Wednesday, November 3, 2010

High times. Wednesday, November 3, 2010.

A special column in honor of the failure of Prop. 19.

“I was making frequent use of cocaine at that time … I had been the first to recommend the use of cocaine, in 1885, and this recommendation had brought serious reproaches down on me.” –Sigmund Freud

I tried pot in high school, and I wound up in the ER with a panic attack like I’d never had before. “If I were you, I wouldn’t use marijuana again,” lectured the doctor. Gee. Good idea. But I felt cheated by the whole experience. Wasn’t the whole point of pot to relax?

I’d already discovered alcohol, though – specifically, my parents’ supply of liquor, which I stole and covered my tracks by filling the vodka and gin bottles with water. I never really went out to parties – my parents were too strict. But somehow I managed to hide a pretty significant drinking habit, starting at the age of 14, right under their noses.

I wasn’t partying in a social way. I was, as they call it in psychiatry, “self medicating.” I was already dealing with significant depression and anxiety, and I had discovered that alcohol alleviated both problems (at least for a few hours).

I would soon be diagnosed with “manic-depression” (that’s what they called bipolar in 1980), but I would not be prescribed medication until years later. Alcohol, it seemed, calmed my frayed nerves and lifted my spirits (so to speak). (That I never became a raging alcoholic is probably due to the fact that my hangovers were so wicked.)

At least 50 percent of people with mental illnesses abuse alcohol or illegal drugs (this compares with 15 percent of those without a diagnosis). Substance abuse affects as many as 60 percent of people with bipolar disorder. And an astounding 90 percent of people with schizophrenia are heavy nicotine users. Self-medication seems to be the name of the game. But what might come as a surprise is that there’s nothing new about this.

People (mentally ill or not) have been “self-medicating” since our ancestors began walking on twos. Use of tobacco, marijuana, and coca date back to prehistory. More recently, during the two periods most associated with conservative values – the Victorian era (1830–1900) and the family-friendly 50s – drug abuse was rampant; it just wasn’t defined as such.

Hashish, absinthe, and alcohol were in common use in the 19th century. And opium and its derivatives were ubiquitous. Opiates were found in the over-the-counter “tonics” that filled every medicine cabinet, even in the most religious of homes. Doctors prescribed them for depression and anxiety. Godfrey’s Cordial was a wildly popular children’s elixir that mothers used to cure tantrums and crying spells; it was made of opium and brandy. Yum.

Sigmund Freud both used and prescribed cocaine. Coca-Cola did, in fact, contain cocaine – this isn’t an urban legend. From 1885 to 1929, Coke had coke (though in ever-decreasing quantities). Cocaine was also an ingredient in children’s’ teething medications. A list of famous Victorian drug addicts includes poets Samuel Coleridge and Percey Bysshe Shelley; authors Lewis Carroll, Oscar Wilde, Edgar Allan Poe and Charles Dickens; and even the President’s wife, Mary Todd Lincoln, who wound up in an asylum.

Then there was the 1950s. The post-war years ushered in an age of prosperity that Americans can only dream of today. For the first time, there was a financially-secure middle class, and the “American Dream” of a house in the suburbs, an automobile, and a yearly vacation was in reach for millions of Americans.

But along with that discretionary income (and an undercurrent of fears: the bomb, Communism) came an increase in the use of mind-altering substances. Alcohol was everywhere – it was not uncommon for people to drink in the office (anyone watch “Mad Men?” My mom says its portrayal is quite accurate), at lunch, and at “cocktail hour” at the end of the business day.

Virtually everyone smoked, virtually everywhere. (In my favorite “retro” photo of my mother, she’s at her baby shower, eight months pregnant with me, with a martini in one hand and a cigarette in the other! She’d cut way down on both habits during her pregnancy, however, even though her doctor assured her she didn’t need to.)

There were also “Mother’s Little Helpers” – Valium and Milltown, which were passed out to bored and anxious housewives like Skittles. Amphetamines were also used for weight loss with little consideration for their abuse and addiction potential. Studies of the era reveal a population that was “tuned out” a decade before the next generation would be condemned for using pot and LSD.

And while there is hullabaloo over the use of prescribed psychiatric medications, at least antidepressants don’t affect people in the way barbiturates or amphetamines do. It seems we’ve evolved a bit from that. In fact, while the use of alcohol and most “hard” drugs is associated with an increase in suicidal behavior, the use of SSRI’s has actually been linked to a decrease in suicide. (The anti-pharma people won’t like that, but it appears to be the case.)

The news today of California’s voting against Prop. 19, which would have legalized pot, saving law enforcement money and bringing in tax dollars, strikes me as ironic and silly when our nation faces its greatest threats to stability since World War II and Great Depression. Just as the poor will always be with us, so will mind-altering drugs. The question is whether their use will be considered a moral offense, or whether appropriate medical treatment will be available for those who self-medicate.

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