The Seattle Weekly

                         May 1, 1992                                  

                    JUST SAY YES AND NO 

            HOW PAST DRUG USE MAY (AND MAY NOT) 
                  HAVE ADDLED YOUR BRAIN. 

                        by Rose Pike 


Copyright 1992, The Seattle Weekly.

Elaine took her first toke of marijuana as a 15-year-old high-school 
student -- "We got it from older hippies," she says -- and went on 
to use acid, peyote, alcohol, and other substances, natural and 
chemical, from the late 1960s to the early 1970s.  "I was going to 
do it forever," she remembers, "I thought my kids would, too.  I was 
going to be real mellow.  What was the slogan?  Turn on, tune in, 
drop out?"  She had some bad trips, but continued down the flower-
child path because "I thought it would make me part of something." 

Now a counselor in a drug-abuse program, Elaine says she wonders 
"what I would be like if I hadn't done it."  She attributes her 
later drinking problems (she is now a recovering alcoholic) to 
youthful use of illegal substances, and contends that her memory and 
learning ability were adversely affected.  "In the real world", she 
believes, "you'll see people who are fried on acid right and left, 
just not all there." 

A quarter-century after the Summer of Love, Elaine and some other 
erstwhile flower-children look back on their early chemical 
indiscretions with worry and regret, both for themselves and their 
kids.  They didn't pay much attention at the time, but now recall 
the old cautions and link them to present physical and emotional 
problems. 

The predictions _were_ scary.  GENETICISTS WARN OF LSD PERIL TO 
CHROMOSOMES, blared a typical 1967 headline.  The article, a report 
on a March of Dimes conference, went on to say that "a panel of 
experts in human genetics advised that no one in his or her 
reproductive years should take . . . LSD unless there was a very 
good medical reason for doing so."  Similarly, a New York physician 
claimed that "chromosome damage has been unequivocally demonstrated 
on those who tried LSD, even in some who have only had one dose." 

That same year, an official of the Federal Bureau of Narcotics 
asserted that his agency's files were "punctuated with murders and 
atrocities committed under the influence of marijuana."  In 
addition, the bureau maintained that "evidence shows that the drug 
is dangerous, that many heroin addicts began by smoking marijuana."  
According to a Greek researcher, two marijuana joints a day meant 
almost certain "adverse personality changes . . . and damage to the 
brain and other organs." 

Some of the scare stories turned out to be all sound and fury, 
laughable in retrospect.  Remember the federal investigation into 
"mellow yellow" -- smokable dried banana peels -- following a 
_Berkeley_Barb_ story touting the fruit's euphoric potential?  
Bananas turned out to be neither a natural hallucinogenic panacea 
nor a menace to the national morality. 

The threat to human genetics was also much overblown, in part 
because the field of human genetics was in its infancy and 
scientists did not clearly understand some of the microscopic 
abnormalities they were seeing.  "To this day," says March of Dimes 
national spokesman David Leavitt, "we get questions from women about 
whether their own or their husband's past LSD and marijuana use 
carries any risk for their present pregnancy."  That idea may 
persist in popular lore, but the specter of LSD-linked chromosomal 
damage was long ago laid to rest by science.  Leavitt now tells 
callers with confidence, "There is no known risk."  And although 
it's true that chronic pot-smoking can dampen male fertility, for 
those who stop smoking, sperm counts usually return to normal.  
Several studies in the past decade seem to show a link between birth 
defects and marijuana smoking during pregnancy -- a fetal drug 
syndrome similar to fetal alcohol syndrome -- but even that 
connection remains tenuous and controversial, says Leavitt. 

According to University of Washington pharmacologist Lawrence 
Halpern, who frequently testifies in trials in which crimes are held 
to be drug-related, "In terms of clinical syndromes, we haven't seen 
anything like longtime adverse effects from LSD.  The drug police 
were out [in the 1960s] and you couldn't believe a word they said." 

