Commentary

It's nothing new. Drugs that are abused or misused by a small segment of society become stigmatized. Other segments of society overreact, and the potential benefits of the drugs become lost in the shuffle.

Case in point... Does anyone remember Quaaludes from the 70s? Maybe. But how many of you remember that Quaaludes were a actually a legitimate, useful drug named Methaqualone? Methaqualone was first made and marketed in India as a "safe, nonaddictive sleeping pill" in 1955. In the late 60s, it was marketed in the US under the brand name Quaalude. By 1973, it was being abused as a street drug by some, and the FDA classified it as Schedule II, which made it more difficult to prescribe as well as illegal to have without a prescription. In 1984, the FDA moved Methaqualone to Schedule I -- illegal to buy, sell or possess. Thus, one of the most useful drugs to patients of that time, became unavailable because of misdirected reaction or perhaps overreaction to misuse and abuse, and is hardly remembered today outside of its reputation as a street drug.

An editorial in the current issue of The Lancet, entitled "Reviving research into psychedelic drugs," makes points along the same lines. The editorial begins...

"That psychedelic drugs, such as LSD and MDMA (ecstasy), can be effective treatments for various psychiatric illnesses is an old idea. Once considered wonder drugs... Although such bans were largely put in place to quash concerns about rampant recreational drug use fuelling the counter cultures of the 1960s and 1980s (LSD and MDMA, respectively), criminalisation of these agents has also led to an excessively cautious approach to further research into their therapeutic benefits."

The closing of the editorial is certain to please patients, many researchers, and patient advocates...

"...the social prescription against psychedelic drugs that hinders properly controlled research into their effects and side-effects is largely based on social and legal, as opposed to scientific, concerns. To maximise research into therapeutic benefits without exacerbating real social harms a legal structure that recognises this distinction is sorely needed."

Sadly, if left to their own devices, I fear that administrators and bureaucrats such as DEA officials are unlikely to admit the sound logic here, even if they were to read and understand it. After all, it was the DEA who issued their "Prescription Pain Medications: Frequently Asked Questions and Answers for Health Care Professionals and Law Enforcement Personnel" in August of 2004, withdrew it in October of 2004, and despite promises, has yet to reissue the document or any document to address the issue.

Stigmatization of drugs leads to stigmatization of health conditions and people. It leads to horrid misconceptions about people. To use an example everyone will recognize, take the case of Elvis Presley. Rumors were rampant during the years leading to his death and surrounding his death. Details leaked from his autopsy about propranolol, Demerol, LSD, and antiemetics in his bloodstream. Three out of four of those were true, yet the impression given was false. He was taking propranolol for hypertension and Migraine prevention. His doctor had prescribed Demerol and antiemetics to be used when Migraine abortives failed. He had not taken LSD; he had take DHE45 (dihydroergotamine), which is a Migraine abortive. Both LSD and DHE are ergot derivatives and, to this day, anyone who has used DHE will test positive for LSD. But, is Elvis remembered as an extremely talented musician who died too young? No, he's remembered as a talented musician who died while taking illegal drugs. Pathetic.

When will government agencies charged with the health of the nation begin to work with health care professionals? When will such issues be treated as health care issues rather than law enforcement issues, or at the very least, with due consideration for the negative effects to legitimate uses for such drugs?

When indeed. To quote a very old statement, "If we're not part of the solution, we're part of the problem." When we read about someone abusing drugs or when we read about a particular drug that's being abused or misused, let's be cautious of our own reactions so we aren't part of the problem. That's also part of the solution. We also need to, whenever opportunities present themselves, let our elected officials know that making helpful drugs illegal as a reaction to a small segment of the population abusing them is an unacceptable action. Then, when elections are coming up, let's take the time to study voting records and other information to see if the people we're electing are really acting in our best interests.

It's nothing new. It would be nice to see it become something of the past.

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Resources:

Erowid. "Methaqualone Timeline." The Vaults of Erowid.

Randerson, James. "Lancet calls for LSD in labs." Guardian Unlimited, Guardian Newspapers Unlimited. April 15, 2006.

Editorial. "Reviving research into psychedelic drugs." The Lancet 2006; 367:1214. DOI:10.1016/S0140-6736(06)68515-2.

Published April 14, 2006
© Teri Robert