Is There a Difference between Drugs and Medicine?

The fact is, in recent years, the terms 'drug' and 'medicine' have almost become interchangeable in usage.

Using Merriam Webster as our gold standard in the lexicon world, we find that medicine means "a substance or preparation used in treating disease."

Sounds right--and so far, so good.

Now, according to the Food and Drug Administration's Food, Drug and Cosmetic Act, drugs are defined as  "articles intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease" and "articles (other than food) intended to affect the structure or any function of the body of man or other animals" [FD&C Act, sec. 201(g)(1)].

Interestingly, the FDA doesn't define 'medicine' at all--it seems to use 'drug' instead of medicine, as if the two terms could be used interchangeably, and as if the term 'drug' has no negative connotations that 'medicine' itself doesn't have.

Chemically, too, there is very little way to differentiate between drugs and medicines. Drugs are medicines and medicines are drugs.

In science both come to be defined as "any foreign substance used in treatment that can cause a change in the way the body works." It is only in popular culture that drugs are illegal substances, not in the medical or scientific realm.

Not all have signed on to this identification of terms, however. Note that some scientists and researchers refer to medicines as legal drugs, substances prescribed by doctors for patients, sold in stores, and legally bought.

That emphasis on the world ‘legal’ highlights a potential difference between the two terms.

'Drug' can have an additional layer of meaning, in that it often refers to a narcotic, hallucinogen or stimulant, and is a substance that can potentially cause addiction, although we often clarify this reference by referring to some such substances as 'recreational drugs.'

Most people, when they call someone a 'druggie,' aren't referring to people who take psychiatric or diabetes medications. And we rarely mean a person who devotedly takes his Lipitor when we refer to a 'drug addict'. [Note that the most famously addicting medications, say, Oxycontin or Vicodin, do indeed fall into the narcotic category.]

When we talk about the War on Drugs, most people recognize the government is not spending money to fight access to chemotherapy, or to diuretics.

In fact, if popular culture agrees that a 'drug' has the negative connotations that can accompany that term, and then a section of the populace wants to use the drug for treatment purposes, we stick the word 'medicinal' in front of the drug's name, as we've done with ‘medicinal marijuana,’ to clarify that it's now moved out of the illegal and into the healing realm.

But the slippage between the two terms continues.

In researching the topic I came across the following distinction between the two, that I only wish were true:

"A medicine is a chemical substance which cures the disease, is safe to use, has negligible toxicity and does not cause addiction. In contrast, a drug is a chemical substance which also cures the disease but is habit forming, causes addiction and has serious side effects."

Unfortunately, many people who've taken medications are aware that their medicines have much more than 'negligible toxicity'--and many, in fact, do cause addiction. So many have serious side effects that I couldn't begin to count.

Clearly pharmaceutical companies don't think of themselves as purveyors of addiction and toxicity when they call themselves 'drug companies.' Note that they do not call themselves 'medicine companies,' and that they refer to their molecules in their pipelines as 'drugs.'

So although some may try to force medicines and drugs into separate categories, and although popular culture is more clear on the distinction, the terms continue to merge in the scientific and medicinal realms, despite their best efforts.