During the 1970s, the U.S. began what has now become known as the “war on drugs,” a reaction to the counterculture and drug-fueled climate of the 1960s. To the government’s dismay, these policies did nothing to quell the use of illicit drugs; rather, it opened a huge market for the illegal development, distribution and importation of psychoactive and hallucinogenic substances like marijuana, cocaine, LSD and, later, ecstasy and designer drugs.

Forty years later, the U.S. is facing a very different problem—a nation addicted to prescription drugs. And to make things a bit more complex, some of these illicit “street drugs” are now being hailed as potential breakthrough therapies for depression, post-traumatic stress disorder, and possibly even autism. With the FDA’s recent decision to designate MDMA (also known as ecstasy) as a breakthrough therapy for PTSD, the increasingly blurred lines between prescription and illicit drugs in the U.S. and their impact on health and society are becoming even more complex.

The effects of psychoactive substances on the nervous system by bioactive substances—from caffeine to diet pills to cocaine—should be labeled as drugs, regardless of their legal status. I was met with blinking, vacant stares. Surely this perspective is not earth-shattering and most people agree that, yes, a drug is a drug no matter what label it maybe attached to.

But from a sociocultural perspective, different types of drug use are associated with different, harmful stereotypes. For example, a homeless person who uses heroin is a “menace” to society but a mom recovering from back surgery who uses opioids for pain relief is just taking medicine her doctor prescribed. These problematic stereotypes have been ingrained into our culture, creating a dichotomous framework by which people understand drug use; taking (and even abusing) prescription drugs is okay because a doctor gave them to you but taking (or abusing) illicit drugs is not okay because decades ago they were placed into the illegal category.