Thomas Szasz, Drug Prohibition, and the Psychiatric Pill Mill

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Thomas Szasz, Drug Prohibition, and the Psychiatric Pill Mill

an open letter to Professor Jan Domaradzki of the Poznan University of Medical Sciences

by Brian Ballard Quass, the Drug War Philosopher

June 3, 2026

Dear Dr. Domaradzki:

I enjoyed your excellent paper entitled "Thomas Szasz: The uncompromising rebel and critic of psychiatry."¹ I am a philosopher in Virginia, USA, who has taken up the gauntlet of Szasz's views on drugs and psychiatry from a unique perspective: that of a patient who is on the receiving end of the default treatment for depression in the age of drug prohibition. Starting seven years ago at age 60, I decided to devote the remainder of my life to analyzing drug attitudes as they relate to the psychiatric treatment paradigm, thanks to which I have been turned into a ward of the healthcare state after being placed on highly dependence-causing "meds" in my youth. I have been taking such "meds" for 40+ years, and yet I still have to see a doctor ONE-THIRD MY AGE every three months of my life in order to qualify for a prescription refill. How? By answering a series of humiliating questions, including, "Have I considered suicide in the last three months?", to which I want to respond: "Only when I consider how drug prohibition has turned me into a ward of the healthcare state." It is from this point of view that I am a passionate supporter of the ideas of Thomas Szasz. I hope you will find time to consider the issues that you raised in your paper from the point of view of someone like myself, a sort of "patient malgré lui" who yearns to be treated like an adult and to take care of his own health as he sees fit, someone who demands not just his rights as a patient, but the right not to be a patient in the first place.

NOT A LIBERTARIAN

I do not believe that Szasz's ² main arguments are truly Libertarian. They are in agreement with Libertarian philosophies, but they do not depend upon Libertarian ideas for their justification. The Libertarian defense of drug re-legalization generally takes one of two forms: it may be based on a weighing of the supposed costs and benefits to society of the re-legalization of drugs, or it may be based on the belief that human beings have "the right to go to the devil in their own way." Neither of these viewpoints were advanced by Szasz. His point was rather that there is nothing written about drug prohibition in the Bible, nothing written about drug prohibition in the U.S. Constitution, and that human beings -- with limited exceptions -- have always been able to take care of their own health as they see fit, that this has always been considered to be, in fact, the most basic of human rights. His point was that the outlawing of all psychoactive medicine was an unprecedented "power grab" by government, one that flies in the face of the Lockean natural rights upon which Thomas Jefferson founded America. As Szasz wrote in Our Right to Drugs: "The right to chew or smoke a plant that grows wild in nature... is anterior to and more basic than the right to vote."³ It is interesting to note in this connection that Reagan's DEA raided Jefferson's Monticello estate in 1987 to confiscate his poppy plants, a raid that can justifiably be seen as a coup against Jeffersonian freedoms of all kinds ⁴.

To repeat: the controversial ideas of Szasz about drugs and psychiatry do not rely on Libertarian arguments. I believe that his critics bring up that label in order to imply that he is an extremist. Yet from my perspective, the extremists are those who think that a psychiatrist knows more about my mental states than I do; the extremists are those who cannot see how substances like cocaine or laughing gas could help the depressed; the extremists are those who think that every problematic behavior is a physical disease -- an idea which, if true, would mean that the Bible is a collection of stories about pathological human beings interacting in a benighted time when the cause of their behaviors had yet to be analyzed, categorized and prescribed for by enlightened psychiatrists. The extremists are those who think that it is helping a patient to turn them into a ward of the healthcare state, while denying them once-obvious godsends, like opium, which has been considered the closest thing to a panacea since the time of Galen.⁵ The extremists are those who refuse to listen to the depressed but rather tell us to "take our meds" and to ask our doctors what is right for us. The extremists are those who discuss assisted suicide for the depressed without discussing the drug prohibition which makes that option necessary (at least in the minds of the suicidal) by outlawing all drugs that can inspire and elate.

