Drugged: The Science and Culture Behind Psychotropic Drugs

374 Pages·2013·3.47 MB·English

by  Richard J. Miller

Drugged
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Drugged
Th e Science and Culture Behind
Psychotropic Drugs
(cid:2)(cid:3)(cid:2)

Richard J. Miller, PhD
Alfred Newton Richards
Professor of Pharmacology
Northwestern University
Medical school
Chicago, IL
1
3
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Library of Congress Cataloging-in-Publication Data
Miller, Richard J., 1950- author.
Drugged: the science and culture behind psychotropic drugs / Richard J. Miller.
p. ; cm.
Includes bibliographical references and index.
ISBN 978–0–19–995797–2 (alk. paper)—ISBN 978–0–19–995798–9 (alk. paper)—
ISBN 978–0–19–932196–4 (alk. paper)
I. Title.
[DNLM: 1. Psychotropic Drugs—history. 2. Behavior—drug eff ects. 3. Brain—drug
eff ects. 4. Civilization—history. 5. Psychotropic Drugs—pharmacology. QV 77.2]
RM333.5
615.7′88—dc23
2013009308
9 8 7 6 5 4 3 2 1
Printed in the United States of America
on acid-free paper
To Lauren—with all my love for ever and ever.
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PREFACE
“I’ll have a tall latte with an extra shot.”
“Make mine a scotch and soda.”
“Excuse me, but do you have a light?”
Th e chatter of our everyday lives is fi lled with references to the use of psy-
chotropic drugs. Caff eine, alcohol, nicotine—there can’t be many people
around today who haven’t tried these substances in one form or another.
Indeed, many people partake of these things fairly regularly; their use is
completely integrated into our society.
But what exactly do we mean by the term “psychotropic drug”? Generally
speaking we are talking about chemical substances that enter the brain and
change the way it operates. Th ese alterations aff ect one of the brain’s most
important outputs: the quality of our conscious experience. In most peo-
ple’s view, consciousness is an expansive property that “emerges” from the
complex behavior of the cells that make up the physical substrate of the
brain, although exactly how this happens is still a great mystery.
But our consciousness is also limited. Like the prisoners in Plato’s cave,
our normal experiences may only represent the shadows of a greater real-
ity. Mankind has always been interested in using psychotropic drugs for the
purpose of changing or expanding his consciousness so that he might open
up new visions of time and space. William Blake, a man whose day-to-day
experiences were so mystical and exalted that he didn’t really need chemical
substances to expand them further, seemed to have this in mind when he
wrote, “If the doors of perception were cleansed every thing would appear
to man as it is, Infi nite. For man has closed himself up, till he sees all things
thro' narrow chinks of his cavern.” Man has always used psychotropic drugs
to enlarge these narrow chinks and unlock the doors of perception.
Th e use of psychotropic drugs is an ancient practice. Exploration of
prehistoric grave sites has frequently yielded evidence suggesting that
ancient man was aware of, and presumably used, numerous mind alter-
ing substances. Th ese early psychotropic agents were probably employed in
( vii )
( viii ) Preface
religious practices by shamans and witch doctors who were responsible for
the spiritual lives of their people and who used drugs to produce ecstatic
states that allowed them to commune with gods and spirits. Th e drugs they
used were generally obtained from diff erent kinds of plants. Substances like
opium, cannabis, peyote, and ayahuasca all have a deep history of usage by
ancient peoples. Other drugs, such as cocaine, caff eine, and nicotine were
also employed, but usually for more practical purposes such as increasing
energy levels, sharpening perceptions, and helping people to work longer
and more eff ectively free from pain and hunger.
But what exactly are the chemicals contained in these plants, and how do
they engage the mechanisms of the brain? Th is wasn’t properly understood
until the development of organic chemistry in the nineteenth and twenti-
eth centuries. Th e evolution of this science not only provided information
about what psychotropic drugs are and how they work, but also helped to
increase our understanding of how the brain goes about its daily business.
Artists have frequently used drugs to ignite their imaginations or to
increase the powers of their fi ctional creations. Characters from Oberon
