Between Politics and Reason
Appendix A Brief Guide to Drug Effects
Erich Goode — State University of New York, Stony Brook
For the purposes of this book, the definition of drugs that pivots
on psychoactivity makes the most sense, since drugs that influence
the mind are often used for the purpose of intoxication or getting
high, and, in turn, many users who seek intoxication use substances
that achieve that intoxicating effect frequently, compulsively,
chronically, and in an abusive manner. To take the process a step
further, publics have become concerned, and legislatures have
attempted to curtail, such abuse. Legislation which attempts to
control such abuse, and whether it represents a workable
and wise approach, are the subjects of this book. Hence, my focus
on psychoactivity.
Different psychoactive drugs have very different sorts of effects
on the human mind. Drugs are classified according to type, that
is, according to the nature of their effects. Drugs are
placed together in the same category, or put into different categories,
because of the similarities and differences in these effects.
To be more specific, since all drugs have multiple effects,
a drug is classified according to the nature of its "main"
or "principle" effect. (Side effects are those the classifier
is less interested in than the "main" effect.) Below,
I will summarize the effects of the most important of the psychoactive
drugs, according to a commonly agreed-upon classification scheme.
Following common practice, I capitalize trade or brand names (examples:
Seconal, Dexedrine, Prozac) and use the lowercase letter for generic,
general, or chemical names (barbiturate, amphetamine, morphine).
For a more detailed, book-length, discussion of the effects of
the drugs and drug types discussed here, see Goldstein (1994),
Julien (1995), and Ray and Ksir (1993).
Some drugs energize, speed up, or "stimulate" signals
passing through the central nervous system (the CNS), that is,
the brain and spinal column. They are called stimulants, and
they include amphetamine, methamphetamine, and cocaine. A second
category retards, slows down, or "depresses" signals
passing through the CNS; they are referred to as depressants,
and they include the sedatives (such as barbiturates) and
alcohol. Tranquilizers or "antianxiety agents," such
as Valium and Halcion, are closely related to the sedatives. A
third category of drugs comprises those whose principal action
is "obtunding" or suppressing pain; they are referred
to as narcotics or analgesics, and they include
the opiates, or the natural derivatives of opium (principally,
opium, morphine, heroin, and codeine) and the opioids, or artificial
narcotics. A fourth category includes drugs which induce profound
alterations in perceptions of reality; they are referred to as
hallucinogens or psychedelics; they include LSD,
peyote and mescaline, and psilocybin. Marijuana's effects are
so different from the others that it is usually placed in a category
of its own. In addition, there are several other psychoactive
drugs whose use is limited to psychiatry and medicine, that is,
which are very rarely used recreationally, for the purpose of
intoxication, and whose use almost never leads to abuse. They
include the antipsychotics (Thorazine, Stelazine, Haldol) and
the antidepressants (Prozac, Elavil, Nardil); they will not be
discussed here, since hardly anyone is concerned with their legal
status.
STIMULANTS
Someone taking low to moderate doses of stimulants will be more
alert, aroused, and mentally acute; he or she will be able to
focus on a given task with greater concentration than normally.
In addition, stimulants generate a feeling of confidence, competence,
and well-being, even a voluptuous sense of mastery. Stimulants
generate the need to engage in physical activity. As we saw earlier,
of all drugs, stimulants possess the greatest immediate sensual
appeal. This means that when experimental subjects who are
unaware of what they are taking are administered stimulants, they
are more likely to say they enjoyed the effects of these drugs,
and want to take them again, than any other drug or drug type.
Amphetamine and cocaine are stimulants; methamphetamine ("crank,"
"crystal," "speed," or "ice") is
closely related to, but somewhat more powerful than, amphetamine.
"Crack" is a crystalline but impure form of cocaine.
(Technically, nicotine is also a stimulant, except that it has
too many side effects to fit comfortably into this category; caffeine
is a stimulant, too, but its effects are mild and subeuphoric.)
Stimulants, especially cocaine, are highly reinforcing, and a
substantial proportion of users end up taking them frequently
and abusively; that is, they become dependent on or "addicted"
to these drugs. (Most are moderate in their use, however.) At
higher, abusive, levels, a substantial proportion of users become
irritable, anxious, compulsively focused on activities others
regard as trivial, and even paranoid, psychotic, and violent.
A very high proportion of persons who commit common street crimes,
especially robbery, have cocaine in their system at the time of
committing the crime for which they are arrested. Heavy, chronic
abuse is accompanied by a strong craving for the drug, and abstinence
will bring on withdrawal symptoms, including depression, anxiety,
tremors, and even seizure.
