PROEMIUM

A Scientific Perspective

Drug prohibition statutes are typically justified as "Public Health Laws," and conventional wisdom holds that enacting and enforcing such measures, governments are exercising their paternalistic function of protecting the citizenry from dangers to the public health, much as they would in framing and enforcing laws regarding the disposal of sewage, vaccination of schoolchildren, or pollution of the air by motor vehicles and industrial processes. Regarded from this perspective, drug prohibition is seen as benign, indeed, beneficent, and this viewpoint has becomes so firmly rooted in the public consciousness as to make the concept accepted universally as a legitimate exercise, nay, as a solemn responsibility of capitalist and socialist governments alike (Szasz 1974; Szasz 1992). In the United States, only the Libertarian Party has consistently opposed drug prohibition as an abuse of governmental power. In some countries, violations of drug laws are called euphemistically delitos contra la salud, "crimes against [public] health."

Nevertheless, viewed from a dispassionate, strictly scientific perspective, this public health justification for drug control simply won't hold water, and it can be argued that, by placing certain drugs outside of the established quality control regimen for pharmaceutical products, governments are defaulting on their responsibility to protect the public welfare. While some prospective drug users dissuaded by laws prohibiting their chosen drugs, many, perhaps the majority, are not. During the experimental federal prohibition of alcohol in the United States from 1920-1933, some former alcohol users took the pledge and obeyed the law, whereas many, probably at least half, continued to use alcohol in spite of the laws (it is worth noting that alcohol use, like illicit drug use today, remained legal, and their were exceptions to the laws...sacramental wine was allowed to be manufactured and dispensed, and physicians suddenly discovered that prescription alcohol was a panacea, and it was prescribed liberally). Although it is impossible to establish firm numbers for present use of illicit drugs and the efficacy of the laws prohibiting them (Barnes 1988c), there is no question that many millions of users, more than 20-40 million in the United States or at least 10-20% of the adult population (Goldstein & Kalant 1990; Nadelmann 1989), are undeterred by the laws, and use drugs illegally. During alcohol prohibition in the United States, many inveterate users were accidentally poisoned by methanol and other solvents- poisonings which would not have occurred had legal controls of purity and concentration been in place; poisonings which ceased to occur once ludibund use of alcohol and its sale for that purpose again became legal. Similarly, now there are annually some 3500 premature deaths per year in the United States due to illicit drug use (Goldstein & Kalant 1990), many of them so-called "overdose" deaths from injected drugs, mainly opiates. Although these deaths are written off as "heroin overdose," the majority are rather due to adulterants and contaminants in illicit drug products (Chein et al. 1967; Escohotado 1989a). After all, the typical samples contain only a few percent of heroin or one or another artificial succedaneum, and illicit products may also contain dust, mites and other minuscule arthropods, spores, virus particles and bacteria, which may either promote infection or sudden death from anaphylaxis or the toxicity of one or another adulterant. On the other hand, the injection, including self-administration, of sterile samples of pharmaceutical opiates of known potency is a common and safe procedure, and deaths as a consequence of such use are virtually unknown.

As for the presumed adverse ecological effects of illicit drug production, these are invariably the consequence of the drug laws themselves. Official drug-eradication programs involving spraying of 2,4-D, Paraquat and other herbicides have resulted in exposing smokers to toxic residues in marijuana, not to mention the massive ecological destruction, and its consequent deleterious effects on health of the exposed populace, occasioned by anti-drug herbicide spraying. By fostering the spread of clandestine laboratories, often in pristine jungle environments, drug laws lead to uncontrolled and unmonitored environmental pollution from unregulated chemical facilities. Under a legal regimen, presently illegal inebriating drugs would be manufactured in the open in existing facilities, whose liquid and gaseous effluents might effectively be observed. Not only are our health authorities defaulting on their responsibilities with regard to regulating purity of pharmaceutical products, but our environmental authorities are guilty of defaulting on their responsibilities to protect the environment and public health.