Similarly, drug-enforcement professionals still frequently cite the 
so-called "gateway" or "steppingstone" effect -- that experiment-
ation with MJ will inexorably lead to harder stuff and addiction -- 
even though research has shown that not to be the case for the 
majority of users.  But in a study presented at a 1983 meeting of 
the American Psychiatric Association, researchers from the 
University of Kansas reported that approximately one in nine 
marijuana users develops a dependency on the drug -- about the same 
rate as for alcohol. 

Indeed, negative medical and psychological repercussions of that era 
have turned out to be subtle and difficult to attribute with 
certainty to any particular factor.  There's a tendency among baby-
boom patients, say some who specialize in the treatment of chemical 
dependency, to attribute a variety of present emotional problems to 
past use of illicit pharmaceuticals.  "I encounter people who feel 
that the somehow broke their brains in the '60s," says University of 
Washington professor and psychiatrist Albert Carlin, but he's 
skeptical of the connection.  "The notion of the person who fried 
his brain tends not to be borne out clinically," he says, though he 
hastens to add that "of course, anyone who was reduced to a raving 
maniac as a result of drug use is not around to study." 

In the '70s, Carlin worked on a project that sought to determine if 
certain illegal drugs caused brain damage.  "The ultimate answer," 
he recalls, "was yes and no.  In a group of multiple-, heavy-drug 
users, a significant portion were impaired, but we couldn't pin down 
drugs as the specific cause.  When we began to look at childhood and 
other social factors, it wasn't so clear."  He also cites the 
"cracked vase" phenomenon, meaning that there were "people who were 
vulnerable already and whose vulnerability was highlighted by 
drugs."  Paradoxically, Carlin points out, some studies of marijuana 
use have shown a higher level of overall functioning in those who 
smoked than in those who didn't. 

BEYOND THE SUMMER OF LOVE 

Much of the movement away from the drug culture came as the result 
of uncommon, though sometimes severe and tragic, drug reactions, 
rather than from any fear instilled by the drug nay-sayers.  Before 
those losses of health and life occurred, the nation -- at least 
that part of it that was the baby-boom bulge -- had fallen under the 
spell of Haight Ashbury's mellow hippies.  Every city had a drug-
laced rock-and-roll scene. 

Grass was smoked and acid savored in an atmosphere etched with 
adolescent rebellion and fearlessness and with an intensely naive 
spiritual and intellectual curiosity.  For a while, it seemed that 
chemical euphoria might provide an answer to the dilemmas of our 
post-assassination, Vietnam War-era lives. 

As the scene degenerated, a flurry of perilous chemicals hit the 
streets and sent casualties to emergency rooms:  PCP (phencyclidine, 
an animal tranquilizer also called "angel dust", "crystal", and 
"peace pill"); the amphetamine DOM, known on the streets as STP 
(Serenity, Tranquility, Peace), guaranteed to produce a three-day 
high; and DMT, the so-called "half-hour" hallucinogen.  The Summer 
of Love segued into a season of bad trips and came to an abrupt and 
sobering end with the tag line "Speed kills." 

LSD also killed, by triggering suicides in a small number of people 
(the well-publicized delusional leaps from windows or high places).  
Also for a few, acid was the spark that ignited full-blown schizo-
phrenia, though the consensus among psychiatrists is that some other 
substance or event would have done the trick sooner or later in 
susceptible individuals. 

Even in the highest of high times it was clear that those who 
strayed from dope-smoking or an occasional, sacramental hit of acid 
to shooting up were at much greater risk.  "The vector for getting 
into trouble," recalls a participant in the '60s scene who also ran 
a drug-crisis clinic, "was speed rather than marijuana or acid.  It 
was the speed freaks who got into difficulty, especially the ones 
who crossed the line of putting needles into their veins." 

