Today to see articles in which the author reckons without the Drug War, in which they pretend that banned substances do not exist and so fail to incorporate any topic-related insights that might otherwise come from user reports.

If we cared about the elderly in 'homes', we would be bringing in shamanic empaths and curanderos from Latin America to help cheer them up and expand their mental abilities. We would also immediately decriminalize the many drugs that could help safely when used wisely.

MDMA legalization has suffered a setback by the FDA. These are the people who think Electro Shock Therapy is not used often enough! What sick priorities.

We need a Controlled Prohibitionists Act, to get psychiatric help for those who think that prohibition makes sense despite its appalling record of causing civil wars overseas and devastating inner cities.


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