Critics of drug re-legalization write as if there were no positive uses for drugs. It is not surprising that this is the case since the media simply will not publish stories about positive use. Imagine, for instance, a book entitled "How I used opium advisedly to better appreciate opera and to better understand the powers of the human mind and the nature of consciousness" (or "How I used cocaine..." or "How I used phenethylamines...", etc.) Such books simply do not exist, partly because publishers would not publish them if they did and partly because most Americans would not even think of writing them, having grown up in a world in which they have been shielded from all talk of beneficial drug use. Historian William Shirer could have been referring to Drug War America when he wrote: "No one who has not lived for years in a totalitarian land can possibly conceive how difficult it is to escape the dread consequences of a regime's calculated and incessant propaganda."⁶ Americans simply do not understand how they have been biased to see the whole politically choreographed subject of drugs. They do not see that when you outlaw drugs, you outlaw far more than drugs: you outlaw the right to heal, you outlaw the right to Mother Nature's bounty, and you outlaw the sort of philosophical investigation that William James urged us to undertake in order to understand the nature of human consciousness and of reality writ large.⁷ Again, the extremists, to me, are those who see no problem with losing such rights in a purportedly free society.

It is not a coincidence that Szasz wrote about both psychiatry and drug prohibition. It was drug prohibition which gave psychiatry a monopoly on dispensing mind and mood medicine in the first place. The two are inseparably linked. The pill-popping paradigm and the enormous profits that it generates are both made possible by drug prohibition. And how did drug prohibition come about? Largely, because self-interested doctors claimed to see no positive uses for drugs. And so they wrote op-ed pieces against cocaine, for instance, judging that drug only by downsides and never asking the depressed what they thought about the drug. The depressed were never considered stakeholders in the drugs debate -- only the young white suburban westerners whom we refuse to educate about safe drug use. And so drugs were judged without any regard for common sense, let alone basic human rights. And this attitude continues to this day. In a 2025 article in Rolling Stone, Wade Davis implies that cocaine was justifiably outlawed because there were 400 cases of cocaine toxicity discovered in the early 20th century ⁸. What he fails to mention is that 3,000 Brits die every year from taking aspirin ⁹, to say nothing of the 178,000 who die yearly in America from using our drug of choice: alcohol ¹⁰. So even if we give up on the idea that there are such things as basic human rights, like the right to use Mother Nature's bounty for human benefit, our risk assessment of drugs is always politically biased and statistically challenged.

The truly frustrating part for me is that I have no standing in this debate. If you search online for "drug prohibition, psychiatry and depression," you will see impressive-looking papers, many of them hidden behind academic paywalls, with plenty of footnotes and plenty of awe-inspiring abbreviations following the names of the authors. These papers are all written in favor of the disempowering status quo of psychiatry -- or, more often, by taking the propriety of that status quo for granted. Meanwhile, Google will not even index my website of contrarian essays because patients like myself have no standing in the debate about drug prohibition and society. Google basically is telling me to "shut up and take my meds." Even the sites that claim to help med-dependent patients will not publish my views because they insist that I am giving medical advice when I say that there are positive uses for drugs. Consider this situation from my point of view: first, doctors demonize godsends; then they turn the time-honored right of self-medication into a sin in the public mind. Not yet content with safeguarding the enriching status quo, they then tell us that we are an "addictive type" if we still insist on using the substances that they have decided could not help us. Should we merely even say positive things about drugs, we are told that we are infringing on the doctor's territory by giving medical advice without a license. And so they do an end run around the constitutional guarantee of the freedom of speech when it comes to drugs. And yet I am the only one who sees this status quo and asks the obvious question: "Cui bono?" Who is benefitting from such an anti-democratic status quo? Hint: It's certainly not the depressed.

You conclude that the ideas of Thomas Szasz "influenced significantly neither psychiatric thought nor practice." No wonder, since the status quo is immensely enriching -- to everybody except patients. But the debate is not over. The psychiatric field has not yet heard from the victims of medicalization and the pill mill which was brought about by drug prohibition. Someday the psychiatric field is going to have to come to terms with the fact that the status quo is a hugely disempowering paradigm and that the widespread use of dependence-causing pills is absurd and inhumane and makes no sense in a world in which we outlaw time-honored godsends. Someday the psychiatric field will listen to patients like myself rather than telling us to shut up and take their meds.

Key Takeaways:

The arguments of Thomas Szasz about drugs do not depend on Libertarianism.
The psychiatric pill mill would not exist but for drug prohibition.
Drug prohibition turns the depressed into patients for life.
Brian is the only philosopher who is unequivocally carrying on the work of Thomas Szasz when it comes to drug prohibition and modern psychiatry.
Drug prohibition was an unprecedented power grab by government.
Reagan's DEA raided Jefferson's Monticello estate in 1987.
Extremists tell us that drugs that inspire can have no positive uses.
The media will not publish stories about benefits of drug use, thereby giving the impression that no such benefits exist.
When you outlaw drugs, you outlaw far more than drugs.
Self-interested doctors helped to demonize cocaine, never considering how the depressed felt about the drug.
Americans are statistically challenged when it comes to evaluating drug risk.
The depressed are not considered stakeholders in the war on drugs.

