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The use of substances that alter the quality of the consciousness is not something intrinsic to exploitation.
The primitive communists used consciousness transforming substances collectively, following their hunter-gatherer lifestyle. Mushrooms, plants and other substances were all experimented collectively.
Cannabis, for example, has been domesticated by human beings for more than 14,000 years in Asia, and emerged even before private property became the prevailing system, which was about 10,000 years ago.
Our perspectives on drug abuse today are metaphysical, backward and reactionary: we treat addiction as phenomena directly caused by substances, not by the material conditions human beings find themselves in.
The prohibition of drugs in the capitalist system is a racist policy in Brazil and in the USA. The use of drugs is usually not allowed for workers in an exploitative system, because it influences the quality of your labor (therefore, your capacity of providing surplus-value). Since workers do not work for themselves, in an exploitative system it is not up to workers to decide what they want to produce and consume.
In socialist relations of production, in which production would be collective and workers could decide the directions of their production, the use of consciousness-transforming substances would tend to be, obviously, a collective activity, and without the alienating factor of capitalism.
Workers, even for convenience, would already coexist materially as a collective throughout their days, at work, at home or at leisure.
In the capitalist system, the use of drugs becomes something individualizing, isolating, anti-social, because we reproduce the logic of liberalism, whose conception of being human is that "we are selfish by nature."
That is the power of ideology. It is the distortion of consciousness. An exploratory regime is going to contradict the transforming substances of consciousness, because exploitation also needs to dispute the consciousness of human beings.
Do you want to see it in practice? These substances, which I was careful to call something else, all carry names with extremely negative connotations: drug, narcotic, psychedelic, etc.
This is a sign that drugs are such a historical oppression that in our language words that do not carry a negative connotation to define it have not survived. I recommend Stalin's text about marxism in language [1], he has a very interesting reflection about it.
In short, substance abuse does not cause alienation, it is alienation that causes substance abuse. It is a classic inversion of values.