The Future of Drugs

The Future of Drugs
Posted by FoM on November 12, 2000 at 19:23:31 PT
A Special Report
Source: Feed Magazine
The title of this issue is big and ambitious, but you'll notice two things right off: One is that we're talking about only certain drugs, specifically psychoactive substances, whether that's whiskey or MDMA, Paxil or peyote. And you actually won't find a lot of future-shock prophecies. There is a lot of delving into the present. That's the only way we can fathom what's ahead. And in taking a hard look at the present, we were dismayed to find out how much information about drugs lies in the realm of the unknowable, and so couldn't be included here. 
For instance, we wanted to know how much prescriptions for SSRIs (Prozac and its siblings) have risen over the last decade and whether the number of people taking lithium has increased or declined. These were elusive figures. It's not that nobody knows this information, it's that you have to pay to get a hold of it. A lot. On the other hand, if you want to know how many people used marijuana in 1998, that's comparatively easy (18.7 million) or if coke is really back (it's not -- the number of cocaine users has decreased by 62 percent since 1979). The more illegal the drug, the easier it is to find out about its users. The whole nation might be on Zoloft, but we'd have only anecdote and Pfizer's profits as proof. A few decades ago, Hubert Selby, Jr. vividly depicted New York as a world in which aimless kids become smack fiends while their mothers become speed freaks. Selby hammered the point that the junkie hustling for a fix is no different, no worse, than the one who simply calls up her doctor for more diet pills. The trajectory of both addicts into abjection was direct and inexorable. We don't romance excess so much anymore. We're more focused on balance and optimal performance. Even the psychonauts concocting new psychedelics do so methodically, scientifically, as Erik Davis discovers, in "Adventures Through Inner Space." But there is still profound confusion about the role drugs should play in our lives, a confusion that has been abetted by misguided public policy and genuine parental concern. The source of the confusion is a faulty taxonomy. Fatuous distinctions between various mind- and mood-altering substances have justified billions in federal spending, indifference to many who want drug treatment but can't afford it, quasi legal searches and seizures, and nonsensical sentencing laws. It's enough to make you want to get high. If you look back a little at the history of drug use in America, which we do in our timeline, "Long Strange Trip," you can see the roots of this madness and the points at which one intoxicating substance, say alcohol, is stitched more tightly into our culture, while another, say marijuana, is pushed underground. The effects of this marginalization on the drug -- its potency and purity -- and its users are numerous and usually negative. The fact is, humans dose themselves. To see God, to dig deeper into the nature of consciousness, to calm down, to get it up, or to just live. Well-financed media campaigns to reprogram this impulse, as most American teens know, are comically ineffective, which Alex Abramovich documents in "Just Say...Oh No!" How could they work anyway, when the incoming president of the United States has a public record of illegal drug use? Besides failing to materially affect drug use by kids, the propaganda supports indefensible categories and obscures real science that has unraveled the effects of drugs on the brain. In our Dialog,"The War on the War on Drugs" Ernest Drucker, professor at Montefiore Medical Center/Albert Einstein College of Medicine; Richard Doblin, head of MAPs (Multidisciplinary Association for Psychedelic Studies); Deborah Small, from the Lindesmith Center; and Dave Miller, New Mexico governor Gary Johnson's advisor on drug policy, discuss alternative strategies for integrating drugs into your life -- reforms that reject the official distinctions between good and bad drugs, between legal and illegal psychoactive substances. Also in this issue are two stories coproduced with Wired News: The first, "Prospecting for Drugs," looks at technology that accelerates the discovery of new drugs, and the second, "High and Inside," reports on the use of psychedelics in psychotherapy. Drugs that make you happier and more productive are a legacy of the 20th century. Drugs that make you measurably smarter are definitely on the way. And then there are the drugs that are pure entertainment, the ones that end up turning you around and fucking you up. In "What I Did on My Chemical Vacation," Ben Neihart, David Berman, Brenda Shaughnessy, Geoff Dyer, Tim Page, Hubert Selby, Jr., Michael Musto, Jonathan Ames, Lisa Carver, and Sam Lipsyte share potent memories of intoxication and the strange situations that resulted. The stories are funny and sad. Their radically different experiences show us how tricky it is to put mind-altering drugs into neat, enforceable categories. Hopefully, the whole issue does as much. We'll be rolling one to two stories out every day for the next week. So go on, FEED your head. -- Stefanie Syman Part IIAdventures Through Inner Space:Let's say you're a buttoned-down organic-chemistry jockey at Merck. One day you tweak a molecule ripped off from a Peruvian native medicine, and you wind up with a powerfully psychoactive compound. Instead of squelching anxiety, instilling a reliable boner, or giving young minds that magic amphetamine edge, the drug helps you touch the hem of God -- or at least something a lot like the hem of God. At times it hurtles you into a blazing hieroglyphic phantasmagoria more sublime and gorgeously bizarre than anything on the demo reels of Hollywood FX shops. On other occasions it leads you to the lip of a fundamental insight into the dance of form and emptiness. And though later attempts to communicate your insight founder on the shoals of coherence, the experience still leaves you centered and convinced that ordinary life is fed by deeper springs. Now, you think you'd zero in on this molecule, not only as a potential vector into the enigma of consciousness but as the basis for some really interesting commercial drugs. In other words, you'd be psyched. Right? No way! It's common knowledge that such molecules have been recognized and consumed by people for millennia, but have been effectively banished from the scientific mindscape