Notes for essay entitled Thomas Szasz, Drug Prohibition, and the Psychiatric Pill Mill: an open letter to Professor Jan Domaradzki of the Poznan University of Medical Sciences:

1: Domaradzki, Jan. 2021. Review of Thomas Szasz: The Uncompromising Rebel and Critic of Psychiatry. Psychiatriapolska.pl. Psychiatria Polska. 2021. https://www.psychiatriapolska.pl/. (up)
2: “The Thomas S. Szasz Cybercenter for Liberty and Responsibility.” 2025. Szasz.com. 2025. https://www.szasz.com/. (up)
3: Szasz, Thomas. 1992. Our Right to Drugs. Praeger. (up)
4: Rossen, Jake. 2018. “The DEA Crackdown on Thomas Jefferson’s Poppy Plants.” Mental Floss. March 22, 2018. https://www.mentalfloss.com/article/534703/dea-crackdown-thomas-jeffersons-poppy-plants. (up)
5: Archaeological evidence on the use of opium in the Minoan world Askitopoulou , Helen, ScienceDirect, 2002 (up)
6: Shirer, William Lawrence. 1984. The Rise and Fall of Adolf Hitler. https://www.goodreads.com/book/show/199576.The_Rise_and_Fall_of_Adolf_Hitler. (up)
7: “The Varieties of Religious Experience : William James : Free Download, Borrow, and Streaming : Internet Archive.” 2021. Internet Archive. 2021. https://archive.org/details/the-varieties-of-religious-experience_202109. (up)
8: The Secret History of Coca Davis, Wade, Rolling Stone magazine, 2025 (up)
9: “Daily Aspirin Linked To More Than 3,000 Deaths Per Year, Scientists Warn.” 2017. HuffPost UK. June 14, 2017. https://www.huffingtonpost.co.uk/entry/daily-aspirin-causes-more-than-3000-deaths-per-year-scientists-warn_uk_593fb481e4b0b13f2c6daa10. (up)
10: CDC. 2024. “Facts About U.S. Deaths from Excessive Alcohol Use.” Alcohol Use. July 8, 2024. https://www.cdc.gov/alcohol/facts-stats/?CDC_AAref_Val=https://www.cdc.gov/alcohol/features/excessive-alcohol-deaths.html. (up)

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Many psychedelic fans are still drug warriors at heart. They just think that a nice big exception should be carved out for the drugs that they're suddenly finding useful.

Prohibitionists have the same M O they've had for the last 100+ years: blame drugs for everything. Being a drug warrior is never having the decency to say you're sorry -- not to Mexicans, not to inner-city crime victims, not to patients who go without adequate pain relief...

Americans believe scientists when they say that drugs like MDMA are not proven effective. That's false. They are super effective and obviously so. It's just that science holds entheogenic medicines to the standards of reductive materialism. That's unfair and inappropriate.

The drug war is the defeatist doctrine that we will never be able to use psychoactive drugs wisely. It's a self-fulfilling prophecy because the government does everything it can to make drug use dangerous.

Question: Why do doctors judge cocaine by its worst possible use? Answer: Follow the money.

Scientists are so used to ignoring "drugs" that they don't even realize they're doing it. Yet almost all books about consciousness and depression (etc.) are nonsense these days because they ignore what drugs could tell us about those topics.

We live in a make-believe world in the US. We created it by outlawing all potentially helpful psychological meds, after which the number-one cause of arrest soon became "drugs." We then made movies to enjoy our crackdown on TV... after a tough day of being drug tested at work.

Any self-respecting mycologist should denounce the criminalization of mushrooms.

The best long-term treatment for OUD would be to normalize the nightly smoking of opium at home, not to addict the user to government-supplied drugs that render them impervious to the benefits of the poppy plant.

When scientists refuse to report positive uses for drugs, they are not motivated by power lust, they are motivated by philosophical (non-empirical) notions about what counts as "the good life." This is why it's wrong to say that the drug war is JUST about power.

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Thomas Szasz, Drug Prohibition, and the Psychiatric Pill Mill

an open letter to Professor Jan Domaradzki of the Poznan University of Medical Sciences

Key Takeaways:

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Diary of a Drug Fiend