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“Drugs Cause Paranoid Reading and Writing”

Updated: Aug 29, 2023

Editor’s Note: Today’s post comes from Sean A. Witters, Ph.D., a Senior Lecturer in the Department of English at the University of Vermont. His current book project, Using Addict, looks at the evolving language of addiction, tracing the images and stories of drug use and dependency that flow through literature, film, medicine, and culture from the 19th century to the present. In this post, he responds to Alex Berenson’s recent book Tell Your Children: The Truth About Marijuana, Mental Illness, and Violence, about which Points hosted a roundtable in January.

“Oppressive language does more than represent violence; it is violence; does more than represent the limits of knowledge; it limits knowledge.” 

-Toni Morrison, 1993 Nobel Address

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What matters about this defense is not simply a petty clash of expertise or some question of credentials. Drug discourses require multi-disciplinary inquiry and are best shaped by perspectives from across relevant scholarship reported in writing that is carefully attenuated to the ethics of rhetoric and the lessons of drug history. A fair-minded reader of Berenson’s fundamental plea would entertain his potential value in such a conversation. The inherent problem with Berenson’s criticism of the letter and, more significantly, with his book is the implied posture toward the phenomenology of knowledge. Berenson depends on a paranoid ideal of truth, the “hard yes or no answer” (xxxvi)[2] that pre-supposes a hidden, unifying, and universalizing conclusion that only certain readers, certain writers, and certain subdivisions of expertise can grasp. This is a problem that shapes the history of drug discourses. Berenson has not simply been incautious about this problem. The consciously sensational lineage of his title and the habits of his prose and reasoning make it hard to sustain conciliatory judgment.

It is in this context, and because some might question or even offer a pithy joke about, the relevant expertise of an “English professor,” that I am responding. The present conversation on drugs, addiction, and mental health is strongly tied to positivistic or mechanistic mind/body theories, echoing the wider privileging of STEM fields in the discussion on educational value. Contrary to the all-too-easily formed opinion that “English” is a hazy field of “imagination” and “feelings,” my work relies on concrete inquiry into the relationship between power, language, and the texts, characters, and narratives that fuel that imagination and give form to our feelings—forms that shape popular opinion and the technical work of medicine, law, and policy-making.

I am presently writing a book on the representation of “the Addict” in literature, cinema, medicine, and the wider cultural discussion that runs from the 19th century to the present. My analysis of this subject has shown me two clear issues in this otherwise dizzyingly complex space. First, the language and terminology under which we organize, name, and pathologize human behavior is always bound to questions of power and is rife with blind spots and myth-making, especially when the discussion involves historically “othered” populations marked out by associations of race, class, gender, sexuality, ability, and mental health. Second, and this is vital to re-thinking Berenson’s book, “Drugs” have a long history of making writers, researchers, and policy-makers paranoid. What I mean is that paranoia seeks unifying narratives and strong theory. It puts its faith, as Eve Kosofsky Sedgwick argues, in revelation of a hidden organizing agency, and therefore it is susceptible to making every “seeking” a “finding” that turns correlation into causation. In this way, paranoia is ironically comforting—offering coherence to the overwhelming chaos of human life.[3] “Drugs” are, as such, both medicine and poison[4] for describing social problems and sustaining the implied relationship between the normal and the pathological.[5]

Even the work of well-intentioned and critically alert writers is susceptible to this problem because, as literary and linguistic theories show, intention is not stable. Every reading is a kind of translation inevitably shaped by the images, associations, and signifying structures that mediate the reader/writer relationship. This is an especially powerful problem in writing about drugs and addiction. Words such as “marijuana,” “drugs,” “addict,” “psychosis,” “madness,” or even “healthy” or “normal” may have intoxicating effects regardless of the writer’s conceived intent to be clinical, precise, or even-handed.  

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A still from the 1936 film “Reefer Madness,” in which drugs are hidden in a book

Berenson’s book both invites and indulges paranoia. Even where it is not purely sensational, it evokes the myth-making and hysteria that haunts readings of drug history as surely as the spirit of Harry J. Anslinger persists in institutionalized drug war rhetoric.[6] Berenson’s title, which invokes the original title of the 1936 film, Reefer Madness, illustrates this peril. The title imposes an imperative: Tell Your Children: The Truth About Marijuana, Mental Health, and Violence. The call to educate children about the matrix of risk-factors that could alter their health is a sensible and self-apparent ethical obligation; yet, Berenson chooses to draw on the sensationalizing spirit of reefer madness and to begin with a unidirectional imperative. He commands us to “tell” rather than “teach” or “talk with.” The act of telling, set in this syntax, replaces dialogue with the absolute truth claims of paranoia that, as I’ve already suggested, invite correlation to become causation.

The book’s title is paranoid. It posits a “truth” that organizes a menacing chain of signs. The sensational book-ended effect of the title’s syntax exploits the visual mechanics of reading and uses of the periodic sentence in the English language (i.e. the “main idea” is emphasized when it falls last in sequence) to position “the truth of marijuana” as the unified organizing middle, coordinating “children” and “violence.”

