Drugs
V. Vemuri
On my recent trip to India, a huge poster caught my eye in the pedestrian subway leading to the Birla Temple in New Delhi. You cannot miss it. The poster shows a junkie injecting some drug into his veins and the usual admonition not to get enslaved to drugs. Initially I was shocked because, for the first time, I was informed that drug abuse has come to India also. Soon I realized that drug abuse, of one kind or another, has been in India all along. What probably caused the shock was the appearance of a needle and syringe.
In fact, drug abuse is worldwide. Some countries are literally waging wars, with little success, to control the trafficking as well as abuse of drugs. It is almost impossible to tackle all the facets of this problem here. We are only interested in learning more about some of the naturally available drugs, their use and potential abuse.
What is a Drug?
Let us first try to answer two simple questions: What is a drug? What is drug abuse? Sugar and heroin are both white. Both produce strong affects on the body. Both are known to influence mental function and mood. Both are known to be addictive. What about salt? Many people say that they cannot live without sufficient doses of salt in their foods and it has dramatic effects on the body. Take chocolate. It is widely used as a food or flavoring, but it contains a stimulant related to caffeine. Chocolate can be addicting too. Yet, society does not view sugar, salt and chocolate as drugs, whereas most people would agree that substances like heroin and cocaine are dangerous drugs.
A little thought quickly reveals that foods, drugs and poisons are not distinct categories. Many poisons act as drugs when used in small quantities. All drugs become poisons when used in large doses. Foods can be used for therapeutic purposes. It is also known that what is good food for one may turn out to be bad to another.
Whether a drug is deemed good or bad depends on who is making the judgment. When doctors prescribe drugs, we call them medicines and they are expected to do us good. When minute amounts of drugs are taken in a religious ceremony, that is tolerated. For example, Roman Catholics regard wine as a traditional sacrament. Early Muslims used coffee in religious rites, but had strict prohibitions on alcohol. Native Americans use tobacco in religious rituals, but shun alcohol as a curse. Mormons (a Christian denomination, with a following primarily in the U. S.) shun alcohol, tobacco as well as coffee. In India, people performing Trinath vrata eat a piece of marijuana leaf as prasadam. But many youngsters, in the United States, went to jail for experimenting with marijuana. Some of the modern religious cults tried to elevate the status of some psychedelic drugs to a sacramental level.
Let us call drugs like penicillin by the term medical drugs, which are used to treat a physical illness. In contrast, we have psychoactive drugs, which are substances that affect mood, perception and thought. The subject of this essay is drugs that, regardless of their possible therapeutic value, are self administered primarily to manipulate one's moods, perceptions and thoughts. In short, we like to use these substances not because our bodies need them, but because we like the feeling after using them. Such a use is abuse if it impairs a person's health, wealth and social well-being. Such a use is abuse if one loses self-control and becomes a burden to society by causing harm to others.
With this definition, cigarette smokers are clearly abusing tobacco, because cigarette smoke, both first hand and second hand, is implicated in cancer as well as in a number of respiratory and coronary diseases. Alcoholics are clearly abusing alcohol because under intoxication they not only batter their wives and children at home, but they also endanger the safety of others at the modern workplace. Other addicts are abusing whatever drugs they are addicted to because they are squandering their money, impoverishing their families and burdening the society with law and order problems.
Benign Drugs
Evidently, there is an ocean of difference between using and abusing a drug. Indeed coffee, tea and cola (nuts) contain caffeine, a stimulant. Coco and chocolate, both obtained from the nuts of cacao tree, are laced with caffeine and a related drug theobromine. (The coca shrub, source of the potent drug cocaine is different from cacao and cola trees.) Surprisingly, women are more likely to get addicted to chocolate than men. Although there have been scattered reports about the ill effects of these stimulants, these are considered benign and society accepted them.
Betel nuts, so widely used in India, contain a drug called arecoline, a stimulant comparable to caffeine. The addition of a pinch of quicklime to the betel leaf appears to contribute to an increase in the potency of the leaf-nut combination. The exact role of betel leaf in a pan is unclear. For one, the leaf serves to wrap the contents in a nice little package. Secondly, the combination of quicklime and betel leaf appears to be responsible for the bright red juice just as the combination of quicklime and turmeric, the powder used for tilak, produces a similarly bright red color.) The nuisance value associated with excessive use of pan is that it first discolors the user's teeth and makes them ugly. Secondly, the way people spit the juice on public pavements is a national disgrace. Yet, betel nut may also be dismissed as a benign stimulant.