There is no doubt that illicit injection of black-market samples of drugs has become a major vector of transmission of AIDS, hepatitis and other diseases. In the United States and Europe, around 25% of all AIDS cases, including the majority of cases in heterosexuals, children and infants, are a direct or indirect result of illicit intravenous drug administration (Nadelmann 1989). The barbarous practice of denying access to sterile syringes without a medical prescription prevails in the United States, and has even taken root in some other backward countries, whereas in the great majority of the world's countries, sterile syringes are sensibly made available at low prices at pharmacies, even supermarkets, over-the-counter. The U.S. House of Representatives recently voted to prohibit use of "federal" funds for the independent state or municipal syringe exchange programs designed to halt the drug-related spread of AIDS (Hamilton 1992). This cruel and misguided drug control measure is directly responsible for at least 25% of the new cases of AIDS in the United States. Far from protecting public health, drug prohibition is drastically expanding the AIDS epidemic and contributing to the deaths of thousands of individuals in the United States alone from "drug overdose"- individuals who are deprived of the protection of the Food and Drug Administration (FDA) and its counterparts in other countries. This is especially important when we reflect that not all black market drugs are inebriants (Krieg 1967), not all illicit drug users are hedonists or thrill-seekers. Owing to the restrictive and monopolistic nature of the U.S. pharmaceutical industry, there are black markets in curative drugs which have not been approved for sale by the FDA but for which there is demand. Recent examples of black market medicines are the controversial cancer drug amygdalin or Laetrile, dimethyl- sulfoxide (DMSO), a topical treatment for bruises and sprains (users have been forced to employ industrial-grade DMSO, as no pharmaceutical grade is available), and the AIDS drug Retrovir or azidothymidine (AZT)- thanks to reforms in the FDA this drug has been made more widely available, and it has all but disappeared from the black market. The AIDS drug Dexulate or dextran sulfate is another example of a medicine which American patients had to "bootleg" from other countries (Booth 1988b). There are even black market drugs which don't fit either in the category of inebriants or chemotherapeutic agents- some products of the biotechnology industry are coming to be used illicitly by athletes. There now exists a black market in human growth hormone (hGH) and Eprox or human erythropoietin, used surreptitiously by athletes to improve their performance (Spalding 1991). The size of the black market in steroids for athletes has been estimated at U.S. $100 million annually (Marshall 1988d) and is growing- athletic steroids are now being sold in health food stores! There are even athletic steroids which boost performance and are psychoactive- East German scientists developed a psychoactive testosteroid nasal spray for illegal use by their Olympic athletes (Dickman 1991).

Other damage to the public health is occasioned by drug prohibition policies. Some presently illicit inebriating drugs have valuable therapeutic properties and thus potential to alleviate human suffering- they are not being systematically researched and developed as pharmaceutical products owing to the pall of disreputability cast over them by their legal misclassification. As we will see in Chapter 2, the most famous entheogenic drug, LSD, was originally developed by Sandoz Ltd. of Switzerland as a pharmaceutical agent, under the trade name Delysid. While the novel medicine showed considerable promise in psychotherapy (Delay et al. 1959b; Grinspoon & Bakalar 1979; Grof 1975; Heim 1961; Naranjo 1973a; Ratsch 1989), one of the most exciting pharmaceutical prospects which developed for the drug was an analgesic and psychotherapeutic adjunct to agonious therapy, treatment of patients with painful terminal cancer or other fatal diseases (N.B. this has been incorrectly called agonic therapy; misusing a geometric term meaning "without angles" as opposed to polygonic "with many angles"). LSD, DPT (see Chapter 3) and other entheogenic drugs proved to be valuable long-lasting analgesic agents in some patients with severely painful, terminal conditions, drugs which did not benumb and cloud consciousness in the manner that potent opiate analgesics do (Kast 1963; Kast 1966; Kast 1970; Kast & Collins 1964; Pahnke et al. 1970a; Pahnke et al. 1970b). The drugs also proved their worth in "brief psychotherapy"- aiding dying patients to cope with their situation (Grog and Halifax 1977; Pahnke 1970; Pahnke 1971; Pahnke & Richards 1990; Richards 1975; Richards et al. 1977; Richards et al. 1979). Thanks to this demonstrated medicinal value, the Swiss government has recently reclassified LSD as an experimental psychotherapeutic agent, making it again available to physicians (Hoffmann 1991; Rayl 1992). Entheogens have also shown promise in treatment of alcoholism (Mikuriya 1971; Mikuriya 1973; Rhead et al. 1977; see Grinspoon & Bakalar 1979 for a review of this controversial research). Despite this plethora of therapeutic benefits shown by entheogenic drugs, their development as pharmaceutical agents was cut short by their legal proscription, and their illogical classification in Schedule I, as drugs with "no currently accepted medical use," all but eliminated any further research along these lines. Even much-maligned visionary drugs like the anesthetic phencyclidine (PCP or Sernyl) and its congener ketamine (Ketalar or "Vitamin K", used by some as an entheogen; Moore & Altounian 1978) have proven to have medicinal potential- as antagonists to N-methyl-D-aspartate receptor agonists in the brain and potential protective agents against brain damage as a consequence of stroke and other neurological disorders (Barinaga 1990b, Olney et al. 1991). It has similarly been proposed to exploit the tendency of psilocybine to stimulate specific areas of the brain in the diagnosis of circulatory and other problems in the brain (Gartz 1993), perhaps in combination with magnetic imaging technologies. Even heroin, considered to be deadly poison in the U.S., continues to be regarded as valuable medicine in other countries such as Great Britain. Known pharmaceutically as Diamorphine, heroin is considered to be more effective and safer than morphine in treating pain of myocardial infarction (MacDonald et al. 1967). Since both heroin and LSD have legal, medicinal use in other scientifically advanced countries, their U.S. legal designation as Schedule I drugs (with "no currently accepted medicinal use") is patently false and prejudicial.

