Professional Documents
Culture Documents
Eighth Edition
1.1
A B C
Marijuana can be examined (A) as molecule, (B) as an exotic plant, or (C) as a source of fnancing for insurgencies.
Molecular graphic image produced using the MidasPlus® package from the Computer Graphics Laboratory, UCSF. Microphotograph of a marijuana bud courtesy of the U.S. Drug
Enforcement Administration. Insurgent in Uzbekistan guarding marijuana feld © 1990 Alain Labrouse.
increased alertness, insomnia, increased heart rate and blood minishes pain and controls diarrhea. Opiates and opioids can
pressure, and decreased appetite. cause nausea, constrict pupils, and induce constipation.
Frequent use of the stronger stimulants (cocaine, metham- Excessive drinking and sedative-hypnotic, or opiate/opioid
phetamine, and bath salts) over a period of a few days will use can disrupt physical coordination, slur speech, cause di-
deplete the body’s energy chemicals and exhaust the user. gestive problems, induce sexual dysfunction, and create tis-
sue dependence.
If large amounts are used chronically or if the user is extra-
sensitive, heart, blood vessel, and seizure problems can oc- Downers in large doses or in combination with other depres-
cur. Although tobacco is a comparatively weak stimulant, sants can cause dangerous respiratory depression, over-
the long-term health effects of smoking can be perilous dose, and coma.
(e.g., cancer, emphysema, and heart disease). The Surgeon
General states that, “tobacco is toxic to each and every organ Mental and Emotional Effects
of the human body.” Initially, small doses (particularly of alcohol) act like stimu-
lants because they lower inhibitions, which can lead to freer
Mental and Emotional Effects and sometimes irresponsible behavior.
A small-to-moderate dose of one of the stronger stimulants
As more of the drug is taken, the overall depressant effects
can make someone feel more confdent, excited, outgoing,
dominate, relaxing and dulling the mind, diminishing anx-
and eager to perform. It can also cause a certain rush or
iety, and controlling some neuroses. Certain downers can
high, depending on the specifc drug and the physiology of
also induce euphoria or a sense of well-being.
the user.
Long-term use of any depressant can cause psychological/
Larger doses can cause jitters, anxiety, anger, rapid speech,
physical dependence and addiction.
and aggressiveness.
Prolonged use of the stronger stimulants can cause extreme
anxiety, paranoia, anhedonia (inability to experience plea-
sure), mental confusion, and an induced psychosis.
Physical Effects
Other Drugs and Addictions Anabolic steroids increase muscle mass and strength. Pro-
longed use can cause acne, high blood pressure, shrunken
There are three other groups of drugs that can stimulate, de- testes in men, and masculinization in women.
press, or confuse the user: inhalants, anabolic steroids and Mental/Emotional Effects
other sports drugs, and psychiatric medications.
Use of anabolic steroids often causes a stimulant-like high,
increased confdence, and increased aggression. Prolonged
large-dose use can be accompanied by outbursts of anger
known as “roid rage.”
Inhalants (deliriants)
Inhalants are gaseous or liquid substances that are inhaled
and absorbed through the lungs. They include organic sol- Psychiatric Medications
vents, such as glue, butane, gasoline, metallic paints, gaso-
line additives (STP®), and household sprays; volatile ni- Psychiatric medications are used to rebalance irregular brain
trites, such as amyl, butyl, or cyclohexyl nitrite (also called chemistry that has caused mental problems, drug addiction,
“poppers”); and anesthetics, especially nitrous oxide and other compulsive disorders. These are the most common:
(“laughing gas”). antidepressants: Celexa,® Prozac,® Luvox,® Zoloft,®
Paxil,® Cymbalta,® and Pristiq®
Physical Effects
antipsychotics: Seroquel,® Risperdal,® Abilify,® Haldol,®
Use results in CNS depression, causing dizziness, slurred and Zyprexa®
speech, unsteady gait, and drowsiness. Some inhalants lower
antianxiety drugs: Xanax,® Buspar,® Lyrica® (off-label)
blood pressure, causing the user to faint or lose balance.