of the West. Despite their mighty psycho-spiritual effects, the potential insight they might provide into the mind, and the largely non-addictive behaviors they elicit, psychedelic drugs like LSD, psilocybin, mescaline, ketamine, and DMT have been crudely lumped into the same legal and socio-cultural categories as speedballs and crank. And one result of this social policy is a withering of the research strategies that a rational civilization is supposed to bring to bear on the conundrums it confronts. Despite the continued ferocity of the "war on drugs" and the largely foolish ideas about psychoactive substances it pushes, the last decade has seen a small renaissance in psychedelic research, both above and underground. On the official stage, advocacy groups like MAPS (Rick Doblin's Multidisciplinary Association for Psychedelic Studies) and the Heffter Reseach Institute (headed up by Dave Nichols), as well as individual researchers like Rick Strassman and the U.K.'s Karl Jansen, have done their homework, balancing loopy subjective accounts with the dry, methodical language of protocols, pharmacology, and action studies. Hopefully, these modest research reports are laying the groundwork for a resumption of the kind of official in-depth psychological studies squelched over thirty years ago. Meanwhile, in the far margins of legality, small crews of brave, compulsive, and sometimes wacked individuals continue to compile and share fact, anecdote, and lore about exotic and new-fangled psychoactives and the even more exotic combinations they allow. Think of these so-called "psychonauts" as hobbyists of neural R&D. They like to plunge as far as any hippie into the bejeweled halls of hyperspace, but they also bring an almost geeky spirit of investigation to their exploits. They know their chemistry, and understand that the envelope of psychedelic pharmacology is pushed by recombining existing molecular Tinkertoys. They also take this recombinant logic a step further by mixing and matching different drugs from an ever-widening pharmacopoeia in order to craft new highs. Even Burning Man veterans may not have heard of many of the esoteric compounds that float around the scene: AMT, 5-MEO-DMT, 2C-T-2, 2C-T-7, 5-MEO-DIPT, 4-Acetoxy-DiPT, DPT, DOB, 2-CB. With a few exceptions, these white powders have largely resisted being branded with cool names. Some have been known for decades, others are relatively new; a few have been scheduled, but many have so far been overlooked by the Feds and remain uncontrolled. However, because the vast majority of these substances are chemically similar to illegal drugs, people gobbling them technically can be snagged under the Federal Analog Act, which allows individuals to be prosecuted for recreational use of drugs that are "substantially similar" to scheduled drugs. But this rarely seems to happen, especially given the obscurity of many of these drugs and the difficulties involved in proving "substantial" similarity. It's impossible to say how many grams of these compounds are being synthesized and consumed annually, but there's probably morsels of intrigue all over Europe and America. Though some demand complex procedures and elusive precursors to synthesize, the lion's share can be cooked up by most anyone with undergrad training in chemistry and access to a lab. There's really nothing to stop curious amateur organic chemists from brewing up a small batch of AMT or 2-CB in a weekend to share with a small circle of friends, and anecdotal evidence indicates that many do. Some of these modern alchemists even exploit the gray-market status of these compounds by marketing them for nonhuman "research purposes" over the Internet. The backroom circulation of these drugs has engendered a loose-knit and rather hermetic psychedelic scene devoted less to partying or cosmic communion than to a kind of weird science, where the purple haze is filtered through a knowledge and respect for methyl groups, monoamine oxidase inhibitors, and the value of keeping your eye on the clock. The godfather of this particular psychedelic style is Sasha Shulgin, a cheery, eccentric Bay Area chemist best known for the rediscovery of MDMA. With his wife, Ann, he wrote PiHKAL and TiHKAL, two phone-book-size tomes devoted, respectively, to phenethylamines and tryptamines, the two pillars of psychedelic pharmacology. Though Shulgin once had a license to study scheduled drugs, an irritated DEA responded to the publication of PiHKAL by swooping down on Shulgin's grubby lab and slapping him with 51 violations they then effectively swapped for his license. In reaction, Shulgin simply continued to devote himself to the art of recombination that characterizes the synthesis of novel molecules. "Once they schedule something, I throw away my samples and continue my research in another direction," he says. The creator of 2C-B and 2C-T-7, two drugs popular among psychonauts, Shulgin has described, synthesized, and analyzed scores of substances whose potential for thrills and profit remain untapped. Many of the hundreds of compounds described in PiHKAL and TiHKAL are duds; others are actively unfun. 2C-B, on the other hand, has gained quite a following for its electric visuals and mescaline-like effects, while the more esoteric 2C-T-7 can unleash a hyperactive barrage of 3-D psychedelic imagery that can take some users to the edge of delirium. Dosage, of course, matters greatly, but dosages are by nature provisional in this scene -- a psychonaut recently died after snorting an ungodly amount of 2C-T-7. Still, even at the right amounts, it could turn out that nothing in the Shulgin universe will ever match the depth of LSD, mushrooms, or DMT. But the genie is out of the bottle. "I find postings about compounds that are slipped away in little corners of my books," says Shulgin. "And all of a sudden they are commercially available and people are talking about them. The seeds are all in there." To no one's surprise, the weird scientists have embraced the Internet, which links the gossamer strands of data and debate necessary to support a shadowy and fragmented community that needs to stay informed. Sites like the Vaults of Erowid and the Lyceum provide loads of information on dosage, chemistry, legal status, effects, and, perhaps most importantly, experiential feedback. The problem is that such public information also runs the risk of killing the scene, especially when kids get into the act. "The more people know about