The effects of stimulants, as with all drugs, are highly dependent
on route of administration, that is, how they are taken,
as well as on dose, that is, how much of the
drug is taken in a single episode of use. Cocaine and amphetamine
are taken by four common routes of administration: first, intranasally,
that is, by sniffing or "snorting"; second, by smoking
or, to be more precise, by heating then inhaling the drug's vapors;
and third, by injection; in addition, amphetamine may be taken
orally, in the form of a capsule or tablet. Smoking is by far
the quickest, most efficient means of using any drug, including
the stimulants. With cocaine, including crack, smoking delivers
a sudden, intense orgasm-like "rush" or jolt of pleasure
directly to the brain within six to eight seconds of administration.
Injecting the drug intravenously (IV), that is, directly into
a vein, also generates an intense euphoric, ecstatic sensation,
usually within 10 to 12 seconds. Typically, users who take stimulants
by smoking or IV injecting will take fairly large quantities of
the drug through this route, often 50 to 100 milligrams per "hit"
or dose. Injecting directly into a muscle rather than a vein ("joy
popping") produces a much slower and less intense high or
intoxication. Intranasal administration (or "snorting")
is an even slower, more inefficient means of getting high; for
most users, its effects are voluptuously pleasurable, but less
intensely so, slower to take effect, and more protracted, than
is true for smoking and IV injection. The slowest, least efficient,
and least intense means of getting high is oral administration,
that is, by tablet or capsule, or by drinking the substance in
liquid solution.
DEPRESSANTS
Depressants retard the activity of a wide range of organs and
functions of the body. As a consequence, they reduce anxiety,
release inhibition, and bring on sleep. In larger doses, they
can induce unconsciousness and coma. An overdose of a sedative
drug results from an inhibition of the breathing mechanism and,
hence, deprives the brain of oxygen. Depressants also produce
ataxia, or discoordination, and a lowering of an awareness of
one's surroundings. In addition, they are highly addicting: If
enough of any one of the depressants is taken over a long enough
period of time and then use is discontinued, painful, life-threatening
withdrawal symptoms will ensue—nausea, vomiting, chills, muscular
spasms, and intense bodily aches and pains. With alcohol, these
are known as "the DTs"—delirium tremens. Alcohol
and barbiturates are known to cause brain damage if taken in sufficient
doses over an extended period of time. Historically, alcohol and,
in the first half of the twentieth century, barbiturates were
used for a wide range of medical and psychiatric ailments, including
insomnia and anxiety; however, as a result of the generality of
their action, their addicting properties, the medical damage associated
with their use, and their overdose potential, for the most part,
this has been discontinued. Today, the number of legitimate medical
uses for barbiturates is extremely limited. Methaqualone (Quaalude,
or "'ludes"), a popular sedative of the 1970s, is no
longer prescribed at all. At one time a popular street drug, in
a sufficient dose, barbiturates produce a stuporous, dazed, half-conscious
sensation—similar to being drunk—often accompanied by irritability
and belligerence. Such use has declined sharply since the 1970s.
At sufficiently large doses, antianxiety agents or tranquilizers
have effects that are remarkably similar to the sedatives.
NARCOTICS
The narcotic drugs "obtund" or reduce the mind's sensation
of pain; hence, they have been used for thousands of years as
analgesics, or painkillers. (Aspirin, acetaminophen, or
Tylenol, and ibuprofen are weak analgesics, but they have none
of the other properties of the narcotics including intoxication.)
Narcotics generate an intense, voluptuous, orgasm-like "rush"
upon IV administration; produce a strong dependency or addiction;
and can precipitate death by overdose in only 10 times the dose
that generates a high or intoxication. Opium, which is derived
from the opium poppy, has been smoked for millennia for both ecstasy
and analgesia. Morphine, first isolated in the early 1800s, is
derived from opium; it is even more effective both as an intoxicant
and as a painkiller Heroin, in turn, is derived from morphine,
and it produces a quicker and more intense high. The narcotic
drugs that are derived from opium are generally referred to as
"opiates." There are a number of synthetic or chemically
produced narcotics ("opioids") as well, with effects
very similar to the natural opiates—methadone, Demerol, fentanyl,
and Dilaudid. All are addicting, produce an intense high, and
can produce death by overdose. Heroin is the drug of choice among
street narcotic addicts and abusers, but any of the other narcotic
drugs will be substituted in the absence of a heroin supply. Until
the late 1980s, the principal means by which street heroin addicts
administered narcotic drugs was IV injection. However, recently,
a new generation of abusers is taking heroin by means of smoking
and snorting, often in conjunction with cocaine or crack cocaine.
HALLUCINOGENS
A group of drugs produces profound alterations in the user's perceptions
of the material world. These drugs are often referred to as "hallucinogens,"
although this term is not entirely appropriate, since users are
typically aware that these alterations are not literally or concretely
"real"; in fact, true hallucinations are rare and take
place only at very high doses. The term "psychedelic"
is often used to refer to these drugs; it means that the mind
works best (or is "made manifest") under their influence.