and panic disorder drugs (e.g., Inderal®)
Because they are depressants, they can cause stupor, coma,
and asphyxiation. The organic solvents can be directly toxic The number of new drugs developed for the modifcation of
to cells in the lungs, brain, liver, kidney tissues, and blood. behavior and the alleviation of symptoms is an indication of
how fast the feld of psychopharmacology has grown and il-
Mental/Emotional Effects lustrates the emphasis on medication as a treatment strat-
Small amounts can produce impulsive behavior, excite- egy rather than psychotherapy. These drugs are prescribed
ment, mental confusion, and irritability. Some inhalants more and more frequently despite the fact that the national
cause a rush through a variety of mechanisms. Larger incidence of psychiatric disorders has remained fairly con-
amounts can cause delirium and hallucinations. stant over the past 40 years.
Physical Effects
“Ibelievethisisagoodtime
Psychiatric medications produce a wide variety of physical forabeer.”
side effects, particularly involving the heart, blood, and Franklin Delano Roosevelt
musculoskeletal system. Side effects and other adverse or after the 1932 repeal
toxic reactions from antipsychotic drugs (also called neuro- of Prohibition
leptic drugs) are especially severe.
History of Psychoactive
Drugs “Muchoftherootcauseforviolencethathasbeen
happeninghereinMexico,forwhichsomany
Mexicanshavesuffered,isthedemandforillegal
Introduction drugsintheUnitedStates,”
Barack Obama, during state trip to Mexico, May 3, 2013
“[Prohibitionis]agreatsocialandeconomic
experiment,nobleinmotiveandfar-reaching Although presidential attitudes toward drugs and alcohol
inpurpose.” in the twentieth and twenty-frst centuries vary widely, the
Herbert C. Hoover in a letter to William E. Borah, laws and the attitudes regarding substance use have as
February 28, 1928 much to do with the political climate at the time they were
“LetusnotthensimplycensurethegiftofDionysus(GreekGod
ofFertilityandWine)asbadandunfttobereceivedintothe
Stateforwinehasmanyexcellences.Shallwebeginbyenacting
thatboysshallnottastewineatalluntiltheyareeighteenyears
ofage;wewilltellthemthatfremustnotbepoureduponfre,
whetherinthebodyorinthesoul.”
Athenian Stranger in The Laws by Plato, 360 B.C.
2 Human brain chemistry can be affected by psychoac-
tive drugs, behavioral addictions, and mental illness in
ways that will induce an altered state of consciousness.
In fact, if psychoactive drugs and behavioral addictions did
not affect human brain chemistry in a desirable manner (at
least initially), they would not be used. The chemistry of
individual psychoactive drugs has counterparts within the
central nervous system.
Drugs affect the primitive, or “old,” part of the brain that
controls emotions, instincts, natural physiological functions
(e.g., breathing and heart rate), emotional memories,
sensory perception, and physical or emotional pain. They
also affect the reasoning and decision-making centers of
the “new” brain, called the neocortex. Because mental
illnesses are caused by unbalanced brain chemistry, psycho-
active drugs have been used to try to control illnesses such as
depression and schizophrenia. The brain’s neurochemicals,
neurons, and structures evolved over hundreds of millions of The New York City deputy police commissioner watches agents pour
years, starting in invertebrate creatures such as insects and liquor into a sewer following a raid during the height of Prohibition.
snails and growing in complexity in vertebrate creatures, Courtesy of the Library of Congress
especially Homo sapiens.
4 Technological advances in refning, synthesizing, and
manufacturing drugs have increased the potency of
these substances.