My close reading is not just a case of arcane pickiness or “reading too much into a text.” Berenson invites attention to the chains of language and logic when he pedantically explains the fallacy of the false syllogism to set up his core argument. This is exemplified by his effort to establish an analogy between defenses of Tasers and marijuana in the book’s introduction. He attacks the claim “marijuana never killed anyone” as a product of “the same circular argument” used to defend Tasers (xxxiii). In this way, his own argument tries to replace a false syllogism with a true one without questioning the absolutism of his own terms.

What a reader might overlook is the quiet operation of the drug-free world ideal and the cultural logic wherein “drugs” always already equal non-productivity, inauthenticity, madness, and death. This story, on which Berenson’s reasoning hinges, has deep cultural roots and flows unpredictably across substances, people, cultural spaces, artistic forms, and genres, figuring in narratives that both affirm and dissent against it. This story links Thomas De Quincey’s romantic and imperial opium-eating to a range of imitative warnings on the pains that lie beyond the pleasures of various drugs. It mingles with our fears about science and medicine in a lineage that links Dr. Jekyll and Mr. Hyde to A Long Day’s Journey into Night and Requiem for a Dream. It shapes dreams and anxieties about race, class, gender, sexuality, and modernization from Ellison’s Invisible Man to Tama Janowitz’s Slaves of New York to Amitav Ghosh’s Ibis Trilogy. It fills in the punchlines we must know to enjoy the postmodern absurdity of Inherent Vice, the iconic stoner stoicism of The Big Lebowski [7], and the dark humor of Trainspotting.

Poet, film-maker and artist Jean Cocteau, so obsessed with the power of the mirror-images that entrap us, offers a surreal portrait of this condition, when, writing of his own addiction and recovery, he muses, “The half-sleep of opium makes us pass down corridors and cross halls and push open doors and lose ourselves in a world where people startled out of sleep are horribly afraid of us.”[8] This is the implicit fate and historically generalized representation of the drug user—that dislocated person rendered as abstraction and compelled to walk through the stories of our culture as a trope used to frighten people out of sleep with the threat of enslavement, madness, and death. The particular substance may vary but the image persists. At their origins, drug and addiction discourses are, as Susan Zieger shows, dependent on metaphor.[9] The play of Berenson’s own title reminds us of the interactions of these stories and images, and the necessity of thinking across genre, cultural status, and discipline. That history also carries warnings about the human cost of reductive and violent rhetoric. His titular warning speaks to a readership that consciously and unconsciously seeks the fatalistic drug narrative and the doomed user.

It is precisely this matrix of always already known stories that allows Berenson’s argument to move silently from the claim that one cannot fatally overdose on marijuana, as one can with alcohol or opiates, to a straw-man argument where the subjects of his criticism claim: “1) Marijuana doesn’t cause schizophrenia. 2) It never has. 3) It never will. 4) Therefore, marijuana can’t have caused this person to become psychotic, or the violence that followed. 5) Therefore marijuana doesn’t cause schizophrenia” (xxxiii). He follows this satire of reasoning with an absolute truth claim: “But it does.” In a later chapter, he revives this syllogistic reasoning to state “Marijuana causes psychosis” and thus violence (173). With this rigid causal assertion, Berenson’s more nuanced calls to re-think the relationship between violence, mental health, and vulnerable populations are surrendered to the intoxicating and paranoid explanatory power of “drugs.” He abandons ethical duty for the impact of powerful rhetoric, embracing and barely repurposing the historically xenophobic language of drug hysteria when he warns, “The black tide of psychosis and the red tide of violence are rising together on a green wave, slow and steady and certain” (218).

What is lost here? The health and humanity of the people that Berenson, in his best moments, wishes to spare from psychosis and violence. What might be gained from measured reflection is an affirmation that re-thinking “violence” in our culture and the language that structures our vision of the pathological or unhealthy is absolutely worth talking about with our children and also with our “grown-ups.” The long history of representations and attributions of pathological drug use shows institutional resistance to efforts to A) ground discussion of drug policy and mental health in holistic accounts of oppressive socio-historic and economic orders, B) recognize the problems caused by research and policy predicated on single drug cause rather than, as neuropsychiatrist Dr. Carl Hart has suggested, multi-drug interactions understood in the matrix of the issues above,[10] and C) consider or even recognize the fact that the majority of drug users do not use in ways that are pathological or confidently diagnosable under the apparently evolving DSM attributions.

These images and problem are bound up in the language we have used in the past. In this sense, we should consider historian David Courtwright’s observation that the pharmacologically messy word “drugs” has persisted in discussion because of the linguistic principle of economy.[11] This word is short where an unwieldy term such as “illicit psychotropic substance” is not. The same stands for our present debate over the term “addict.” I have undertaken a thoroughgoing re-thinking of its history and use, but I suspect it is an instance of what theorist Raymond Williams would mark as a “residual” keyword[12] that will hold on in spite of efforts to replace it with more precise and less historically burdensome terms such as “substance use disorder.” Precisely because it is so difficult to re-shape the language of drug history, precisely because we already “get” the fatalistic joke or feel the tragic affirmation of often-told stories of drug users doomed to insanity or addiction, writers have a responsibility to think about the violence of sensational rhetoric.   

Even this account risks being pulled into the paranoid gravity that shapes drug discourses. In the last few paragraphs, I have invited “healthy” dialogue, but have done so by implicitly positioning “drugs” at the center, risking the suggestion that they alone organize and explain mental health and violence. No serious and ethical thinker would deny that they are a significant part of that matrix of issues, but all too often, especially in the raced and gendered history of the drug war and in the practices of mass incarceration, “urban renewal,” economic austerity, education policy, interdiction-based policing, and medical treatment, they assume the role of the “the explanation for everything.”[13]

The question when writing about drugs, or in this case a single drug, is the degree to which we use them to organize and explain political, social, mental, and medical problems. If, as the history of writing about “drugs” shows, the language of addiction and pathology intoxicates writers and makes them paranoid, then we must tell future writers to think carefully about the founding principle of toxicology. Paracelsus, “the father of toxicology,” gives us the axiom: “All things are poison and nothing is without poison; only the dose makes a thing not a poison.” The co-factors of history, language, clinical terms, and ideology carried by certain readers leaves any act of writing about drugs and mental health susceptible to a toxic and unhealthy dose of paranoid correlation. Of course, this is not the case with every reader. Some will have healthy and reflective critical experiences when reading about this subject. The risk of violence stemming from paranoid reading is not universal, but the risk is pressing. Berenson’s book should give us pause. In certain readers and writers, this subject may unlock latent paranoia. In other words, the writing and reception of Tell Your Children bears an ironic relationship to its own underlying argument.  


  1. Campos discusses the errors of Berenson’s use of his work in Dufton, Emily. “Points Roundtable Part 2: Isaac Campos on Alex Berenson’s ‘Tell Your Children,’” Points: The Blog of the Alcohol and Drug History Society, 24 January, 2019.

  2. Berenson, Alex. Tell Your Children: The Truth About Marijuana, Mental Illness, and Violence. Free Press, 2019. Print.

  3. Sedgwick, Eve Kosofsky. “Paranoid Reading and Reparative Reading, or, You’re so Paranoid, You Probably Think This Essay is About You.” Touching Feeling: Affect, Pedagogy, Perfomativity. Duke UP, 2003, pp. 123-151. Print.

  4. See Jacques Derrida’s work with the Greek word pharmakon in Plato’s Pharmacy and his interview ‘The Rhetoric of Drugs” in Alexander, Anna and Mark S. Roberts. High Culture: Reflections on Addiction and Modernity. State University of New York Press, 2003, pp. 19-43. Print.

  5. These terms point to Georges Canguilhem’s influential work on pathology, nosology, and the philosophy of medicine of the same title. It is difficult to miss the influence on his younger colleague, Michel Foucault, who described Canguilhem’s study as a key to reading major contemporaries, including Althusser, Bourdieu, and Lacan. Canguilhem, Georges. The Normal and the Pathological. Zone Books, 1989. Print.

  6. Berenson embraces Anslinger, writing “Harry Anslinger might have been a racist jerk, but eighty-five years ago, he was right about marijuana” (178). He does not acknowledge the implication that to say Anslinger was “right” is to accept his exploitation of racial panic and his reliance on white supremacist theories as both basis and rationale for prohibition.

  7. Co-signator, Ingrid Walker’s recent book offers cogent commentary on the unusual dynamics of comedy relating to film and television’s dissemination of negative drug use stereotypes. See Walker, Ingrid. High: Drugs, Desire, and a Nation of Users, University of Washington Press, 2017. Print.

  8. Cocteau, Jean, Opium: The Diary of His Cure, Trans. Margaret Crosland, Peter Owen Books, 2013, p. 86. Print.

  9. Zieger, Susan Marjorie. Inventing the Addict: Drugs, Race, and Sexuality in Nineteenth-Century British and American Literature. University of Massachusetts Press, 2008. Print.

  10. Hart, Carl L. High Price: A Neuroscientist’s Journey of Self-Discovery That Challenges Everything You Know About Drugs and Society. 1st edition, Harper, 2013. Print.

  11. Courtwright, David T. Forces of Habit: Drugs and the Making of the Modern World. Harvard University Press, 2001, p. 2. Print.

  12. Williams, Raymond. Keywords: A Vocabulary of Culture and Society (1976). New edition. Oxford University Press, 2014. Print.

  13. This is a problem that links the “drive to know” to a range of historically oppressive discourses. We might note this interaction is exemplified in the symmetry of drug discourses and queer theory. This insight is affirmed by Eve Sedgwick’s “The Epidemics of the Will” (1993) and, though to a less immediate extent, Paul Morrison, whose book this phrase invokes.


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