Same as it ever was: drugs past, present and future

Drugs have played an integral part in human experience from the long distant past to the present. Doug Sellman explains why the future is likely to be no different.

Following a lifetime of research into psychoactive substances, the famous German research pharmacologist, Louis Lewin (1850-1929) wrote the following in his often quoted Phantastica, Narcotic and Stimulating Drugs: Their Use and Abuse: “From the first beginning of our knowledge of man, we find him consuming substances of no nutritive value, but taken for the sole purpose of producing for a certain time a feeling of contentment, ease and comfort.”

Taking drugs for their psychoactive effect is not unique to human beings, but securing a steady supply for regular use is. Drugs are an integral aspect of the technology of homo sapiens and can be thought of as just as important to the global culture of the species as clothing. In fact, drugs may have been an important element of the adaptability of early humans; providing emotional and psychological comfort similar to that derived from belief in supernatural gods, and helping our early ancestors cope with the nasty, brutish and short life of a hunter-gatherer.

Currently, drugs are divided into the following seven categories: depressants, stimulants, cannabinoids, opioids, hallucinogens, inhalants, and other. This categorisation is made largely on the basis of the different target receptors in the brain that these substances attach to towards releasing dopamine from the nucleus accumbens, the common neurobiological process that underlies all hedonic experience.

In the future, these seven categories could very well expand to incorporate new ‘designer drug’ categories such as hallucinogenic stimulants, stimulant opioids and/or opio-cannabinoids. In fact, ecstasy (3,4 methylenedioxymethamphetamine), one of the most popular recreational drugs in the Western World at present, is a synthetic, psychoactive drug chemically similar to the stimulant methamphetamine and the hallucinogen mescaline, providing a compelling ‘love drug’ hallucinogenic stimulant experience for users.

The main reason there is a great future for drugs in the human world is the same as it ever was - the ability for people to short-cut pleasurable rewarding experience. Apart from the effort of procuring the drug, no work is required to have the emotional high. The different types of euphoria produced by the different categories of drugs provide people with a variety of options. Vulnerability to addiction to a particular drug has been shown to correlate with the degree of pleasure that a user derives from it (as well as the lack of negative effects from taking that drug).

There are at least four major concerns for the West over the next 10-20 years:

1. Increasing anxiety about global conflict over diminishing natural resources and increasing influence of human pollution;
2. Increasing anxiety, anger and pain in an expanding, disenfranchised, poor underclass;
3. Increasing tiredness and stress as people feel they need to work harder to get ahead in a consumption-obsessed economy; and
4. Increasing meaninglessness as Christianity further dissolves into the secular world.

In relation to these four groups, I would predict that our favourite drug ethanol (alcohol), with its powerful anxiolytic effect involving a relaxed euphoria, will continue to find great favour for those in the first group along with those who have anxiety over more immediate concerns.

Opioids such as morphine, with their analgesic properties underlying a ‘warm heavenly comfort’, provide solace in a chronically miserable world for those in category two, who are also often dealing with pain from the past.

Stimulants have a great future with modern people stressing out to get ahead. Caffeine, BZP-based party pills and methamphetamine will all continue to be sought out for the purpose of staying alert with an energised euphoria, although the negative effects of BZP will be a selflimiting factor.

Finally, for some, the meaningfulness of a drug-induced spiritual experience will help them to find God (or something), and derive comforting meaning from the random complexity and essential emptiness of life in this universe.

There is one drug that needs special mention - nicotine. Bontekoe, a Seventeenth Century Dutch physician, said, “Nothing is more necessary and beneficial to life and health than the smoke of tobacco. It gladdens the heart in solitude and relieves a sedentary life of all discomforts.” Even though the current medical profession has a somewhat different attitude towards cigarette smoking compared with 400 years ago, nicotine addiction remains the most common yet most neglected drug addiction. Louis Lewin again: “The use of tobacco, which has made its way thanks to the spirit of imitation as well as to its peculiar effects, has vanquished humanity and will continue to reign until the end of the world.” Nicotine is here to stay. The challenge is to develop safe nicotine products that will trump cigarettes. Swedish snus may be such a product.

Finally, it is clear that there is an ‘unholy trinity’ operating in the market-driven, consumption-obsessed, freedom economy that we all enjoy so much which will continue to drive regular, heavy use of drugs and other addictive products.

First are the highly effective, financially powerful, psychopathic business corporations: the alcohol industry, the tobacco industry, the illicit drug industry, the gambling industry, the food industry, and the retail industry. These corporations know that a good proportion of their profit is derived from customers who exhibit unwanted compulsive behaviour around their product and are suffering because of it.

Second is the complicit political pragmatism of government and opposition, who not only know there are billions of dollars of tax revenue that flow from the ‘addictionogenic industries’ but that the economy as a whole is somewhat dependent on their activity.

Finally, there is the relatively ineffective, under-resourced and poorly organised public health advocacy sector. The millions of dollars of marketing invested by the ‘addictionogenic industries’ to perpetuate their market share casts a dense dark shadow over any light that is shone by us ‘do-gooders’ in health promotion

Doug Sellman is the Professor of Psychiatry and Addiction Medicine at the National Addiction Centre, Department of Psychological Medicine, Christchurch School of Medicine and Health Sciences.