what's going on, the more likely somebody is to come in and try to squash it," explains Scotto, one of the more balls-out contributors to Erowid's growing vault of reports. At the same time, the persistent curiosity of psychonauts and the endless potential for pharmacological novelty may have created a perpetually expanding zone of gray-market psychedelia. "Humans are going to keep inventing these things faster than the government's going to make them illegal," says Scotto, pointing out that the efflorescence of esoteric synthetic compounds mocks the "logic" of the war on drugs. "Are we going to reach the point where I can be imprisoned for doing twenty milligrams of 4-acetoxy diisopropyltryptamine in my bathtub, when nobody even knows what that fucking is? What kind of culture is that?" I'll tell you what kind of culture that is: a posthuman one. Part IIIProspecting for Drugs:Pharmaceutical Companies want more drugs and they want them cheaper and faster. After all, that was at least part of the promise of the Human Genome Project. But the technologies in place will surely buckle under the weight of too many A, C, T, G sequences, experts say. Bioinformatics -- the mining of biological data using information technology -- is the buzzword du jour in biotech. Bioinformatics companies, however, are using the brute force of old technologies to crunch their data. Unless someone introduces a new and unique technology to process all this information efficiently, experts say, the decade-long, $3-billion Human Genome Project could be nothing but an expensive science project. "Computers can solve things, but they can't predict anything new," said Dr. Alan Walton, chairman of Oxford Bioscience. "We're going to have to have a breakthrough here." If researchers are going to extract drug discoveries out of GenBank the Human Genome Project's free database, and Celera the company that created its own genome map, without getting buried in information, biotech will need revolutionary, eureka-style discoveries. Jeremy Levin, CEO of Physiome Sciences in Princeton, New Jersey, is shouting "eureka!" and some experts say he's worth a listen. Physiome has developed technology called "In Silico Cell" that helps researchers create models of living systems to predict which drugs will work before they begin clinical trials. Using an XML-based language called CellML, scientists can create a mathematical representation of any type of cell -- from heart, to lung, to kidney -- and perform simulations to test drugs. "Here you've got a situation where I believe you can predict things the pharmaceutical industry would not know by any other method," Walton said. The program can tell researchers that a certain heart drug, for example, will cause the left ventricle to expand. If researchers can test drugs "in silico" and get meaningful results before they go into clinical trials, they could save millions of dollars and possibly save lives. "For the first time in the history of biology, we have the capability to reduce biological functions to mathematics and compute them in a cost-efficient fashion," Levin said. Money spent on research and development at pharmaceutical companies has increased at a staggering rate. In 1980, researchers spent $3 billion, according to the Pharmaceutical Research and Manufacturers of America. This year they spent nearly $23 billion. Even more surprising is the fact that only $2.4 billion of that was spent on drugs that made it successfully through Food and Drug Administration clinical trials. "This is a major crisis," Levin said. "Preclinical expense -- unless pharmaceuticals improve all their systems -- is going to drown this industry." Drug discovery is an imprecise process that relies heavily on serendipity. Pharmaceutical companies come up with about 140 new drug candidates per year, but only about seven are marketed. Big pharmaceuticals typically aim to develop two new drugs per year, and most have failed. "The industry is built on failure," Levin said. With $50 million in venture capital money in its coffers, Physiome hopes to garner revenue by helping pharmaceuticals know what will be a success before they even begin clinical trials, which can take more than a decade and about $800 million for just one drug. Scientists tested the In Silico Cell on a heart drug originally developed by Bristol-Myers Squibb. The drug made it to Phase Three clinical trials in 1995 where, unexpectedly, it killed several women. In 1999, Physiome used the drug to test In Silico Cell. Researchers mathematically coded biological models of men and women with different genetic backgrounds, and simulated a dosage of the drug. "The results were striking," Levin said. "You could see that the female was three times more sensitive to this drug. It could have saved lives." Physiome scientists also are using In Silico Cell to examine the FDA's entire database of would-be heart drugs that never made it through clinical trials. By choosing trial subjects they know are more likely to respond to a drug, some of these failed drugs could actually get approval for specific populations. "The FDA has unofficially said they love it," Levin said. Of course other companies hope they'll be the ones with a revolutionary solution for the information bottleneck for pharmaceuticals. Stephen Friend, CEO of Rosetta Inpharmatics says his company has built a system that allows researchers to use the entire genome of a human or other organism as a "sensor pad." While Physiome's system is focused on modeling the biochemistry of cells, Rosetta's technology takes a snapshot of an entire genome and shows researchers what changes a drug makes. The company's core product, the Resolver System, is a "decoder" that can find patterns in gene sequences and identifies protein function. "Whether it's a cardiac or central nervous system cell, we figure out what the changes are in all of its proteins," Friend said. Rosetta hopes to first supply tools to pharmaceutical companies and then to work with them as collaborators. "We picture that within the next two to three years we'll primarily be working as collaborators with big pharmas doing drug discovery," Friend said. Putting biology "in silico" could also help doctors know what drugs are best for individual patients after they're on the market. Scientists recently used a computer model to understand how the HIV virus mutates to make itself resistant to the AIDS drug stavudine, which could help doctors tailor