Drugged The Science and Culture Behind Psychotropic Drugs

650 Pages·2013·5.871 MB·English

by  Richard J. Miller

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Drugged
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Drugged
The Science and Culture Behind Psychotropic
Drugs
Richard J. Miller, PhD
Alfred Newton Richards
Professor of Pharmacology
Northwestern University
Medical school
Chicago, IL
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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.
5
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 effects. 3.
Brain—drug
effects. 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
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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?”
The chatter of our everyday lives is filled with references to the use of
psychotropic drugs. Caffeine, 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. These alterations affect one of
the brain’s most important outputs: the quality of our conscious
experience. In most people’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 reality. 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,
Infinite. 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.
The 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
altering substances. These early psychotropic agents were probably
employed in 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. The drugs they used were generally obtained from different
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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, caffeine, 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 effectively
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? This wasn’t properly
understood until the development of organic chemistry in the
nineteenth and twentieth centuries. The 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 fictional 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
difficult to imagine the works of Coleridge or William Burroughs, for
example, separated from their drugs of choice: opium and heroin. The
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 effects and mechanisms of action. From the crude opium of the
ancients, man purified morphine and used organic chemistry to turn it
into heroin. Modification of the products of the ergot fungus produced
LSD, a much more powerful hallucinogenic drug than any previously
extracted from nature. The 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
psychotropic drugs much further than previously imagined, and for
newer medicinal purposes. Our increasingly sophisticated understanding
of 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.
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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
classified as religious mystics or as possessed by devils, but as victims of
different 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 schizophrenia, depression, and anxiety were now
treated with new sophisticated medicines. 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 developed 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
dyestuffs in the nineteenth century.
If we want to understand how psychotropic drugs produce their
effects, 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. The
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 enhancing the effects of
neurotransmitters.
This book is an exploration of the different 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 difference
between morphine and heroin, or between amphetamine, cocaine, and
Ecstasy? What exactly is cannabis, and how is it different from all of
these other drugs? What are antidepressants and antipsychotics? How
exactly do these substances 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
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