The story is radically different with nicotine and alcohol. These are drugs of the twilight zone. They are definitely more potent than caffeine and they are not as feared as cocaine, heroine and other hard drugs. Their use is accepted, even glamorized by savvy advertisers. Governments indirectly encourage their use because their sale brings in huge amounts of tax money. Unfortunately, the dangers attendant with their abuse is not as clearly realized. They are doing immense damage to the health, wealth and productivity of individuals as well as nations. The loss of productivity due to morbidity and mortality far outweigh any revenues they might earn to the government's exchequer.
Tobacco
Tobacco is one of the most stimulant plants known to humanity. Nicotine, the active ingredient of tobacco, is the most toxic of all drugs. A big cigar contains enough nicotine to kill several people. When smoked, most of the nicotine is destroyed; only a tiny portion reaches the lungs, and that small dose is enough to kill people, over time. In the form of cigarettes, tobacco is the most addictive drug known. It is harder to break the habit of cigarette smoking than it is to break the habit of alcohol or heroin. Also, tobacco is the easiest to get addicted to. One can remain an occasional drinker of alcohol, but there is nothing like an occasional smoker. Once you begin, you are hooked. A British government study showed that an youngster who smokes more than one cigarette has only a fifteen percent chance of remaining a nonsmoker. Another soon-to-be-published British study claims that only ten percent of smokers who ever try quitting really succeed in doing so. These studies prove that tobacco is the easiest to get addicted to and the hardest to quit.
Snuff and chewing tobacco are euphemistically called smokeless tobacco. The only advantage of these modes of using tobacco is that they do not pollute the air and cause irritation to nonsmokers.
Alcohol
Alcohol is the most popular psychoactive drug in the world. It is probably the oldest drug known in heaven, earth and the nether worlds! Amarakosa lists well over fifteen different potent drinks that contain alcohol as an active ingredient. This attests to the omnipresence of this drug even in ancient India. In Sanskrit there are distinct names for distilled liquor, fermented liquor, liquors made from palm sap, sugarcane juice, flower nectars, and so on. The dangers of alcohol were realized early. From Sukracharya to Mahatma Gandhi, many stalwarts opposed its use. Many governments across the globe tried to prohibit its use and failed.
Really, the word alcohol represents a family of chemicals. Here we use the word alcohol to mean ethyl alcohol or ethanol. While many others in the alcohol family are extremely dangerous and deadly, ethyl alcohol is a qualified poison. If you do not believe this, just think what a physician does before an injection. An area on the skin is dabbed with alcohol, to kill the bacteria there, before the skin is pierced with a needle. In fact alcohol can even kill yeast which is used in its production. Given time, it can kill people too.
Alcohol is absorbed into the blood very quickly from the digestive system. When it reaches the brain, it causes its effects on mood and behavior. The effects of alcohol are directly related to its amount in the blood stream at any given time. Low concentrations cause alertness, good moods, a feeling of warmth and confidence, and the dissipation of anxiety and inhibition. Most people find these experiences pleasant. However this sense of confidence is false. Alcohol is not a stimulant; it is a depressant. It slows down the function of the nervous system, including reflexes, response times and efficiency of muscle responses. This is why drinking and driving, is so dangerous.
There may be some light at the end of this dark tunnel. The Food and Drug Administration of the U. S. is testing the efficacy of a substance called detoxohol. If an intoxicated person drinks this potion, it is claimed that the alcohol content of the blood decreases by fifty percent in thirty minutes. If this is true, detoxohol can potentially save thousands of lives of people who are routinely getting slaughtered on the highways by drunk drivers all over the world.
There is no denying that occasional use of alcohol in small doses, and in social contexts, has its value. Used intelligently, alcohol can relieve stress, enhance the taste of foods, and may even be beneficial to health. But the transition zone from safe to unsafe use is very narrow and crossing that zone is so much easier after the first one or two drinks when the depressing effects of the drug are just taking over.