In fact, the connection between past use and present impairment is 
clearer for street-manufactured amphetamines than for any other 
illegal drug.  Speed was perilous -- still is -- and it left some 
victims permanently panicked and paranoid.  "Certainly," says Dr. 
Peter Roy-Byrne, of the University of Washington's Anxiety Disorders 
Program, "long-term amphetamine use had been reliably associated 
with paranoia.  The same is true for cocaine."  Both types of drugs 
produce "a 'kindling' phenomenon in the brain.  The brain becomes 
more sensitive over time to smaller doses."  Dr. Roy Clark, a 
clinician who specializes in the treatment of chemically dependent 
patients who've failed in other programs, reports another ampheta-
mine-related difficulty:  "We are beginning to see a number of 
individuals who were involved with speed on its initial run and are 
now seeking treatment for chronic depression." 

CHRONIC POT USE 

Marijuana, of course, was the most widely used and at the time the 
mildest of the illegal substances; to date, 68 million Americans are 
said to have tried marijuana, as compared with 10 million who've 
tried LSD.  Like those who stopped smoking cigarettes years ago, 
people who gave up pot or became moderate, occasional tokers are 
probably off the hook in terms of health effects. 

The biggest single problem associated with past pot use, however, is 
that some people never stopped, and at some juncture realized they 
couldn't.  According to Roger Roffman, a University of Washington 
psychologist who is well known for his studies of chronic marijuana 
users, "Many people come into our program saying, 'If only I could 
take it or leave it the way I used to.'  They find that if they have 
access to it, they smoke grass compulsively and get very anxious if 
there's none around." 

Some chronic dopers have been smoking every day for 20 or 30 years 
and have difficulties much like those of the problem drinker.  The 
average person in Roffman's program is male (three-quarters of those 
enrolled), middle-class, employed, and in their 30s or 40s.  Many of 
those who applied to be part of the latest round of studies were 
dependent on more than one drug concurrently -- alcohol and pot, for 
example. 

Marijuana (and hashish, another derivative of the _Cannabis_sativa_ 
plant) has been used recreationally in various cultures for 
centuries.  But it was not until the mid '60s that scientists in 
Israel were able to isolate Delta-9 THC, the ingredient that 
produces a high.  Just three years ago, National Institutes of 
Mental Health scientists described the was in which cannabis 
receptors work in the brain (though the treatment or policy 
implications of that finding aren't clear at this point). 

Unlike LSD, marijuana has grown more potent over the years; street 
pot not contains about five percent THC (although this figure can go 
as high as 20 percent), compared with the one percent average of 25 
years ago.  As a result, some chronic dope-smokers are finding it 
more difficult than ever to moderate their intake, and it's 
possible, say some experts, that the new breed of dope may rope in a 
higher percentage of chronic users. 

Back in the '60s, even before the discovery of THC, scientists 
observed that heavy hashish users sometimes experienced an 
amotivational syndrome, becoming the classic picture of the 
stuporous, slow-moving hash head.  A version of that syndrome is not 
commonly seen in low-dose, chronic marijuana users;  Roffman 
describes people in his program who worry about "procrastination, 
feeling out of control, wishing they had better thinking and memory 
capacity." 

While some chemical-dependence professionals tend to write off 
complaints of memory loss due to drug abuse in the distant past as 
"aging hippie syndrome" (we all have a tendency toward forgetfulness 
as middle age creeps up), a report in the British medical journal 
the _Lancet_ in 1989 outlined evidence that chronic cannabis use 
seems to cause short-term memory deficits. 

Another hazard for chronic, heavy dopers is lung damage.  "The net 
respiratory burden of particulates was approximately four times 
greater during marijuana smoking than during pot smoking," wrote a 
UCLA research team in the _New_England_Journal_of_Medicine a couple 
of years ago.  Though a person would have to smoke an unlikely four 
joints a day to equal the harm caused by one pack of cigarettes, the 
finding nonetheless is significant for those who indulge in both 
tobacco and pot or those with a predisposition to chronic lung 
diseases such as asthma and bronchitis. 