treatments more precisely. Scientists at Belgian company Virco designed a neural network to replicate the mutations. Ultimately, these companies hope that the FDA will accept results produced by their technologies to provide safety data for the first phases of clinical trials. Although that may seem like a pipe dream now, experts say changes that big need to happen if the drug-discovery industry is to stay afloat. "My dream is in ten to twenty years, rather than biotech companies having three hundred employees, a high burn rate, and the public getting turned off every two or three years," Walton said, "it will be a couple people and a great computer, and they'll go from zero to Phase Two (clinical trials) in a matter of hours rather than the time and cost now." Kristen Philipkoski covers the science and ethics of genetic research and medical technology for Wired News. Before joining Wired News, Kristen wrote on a freelance basis for the print magazines Wired, Health, People, and Life. Part IVJust Say... Oh No!Back in the early days of the public service announcement, the Do It Now Foundation convinced white shaman Jim Morrison to tape an anti-drug ad for their "Speed Kills" radio campaign. Alice Cooper had already lent his satanic services to the crusade, and Frank Zappa made a splash with an equally ominous spot warning listeners that "In general, this drug will make you just like your mother and father." The foundation had less success, however, with the indefatigably poetic Lizard King: "Hi, you little assholes out there listening to the radio instead of doing your homework," said the erotic politician, who was more used to preaching a Rimbaudian gospel of systematic sensory distortion than weaning kids off crank. "This is Jim Morrison of the Doors." Here the self-taught disciple of Kerouac, Nietzsche, CÚline, Bosch, and Baudelaire was interrupted. His spunky enthusiasm was dead on target, but the tone was off. "Hey," the singer said on take two, "how you guys out there doin'? This is your old buddy Jim Morrison. I sing with a group called the Doors. You might have heard of them. We done a few songs, but I never, never did a song on speed. Drunk? Hell yeah!" This, too, was off the mark, and Mr. Mojo Risin' tried again: "Hello, this is Jim Morrison. Don't shoot speed. Christ, you guys, smoke pot!" And again: "Shooting speed isn't that smart. Shooting speed kills geese. If you shoot a goose full of speed that goose is gonna swim in circles forever." And again: "Hello, this is Jim Morrison from the Doors, and I just got one thing to say. Don't shoot speed. Speed kills. Please don't shoot speed. Try downers, yeah downers, barbs, tranqs, reds -- They're much less expensive." The recordings say less about Morrison's character than about the character of public-service announcements -- a subgenre that never quite managed to reconcile the bearer and the message. To this day, most PSAs lobbed at the no-man's-land between those who score and those who know the score tend to land on the wrong side of the divide. Take the "Everclear" ad (the top image on the right side of this page). Here the band's frontman, Art Alexakis, talks about his own drug use, but without quite shaking his voice free of the bragging, fuck-all addict's tone that made him a star in the first place. "I'd do any drug on the table," he says "It didn't matter what it was." Art, we discover "threw away fourteen years," but knows the futility of convincing others to do otherwise. "Don't take my word for it," he concludes. "Figure it out for yourself." What we're left to figure out is that fourteen years of drug use, coupled with a band named after a brand of grain alchohol, is a fine way to land yourself on MTV. "Frying Pan," released a few years ago as part of the same campaign, sends an equally mixed message. A heroin-chic waif wearing lots of mascara (and not a lot of bra) smashes her kitchen apart in a fit that's supposed illustrate what effects snorting (not shooting -- no needles on prime time TV, please!) heroin might have. Namely, snorting heroin might make you look more like that paper-thin Lolita having sexy fits on the nation's TV screens. Nor is the message of "No Thanks" entirely clear: "Mike," the twelve-year-old protagonist, seems to have snuck into Twilo on a Saturday night. There he's propositioned by a pot-smoking samaritan who thinks a toke or two on Mike's part might offset the effects of an atrociously lame haircut. "No thanks, man," Mike tells him cloyingly, "That stuff is illegal." Poor Mike. He should have said the same thing to his barber. More useful are ads that forgo attitude and aim for honesty. In "O'Connor," TV star Carrol O'Connor, whose son Hugh killed himself while hooked on drugs, delivers a monologue so wrenching it's almost impossible to sit through. In "Drowning," the simple equation of inhalent intoxication and the oxygen deprivation caused by drowning suddenly makes the prospect of sticking your snout in a bag full of airplane glue a lot less enticing. Also effective are ads that encourage parents to broach the subject frankly with their kids, and those aimed at kids -- young kids -- themselves. Kids, it seems, are too young to care about acting cool for their friends, and parents are too old, so kids and parents together form a bond no crank dealer can sever. This, it turns out, is something more than effective strategy, as far as advertisers are concerned, since the official war on drugs now sees teenagers as expendable assets.Part VThe War on the War on Drugs:When FEED ran its first dialog on drug policy five years ago, our participants took stock of the victories and body count racked up in the war on drugs and found considerably more of the latter. We now revisit the subject, starting from the position that, however politically successful, the drug war has been a practical failure, clogging our courts and prisons without doing anything to stem the availability of illegal drugs. We've invited four experts to share their ideas for the next stage in drug regulation. They've come up with provocative solutions, from drug-purchasing licenses to revamped drug-education programs to narcotics-by-prescription. We hope you'll weigh in on these suggestions and share your own ideas in the LOOP. QUESTION ONE: If we could replace the drug war with a better strategy, what would that strategy look like? How would your reforms address the concerns of parents, who form such an enormous and powerful political