The illicit drug best known for its medicinal use is marijuana (see Appendix A; Paton et al. 1973; Roffman 1982; Zinberg 1979). This drug has shown many medicinally-valuable properties, but is best known as an anti-nausea agent for patients receiving cancer or AIDS chemotherapy, and as a treatment for glaucoma- a drug to lower the excessive intraocular pressure of this disease, which can lead to blindness (Roffmann 1982; Zinberg 1979). Both smoked marijuana and orally-ingested tetrahydrocannabinol (THC or Marinol, one of the active principles) have proven to be valuable adjuncts to cancer and AIDS chemotherapy and to glaucoma treatment. Nevertheless, the U.S. government, to avoid giving "mixed signals" in the matter of marijuana, recently stopped the distribution of government marijuana to new cancer, AIDS and glaucoma patients, although for the moment Marinol tablets will still be available (Blumenthal 1992). There is some evidence, however that smoked marijuana may be more effective for some patients (Roffman 1982), and it would be certainly less expensive, especially were cultivation for this purpose permitted. In any case, the U.S. government does give mixed signals with regard to marijuana and THC- on the one hand the marijuana plant and its active principal are listed in Schedule I as having "no currently accepted medical use"; then the same government shows the error of this misclassification by itself distributing marijuana and THC for medical use! Summing up the negative effect of drug prohibition on medical research in a recent article of Science magazine, Princeton University professor E.A. Nadelmann stated (Nadelmann 1989):

Current drug laws and policies, however, greatly hamper the efforts of researchers to investigate these and other potential medical uses of illegal drugs; they make it virtually impossible for any of the illegal drugs, particularly those in Schedule I, to be legally provided to those who would benefit from them; and they contribute strongly to the widely-acknowledged undertreatment of pain by the medical profession in the United States.

