An essay on biomedicine and the body politic. Millions of addicts in America want effective treatment, and cannot get it. Funds for research and treatment are still scarce, compared to money for interdiction and law enforcement. What would happen if we took the billions spent on interdiction and let it flow into addiction research and treatment? What would happen if we gave people truthful, accurate information about drugs, and trusted them to make intelligent decisions more often than stupid ones? Can it end up any worse that the present state of affairs? Susan Sontag’s warnings about the danger of disease as metaphor still ring true. In modern American society, heart disease, cancer, AIDS, alcoholism, and cigarette addiction account for millions of deaths. They are all disease entities with strong psychological and behavioral components—complicated, multicellular, multi-organ disorders. But they have all been associated, at one time or another, with negative personality traits and moral flaws. The less we know about the mechanics of a human disorder, the more likely we are to view its external symptoms as signs of laziness, or neuralgia of the spirit, or as a form of damage caused by specific kinds of thoughts and emotions. Without a doubt, all kinds of flaws are sometimes expressed in the behavior of people who have these disorders. Yet none of these flaws can be considered the root cause of the diseases. The genuine drug war is being fought in the arena of biomedicine. Addiction is being added to the roster of physical disorders once thought to be symptoms of insanity, but which are now seen to be physiological disease entities with mental components. The real crisis is the indisputable fact that there exists today an appalling shortage of funds for biomedical research. The cause of the dilemma is a fundamental misunderstanding among politicians and the public about how diseases can be understood and conquered. Research into the viral mechanisms of the common cold may ultimately yield more insights into AIDS then all of the directed research now underway. In biomedicine, there is no guarantee that goals can be reached through the front door, by a systematic assault akin to an engineering project. We cannot, for example, hope to cure addiction, or even the common cold, by means of the same methods we used to put a man on the moon

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