Over the centuries cultures have learned how to:
Discovery of the survival circuit (reward/reinforcement circuit), which distill alcoholic beverages to higher potency (Arabia,
includes the VTA, lateral hypothalamus, amygdala, and especially the tenth century)
nucleus accumbens, has helped researchers understand the roots of
addiction.
refne morphine from opium (Germany, 1804)
© 2012 CNS Productions, Inc. refne cocaine from coca leaves (Germany, 1859)
use manufacturing innovations to increase production
(automatic cigarette rolling machine, United States,
3 Historically the ruling classes, governments, and in- 1881)
dustry, along with criminal organizations, have been synthesize the stimulant amphetamine to create a re-
involved in growing, manufacturing, distributing, tax- placement for ephedra (Germany, 1887)
ing, and prohibiting drugs.
synthesize LSD (Switzerland, 1938)
The intensity of the demand for substances that relieve pain use the sinsemilla growing technique to increase delta-
and induce pleasure is matched by the struggle to control the 9-tetrahydrocannabinol (THC), the main active ingredi-
supply: ent content of marijuana (United States, 1960–1980)
monopolization of coca leaf growing by the Spanish create cocaine/methamphetamine-like substances that
conquistadors in Peru to increase tax revenues avoid detection (United States, 2009)
excise taxes levied on whiskey, hemp, and tobacco to
These and other techniques enabled drug users to deliver
fnance the American Revolution
more of an active psychoactive ingredient into the body at
sale of opium to China by Britain, France, Japan, and one time. For example, the percentage of cocaine found in
other imperial powers to support their colonies coca leaves is 0.5% to 2.0%; in street cocaine it is often 60%
drug trade by al Qaeda to fnance terrorist activities to 70%. Today marijuana contains up to 14 times more THC
than did the street marijuana of the 1970s.2 Research shows the recurrent yet progressive nature of drug use and abuse, it
that the more potent the psychoactive drug, the more rapid is evident that solutions must change and adapt as society
the development of addiction. changes and as science presents us with a clearer picture of
the reasons for craving and addiction.
5 The development of faster and more-effcient methods
of delivering drugs into the body has intensifed the
effects. Prehistory and the Neolithic Period
Technological and pragmatic discoveries have taught users to: (8500–4000 B.C.)
mix alcohol and opium for stronger effects
(Sumer, 4000 B.C.) Many of the drugs available today have antecedents in psy-
absorb more juice while chewing a coca leaf by mixing choactive plants that have been around for millions of years.
it with charred oyster shell (Peru, 1450) It is estimated that 4,000 plants yield psychoactive sub-
stances, although only about 60 are commonly used.
inhale nitrous oxide to become giddy and high
Opium poppies, marijuana tops, coca leaves, tea leaves, betel
(England, 1800)
nuts, khat leaves, coffee beans, tobacco leaves, and fruits or
inject morphine directly into the bloodstream (England, other plants that ferment into alcohol have been the most
1855) popular over the millennia.3
snort cocaine to absorb the drug more quickly
While there is some evidence that Neanderthals and early
(Europe, 1900)
man used plants such as ephedra (a stimulant) and alcohol
smoke crack cocaine to intensify the high from naturally fermented fruits at least 50,000 years ago,
(United States, 1975–1985) most of the evidence places serious use of psychoactive
crush and inject time-release medications, such as drugs about 12,000 years ago at the start of the Neolithic
the opiate pain reliever OxyContin® for a bigger rush period.4 This era, considered the last part of the Stone Age,
(United States, 2003) was marked by settlement into permanent villages, the use of
vaporize nicotine in electronic cigarettes agriculture to grow crops, the raising of domesticated ani-
mals, and the transition from stone to metal tools.