Perhaps more troubling is a recent finding that the world's finest 
cannabis may contain significant amounts of mercury.  "The best-
quality marijuana," according to a study done at the University of 
Hawaii and reported in the journal _Bioscience_, "appears to come 
from areas known to have rich mercuriferous soils, such as Hawaii, 
California, and parts of Mexico."  Mercury inhaled through the lungs 
in pot smoke is absorbed at a rate 10 times higher than mercury 
traveling through the digestive tract in food.  Bio-accumulated 
mercury, moreover, is known to precipitate many of the same 
neurological symptoms associated with chronic marijuana or hashish 
use:  forgetfulness, irritability, tremors, and paranoia. 

LSD AND LONG-TERM RISKS 

Compared with the brain damage that some scientists now believe a 
small minority of LSD users may have incurred, the signs and 
symptoms associated with chronic cannabis use are relatively easy to 
discern.  Impairment related to pas LSD use may be so subtle -- on 
the level of biochemical "scarring" -- that we don't yet have tools 
sophisticated enough to measure it.  Recent research using 
electronic devices such as the BEAM system (the Brain Electrical 
Activity map, which creates colored "virtual" maps of brain 
centers), seems to be breaking through the mystery of lysergic acid 
diethylamide, a substance that has been the subject of fascination 
since its debut, in the 1940s. 

Originally manufactured by Sandoz, the Swiss pharmaceutical company, 
LSD (the initials come from the German chemical name) first captured 
the attention of the medical community as the world's most powerful 
hallucination-inducing compound.  A byproduct of ergot, a fungus 
that grows on rye, LSD was thought to have potential as a treatment 
for mental disorders, but that promise was never realized.  
According to UCLA neuropsychiatrist Lewis West, who has studied the 
drug since the 1950s and once took a hit as part of his training, 
"It was going to be the royal road to the unconscious, like having 
patients dream while they were awake."  But despite LSD's auspicious 
pedigree as a legal drug and our considerably greater understanding 
of brain chemistry 50 years after its discovery, "we still don't 
know how LSD works," says West.  "There's a change in the brain 
chemistry that's reversable in most people, but not in others." 

Dr. Henry Abraham, a Harvard research psychiatrist who works out of 
Boston's St. Elizabeth Hospital, investigates LSD's neurological 
sequelae in both past and present users.  Acid's complications fit 
into three categories, he explains:  bad trips, flashbacks or "free 
trips", and the relatively rare phenomenon of prolonged psychosis.  
The bad trip -- acute panic or temporary psychosis soon after 
ingestion -- usually goes away with time and treatment, though there 
is speculation that some LSD users eventually develop chronic panic 
disorder related to the original bad trip.  If so, Abraham and his 
colleagues suspect that the mechanism that triggers panic attacks is 
similar to the kindling effect associated with other stimulants. 

So far, brain abnormalities that might cause an LSD kindling effect 
aren't nearly as well documented as those associated with 
flashbacks.  A few years ago, Abraham identified a syndrome called 
post-hallucinogen sensory disorder, in which patients see 
"continuous visual disturbances of an abstract nature, such as 
flashes of light, auras, patterns of dots vibrating in the air, 
trailing, after-imagery.  These things can go on forever.  Post 
hallucinogen syndrome occupies a spectrum -- some people react 
occasionally, some every few seconds." 

Imagine viewing the world as a sort of psychedelic Georges Seurat 
painting from which you can't turn away, or seeing a perpetual 
migraine-type aura around everything.  One post-hallucinogen 
sufferer endures a light like a flash bulb that goes off in front of 
his eyes every few seconds; another notices auras around objects 
only occasionally, for example, when he's tired at the end of a day.  
The syndrome, which can also involve greater sensitivity to glare, 
is treatable in some (with Valium and related drugs), not in others. 

Using the BEAM method, says Abraham, "we've done brain-mapping and 
found that these people have visual-field disturbances in the 
temporal lobes."  The maps show abnormalities similar to those found 
in temporal-lobe epilepsy, a malady that also causes visual and 
auditory hallucinations and personality changes (unlike people with 
epilepsy, post-hallucinogen sufferers don't have seizures).  The 
temporal lobes are instrumental in the processing of visual, aural, 
and tactile data, and they also play a part in the synthesis of 
emotion and memory.  It's possible, then, that some past users of 
LSD might have damaged these segments of the brain in such a way 
that, as one researcher put it, they may be "seeing sound and 
hearing color". 