constituency? QUESTION TWO: Are there drugs out there that simply should not be decriminalized or legalized? What parameters, if any, should be taken into account when deciding issues like legal-age requirements for drug use? Aren't there legitimate, rational reasons for forcibly keeping drugs out of the hands of people who have been known to hurt themselves or others when under the influence?A NOTE ON THE PARTICIPANTS: ERNEST DRUCKER is Professor of Epidemiology and Social Medicine at Montefiore Medical Center/Albert Einstein College of Medicine. RICHARD DOBLIN has a PhD in public policy from the Kennedy School of Government, Harvard University, with a dissertation on the regulation of the medical uses of psychedelics and marijuana. He is the founder and president of the Multidisciplinary Association for Psychedelic Studies ( DEBORAH SMALL is a graduate of City College of the City University of New York, where she majored in law and political science. She attended Harvard Law School and the John F. Kennedy School of Government, receiving her JD/MPP degrees in 1987. In 1998, she joined the staff of the Lindesmith Center as Director of Public Policy and Community Outreach. DAVE MILLER is legislative liaison and office advisor on drug policy at New Mexico Governor Gary Johnson's office. QUESTION ONE:We all agree that the drug war has been a costly failure. What is far less clear is how to handle the plethora of drugs -- from heroin to Ritalin -- now easily obtainable, as well as those constantly in development worldwide. But one can also say that, in many ways, the drug war has been a fantastic political success. (And a recent Frontline series, "Drug Wars," makes clear that this is due, in large part, to the support of parents.) If we could replace the drug war with a better strategy, what would that strategy look like? How would your reforms address the concerns of parents, who form such an enormous and powerful political constituency? ERNEST DRUCKER Any alternative strategy must differentiate between current users, non-using adults, and "not yet" users -- really young populations from which future users will come. What makes sense for each is different. For the current users -- some sort of legal provision -- perhaps with registration or, for those with problems (maybe 20%) some sort of treatment options that include prescribed drugs. For the non-users (e.g., concerned parents), non-crazy education and help with understanding drug use -- and addiction. If that distinction was made and real help offered for problems, most parents would calm down. For future users -- really good info on drug use as safety, and access to safer forms of drugs (mild opiates, mild stimulants) regulated like tobacco and alcohol. To protect children from predatory marketing, heavy penalties and serious enforcement. The smaller markets would permit concentration of enforcement on this aspect and should restrict underage use about as much as for tobacco and alcohol -- not perfect but good enough, if the moralizing about use per se is kept to a minimum. That's what attracts a lot of kids anyway. RICHARD DOBLIN As a parent of three young children, I've been asked by a DEA agent whether my views have shifted as a result of my becoming a parent. On the contrary, I am now even more persuaded that we need to abandon prohibition and the resultant exaggerated and counterproductive government propaganda about the risks of illegal drugs. Though my oldest child is not yet six, I try to talk honestly with him about all manner of issues and all manner of risks. I'm appalled at the number of parents I know who hide the fact they smoke pot from their kids, not because they think their kids shouldn't have this information but because the parents are afraid that their kids will incriminate them inadvertently, for example in DARE programs that seek out this sort of information from kids. I think that adults should have licenses to purchase and consume drugs, much like a driver's license. If people misbehave as a result of drug use, they should be punished for their misbehavior and also lose their license to purchase and use drugs. Minors should be permitted to use drugs if such use is approved by their parents or guardians, who also assume responsibility for the actions of their minors when under the influence of the drugs. This permits parents to educate and regulate the drug use of their own kids, taking this power back from the government, which insinuates itself into the parent/child relationship by criminalizing parents who think it preferable to teach peaceful coexistence with drugs to their kids rather than the willful blindness of Just Say No. I think an organization of parents for drug-policy reform needs to be created, to argue that the safety of our kids can be better protected after the end of prohibition than under its poisonous influence. Current drug policy focuses on drugs, not on the relationship people have with drugs. This simplistic approach leads to hyperbolic, non-scientific statements by Dr. Alan Leshner, Director of the National Institute on Drug Abuse (NIDA), such as, "Our job is to provide accurate scientific information. And since we understand that drug use basically is bad for you -- from a public health perspective, not an ideology perspective -- we think people shouldn't engage in the behavior." According to Dr. Leshner, there is no distinction made between drug use and drug abuse. All drug use is basically bad for you, with no offsetting benefits. And people should not make risk/benefit decisions on their own but have these decisions made for them by Dr. Leshner, backed up by the coercive power of the police and the horribly punitive nature of the prison system. Kids do not take well to such exaggerated and easily falsifiable statements that all drug use is harmful. Rather than treat adults like children, we should treat adults like adults and let parents have some say in how they wish to educate their own kids about drugs. DAVE MILLER First, some thoughts on the posed question: 1. The reference to the "plethora of drugs available" is provoking. We need to single out alcohol and tobacco as the Big Two in terms of personal and societal impacts. All other drugs pale by comparison. For example, the latest SAMHSA household survey for New Mexico shows cigarette use at 27%, binge alcohol at 21%, marijuana at 7%, and all other illicit drugs at 4%. And that's the use rate. The dependence rate in our little western state for illicit drugs is 2.7%. Does this reflect a "plethora" of drug use or abuse? Yes, with extensive black markets now established, there is wide availability (a plethora), but is there extensive use or, more importantly, abuse? 