WHERE DO WE GO FROM HERE?

WHERE DO WE GO FROM HERE?

There is an ongoing debate in the United States about the legalization or decriminalization of drugs by society. Several states have either passed laws or are considering laws that allow the use of marijuana for medical and possibly recreational purposes, but these laws are still controversial, and there is the additional problem that these state laws can be in conflict with federal laws. As a result, no one knows what the outcome will be even though it appears that federal officials are beginning to limit some prosecutions.

A number of prominent Americans—including the conservative Repub­lican senator Rand Paul—have concluded that the War on Drugs is leading to injustices. As this is being written, Senator Paul and Democratic senator Patrick Leahy want to change the law and have introduced the justice Safety Valve Act, which will allow judges more discretion in sentencing.

On the other side, many people believe that any effort to reduce the pressure on drug users and dealers will result in a flood of illegal sub­stances that, in their worst nightmares, will become readily available to children. Unfortunately, drugs are already readily available to anyone, including children, from all economic levels. So that nightmare is here right now.

To reduce demand, we need to increase education. As we have said elsewhere in this book, effective drug education is not just a matter of exhortations to refuse all drugs, because many individuals believe that the drugs they use are harmless. It is a matter of teaching the basic science that can help us appreciate what complex and delicate organisms our brains are, how body chemistry may vary from person to person, and how little we know about the many ways, both positive and negative, short-term and long-term, that the powerful chemicals we call "drugs" can affect us. Good education is expensive, but with it we will be healthier, and as a society, we will save the enormous costs of lost wages, law enforcement, and prisons that drugs have brought us.

GETTING CAUGHT

GETTING CAUGHT

Most people believe that they will not get caught. Teenagers, in particular, have the feeling that they are "beyond the law" But it does happen. It hap­pens to grandmothers, teenagers, lawyers, doctors, and the most ordinary people on the face of the earth.

Many drug arrests come from the most random events imaginable. In Virginia, an officer stopped a car for having something hanging off the rearview mirror. He became suspicious, legally searched the car, and found major quantities of cocaine. Another drug transporter thought he had the perfect scheme and filled fruit juice cans with cocaine, then resealed them. It is a regular practice for tourists to bring back food from vacation in the Caribbean, and he expected to walk right through customs. What he did not realize was that customs officials knew there was no reason to bring

canned fruit juice from the Caribbean, where it is expensive, to the United States, where it is cheap. He was arrested and convicted for transporting millions of dollars' worth of cocaine.

Even grandmothers are not immune to arrest. A pair of DEA agents working a bus station in North Carolina noticed an elderly woman behav­ing oddly. When they approached her, she moved away and they became suspicious. They conducted a legal search and found a large quantity of cocaine in her luggage.

A college student came back to her dorm room to find the place crawl­ing with campus and city police. While she had absolutely no role in any illegal activity, a friend of her roommate had come to town from another college with a shipment of drugs. Another student, obeying the honor code, had called the campus police. Fortunately, the innocent student was not arrested because the roommate cleared her, but it was a very close call.

The law-enforcement community is actually quite sophisticated in its drug-enforcement efforts. DEA agents work all over the world trying to prevent the transport of drugs into the United States. They have agents working major and minor airports, and even bus stations. The highway patrols of most states have drug interdiction units looking for suspi­cious vehicles. This is not a trivial effort, and it results in so many con­victions that both the state and federal prison populations have grown dramatically.

Yet everyone realizes that most countries are overrun with drugs. It is usually easy to buy the most common illegal drugs in many areas of cit­ies and on college campuses. So why is the legal interdiction effort per­ceived as failing? It is not exactly failing, but rather it is being overwhelmed. Many, many people are caught in the legal system, but there is always someone else to replace each person caught. Routine usage of cocaine, crack, or heroin can be a very expensive habit, and the only way that most people can maintain such expensive behavior is to turn to dealing. As we say elsewhere in this book, cocaine and opiates can be extremely reinforcing, and they are also expensive in the quanti­ties that habitual users consume. The combination of dependence and expense often leads users to become dealers until they are stopped by medical intervention, arrest, or death.

What does this have to do with the average reader of this book? Any­one who can read this book no doubt has the ability to do honest and legal work and have a successful life. Such a reader might feel that she is above being caught, or just not in the "wrong" circle of friends. This

naiveté might be the most dangerous attitude of all, because, like most jobs, illegal drug dealing depends on knowledge, skills, and having a network of people. Most casual dealers do not have the knowledge or, fortunately, are not willing to do what is necessary to involve themselves fully in the drug culture. Thus, they approach the whole issue as ama­teurs, and like many amateurs in anything, they fail miserably. Only in this case, the stakes are much higher. They can get caught, lose a lot of

money, become victims of criminal violence, or become heavily depen­dent on the substance they are dealing.

