Maybe I am missing something but what is new in the proposition Spence has outlined? ^{Reference Spence1} When a Yanomani tribesman snorts a powerful concoction of hallucinogens he does so as part of a ritual that includes the shamanistic healing of others in the tribe and maintaining tribal cohesion through tradition. When a footballer plays on despite injury, with pain relieved by analgesia, he does this in part for his team and fans. When a Peruvian highlander chews coca leaves so that he can work longer hours he does so to keep his family fed; and the same applies to the kratom user in the Far East. When millions of soldiers took amphetamines to enable them to fight for longer hours, thereby exposing themselves to ever greater dangers, they did so to win what they believed to be just wars. When a mother solicits fertility treatment so as to produce a child that will not only add to the family, but also potentially save the life of another sibling, the use of these potentially dangerous drugs is largely driven by the mother's need to save the other child. When groups of men gather every afternoon in the Yemen and chew qat, this is a social activity enhanced by the use of qat. In the Middle East, coffee shops have always served this purpose, providing socially stimulating conversation, and do so in Europe to this day. Tobacco has had a similar use in many countries and alcohol has done much the same, despite the harm associated with the use of both of these substances. Psychiatrists, on a small scale, have started to use what some term empathogens (i.e. MDMA) so that they can better understand and help their patients (although the less charitable question their motives).

I think we would be splitting hairs to argue that taking a drug to achieve a moral end is fundamentally different from achieving a moral end through use of a drug; they exist on a continuum. Drugs simply allow us to explore and alter our behaviour and thoughts. How we use this allowance is up to us.