2. I would argue that we have to always cull out booze and cigarettes, always distinguish between drug use and abuse, pull marijuana away from all other hard drugs, and keep the issue scaled and sized to what's real. This may be obvious to some but I believe a majority of Americans do not get it. And once you have mangled the definition of the public-policy problem, then any solution ( like a drug war) will do. This is not intended as hair-splitting or policy semantics; it's intended to point toward new strategies that address the real problems we face. 3. More in this vein -- we really may not have a plethora of problem drugs/drug abuse, but we definitely may have a plethora of "social/psychological drivers" of drug abuse, i.e., vast cultural materialism, social isolation, bowling alone, divorce, BoBo non-parents, crushing poverty, video violence, hero glorification, etc. Again, any new strategies may need to be targeted at the underlying causes (social/psychological drivers) more than at the drugs. I don't know. 4. More on the posed question -- FEED refers to "the drug war as a fantastic political success." This deserves group discussion. Political success at what costs? Americans and their elected officials need to know the war's body count, the corruption of western democracies, the effects on the Fourth Amendment to our national Constitution, the impacts on kids of low-level traffickers/possessers, etc. The continuation of some drug war strategies/budgets/policies is inevitable over the short term but can't we do this with our eyes wide open, strategies more targeted, programs assessed for budget effectiveness, etc.? 5. Finally, "what does the new strategy look like?" Maybe something like this: Call for a truce on the war. Do no more harm. Draw the line on getting any tougher on drugs. Stop the train rather than trying to change the wheels while moving down the tracks. That's Step One. Then get the congress and the White House to authorize a federal blue-ribbon drug-policy commission. Boring, but necessary to frame a legitimate debate and provide political cover to politicians afraid to speak out on their own. Third, a fairly widespread demonstration of harm-reduction strategies. Let Americans see and feel the pragmatic alternatives available. Europeanize the feel of the debate by just doing it. Fourth, decriminalize marijuana. Now. We need to take a big symbolic (yet real) step away from the war. The science, the facts, and common sense dictate this action. Fifth, a national conversation about drugs, booze, policy, families, individual freedom, etc. needs to take place. "Just say no" needs to be replaced by "just say know." I'm afraid that Americans really are still deeply Calvinist, puritanical prohibitionists at heart. The stark fact that two million are in jail today speaks volumes about us as a people. Just changing laws, policies, budgets, etc. without Americans changing inside may not get the job done. DEBORAH SMALL The new strategy would start from the presumption that a drug-free society is neither an obtainable goal, nor an advisable goal (most people want to continue to have access to psychoactive substances for both medicinal and recreational purposes). Consequently, the principal focus of national drug policy would be to reduce the harms associated with drug abuse. It would distinguish between casual, non-problematic users and addicts. Adult users would be provided information to enhance their safety and the safety of others. Persons with addiction problems would be offered counseling upon request and health care to address any drug-related health problems. The principal focus of interventions with chronic problematic drug users would be to assist them to stop using drugs if they wanted to and, if not, to offer them support to help reduce the harm their addiction causes to themselves and others. The markets for soft and hard drugs would be kept separate along the model adopted in the Netherlands, and young people would be provided comprehensive and effective drug education that was age, gender, and culturally appropriate. The principal goal of such education would be to assist them to make informed decisions based on a reasonable asessment of the harms associated with drug use. As a parent of a young man (23), I am well aware of the fears that drive parents to want to shelter their children from drugs, sex, violence, and similarly complicated aspects of adult life. Nonetheless, if recent events (school shootings, increase in overdose deaths, and teen suicides) tell us anything, it is that in our modern highly technological society it is impossible for us to shield our children from information that is in the world. The Internet, cable television, satellite communications all make it very diffiicult to restrict access to information. Americans are generally resistant to change. It took American parents a long time to accept the notion that sex education should be taught in schools. But a recent survey by the Kaiser Foundation demonstrated that now parents overwhelmingly favor comprehensive sex education -- that stresses abstinence as the preferred course but also helps young people to negotiate the conflicting feelings associated with sexual desire and that provides information that will enable young people to stay disease-free and safe. I believe that eventually parents will adopt a similar attitude with respect to drugs. What most parents want is for their children to be safe. In the area of drugs, as with sex, ignorance does not promote safety. It's our job to keep letting parents know that they can help their children and still maintain their standards and values with respect to drug use. I'm proud to be part of an organization that does just that. RICHARD DOBLIN From my perspective, Deborah's initial approach is excellent. I totally agree with her remark that "the strategy would start from the presumption that a drug-free society is neither an obtainable goal, nor an advisable goal." However, I wonder what she meant by "the markets for soft and hard drugs would be kept separate along the model adopted in the Netherlands." Does she propose that there be no legal market for cocaine or heroin or methamphetamine? DAVE MILLER Some early-morning