Wednesday, October 17, 2007

Treatment vs Recreation

Tim Wu at Slate is taking a look at a subject I have been discussing for years. The idea that illegal drugs do the very same things that legal drugs do. Treat what are called emotional problems.

Over the last two decades, the FDA has become increasingly open to drugs designed for the treatment of depression, pain, and anxiety—drugs that are, by their nature, likely to mimic the banned Schedule I narcotics. Part of this is the product of a well-documented relaxation of FDA practice that began under Clinton and has increased under Bush. But another part is the widespread public acceptance of the idea that the effects drug users have always been seeking in their illicit drugs—calmness, lack of pain, and bliss—are now "treatments" as opposed to recreation. We have reached a point at which it's commonly understood that when people snort cocaine because they're depressed or want to function better at work, that's drug trafficking; but taking antidepressants for similar purposes is practicing medicine.

This other drug legalization movement is an example of what theorists call legal avoision. As described by theorist Leon Katz, the idea is to reach "a forbidden outcome … as a by-product of a permitted act." In a classic tax shelter, for instance, you do something perfectly legal (like investing in a business guaranteed to lose money) in order to reach a result that would otherwise be illegal (evading taxes). In the drug context, asking Congress to legalize cocaine or repeal the Controlled Substances Act of 1970 is a fool's errand. But it's far easier to invent a new drug, X, with similar effects to cocaine, and ask the FDA to approve it as a new antidepressant or anxiety treatment. That's avoision in practice.

Are the new pharmaceuticals really substitutes for narcotics? The question, of course, is what counts as a substitute, which can depend not just on chemistry but on how the drug in question is being used. But as a chemical matter the question seems simple: In general, pharmaceuticals do the same things to the brain that the illegal drugs do, though sometimes they do so more gently.

As many have pointed out, drugs like Ritalin and cocaine act in nearly the exact same manner: Both are dopamine enhancers that block the ability of neurons to reabsorb dopamine. As a 2001 paper in the Journal of the American Medical Association concluded, Ritalin "acts much like cocaine." It may go further than that: Another drug with similar effects is nicotine, leading Malcolm Gladwell to speculate in The New Yorker that both Ritalin and cocaine use are our substitutes for smoking cigarettes.
Eric Scheie at Classical Values made that exact point in his post about Schizophrenia and Tobacco. I made that point in posts such as
Addiction or Self Medication?
Cannabinoids - the Key to many Pains?
Capitalism, Pain and the War on Drugs
The Pain Enforcement Administration
Better than Viagra
PTSD and the Endocannabinoid System
The War On Unpatented Drugs
and a host of others which you can find on my page Drug War Articles.

I think all together they make a pretty good case about why the pharmaceutical companies support the war on drugs. They don't want the competition from substances you can grow in your back yard or in your basement. As I put it in my post Addiction or Self Medication?:
It turns out that anxiety disorders are the most common mental health problem in the United States. They are worth $46 billion a year to the pharmaceutical industry. You don't suppose this fact has any thing to do with the pharmaceutical industries being in the forefront of the Drug Free America campaign do you? Of course not. They are just trying to keep you from being addicted to natural products at the cost of 1/10th of a cent per dose when they are more than willing to sell you an FDA and doctor approved, pharmacy sold product that will do the job for a dollar a dose. They have only your best interests at heart. Just ask their accountants.
Plainly one of the reasons we have between a quarter and a half-million drug users and suppliers in prison and why we arrest about a three quarters of a million pot smokers a year is that the medical cartel doesn't want the competition.

And you thought it was because drugs were bad for you. Well they are. If you don't buy from the cartel you can go to jail.

HT Instapundit

Cross Posted at Classical Values

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