The Marxist critique of prohibitionism and the pathologization of cannabis use

Abstract

This paper presents a Marxist critical analysis of prohibitionism and the pathologization of cannabis use, grounded on the theoretical perspective of the social determination of health and articulated with contributions from collective health, popular education, and Foucault’s critique of disciplinary power. The main objective is to understand how prohibitionist policies and the biomedical discourse that pathologizes cannabis use act as mechanisms of social control, legitimizing capitalist power structures and reproducing inequalities of class, race, and gender. The study adopts a qualitative, theoretical, and documentary approach, based on three central sources: the article “Uso medicinal da Cannabis sativa e sua representação social” (Santos & Miranda, 2019), the monograph “Marcha da Maconha: Antiproibicionismo e luta contra a estigmatização (2007–2012)” (Melo, 2018), and Michel Foucault’s Discipline and Punish (1975). Together, these references make it possible to reflect on how moral and bodily control are expressions of the contradictions between capital and life.

From a Marxist perspective, the debate on drugs moves beyond the moral and individual dimension and becomes a structural and historical question. Prohibitionism is not merely a policy against certain substances but an ideological instrument that reinforces alienation and social domination. The criminalization of cannabis users operates through a dual mechanism: on one side, the State exercises coercion through police and legal apparatuses; on the other, medicine and psychiatry produce a discourse of pathologization that transforms cultural practices into diseases or moral deviations. This medicalization of life, characteristic of capitalist rationality, turns the body into an object of surveillance and discipline, maintaining a social order based on productivity and docility.

The bodies of cannabis users, especially those belonging to Black and working-class communities, are the primary targets of repression and stigmatization. This social selectivity of prohibitionism reveals its class character and its function in containing subaltern populations. The scientific discourse that defines cannabis use as “addiction” or “disorder” is not neutral—it serves to legitimize exclusion and strengthen biopower, the Foucauldian concept of the regulation of life through norms. In dialogue with Marx, prohibitionism can be seen as a form of ideology: an inverted representation of reality that naturalizes domination and conceals the material roots of social suffering.

The anti-prohibitionist movement, embodied in the Marcha da Maconha and other grassroots initiatives, represents a form of class struggle within the health field and a space for emancipatory popular education. These movements advocate autonomy over one’s body and the right to therapeutic and recreational use of Cannabis sativa, challenging both medical and moral hegemony. By constructing their own narratives grounded in lived experience and popular knowledge, these movements subvert institutional logics and propose alternative forms of care and social coexistence. Thus, anti-prohibitionism extends beyond the legal debate—it is a project of social emancipation that seeks to transform the structures producing exclusion and suffering.

The theory of the social determination of health, central to the Latin American Marxist tradition, provides the framework to understand that illness and exclusion are not individual failures but outcomes of material living conditions and structural contradictions of capitalism. The social suffering associated with drug use is therefore a product of inequality and precarity, not a matter of moral weakness or deviance. The prohibitionist discourse individualizes social problems, masking their structural nature and perpetuating alienation. This ideological inversion fulfills a key political function in capitalism: it transfers responsibility from society to the individual, preventing collective consciousness and mobilization.

In the health field, the pathologization of cannabis use is part of a broader process of medicalization and commodification of care. By defining the user as a patient, biomedicine reinforces institutional dependency and subordinates subjectivity to market and moral norms. This view distances health from its social dimension as a collective right and aligns it with the capitalist notion of productivity, in which a “healthy body” is one that serves labor and consumption. Overcoming this logic requires reclaiming health as a social practice and a historical process determined by economic, cultural, and political factors.

The historical-dialectical materialist method makes it possible to analyze prohibitionism as a total phenomenon, integrating its economic, ideological, and political dimensions. It reveals that the “war on drugs” is not a health policy but a mechanism of social control that criminalizes poverty and moralizes popular culture. Marxist critique, in contrast, proposes an emancipatory conception of health grounded in autonomy, solidarity, and bodily freedom. Human emancipation demands decolonizing medical knowledge and rejecting state tutelage over forms of pleasure and self-care.

In conclusion, the Marxist critique of prohibitionism and the pathologization of cannabis use contributes to repositioning the drug debate within the field of the social determination of health, showing that illness and exclusion are products of material conditions and capitalist exploitation. Overcoming prohibitionism requires the advancement of popular health education, rights-based public policies, and a science committed to social emancipation. Future research should analyze Latin American experiences of drug decriminalization and their impact on collective health, helping to consolidate an ethical-political paradigm that unites health, freedom, and social justice.