vaporize alcohol and inhale the fumes
(worldwide, 2000s) The need for substances to subdue pain, heal illness, and
deal with fears of real and imagined dangers in the environ-
Societal and cultural changes play a role in new behavioral
ment also spurred the development of spirituality and ulti-
addictions. Rapid-play poker machines, slot machines, and
mately civilization. This need to deal with the physical world
online gambling have resulted in an increase in the number
led to the development of Shamanism, which holds beliefs in
of problem and pathological gamblers. Online games such as
an unseen world of external and internal demons, gods, and
Farmville,® World of Warcraft,® and a thousand other digital
ancestral spirits who listen only to the shaman. The shaman,
activities have captured the imagination of the Internet gen-
a combination priest–medicine man, was the key fgure in
eration and created yet another behavioral addiction.
these religions and functioned as a conduit to the super-
A close examination of the evolution of substance use fnds natural, using both naturally induced (e.g., fasting and
these fve themes appearing time and time again. By studying dancing) and drug-induced altered states of consciousness.
Ancient Civilizations
(4000 B.C.–A.D. 400)
Great civilizations grew and thrived where the land was fer-
tile, usually next to rivers such as the Tigris and the Euphrates
in the Middle East (modern-day Iraq, Syria, and Turkey) and
the Nile in Egypt. The earliest crops were wheat and barley,
used to make bread and beer (beer was far more nutritious
in ancient times than it is today).8 Asian civilizations used
rice as a staple food and to make wine (sake). Some ancient The Egyptian hieroglyphic from 1500 B.C. advised moderation in
cultures cultivated the opium poppy and the hemp plant barley beer drinking as well as avoidance of other compulsive
(Cannabis) for medicinal purposes. behaviors. Written Egyptian references to alcohol that date back to
3500 B.C. have been unearthed.
Alcohol Translation from Precepts of Ani, World Health Organization.
Throughout history alcohol has been the most popular
psychoactive substance. This food/medicine/drug has been
with us since prehistoric times. Perhaps hunger, thirst, or
curiosity made early humans eat or drink fermented fruits,
or perhaps they noticed the odd behavior of animals that ate Osiris gave alcohol to the Egyptians, as did Dionysus to the
the spoiled fruit of the marula tree.9 Greeks and Bacchus to the Romans.12 In ancient Egypt a bar-
The taste, the nutrition, and the psychoactive effects, par- ley beer called hek was a valued commodity and was given as
ticularly the drunken states that made them feel closer to a reward to laborers building the great pyramids. Beer was
their gods, motivated humans to learn how to produce fer- the drink of the workers, and wine was the privilege of the
mented beverages themselves.10 They collected honey to fer- pharaohs as evidenced by earthen jars in King Tut’s tomb,
ment into mead, an alcoholic beverage; they cultivated grains which noted the vintage (year) of the wine and the location
to ferment starchy foods into beer; and they cultivated grapes of the vineyard.
and other fruits to make wine. These agricultural experi- Rice wine was the drink of the masses in ancient China and
ments are the earliest signs of organized efforts to guaran- later Japan, but grape wine was more highly prized. In about
tee a steady supply of a desirable psychoactive substance. 180 B.C., a gift of grape wine served as a bribe to get a civil
In 2004 and 2005, in Jiahu, China, archaeologists uncovered service job.13 For centuries Judaism has used wine in reli-
evidence of the use of alcoholic drinks 9,000 years ago. gious and secular celebrations, including circumcisions,
Residue in ancient pottery vessels from this Stone Age village weddings, and the Sabbath.
in China’s Henan province indicated that a fermented bever- Because alcohol caused not only the desired effects but also
age of rice, honey, and fruit was being made at approxi- side effects capable of creating social and health problems,
mately the same time that barley beer and grape wine were most civilizations throughout history placed religious, so-
being made in the Middle East.11 cial, and legal controls on the use of alcohol and other
The frst written references to alcohol were found on drugs. Many of the 150 biblical references to alcohol include
Sumerian clay tablets from 6,000 years ago (4000 B.C.) a warning.
that were discovered in ancient Mesopotamia (now Iraq and
Iran). They contained recipes for using wine as a solvent for “Givestrongdrinktohimwhoisperishing,andwinetothose
medications such as opium. inbitterdistress;letthemdrinkandforgettheirpoverty,and
remembertheirmiserynomore.”