Again, this designation is not altogether accurate either, since
some perceptions of the world are reduced or distorted, while
others are much more intense. There is no single term that is
entirely appropriate for this drug type. LSD is the best known
of the hallucinogens or psychedelics. Closely related to LSD in
its effects are the peyote cactus, mescaline (the psychoactive
ingredient in peyote), psilocybin (the so-called magic mushroom,
or "'shrooms"), morning-glory seeds, and DMT. Some experts
include Sernyl (PCP, or "angel dust") as a hallucinogen.
But although some users of PCP experience hallucinations, the
drug produces none of the profound alterations of perceptions
of reality associated with the true psychedelics. It is best classified
as a sedative and an analgesic with contradictory side effects.
Likewise, MDMA, or "ecstasy," is often seen as a hallucinogen.
Here, too, we observe none of the perceptual alterations associated
with the true hallucinogens. Some observers prefer to refer to
ecstasy as an "empathogen," or an agent which facilitates
closeness with others.
Psychedelic drugs have an extremely long duration of action; with
LSD, the effects can last up to eight hours. Different sets of
perceptions are likely to take place at different periods or phases
of the experience. Perceptual alterations and distortions are
extremely common in a psychedelic drug "trip." Colors
will seem extremely vivid; solid objects are often seen as unstable,
dynamic, in motion; time is said to stand still or lose meaning;
the senses will blend or translate into one another, so that one
will "hear" color or "taste" sounds (this
is referred to as "synesthesia"); boundaries between
oneself and the world and between disparate phenomena in the world
will seem to dissolve; mental associations will tumble one after
the other, seemingly uncontrollably; one will perceive parts of
one's body, and the bodies of others, in a profoundly different
way—skin will seem to turn green, for instance, or hair will
seem to be made of snakes; emotional intensity or exaggeration
is common; one will often have the sense that one's thoughts are
momentous, extraordinary, profound; great swings in mood, from
ecstasy to despair, are typically reported. The "psychotic
episode," or extreme panic reaction—an emotional disturbance
so serious that it requires professional attention—seems to
be quite rare. Likewise, "flashbacks," or the uncontrollable
return of psychedelic drug effects in the absence of having taken
a drug, have been reported in a significant proportion—a minority—of
users. In the 1960s, it was thought that LSD damaged chromosomes
and produced birth defects in the children of mothers who took
the drug. This proved to be a false alarm; the drug produces no
such effects.
MARIJUANA
The effects of marijuana are so different from those of all other
types of drugs that it is most often placed in a category of its
own. One expert refers to it as "a unique sedative-euphoriant-psychedelic
drug" (Julian, 1995, p.330). Very, very few users report
the sorts of profound visual and perceptual transformations with
marijuana that are common with the psychedelic experience; even
then, they occur only at extremely high doses. Marijuana is a
natural product of the hemp or cannabis plant; its psychoactive
ingredient is tetrahydrocannabinol, or THC. Most marijuana contains
the flowering tops and some leaves of the cannabis plant;
hashish contains only the resin of the female plant. Most commercial-grade
marijuana sold on the street in the United States is 2 to 5 percent
THC; hashish can be as much as 10 to 15 percent. Some specially
cultivated marijuana products, such as sinsemilla (cultivated
"without seeds") contain as much THC as potent hashish,
or more. In the United States, marijuana is most often smoked;
its effects rarely last longer than three or four hours, and they
typically begin to tail off or decrease gradually after a half
hour to an hour after smoking. Since THC is not soluble in water,
it is stored in the fat or lipid cells of the body, including
the liver. Hence, metabolites of THC can be found in the body
more than a week after one's last episode of use. This has caused
some experts to fear that chronic marijuana use may produce an
accumulation of THC over a period of time, which could prove to
be harmful.
Marijuana does not produce a "rush," or an intense,
orgasm-like sensation, upon administration. Hence, it is not strongly
dependency-producing, or "addicting." Users report feeling
relaxed, peaceful, pleasant, mildly euphoric, lethargic, and drowsy.
Intellectual and motor skills decline under the influence; short-term
memory is temporarily impaired. Under the influence, users often
report feeling hungry and finding many more things amusing than
normally. Many of these effects fit in well with a variety of
recreational activities, such as socializing with friends, listening
to music, and making love. Most experts believe that death as
a result of a marijuana "overdose" is next to impossible.
Psychotic reactions seem to be extremely rare, especially considering
the huge number of episodes of use. Most of the medical ravages
of marijuana that were reported in the 1970s and early 1980s have
not been confirmed by later research, with the exception of a
decline in the efficiency and effectiveness of the lungs. The
use of marijuana is associated with a decline in ambition and
the motivation to succeed (the "amotivational syndrome");
it is not clear whether this is a direct effect of the drug or
is an accompaniment of the characteristics of the persons who
use it.