I graduated from college in 1973 and left home shortly after. I had been a sickly kid with several hospitalizations during childhood, including a near-fatal condition at 14. So, as I left my family care, my mother worried constantly about my lack of health insurance. Like most people in their “invincible twenties,” I paid no attention to such worries.

By the time I reached my thirties, I had settled into what has become a lifetime of self-employment. I’ve never had employee-based health insurance, and have never made enough money to justify the expense of getting my own. I’m happy to say that, except for periodic adventures in dentistry, I’ve never missed it.

I have always recognized, however, that I must take full responsibility for my own health. If the medical system would not insure necessary care in the future, I must do whatever I can to assure good health without it.

Lately there have been several articles in the mainstream press discussing the merits of legalizing marijuana and other intoxicants. While most politicians remain obdurate on the subject, the mere possibility of having a frank and spirited public debate, free of “just say no,” knee‑jerk hysteria, is encouraging.

This article is not an advocacy of intoxicant use, nor a denial of the very real problems of abuse and addiction. It is a plea for consistent, humane, and effective substance use and abuse policies. Our current policies inflict unnecessary suffering — on users, abusers and nonusers — while utterly failing to reduce substance abuse and addiction. It is time to try something different; let’s wind down the drug war and get on with the more rewarding work of teaching tolerance and the free pursuit of happiness.

For clarity’s sake this article is limited to a discussion of intoxicating substances. These same arguments can also be applied to the use, overuse and abuse of certain intoxicating activities, such as having sex, watching television, gambling, wielding power, and spending money.

As a species, we will continue to play with half a deck as long as we continue to tolerate cardinals of government and science who presume to dictate where human curiosity can legitimately focus its attention and where it cannot. Such restrictions on the human imagination are demeaning and preposterous. —Terrence McKenna

Overuse

No major American decision was ever made without the influence of alcohol, nicotine or caffeine­‑often all three. —Peter McWilliams

Yet all intoxicants can be overused. This is the ‘tox” in intoxication. Use any intoxicant too much or too often and its positive promise invariably turns poisonous.

The overuse of any intoxicant has a temporarily sickening effect upon one’s body and mind. The stumbling stupidity of too much alcohol, the hacking cough of too much tobacco, the wired agitation of too much coffee, the glazed over eyes of too much marijuana: any intoxicant can be overused and such overuse always results in a short term loss of wellness.

It must be noted, however, that our experiences with specific intoxicants are subjectively determined and therefore personal. One person’s happiness enhancer is another person’s poison. Some people can derive pleasure from scotch, some can’t. Some people can enjoy chocolate every day, some shouldn’t. Even for the individual, moderate use at one time in one’s life might constitute overuse or abuse at another time. All of which argues for social policies that encourage individual responsibility, rather than the promulgation of oppressive dogma and fruitless punishment.

The effects of intoxicant overuse are mostly temporary. They serve as clear feedback to help the individual to moderate any future use of the intoxicant. In some cases, a single instance of overuse (or even just witnessing overuse by another person) may be enough dissuade the individual from ever using a certain intoxicant. Or, some experience with overuse may lead to moderate use, ie, “I never drink more than one beer or “I only get high on weekends.” Or, the individual may miss the lessons of overuse and fall into destructive abuse.

We could argue that all of the positive effects of moderate intoxicant use would be better achieved through such practices as prayer, meditation, good works and simple clean living. At the same time, all of the obvious negative effects of intoxicant overuse and abuse would best be avoided altogether. So we might all be better off, and better people, if society just eliminated the use of all intoxicants. There are some individuals who have already achieved such purity; it might indeed be a better world if everyone did likewise.

But which is the better path to such a world? Prohibition, moral‑mongering, judgment and punishment? Or freedom, individual responsibility, education and growth.

We are gradually coming to understand that human beings learn better when treated with respect, given the truth, and encouraged to make intelligent choices. Positive reinforcements work better than negative conditioning. People of all ages grow more sound and vigorously while in the free pursuit of happiness than while reacting to threats and punishments.

Simply stated, the free pursuit of happiness works. To the extent that intoxicant use is truly enhancing one’s happiness, it is enough to gratefully enjoy such use and all that it brings. When instead one is overusing or abusing, and thus diminishing happiness, the challenge is to learn, to moderate present and future behavior, and to get one’s life moving on a more positive track.

Society’s challenge, in turn, is to provide an environment in which such positive learning and growth is strongly supported. This means taking all of the immense effort and resources of our failed war against drugs and shifting to a policy of honest education, compassionate treatment, and reasonable regulation. This means, in essence, becoming fully committed as a society to the basic entitlements of life, liberty and the pursuit of happiness.

As a child I was sick a lot. I’d get three or four colds a year, always with a nasty strep throat. I missed most of fifth grade with mononucleosis. I’d been born with some sort of digestive difficulties (never diagnosed; I now believe I was allergic to baby formula) that persisted as chronic diarrhea. Then, around the age of nine, I started passing blood in my stools.

By that age I was already averse to doctors and especially terrified of needles. So as my condition developed I kept it secret from my parents. Somehow they missed the fact that I was going to the bathroom twenty times a day, and another two or three times at night, usually just to pass a dollop of mucusy blood. Nor were they aware of the belly cramps, so bad that I’d have to stop whatever I was doing for several minutes until they abated.

Thus I grew into a skinny, pale, chronically tired teenager. Finally, when I was fourteen, I was hospitalized and tests revealed an advanced case of ulcerative colitis — the interior wall of my large intestine was one open, bleeding sore.

A core principle of “commonhealth” holds that the health of individuals cannot be considered apart from the health of their surroundings, including family, workplace, community, and the environment. No body is an island. Individual health fluctuates relative to local inputs — we experience good or ill health in significant measure due to the good or ill health of the world we inhabit.

Michael Marmot, British epidemiologist and author of The Status Syndrome, has shown that individual health rises or falls with one’s high or low status in society. But this is not a simple matter of the wealthy having more money to buy better food and medical care: