ABSTRACT
The chapter investigates the manner in which public health policy targeting alcohol and other psychoactive substances can have a subversive effect, by undermining worldviews. Alcohol is a major public health concern, and due to the interdependence of risk involved in harmful drinking, a new paternalism has emerged, in the shape of the public health model, aimed at restricting the overall availability and consumption of it. This represents a shift from the traditional focus on proximate risk factors, to an attempt to introduce external, formal controls on drinking behaviour. This carries risks however, as it can lead to the subversion of lifeworlds, which enshrine customs of how to drink virtuously, in terms of with whom, when, where and how one should drink. Anthropological research on non-Western societies, have shown that these have a eudaimonian concept of drinking, based on a sense of proportion, which has been preserved to an extent in Mediterranean societies. Central here is the concept of drug, set, and setting, for explaining the importance of interpretive frames for whether the outcomes of alcohol use will be constructive, or destructive. In contrast, Enlightenment thinking crystallised in the public health model, seeks to achieve progress by expanding health, but disrupts and fragments the worldviews by problematizing forms of conduct that were previously settled, through processes of subjectification and biopower. It imposes impersonal, universal, detached rules; replacing concepts of virtue and interpretive schemes enshrined in worldviews, with abstract systems.