reponses and overnight thoughts: 1. To replace the drug war, require what Eric Sterling and Sanho Tree call a two-step process, of which step one is to clearly establish in the public debate that "the war cannot be won" under any terms, at any costs, at any time. That military defeat is inevitable, that military victory is out of the question. This is a "psychological revelation" that needs to be fully, really absorbed by the American public. Sterling and Sanho argue that people need "time to adjust to the shock, greive for the casualities, vent some rage and reorient their views." There is ample evidence that step one is being accomplished: The Frontline piece, Governor Johnson's attacks, etc. Much, much more must be done. It will take time. 2. The second step Sterling and Sanho argue is to spell out what a cessation of hostilities would look like. That's where this first FEED question comes into play. And Deborah's comments start to lay out the terms of the deal: regulation to keep drugs away from kids, science-based drug education, etc. But step one is just that -- the first step. By putting the second step first, the unrepenting warriors can paint an exaggerated picture/scenario of "legalization chaos," where Starbucks will be serving "meth-achinos," Cheech and Chong will teach drug education, etc. 3. One other notion: Deborah mentioned a kaiser poll. Let me refer all to for other polling results on illicit drugs. It's disturbing/disheartening that 64% of Americans may still support the current military action in a drug-producing nation like Colombia; that 84% support getting tough on Mexico about drug exports; 71% support workplace drug testing; etc. Very sobering and I think supports my above thoughts. Part VIHigh and Inside:Psychedelics such as Ecstasy, LSD and mushrooms aren't just for ravers and Deadheads. Not by a long shot. Psychotherapists around the country say if you're using these hallucinogenics as party drugs you're missing the point. As pychotherapeutic agents, many researchers say, they are an immensely valuable and untapped resource. Folks ranging from computer executives to elderly women to church leaders are participating in psychotherapy enhanced by psychedelics, typically thought of as party enhancers for teenagers or burn-outs. "It's one of the most fascinating things happening in psychology today," said a San Francisco clinical psychotherapist who asked to remain anonymous. "I have no question that in many ways it's much better psychotherapy than I could ever do by sitting and talking. But basically I don't choose to do that out of a fear of going to jail." Indeed, people who facilitate and participate in psychedelic-assisted psychotherapy are an extremely underground and secretive bunch. The $350 to $400 sessions, mostly done in groups, are never advertised. It's strictly word of mouth. There are at least seven such therapy groups in the San Francisco Bay Area, and certainly plenty of others around the country, whose members risk jail time in order to, they say, explore the deepest crevices of their minds. The legal risks are worth the insights gained, according one longtime client of the psychedelic sessions who asked to remain anonymous. "This kind of work goes to a much deeper level," she said. "You get a whole lot more than you would in a one-hour session with a therapist.... It reaches different transpersonal levels." They also say it's worth the possible health risks. The first study on methylenedioxymethamphetamine, or MDMA (better known as ecstasy), to show proof that MDMA dangerously depletes the brain of the mood-regulating hormone serotonin was published in Neurology in June. Federal research has found that other drugs used in these group therapies -- lysergic acid diethylamide (LSD), gamma-hydroxybutyrate (GHB) and ketamine (also called Special K) -- can result in confusion, memory loss, high blood pressure, delirium, psychosis, coma and even death. Dr. Lester Grinspoon, an associate professor of psychiatry at Harvard Medical School who sued the DEA when it declared ecstasy a S(chedule 1 controlled substance in 1985, said he doesn't quite trust studies performed by the National Institute of Drug Abuse "The NIH is a wonderful institution as a whole and truly their interest is in science," Grinspoon said. "But the NIDA really lost its where science is concerned and has become a ministry of drug propaganda." Still, researchers outside the United States have come to similar conclusions. Dr. Andy Parrott of the department of psychology at the University of East London, published a study in the medical journal Psychopharmacology showing that young, recreational ecstasy users had impaired memory function compared with non-user controls. "This drug should not be administered to humans, especially on a repeated basis," Parrott said. Nevertheless, many medical professionals and psychologists say the gains outweigh the risks. The longtime client mentioned above is also about to become a therapist herself. She has completed her master's degree in psychotherapy, and is in the process of completing 3,000 hours of a client-work internship necessary to become a licensed therapist. She has participated in about 12 psychedelic therapy sessions in the past two years. She said she has no fear of ill-effects from most of the drugs, although she favors more studies of ecstasy to determine the effects of its repeated use. "In terms of going into a psychotic state, that might happen when drugs are used in very careless way, such as without a group involved or as a party drug," she said. "[The group therapy] is very careful both in terms of dosage and of what they use for your particular issues." Responsible use of psychedelics, she said, means being sufficiently prepared for the session, having a guide on hand at all times and knowing how to "integrate" the experience afterward. A typical session -- which is, pardon the expression, an overnight trip -- goes something like this: Clients typically arrive at a rented space in a rural setting on a Friday evening, after having fasted for the previous 12 hours. Medical professionals are commonly on hand and the facilitators are often experienced and licensed therapists. Part VIIWhat I Did on My Chemical Vacation:Distinguished Junkie William Burroughs said that "anything that can be done chemically can be done by other means." This may be true, but the chemical way often makes for a better story. With that in mind, we've collected