to Isolde have used secret potions to allow them to achieve their aims—
usually to exert control over the thoughts and emotions of others. And
artists have often used drug-fueled experiences to inspire their work. It’s
diffi cult to imagine the works of Coleridge or William Burroughs, for exam-
ple, separated from their drugs of choice: opium and heroin. Th e use of
psychotropic drugs can change the perceptions of the artist, allowing him
to come up with unique visions of the natural world. Or, as Shakespeare
wrote, “Art is a mirror held up to nature.” Psychotropic drugs can alter the
qualities of this mirror.
In more recent times a new development has allowed us to greatly
increase our repertoire of psychotropic drugs. Whereas our ancestors could
only avail themselves of substances that were provided for them by the
natural world, the rise of chemistry has allowed us to modify these organic
substances and create completely new molecules with unique eff ects and
mechanisms of action. From the crude opium of the ancients, man purifi ed
morphine and used organic chemistry to turn it into heroin. Modifi cation
of the products of the ergot fungus produced LSD, a much more power-
ful hallucinogenic drug than any previously extracted from nature. Th e
ancient Chinese drug Ma Huang contains the substance ephedrine, which
in the twentieth century was the basis for the development of the drug
amphetamine.
Organic chemistry also proved capable of expanding the range of psy-
chotropic drugs much further than previously imagined, and for newer
medicinal purposes. Our increasingly sophisticated understanding of
Preface ( ix )
the workings of the brain and of medicine in general ushered in a new
era of therapeutics and with it a new kind of disease: mental illness.
Psychopharmacologists argued that if a terrible disease like tuberculosis
could be cured simply by taking a pill, why shouldn’t mental disorders be
amenable to a similar approach? With our new understanding of mental
illness, people who saw visions or acted strangely were no longer classifi ed
as religious mystics or as possessed by devils, but as victims of diff erent
psychiatric disorders which might be cured by correcting brain chemistry.
And so the new chemical companies that arose at the end of the nineteenth
century became the engines that powered the Psychopharmacological
Revolution of the twentieth century. Mental disorders such as schizophre-
nia, depression, and anxiety were now treated with new sophisticated med-
icines. In the two decades between the 1950s and the 1970s, a host of new
drugs were developed that could be used to treat mental disorders with
considerable success. In virtually every case these drugs were not natural
products but completely new synthetic organic molecules that were devel-
oped solely in the laboratory. In fact, as we shall discuss, the structures of
many of these new drugs were created from molecules originally developed
as dyestuff s in the nineteenth century.
If we want to understand how psychotropic drugs produce their eff ects,
we need to ask how they interact with the brain. Nowadays we have a
fairly sophisticated understanding of how the brain works. We know that
nerve cells send and receive information from other nerve cells by using
both electrical and chemical signals. Chemical messenger molecules called
neurotransmitters are the agents that carry these signals across the gap or
synapse that exists between nerve cells. Th e chemical signals carried by
neurotransmitters encode the information that nerve cells use to carry out
their functions. As it turns out, all psychotropic drugs work by interfering
with this process of synaptic transmission, either by inhibiting or enhanc-
ing the eff ects of neurotransmitters.
Th is book is an exploration of the diff erent types of psychotropic drugs,
an attempt to explain where they come from and how they work. We shall
try to answer questions such as, what’s the real diff erence between mor-
phine and heroin, or between amphetamine, cocaine, and Ecstasy? What
exactly is cannabis, and how is it diff erent from all of these other drugs?
What are antidepressants and antipsychotics? How exactly do these sub-
stances interact with the nerve cells of the brain?
And what comes next? Scientists and doctors are now beginning to
understand that buried deep within the brain are elements of the immune
system, and that the brain and immune system are in constant contact
with one another. Targeting the brain’s immune response may be one of