Such an understanding of drugs makes possible a sharp division between authorized, medical-scientific use and all other uses, which are presumed to be motivated by “recreational” and hedonistic impulses and to be illegitimate. Even to consider other possible motives for drug use (once a substance has been so classified) requires a reconsideration of this deep-rooted dichotomy that is very difficult to achieve (Bakalar and Grinspoon 1984). Perhaps the most culturally significant aspect of the UDV-USA case is the way it raises questions about entrenched understandings of motives for drug use: can they be legitimately religious in character? Would the existence of religious uses of drugs undermine the entire anti-drug effort? And more to the point: is the government required to investigate the specifics of a particular case of drug use to make that determination? This, then, may be the central question in the UDV-USA case: to what extent may the government rely on historical understandings of drug use in formulating policy on the ritual use of ayahuasca and other psychoactive sacraments, and to what extent must the government take into account the particular cultural context in which these substances are employed?