Many ancient cultures considered alcohol, particularly
Proverbs, 31:6–7
wine, a gift from the gods. According to ancient mythology,
“TheScythiansthentaketheseedofthishempand,crawlingin
underthemats,throwitonthered-hotstones,whereitsmolders
andsendsforthsuchfumesthatnoGreekvaporbathcouldsur-
passit.TheScythians,transportedwiththevapor,shoutforjoy.”
Herodotus, The Histories, 4.75.1, 460 B.C.
substances to fnd the correct dose to heal a patient or induce Khat, a stimulant permitted by some Islamic cultures, was
a trance state. They lost quite a few patients in the process. A originally cultivated in the southern Arabian Peninsula and
similar danger exists in the relationship between the amount the Horn of Africa. It was used for long prayer ceremonies to
and frequency of use vs. the liability for addiction. The more help the congregation stay awake (much like coffee). In A.D.
powerful the psychoactive component itself, the quicker 1238 the Arab physician Naguib ad-Din distributed khat to
addiction will develop. soldiers to prevent hunger and fatigue; an Arab king, Sabr
ad-Din, gave it freely to subjects recently conquered to pla-
Alcohol and Distillation cate them and quell their revolutionary tendencies.35
Even though techniques for distilling seawater and alcohol
Historically, for most religions, alcohol per se was not
had been around for thousands of years, it was not until the
shunned but rather what alcohol made a drinker do.
eighth to fourteenth centuries that knowledge of the tech-
Through the centuries temperance gave way to prohibition,
niques became widespread. The evaporation process was
and objections to the debilitating effects of alcohol and other
used to raise the average alcohol content of a beverage from
psychoactive drugs gave way to bans on any substance that
14% to 40%.30 An Arabian alchemist known as Geber (Jabir
could make one forget religious and moral duties.
Ibn Hayyan, A.D. 721–815), called the “father of the sci-
ence of chemistry,” is credited with perfecting a wine dis- Coffee, Tea, and Chocolate (caffeine)
tillation method that produced pure alcohol, which he de-
For centuries the coffee plant Coffea Arabica grew wild in
scribed as “of little use but of great importance to science.”
Ethiopia; by the fourteenth century, it was imported to
Further research was done by the Arabian physician Rhazes,
Arabia and widely cultivated. Initially, people simply chewed
who described the process in his book Al-Asrar (The
the beans or drank bean-infused water. During the later
Secrets). He called the substance al-koh.31 It took 300 years
Middle Ages, people began to roast and grind the beans,
for the process to become common in Europe, around the
which made a tastier, more potent beverage. It was also used
time of the frst Crusades.
medicinally as a diuretic, an asthma treatment, and for head-
Technical advances in cultivation as well as in distillation ache relief. It was not until 1819 that caffeine, the active al-
made a difference in consumption. In the early days, kaloid in coffee and tea, was fnally identifed by the German
Christians celebrated their faith at banquets featuring wine physician Friedlieb Runge.
and bread; but as alcohol use became more and more of a
Approximately 60 plants, including the beans of coffee
problem, less and less wine was consumed until it was used
shrubs and the leaves of tea bushes, contain caffeine (e.g.,
almost exclusively in rituals.
the cacao, maté, kola, and yoco trees and the seeds of the
Limiting alcohol consumption became a moral cause. Saint guarana plant).
