6.21.2018

Too Short for a Blog Post, Too Long for a Tweet 133

Here are some excerpts from a book I recently read, "Buzzed: The Straight Facts about the Most Used and Abused Drugs from Alcohol to Ecstasy," by Cynthia Kuhn.
 
 
 
As scientists, we have devoted years to the study of the effects of drugs on the brain and behavior. We have seen the stunning advances in understanding the actions of the chemicals that have been with us for thousands of years. Yet surprisingly, little of this information is effectively translated for the public. We have become convinced that contemporary efforts to educate people about the effects of alcohol and other drugs are inadequate and misdirected. There is a lot of important information in the scientific literature about addiction and the effects of drugs, but it is not reaching the people who need to know it. The actions of drugs on the brain are complicated and vary tremendously from drug to drug and person to person, making it impossible to make blanket statements like “drugs kill” and have them believed by anyone who has any drug experience.



The marijuana controversy is an excellent example. Some organizations have taken a hard line that this drug is devastating to anyone who uses it. Other organizations view it as harmless and support its legalization for totally unregulated consumption. In our opinion, the truth is somewhere in between. As you will read in the marijuana chapter, marijuana causes memory problems and interacts with the immune system in unknown ways. It has effects many hours after it enters the body, even if the user is unaware of those effects. So it is not harmless. But people do not die from marijuana overdoses (as they do from overdoses of alcohol). Any truthful discussion of marijuana must include a range of topics and a realistic representation of risk, which cannot be accomplished by exchanging slogans.



By the 1600s, trade merchants had introduced coffee to Europe, and “coffeehouses” spread rapidly. One of the hallmarks of these establishments was intellectual conversation. Not all of this conversation was viewed as politically correct, however, and coffeehouses were outlawed in England. That ban was very brief, and the growth of coffeehouses and the use of coffee spread even more rapidly thereafter. In fact, coffeehouses came to be known as places where one could go to learn from notable academic and political figures of the day. The environment created in coffeehouses turned out to be one that gave rise to creative thinking in the entrepreneurial and business realms as well. As an example, the giant insurance firm Lloyd’s of London actually began as a coffeehouse in the early 1700s.



How can we tell if we are releasing endorphins? First, we could give a drug like naloxone (Narcan) and see if the endorphin high stopped. This approach has actually been tested on people listening to their favorite music, who found that they didn’t enjoy the music as much if they were treated with an opiate antagonist.



Many addiction researchers think that once people are established addicts, the desire to avoid withdrawal maintains addiction more than the pleasurable effects of the drug. Obviously, when people first get addicted, they haven’t been taking the drug long enough to go through intense withdrawal if they stop. However, after several months or years, the withdrawal is stronger and may contribute more to an addict’s continued drug taking. If you know taking the drug will solve the problem, it seems an easy solution, doesn’t it? In the end, it is a combination of changes in the brain that create the overwhelming compulsion to keep using narcotics (or any other highly addictive drug). Researchers think that the craving for a drug may result from chemical changes in two parts of the brain that unfortunately combine their efforts: the parts of the brain that seek reward are chemically changed to respond strongly to drug cues, and the parts of the brain that create anxiety and bad feelings start firing as soon as the drug wears off.



Why isn’t there still cocaine in Coca-Cola? The tale is familiar in today’s environment of public activism about product safety. During the early 1900s, unregulated sales of “tonics” containing potent ingredients such as opium and cocaine boomed. Some of these formulations contained so much cocaine (hundreds of milligrams per milliliter instead of the 0.5 milligrams per milliliter in the original Parke-Davis formula) that toxicities became widespread. The medical establishment finally took note. Unfortunately, a scare campaign with racist overtones also contributed to the public furor. Reports that cocaine made African Americans powerful and uncontrollable contributed to the wave of negative publicity. In 1906, the Pure Food and Drug Act required that manufacturers list the ingredients on all tonics, and in 1914, the Harrison Narcotic Act imposed severe restrictions upon the distribution of opium and cocaine products. Today, Coca-Cola contains only caffeine, and clinical cocaine use is restricted to a few surgical procedures.
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