As we all know, some people think they have few opportunities and only a short time to live. They will deal drugs no matter what anyone says. In their lives they see jail time as just the cost of doing business. However, a district attorney who has prosecuted thousands of drug cases had just one bit of advice: people with families, an opportunity for education, and a supportive network of friends have so much to lose from being on the wrong side of the legal system that they should never become involved with it. A felony conviction can strip a person of so many opportunities in this society and can cost families so much in

pain, suffering, and financial loss that no amount of money or drug experience is worth the risk.

HAZARDS OF HERBAL DRUGS

HAZARDS OF HERBAL DRUGS

The greater part of the home grown arrangements that individuals utilize are harmless, and some are viable, particularly in individuals with lacks in the atom that is in the supplement. Moreover, there is some advantage in taking a milder, endogenous variant of an endorsed medicate that may have serious symptoms. Be that as it may, some have genuine threats. Of the gathering specified here, stimulants identified with ephedrine represent the most serious hazard, since individuals can without much of a stretch take enough to cause hypertension, stroke, or heart assault. Frequently, the advertisers of the natural arrangements prescribe taking exces­sive measurements. Such supplements are plainly perilous blade somebody as of now encountering hypertension or any sort of cardiovascular issue. 

A portion of the dietary supplements can be very hazardous for individuals with certain therapeutic conditions, or those taking certain medications. Taking anything that builds the creation of monoamine neurotransmitters (e.g., phenylalanine or tyrosine) is hazardous for somebody who is taking a specific sort of medication to treat misery (the monoamine oxidase inhibi­tor class, for example, Nardil or Eldepry1). These medications keep the breakdown of monoamine neurotransmitters, and unsafe hypertension can come about on the off chance that they are brought in mix with dietary supplements that expansion the generation of these same neurotransmitters. Further­more, taking phenylalanine can be unsafe for a man who experiences phenylketonuria, a sickness that keeps the typical digestion of phenylalanine, which can develop in the blood to risky levels. The long haul impacts in generally solid individuals of taking high measurements of numerous natural medications are not known. The present energy for natural cures will give the information that we require be that as it may, shockingly, at the presumable cost of unwary clients of these items. Our recommendation is to keep your eyes on the logical research about nutritious supplements and mind work, since science is making up for lost time quick.

NITRITES

NITRITES

WHAT THEY ARE AND HOW THEY WORK

These chemicals are yellow, volatile, and flammable liquids that have a fruity odor. The nitrites are part of a large class of drugs (including amyl nitrite, butyl nitrite, isobutyl nitrite, and the nitrates like nitroglycerin) that relax the smooth muscles that control the diameter of blood vessels and the iris of the eye, keep the anus closed, and keep us from dribbling urine. When these muscles relax, the blood vessels enlarge and blood pressure falls, more light is let into the eye, and the bowels are let loose.

The medical uses of these compounds have a long and successful his­tory, beginning with the synthesis of nitroglycerin in 1846. That's right—nitroglycerin, the explosive that we all know about, is also a very important drug. Chemists first noticed that just a bit of it on the tongue produced a severe headache (they did not know that this was because it dilated blood vessels); within a year it was medically used by placing it under the tongue to relieve heart pain caused by blocked blood vessels. Like all of these compounds, nitroglycerin relaxes blood vessels, and today it is very commonly used to relieve the pain that patients with heart disease feel when one of the vessels supplying blood to their heart has a spasm (angina pectoris). Remember the scene in movies when an old per­son grabs his heart, falls to the floor, and struggles to get his medicine out of his pocket? Then the bad guy takes the medicine away and the victim dies? Almost certainly, it was nitroglycerin that he needed.

The nitrites, like the amyl nitrite "poppers" that some people use for rec­reation, have the same basic effects as nitroglycerin. They were first syn­thesized and used medically in 1857, but soon physicians found them to be short lasting and unreliable, so nitroglycerin under the tongue has remained the medicine of choice. Amyl nitrite is now used clinically only when the very rapid absorption through inhalation is necessary for some cardiac medical procedures.

The side effects of nitrates and nitrites are common and consistent, and they are related to the dilation of blood vessels. When physicians pre­scribe these drugs, they tell their patients to expect headache, flushing of the skin, dizziness, weakness, and perhaps loss of consciousness if body position is changed rapidly.

