MONDAY, JULY 14, 1997:
>IN DRUGS WE TRUST
TAKE THE PILLS, GUYS
TUESDAY, JULY 15, 1997:
FIGHTING THE BIG MONSTER
GEN RX
MELATONIN MANIA
WEDNESDAY, JULY 16, 1997:
READIN', RITIN' AND RITALIN
MEDITATION VS. THURSDAY, JULY 17, 1997:
NO SEX PLEASE, FRIDAY, JULY 18, 1997:
THE COFFEE CONNECTION
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BY SCOTT ROSENBERG | A dangerous new substance is flooding into the country from abroad. It causes potent, speedy changes in the user's brain, and it's powerfully addictive. Users huddle in special rooms, breathing in its intoxicating fumes. Religious authorities pontificate against it; political leaders declare war on it. Yet people keep using it in growing numbers. Coffee -- for that is the menacing substance we are talking about -- was a big "drug problem" in 17th and 18th century England, and indeed sporadically throughout Christian Europe, where this new import from the Muslim East was viewed with great suspicion. Gradually, Western culture made its peace with the undeniably popular (and profitable) stuff, classifying it as a harmless beverage, and today it's big business -- the working person's daily wake-up fix and the cafe philosopher's stimulant of choice. It doesn't take more than a moment's contemplation of the history of coffee -- or similar legal mind-altering substances like tobacco and alcohol -- to realize that American society is deeply confused, inconsistent and ambivalent about drugs. In truth, the only constant in our relationships with drugs of every stripe is that they all carry a strong emotional charge. Call anything -- chocolate, windsurfing, online chat -- a "drug" and people nod their heads, understanding what you mean: You're deeply attached to it and you can't live without it, even though you suspect that there's something wrong with it. Some drugs we declare illegal and wage war upon; other drugs we embrace and build vast industries upon. Whether a drug lands in one category or the other seems to depend on historical circumstance, social custom, economic influence and sheer chance. Sometimes -- as with Prohibition, the legal marijuana movement or the recently proposed "tobacco settlement" -- there's pressure to move a popular drug from one category to the other; but such efforts typically create social upheaval and meet great inertial resistance. In the U.S. today, bureaucracies like the Food and Drug Administration have jurisdiction over the line between what's considered food and what qualifies as a drug; but it's the popular media that alternately and selectively romanticize some drugs and demonize others. We live in a nation that has fought a losing "war on drugs" for decades. But while our election-year-timed spasms of drug-war militancy keep our eyes fixed on the violent crimes that surround the illegal-drug business, we are quietly but steadily becoming more and more devoted users of a vast spectrum of legal drugs. While crack took the headlines, Prozac, Ritalin and their many brethren began to take over our daily lives. And they're just the start. Even setting aside anti-drug hysteria and pharmaceutical-industry hype, it's difficult to master the calculus of fear and desire that seems to govern our assessment and categorization of various drugs. One casualty of the drug wars is our very ability to draw any kind of useful distinctions among different drugs. The substances that captured the imagination and bloodstream of the '60s generation -- from marijuana to LSD -- were celebrated as drop-out mechanisms, exits from middle-class conformity and doorways to higher consciousness. Opponents, reacting out of generational fear, medical concern or puritanical mistrust, held that the drug culture's promises were shams or scams. The result was a stalemate that's with us to this day; these drugs are still illegal yet still widely used -- and the kind of rigorous, fair studies that might begin to lead us toward saner judgments remain unperformed, unfundable, unthinkable. Other illegal drugs, from cocaine to heroin, go in and out of fashion but also remain taboo as objects of genuinely unbiased scientific inquiry -- which leaves us in the strange position of knowing far less about them than we do about tobacco, which, despite its deadly effects, remains quite legal. It's hard to find clear thinking about such drugs, but a strong dose of it can be obtained from Andrew Weil's 1972 classic, "The Natural Mind." Written long before Weil's current popularity, "The Natural Mind" argues that the desire for "periodic episodes of altered consciousness" is an innate drive in human beings. (The only culture in the world that lacks a tradition of natural drug use is the Eskimo, according to Weil.) Drugs are simply one means people adopt toward this end; though they may not be the best or most effective one, they are "with us to stay." We can either keep fighting them and keep losing -- or learn from other cultures about effective methods of living with them, minimizing the harm they do to people and maximizing their potential benefits. Weil later also co-wrote the encyclopedia of mind-altering drugs, "From Chocolate to Morphine," an equally lucid work that, among other things, attempts to clarify the difference between drug use and abuse. "Any drug can be used successfully, no matter how bad its reputation, and any drug can be abused, no matter how accepted it is. There are no good or bad drugs; there are only good and bad relationships with drugs." These are the book's guidelines for "good relationships with drugs": "Recognition that the substance you are using is a drug and awareness of what it does to your body"; "experience of a useful effect of the drug over time"; "freedom from adverse effects on health or behavior"; and "ease of separation from use of the drug." But sometime between the '60s, the period that shaped Weil's perspective, and the '90s, during which he emerged as an alternative-medicine guru, the drug landscape radically shifted. The legal prescription drugs that make up the fastest-growing part of the pharmaceutical arsenal -- like Prozac and Ritalin -- are, for the most part, tailored not to offer release from everyday consciousness but rather to provide support for it. A social theorist would explain the popularity of these drugs by pointing out that they efficiently transform malcontents and misfits into docile employees and sedate schoolkids. An economist would note that they provide our cost-cutting health system with cheap alternatives to long-term therapy. Anyone with a humanist philosophical bent -- including authors like Peter Kramer ("Listening to Prozac") and Kay Redfield Jamison ("Touched With Fire") -- will wonder whether they don't provide a superficial fix for deeper existential concerns while cutting off the roots of artistic creativity in human discontent. And yet a person who has been genuinely helped by such drugs -- say, someone who has found real relief from the horrors of chronic clinical depression -- might hear all these objections and respond, who cares? Whatever else you can say about them, these new drugs, like the consciousness-altering drugs celebrated by the '60s generation, have gained wide acceptance because they work. For some sufficiently high percentage of the population, they do what people expect them to do. Our problem with these drugs is that we don't seem to know when to stop prescribing them. Prozac and similar antidepressants can plainly help a lot of depressed people. But tens of millions of people? Are there really that many depression sufferers -- or has the desire to squeeze profits from expensive new drugs inspired a stretching of the definition of full-blown depression to include virtually any bummed-out situation? And what about the increasing prescription of these drugs for children? No matter how narrowly drugs like these are targeted at specific chemicals in the brain and no matter how few side-effects they may induce, they are still serious stuff. They deserve to be distributed with the kind of attentive care doctors are supposed to provide every time they write a prescription. But these very same doctors are under pressure from the HMOs paying the bills; a quick drug regimen is a lot more cost-effective than the slow, uncertain progress of serious therapy (sometimes, true, it's also simply more effective). As the drug companies roll out wave upon wave of new pills -- promoting them in TV ads worded with discreet care to stay inside the law -- our societal dependence on drugs is only going to accelerate. As it does, here's a useful exercise for us all: Take Weil's guidelines for a "good relationship with drugs" and apply them collectively. Are we, as a nation, honest with ourselves about our drug use? Do we get the "useful effects" we seek, or are there diminishing returns? Are there adverse effects on our collective health? And can we stop any time we want to?
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