ten personal accounts of memorable drug experiences: War photographer Tim Page writes of the revelatory effect of mind-dissolving hallucinogens. Hubert Selby, Jr. and Sam Lipsyte recall getting busted. David Berman, Geoff Dyer, Lisa Carver, Michael Musto, Ben Neihart, and Jonathan Ames offer their signature takes on the weird things that happen in altered states (Henry Kissinger was never so hot and onions never so menacing). And while heroin, acid, ecstasy, and pot figure largely here, Brenda Shaughnessy provides us with a more novel method for getting high... Read on for some instructive tips and cautionary tales. "When I'm high or intoxicated, I don't have the discipline to sit down at a desk and type something. I'll happily ramble and be a terrible bore, but I can't sit down and write... But one time in college I came back to my dorm room around 2 AM very stoned and I briefly sat at my desk and penned one line in my journal. It was this: 'My body is like a house and I can hear different doors slamming'..." read more -- Jonathan Ames, author of What's Not to Love?: The Adventures of a Mildly Perverted Young Writer. "My friend Kyle always had a lot of money and could get me into the expensive kind of trouble without the trouble sticking. He didn't mind paying for me if it meant raising hell with loyal company. We were seventeen. You only needed one reason to be friends at that age. I figured we had at least three. So we broke the law every day in every way and laughed our asses off at the fucking stupid world..." read more -- David Berman, author of Actual Air. "It is now minutes since I placed the blotter under the veins in my tongue. I smell it. Empty part in the cellar of my mouth where...where it turned into battery acid and ate away my pink till there was a hole the size of a cement block and room for drills and chainsaws and workmen (big workmen) in yellow slickers -- all there to excavate my brain. Saliva is their cement. I'm burying them alive, oh noooo!..." read more -- Lisa Carver, contributing editor at Nerve and the author of Rollerderby. "It would be very useful for my walk if we could get stoned. Marie was happy to try... We spent a long time trying to find a place where we could get discreetly high. In one little park, there were too many mothers and young children who might have thought we were junkies; in another, too many young kids whom we thought were junkies..." read more -- Geoff Dyer, author of But Beautiful, Out of Sheer Rage and Paris Trance. "It was starting to get crowded in here. There was a guy on one side of me whose face was tethered to the van floor by a long ribbon of snot. I felt bad for him. He was clearly not already high. There was a girl wearing a lot of make-up on the other side of me who kept hissing, "Don't touch me, motherfucker." I smiled and laughed a little because we were all belly down with our hands cuffed behind our backs, but from her look I could tell she didn't think it was funny..." read more -- Sam Lipsyte, author of Venus Drive. "In the mid-eighties, a friend slipped me some LSD. I had always resisted the stuff, since I like to be in control at all times and was mortally afraid of a bad trip, certain that my insecurities would multiply when preyed on. I was so right! The world immediately turned bleak and scary to me, even more so than when straight..." read more -- Michael Musto, entertainment and nightlife columnist for the Village Voice. "In 1972, my dad, Ben, with his Ft. Lauderdale playboy best friend, Bill, opened a tequila-and-reefer bed-and-breakfast. The business card read, 'Bill and Ben's Fun Pad.' Spring Break kids, drifters, and fucked-up jetset wannabes toked by the pool, chased the worm. My little brother and I were the party mascots, fetching drinks and lighting cigarettes..." read more -- Ben Neihart, author of the novels Hey, Joe and Burning Girl. "Today I'm too old for the uncertainty of LSD. Even with the end of the conflict, I just can't take acid in the middle of downtown Cambodia, though I know people who do. The Indochina I've seen, and can still see through the veil of modernity, was weird enough. Everything you saw in Apocalypse Now was real..." read more -- Tim Page, photographer, journalist, and author of Page after Page: Memoirs of a War-Torn Photographer. "Once upon a dreadful time, I was driving home from the connection. It was about 4 or 5 PM so there was an abundance of traffic on the L.A. streets, even back then in l967. I was stopped for a light, only one very short block from home, when a police officer suddenly occurred by the driver's side of the car..." read more -- Hubert Selby, Jr., author of Last Exit to Brooklyn and Requiem for a Dream. "I worked my way up from choking down one massive jug of water a day to two. One day, I slugged an entire two-liter bottle without stopping, and immediately after I felt pleasantly light-headed, even giggly. Then the phone rang, and I picked it up. My usual perky-professional phone voice sounded wavery and squeaky, slurred: 'Drna Gurpa's ofs. Thss Burnda.' And yet my mind was clear, perhaps too clear..." read more -- Brenda Shaughnessy, the author of Interior with Sudden Joy. Part VIIILong Strange Trip:FROM OPIUM DENS AND "TEA PADS" to dorm rooms and crack houses, Americans have always found new places and new ways to get high. Of course, the government has long fought the public's drug appetite (and, courtesy of the CIA, has occasionally helped sate it). As laws have come and gone, new substances have continually been synthesized, snorted, shot up, and smoked; and drugs have remained an integral part of the nation's consciousness. We've taken a look at the past one hundred years of drugs in America, and, while in no way comprehensive, the resulting timeline compiles varied facts from drug-invention to antidrug legislation in each administration. --Christiane Culhane1901 - 1908 | Theodore Roosevelt - 1912 | William Howard Taft - 1920 | Woodrow Wilson - 1923 | Warren Harding - 1928 | Calvin Coolidge - 1932 | Herbert Hoover - 1944 | Franklin D. Roosevelt 1945 - 1952 | Harry S Truman - 1960 | Dwight D. Eisenhower - 1963 | John F. Kennedy - 1968 | Lyndon B. Johnson - 1973 | Richard M. Nixon - 1976 | Gerald R. Ford - 1980 | Jimmy Carter - 1988 | Ronald Reagan - 1992 | George Bush - 2000 | William Jefferson Clinton Feed MagazinePublished: November 6 - 9, 2000Website: In the Sky, With Therapists - Wired Magazine
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