As with almost all drugs, there is a lot we don't know about how they work. In this case, we really don't know exactly why the nitrites have the mental effects that make them attractive for some people to use. Users report a physical sensation of warmth, a giddy feeling, and a pounding heart. The psychological sensations are the removal of inhibitions, skin sensitivity, and a sense of exhilaration and acceleration before sexual orgasm. There is a rather common visual disturbance consisting of a bright yellow spot with purple radiations.' These effects may arise from the dilation of some blood vessels in the brain. Finally, some people use these drugs not for the mental effects but for their muscle-relaxing prop­erties to permit anal intercourse.

INTERACTIONS WITH OTHER DRUGS

INTERACTIONS WITH OTHER DRUGS

Many people who experiment with hallucinogens combine them with other drugs. For example, it is not uncommon for people to take LSD or mushrooms and smoke marijuana at the same time. The effect of these combinations is highly individual and depends on the previous drug experience of the user, the doses, and the particular drugs involved. For example, smoking marijuana often triggers PHPD (flash­backs) in heavy LSD users. Many of these combinations produce bizarre, anxiety-provoking—but not dangerous—states.

The most troublesome reactions are those that are caused by the user taking something without knowing it. PCP is a frequent culprit in this regard. Marijuana can be adulterated with PCP without the user's knowledge and can induce a terrifying or dangerous state in the unsus­pecting users.

What about interactions with prescription drugs? Not surprisingly, other drugs that influence serotonin systems have been involved in reported interactions. There are multiple reports of serotonin-specific rcuptake inhibitors (SSRls) like Prozac (fluoxetine) triggering flashbacks in heavy LSD users. The opposite interaction also can happen: some patients who are taking SSRIs to treat depression report that they do not experience the effects of LSD. A more dangerous interaction could theo­retically happen if people combine SSRIs and avahuasca. The MAO inhib­itor in the ayahuasca can synergize with the increase in serotonin caused by the SSRI, leading to the dangerous "serotonin syndrome" that we dis­cuss in the "Ecstasy" chapter.

CHROMOSOMAL DAMAGE

CHROMOSOMAL DAMAGE

We have one final myth to discuss: the idea that LSD will break chromo somes. This concern, based on scanty research, was raised during the 1960s. While women who used LSD during pregnancy have given birth to children with birth defects, this rate is not higher than that of the general population. Furthermore, most of these women also used other drugs during pregnancy. Most animal research has not shown remarkable effects of LSD on the developing fetus. Some concern about the effects of LSD goes back historically to the widespread use of related ergot alkaloids to induce abortion. However, LSD itself does not have this effect. Never‑

theless, women who are pregnant, or who might be, should avoid drugs in general.

DEATH

Conventional LSD-like hallucinogens are fairly unlikely to produce seri­ous physical effects. However, some newer and fortunately rare designer hallucinogens have blurred the lines between stimulants and hallucinogens. For example, one of these-25I-NBOMe, 4-lodo-2,5-dimethoxy-N-(2- methoxybenzyl) phenethylamine—has been reported to cause deaths. This drug and some like it sometimes are marketed as bath salts, and sometimes as LSD. 'The particular problem with this drug is its extraordi­nary potency: like LSD, it has big effects at very small doses. This drug and several close relatives may represent serious risks to human users, but almost nothing is known about them.

lhe belladonna alkaloids represent a particular danger. These drugs prevent the action of one of the major neurotransmitters in the body (ace­tylcholine) at many of its synapses. At doses that cause hallucinations, they increase heart rate and body temperature to dangerous levels: death can result. It is important to understand that there is not a dose that pro­duces significant behavioral effects that is not toxic: the behavioral effects, like delirium, are signs of overdose. These effects are easily treated by medical personnel if they know what the intoxicating drug is. Therefore, it is extremely important to seek medical attention.

PCP also can cause dangerous side effects or death from overdose (two to five times a single recreational dose). As the user increases the dose, general anesthesia can result (remember, this was the reason the drug was invented). However, a number of dangerous effects occur after high doses, any one of which can be lethal. Body temperature can rise to 108 degrees Fahrenheit, blood pressure can rise so much that a stroke occurs, breathing can cease, or a prolonged period of seizure activity can result. PCP can also cause a prolonged state resembling paranoid schizo h enia. This most often happens in people who use PCP for a long time; however, an abnormal psychiatric state that persists for days can result from a single use. The acute delirium caused by PCP or ketamine can be alleviated with benzodiazepine drugs, such as Valium.