Paul condemned the relaxed behavior excessive drinking
Tea brewed from the leaves of the Thea sinensis (chinensis)
caused because it led users away from God. Paganism and
bush was supposedly used in China 4,700 years ago, in 2700
the use of psychoactive substances to communicate with
B.C., but the frst written evidence of it dates to approxi-
the supernatural gave way to a demand that faith alone be
mately A.D. 350. The cultivation of tea in Japan and the de-
used to understand God.
velopment of tea ceremonies occurred about A.D. 800. Today
Islamic Substitutes for Alcohol tea remains at the heart of social and religious ceremonies in
Japan and in a number of other countries.36
In the Qur’an, the holy book of Islam, few references are
made to wine and intoxicants. Wine is not used in any Chocolate, refned from cocoa beans that grow on the cacao
Islamic sacraments and drinking is frowned upon. The tree, can be traced back to the Olmecs of Mexico (1500 to
prophet Mohammed simply chastised a drunkard for not 400 B.C.). The Mayans (1000 B.C. to A.D. 900) were the
performing his duties. Mohammed’s brother-in-law, Ali, set second people to cultivate cacao on plantations throughout
the tone for alcohol in later Muslim societies. Mexico and the Yucatan Peninsula, followed by the Toltecs
and then the Aztecs. The beans were ground and used to
“Hewhodrinksgetsdrunk,hewhoisdrunk,doesnonsensical make a stimulating, highly desirable though bitter chocolate
things,hewhoactsnonsensicallysayslies, drink (with foam). They were prized and used for barter: 4
andhewholiesmustbepunished.” beans would buy a squash; 8 to 10, a rabbit. The average
Ali18 daily wage of a porter in central Mexico was 100 beans.37
Muslims avoided alcohol, substituting alternative psychoac- The Renaissance and the
tive substances. Opium for the relief of pain, both physical
and mental, was seen as an acceptable substitute. It was used Age of Discovery (1400 –1700)
in Arab society as a general tonic; it supposedly eased the
transition to old age. In later centuries tobacco, hashish As exploration, trade, and colonization broadened in the 15th,
(concentrated Cannabis), and particularly coffee were em- 16th, and 17th centuries, Europeans encountered diverse
ployed as substitutes for alcohol to provide stimulation, cultures and unfamiliar psychoactive plants which were
induce sedation, or alter consciousness. These substances collected and brought home. Some of the most notable sub-
were also used medicinally. stances were coffee from Turkey and Arabia; tobacco, cocoa,
and coca from the New World; tea from China; and the kola
nut (chocolate) from Africa. To a lesser extent, these European
explorers, soldiers, traders, and missionaries in turn carried
their own culture’s drugs and drug-using customs to the rest
of the world; e.g., tobacco to China from Portuguese sailors.
Urbanization, wealth, personal freedom, and fewer religious
taboos also increased the use of these substances.
Alcohol
Laws passed during this period that limited the use of alco-
hol were the result of the effects of overuse, particularly of
high-potency beverages. Those in power wanted to limit
alcohol’s toxic effects and confront the moral consequences
of lowered inhibitions. Switzerland and England passed
closing-time laws in the thirteenth century. Scotland and
Germany limited sales on religious days in the ffteenth cen-
tury.15 These laws were aimed more at temperance than at
prohibition because controlled sales of distilled beverages
produced hefty tax revenues.
Europeans were not the only ones with well-established
drinking patterns. Many African cultures brewed wine from
palm trees or beer from maize and used it in rituals, as a
foodstuff, and for social interaction. When slavers ripped
Africans from their villages and sent them to America, start-
ing in the 1500s, the tribes of Whidah, Ebo, Congo, and
Mandingo brought many of their brewing techniques and
drinking rituals with them.38 Some rituals remained, but
more often the changed power structure disrupted those pat-
terns. Slave ships and ships transporting missionaries to Following a centuries-old tradition, this coca chewer carries his
non-Christian countries brought rum to cultures used to leaves in a pouch on his shoulder. The poporo gourd in his right hand
drinking only beer and wine. Rum’s higher alcohol content contains powdered lime that is mixed in his mouth with the coca to
often led to a disruption in the drinking patterns that had increase the absorption of cocaine.
evolved over centuries and had rarely led to alcohol abuse. Courtesy of the Fitz Hugh Ludlow Memorial Library