The Fear of Drugs Used by Strangers

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Declaration of Interest

The author reports no conflict of interest. The author alone is responsible for the content and writing of the article.

Notes

³ The reader is asked to consider system 1 thinking in terms of two challenging theses which have been posited for more effectively analyzing types of problems and types of questions for affecting planned intervention's unfinished business. Rittel and Webber have suggested that problems can and should be usefully categorized into: “tame problems” and “wicked problems.” The former are solved in a linear, traditional known and tried “water fall paradigm”; gather data, analyze data, formulate solution, implement solution; the basis of contemporary scientific research and its generalizable evidence-informed outcomes. The latter “wicked problems” can only be responded to individually, each time anew, with no ultimate, repeatable solution. Rittel, H. and Webber, M., (1973) Dilemmas in a General Theory of Planning”. Policy Sciences, Vol. 4, pp. 155-169. The cyberneticist Heinz Von Foerster posted that there are two types of generic questions; legitimate and illegitimate ones. The former are those for which the answer is not known and is, perhaps, even unknowable during a given state of knowledge and technology and which is associated with knowledge breakthroughs; a condition which is likely to stimulate and enable a type 2 system of thinking The effective and sustained control of man's “appetite” for a range of psychoactive substances, whatever their legal as well as social status, has yet to be achieved historically anywhere. An illegitimate question is one for which the answer is known, or, at the very least consensualized. An additional facet for considering the implications, and unfinished business, of a culture of consensualized tame problems and illegitimate questions is the ongoing, anchored tradition of moving from unnuanced data, whose generalizability is low (levels and qualities), to derived information (which results in knowing), to interpreted knowledge (understanding, which is not the same as knowing), and, rarely, to levels of wisdom-based (a minimization of errors resulting from random, interacting, interpenetrating and nonmeasurable factors) planned, implemented, and assessed needed interventions. The asking of illegitimate questions has been, and remains, by and large, the acculturated norm. Heinz Von Foerster, Patricia M. Mora, and Lawrence W. Amiot, “Doomsday; Friday, 13 November, A.D, 2026,” Science, 132, 1960. pp. 1291-1295. The reader is referred to Pablo Neruda's The Book of Questions for a poetic exploration of legitimate questions. Editor's note.

⁴ There is the need to distinguish between pharmacological actions, and the “drug experience,” which is the outcome of the complex interactions among the chemically active substance, the user, and where it is being used, or site. (Zinberg, N. E. (1984). Drug, Set, and Setting: The Basis for Controlled Intoxicant Use. New Haven: Yale University Press.) Editor's note.

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Don C. Des Jarlais

Don C. Des Jarlais, PhD, behavioral scientist, Director of Research at the Baron Edmond de Rothschild Chemical Dependency Institute at Mount Sinai Beth Israel; professor at Columbia University Medical Center, a guest investigator at Rockefeller University in New York, is a leader in the fields of HIV/AIDS and injecting drug use. He has published extensively. Consultant to various institutions, including the Centers for Disease Control and Prevention, the National Institute on Drug Abuse, the National Academy of Sciences and the World Health Organization. He is a former commissioner for the U.S. National Commission on AIDS.