America's Love-Hate Relationship with Drugs

By Bruce E. Levine, AlterNet. Posted January 9, 2008.

While Americans are inundated with coverage of the Democrats' quibbling over Barack Obama's use of marijuana and cocaine as a teenager, a truly important drug story continues to be neglected: The hypocrisy of Big Pharma, psychiatry officialdom, and justice institutions regarding mood-altering (psychotropic) drugs -- specifically the denial of the similarity between illegal and psychiatric drugs.

Author and science writer Michael Pollan observed the following about Americans' illegal-psychiatric drug hypocrisy: "Historians of the future will wonder how a people possessed of such a deep faith in the power of drugs also found themselves fighting a war against certain other drugs with not-dissimilar powers. ... We hate drugs. We love drugs. Or could it be that we hate the fact that we love drugs?"

When we recognize that psychotropic prescription drugs are chemically similar to illegal psychotropic drugs, and that all of these substances are used for similar purposes, we see two injustices. First, we see the classification of millions of Americans as criminals for using certain drugs, while millions of others, using essentially similar drugs for similar purposes, are seen as patients. Second, we see a denial of those societal realities that compel increasing numbers of Americans to use psychotropic drugs.

In the history of psychiatry, there has been a revolving door in which a "medication" becomes an "illegal drug" -- and visa versa. Sigmund Freud used cocaine as medication to treat his own and others' depression and despair. In the 1930s amphetamines were prescribed to treat depression; later amphetamines were prescribed for weight loss; while today amphetamines such as Adderall and Dexedrine are prescribed for attention deficit hyperactivity disorder (ADHD). Alcohol was a recommended treatment for anxiety as late as the 1940s; and in the 1950s and early 1960s, psychiatrist Oscar Janiger treated the neuroses of Hollywood stars and other celebrities with LSD. Ecstasy was used in marital counseling during the 1980s, and today researchers are studying it as a possible treatment for post-traumatic stress disorder.

It is politically -- and economically -- incorrect for the corporate press, dependent on Big Pharma advertising revenue, to compare psychiatric drugs with illegal drugs. However, the psychiatry drug textbook A Primer of Drug Action notes that individuals who have used cocaine have difficulty distinguishing between the subjective effects of cocaine and dextroamphetamine (Dexedrine) when both are administered intravenously. The amphetamines Dexedrine and Adderall, besides being prescribed for ADHD, are used by many college kids, truck drivers, and others to pull all-nighters.

Both cocaine and amphetamines enhance the neurotransmitters norepinephrine, serotonin, and dopamine. The antidepressant Effexor enhances norepinephrine and serotonin, and the antidepressant Wellbutrin enhances dopamine; and it is not uncommon to be prescribed Effexor and Wellbutrin at the same time. Effexor in combination with Wellbutrin enhances the same neurotransmitters as cocaine (you won't likely feel the same, mainly due to the quicker impact and shorter half-life of cocaine). And selective serotonin reuptake inhibitiors (SSRIs) such as Prozac, Zoloft, Paxil, Celexa, Lexapro, and Luvox enhance the neurotransmitter serotonin. Ecstasy also enhances serotonin, although by a different mechanism (you won't likely feel the same using SSRIs as you would using Ecstasy in part because Ecstasy has a quicker, shorter-lasting pop).

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Bruce E. Levine, Ph.D., is a clinical psychologist and author of Surviving America's Depression Epidemic: How to Find Morale, Energy, and Community in a World Gone Crazy (Chelsea Green, 2007).