The other long-term acid complication that concerns Abraham is the 
prolonged psychotic reaction that strikes about one user in 1000.  
"These people can be very sick, they can be daunting.  We're 
reviewing the old data on psychotic breaks.  The common story is the 
kid who tripped once and enjoyed it, the second time got into more 
trouble, and by the third time had permanent problems."  In addition 
to pursuing the temporal-lobe/LSD connection, Abraham and his 
colleagues are looking at LSD-experiment data (including the 
notorious US government experiments) from the '50s and '60s for 
clues to acid-related syndromes that might have been overlooked by 
past researchers. 

As far as currently non-using veterans of '60s drug culture are 
concerned, Abraham says, "I don't think we're looking at a 
generation of brain-damaged individuals".  Nonetheless, he frets 
about the current resurgence of interest in acid (which, 
incidentally, is consumed today in much lower doses -- 100 
micrograms as opposed to the 250 micrograms or more in the '60s).  
"There are folks who can eat this stuff like popcorn and stay out of 
trouble," says Abraham.  "They should count their lucky stars 
they're not one of the wounded.  Then there are people who are 
biochemically vulnerable, and for them it's like having Scud 
missiles in your head." 

TODAY'S GENERATION:  NEW DANGERS 

So it would seem that except for those few who permanently rewired 
or disconnected segments of their brains, the vast majority who 
participated in the drug culture of a quarter of a century ago 
escaped unscathed.  In fact, many fortysomethings wax wistful about 
their acid trips or the first time they tried hash in a bar in 
Amsterdam, in much the same tone as an ex-jock might boast about a 
championship season in the distant past. 

What's genuinely confusing for many middle-age former drug users, 
who ran the gauntlet and emerged whole, is how they should regard 
illegal-drug use now.  As a new generation stumbles upon LSD and 
marijuana, Drug Enforcement Administration officials report that 
acid confiscations in the District of Columbia alone rose from 14 
doses in 1990 to 5600 in 1991 (due in part to a more concerted 
effort by the agency).  But there are differences in the current 
drug scene.  Acid is weaker now, pot packs a wallop more like 
hashish used to (and costs 10 times what it used to), and the 
average age of first drug use is dropping almost into the single 
digits. 

"For someone who's 25, to smoke dope periodically is not all that 
toxic," Ries says, "but you take the same exposure with someone 
who's 12 and it has a very different effect.  Your brain is not 
developed and you quickly get in trouble with thinking."  Unlike the 
mostly college-age group that experimented with drugs in the Vietnam 
War era, many of the kids trying LSD today are in junior high or 
high school and have not yet reached physical maturity.  Crack, too, 
with its terrible legacy of permanently addicted babies born of 
addicted mothers, is often used by very young teenagers. 

Indeed, the drug problems that draw our attention in the '90s differ 
dramatically from those of the '60s.  What _hasn't_ changed is our 
addiction to scare tactics as a means to abate the "epidemic" of the 
moment.  The "reefer madness" of the 1920s and '30s became the 
"genetic peril" of the '60s.  For the past decade or so, we've been 
assaulted with the latest version.  "This is drugs," begins the 
public-service announcement, showing smoking butter in a hot 
skillet.  "This is your brain on drugs," is the famous follow-up 
line as an egg is broken into the pan, where it fries furiously. 

But reefer madness never happened, genetic peril remains 
unsubstantiated, and that fried-egg line probably wouldn't deter a 
genuinely troubled teenager from jumping into the frying pan.  Scare 
stories about drugs, especially when the old ones are regularly 
debunked, didn't work back then to stop young people from testing 
the limits, and they still don't work today. 

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
For more information on prescription and nonprescription drugs,
visit OnHealth.com, the leading consumer health site on the Internet.