Narcotics
Narcotics, like opium and its derivatives, are also depressants. The word narcotic comes from a Greek word meaning "stupor" and the English word stupid is derived from this root. Many of the opium derivatives, like morphine and codeine, are very useful medicines to control severe pain. Yet, they are feared most for their potential to cause addiction. For example, the semi-synthetic drug heroine (diacetylmorphine) is much more potent than morphine and turned out to be one of the most popular street drug in the U. S. Like the cigarette addict, the heroin addict cannot do anything without constantly thinking about where the next "speedball" is coming from.
Marijuana
The Kalpa Taru of the drug family is Cannabis sativa, the hemp plant. This plant provides a useful fiber, an edible seed, an oil and a medicine. The intoxicating properties of hemp reside in the sticky resin exuded by the flowering tops of the female plants. Cakes of this resin is called hashish. The whole plant - flowers, leaves, stem, and all - can be chopped and the material can be rolled into marijuana cigarettes.
Marijuana is unique. Its chemical structure resembles no other drug. While most other drugs are soluble in water, marijuana is soluble in oil. So it tends to accumulate in the body's fatty tissue and tends to stay in the body longer. Marijuana defies classification as a stimulant, a depressant or a hallucinogen.
Marijuana is the drug of choice in America's subcultures, counter cultures, revolutionaries, hippies and minorities. As a result of this identification with minorities and extremist groups, the dominant culture began to treat marijuana use as deviant behavior. Thus, in the United States marijuana became an emotionally charged political issue. Now a days, the word marijuana conjures up so much emotion that an utterance of its name is tantamount to committing a "sin," a sin comparable only to the utterance of the word, "communism," until the recent collapse of the Soviet Union. It s not surprising that use of marijuana is now banned in the United States. Marijuana is perhaps the most widely used illegal drug in the western world today.
Marijuana is good at treating nausea and vomitings. For this reason alone it became a very valuable tool in managing cancer patients receiving chemotherapy. It is known to alleviate the suffering of asthma patients. Cannabis is specific treatment for glaucoma, a serious eye disease caused by a buildup of pressure in the eyeball, which in turn can cause loss of vision. Incidentally, glaucoma is a leading cause of blindness in India. Marijuana is known to relieve the pressure buildup. Many believe that the plant itself is more effective than its active ingredient, THC (tetrahydrocannabinol). Research is sorely needed to settle the merits and demerits of marijuana. This work cannot be done in the emotionally charged atmosphere of the United States. This perhaps is an opportunity for Indian scientists to monopolize in the understanding of the pharmacology of marijuana and capitalize on it.
Prescription for Happiness
What I tried to sketch here is but the tip of a proverbial iceberg. There are many more drugs, natural and synthetic that are not discussed here.
Whether one drinks coffee, chews paan, smokes cigarettes, imbibes alcohol or sniffs cocaine, one is essentially trying to get away from some sort of anxiety or difficulty. In the good old days, people tried to sort things out by talking out a problem with a grandmother, a friend, a barber or a bartender. Then came psychologists and psychotherapists to handle what Sigmund Freud once described as "common unhappiness." In America, people are beginning to believe that one can get "better than well" by swallowing an appropriate pill produced by the so-called "cosmetic psychopharmcology." We are indeed entering the era of "magic pill myth." For example, it is estimated that some five million Americans have taken Prozac, a drug created by Eli Lilly and Company for treatment of major depression, and some 100,000 prescriptions for it are written every month. At last America has graduated from Valium to Prozac.
Many are realizing that one need not use drugs either to change consciousness or to get a euphoric feeling. Many are realizing that yoga is a much safer alternative to drugs.
Final Word
Drug abuse cannot be eradicated by legislation and police action. Look at the fate of prohibition in the United States and India. A classic success story in the battle against drug abuse is the anti-smoking campaign being waged in the United States. In this battle many private, non-profit organizations such as the American Cancer Society, the American Lung Association, and the American Heart Association played a key role in educating the public and changing their attitudes toward tobacco. Private industries also pitched in by helping employees quit smoking. With public opinion changing, it became easier for the government to enact supportive legislative action, not to ban tobacco but to discourage its use. During the eighties, these efforts resulted in a seven percent decrease in the number of adult smokers. Now smoking is prohibited in most public places in the U. S.
In India, such a grass roots campaign against alcohol has begun by a small group of housewives from a small village in the Nellore district of Andhra Pradesh. It is imperative that this campaign should not only spread throughout the country but the focus should be on education and assistance, not on legislation. It is also essential that a similar campaign begin against tobacco, the other great killer.