These and other examples underscore the fact that a decidedly negative result of the prohibition of entheogenic drugs has been the curtailment of promising lines of clinical research, and the withholding from the public of potentially valuable medicaments. The laws are thus working to the detriment of public health, quite in contrast to their ostensible purpose of protecting public health. Meanwhile, the proscribed drugs are readily available to all comers on the street corner, and the user is deprived of the quality-control guarantees his tax dollars are paying the Food and Drug Administration authorities (and their counterparts in other countries) to provide. Yes, "junkies" and "long-haired potheads" pat taxes too, and enjoy the same rights to protection as "nicotine fiends" and "short-haired gin freaks." We will leave until the next section a discussion of how the public health has been jeopardized by the criminalization of the black market in drugs. Just as serious as the direct deprivation of potentially valuable medicaments from the pharmacopoeia is the curtailment of basic scientific research consequent to drug prohibition. Because of the bureaucratic difficulties associated with research involving controlled substances (Strassman 1991), and due to stigmatization of the field in the eyes of personnel in the granting agencies and the scientific colleagues of would-be researchers who "peer-review" their grant proposals or decide on awarding of tenure, etc., basic research with entheogenic agents all but disappeared following their legal control in the 1960's. Indeed, investigating positive applications of illicit entheogenic drugs is considered to be the "kiss of death" to a conventional scientific career. Our scientific culture has decided it will "just say no" to information which can be derived from basic research on entheogenic substances (Horowitz 1991), information which could be vital to furthering our understanding of basic brain function. Scientists are thus forced for political reasons to discard a tool enabling them to approach the classic brain/mind problem of philosophy- the biochemistry of consciousness itself. Since the illicit entheogen DMT is now known to be a neurotransmitter in mammalian brains (Christian et al. 1976; Christian et al. 1977; Corbett 1978), research on this drug and related indole entheogens (many of which are already illegal) is a most promising line of inquiry for neurochemists studying information processing in the brain, and for biomedical researchers interested in developing therapeutic agents to modify pathological malfunctioning of the human nervous system. The laws are militating against this sort of research.

Nevertheless, such research will continue, perhaps in countries with fewer regulations or a more enlightened policy toward drugs. The passage in the United States of the "Controlled Substances Analogues Act" of 1986 has been widely perceived as illegalizing research involving synthesis, with the intention of studying their effects in human beings, of any of the illicit entheogenic substances or their automatically illegal congeners (Repke 1992). It has become illegal in the United States even to attempt to synthesize and test completely novel compounds... the government essentially presuming to declare anything illegal unless specifically authorized! Talk about socialistic central planning and governmental control of industry! Pursuing this sort of draconian legal overregulation will ultimately doom the United States pharmaceutical industry to technological and economic inferiority, as the next generation of mind-drugs is developed elsewhere. After an American chemist working for a U.S. pharmaceutical company published (before the enactment of the 1986 law) ethically flawless, legitimate research dealing with completely legal, novel analogues of DMT, research conducted on his own time, his company was subjected to a special investigation by the U.S. Food and Drug Administration and he was threatened with dismissal! When pharmaceutical companies are restricted by excessive regulation, they simply invest elsewhere, where their research can be accomplished with a minimum of interference. A recent example was the decision of Swiss pharmaceutical multinational Ciba-Geigy to abandon plans to construct a new pharmaceutical production facility in the firm's home city of Basel, Switzerland. Because of the political power of anti-biotechnology activists in Switzerland, the firm decided to cancel construction plans for the $125 million facility in Basel, and instead is building a plant across the border in Huningue, France (Aldhous 1992). Needless to say, jobs in Basel are threatened by this development.

Besides crippling neurochemical research and depriving the public of valuable medicaments, drug prohibition occasions other, tangential and collateral damage to scientific enterprise. An important recent example has to do with the U.S. governments deployment of a line of "aerostats"- balloons outfitted with sophisticated radar equipment and tethered at around 10,000 feet altitude along the U.S./Mexico border and the Florida coast. The purpose of these aerostats is to monitor non-commercial aviation traffic across the border in search of aircraft engaged in illicit drug smuggling (Marshall 1988b). These radar eye-in-the-sky balloons, however, interfere with radio astronomical research by observatories in Arizona and elsewhere. In particular, the aerostat radars, which are powerful radio transmitters, broadcast radio signals in the 1215-1350 MHz frequency range, and effectively blind the astronomical equipment to the red-shifted hydrogen spectra of distant galaxies (Stone 1991). Scientific research once again suffers because of the obsession of the U.S. government with drug enforcement- increasingly an anti-scientific endeavor. As an American citizen, it is profoundly embarrassing to me to contemplate the spectacle of an array of gigantic balloons strung along the border with Mexico... just imagine, balloons... the country is coming to look ever more like some sort of immense used car lot, which the broken-down economy mismanaged by an anti-scientific government increasingly resembles as well!