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FOUR Drugs

It is a custom with some people to blame, without limit, those who indulge in nervous stimulants of a nature differing from their own, while serving the same purpose.

MORDECAI CUBITT COOKE,

The Seven Sisters of Sleep (1860)

We all use psychoactive drugs, by which I mean chemicals that alter the functioning of the brain by acting on its internal communication mechanisms. Among the more familiar examples are caffeine, nicotine and alcohol, but the term also encompasses illegal recreational drugs like cannabis, ecstasy and cocaine. We take these substances because they make us feel better – or, at least, different. They are capable of delivering intense pleasure and causing great harm. The paradox of drug use was encapsulated by Louis Lewin, a pioneering German pharmacologist who wrote in the 1920s that they ‘lead us on the one hand into the darkest depths of human passion, ending in mental instability, physical misery and degeneration, and on the other to hours of ecstasy and happiness or a tranquil and meditative state of mind’.

Why do we do it? The brain systems that underlie pleasure, desire and reward evolved hundreds of million years ago and are found, in at least some basic form, in all mammals, birds, reptiles, amphibians and fishes. A long time ago, we humans discovered how to manipulate these brain systems artificially with drugs. We use psychoactive drugs because they produce pleasure, or because they alleviate unpleasant feelings of anxiety and stress, or both. We always have and we always will.

Getting on for half of all young British adults admit to having used an illegal drug during their lifetime, and one in six say they have used a Class A drug such as cocaine or heroin.¹ The most popular illegal drug is cannabis, which has been tried by 40 per cent of young British adults. Next in popularity comes amyl nitrite, used at least once by 12 per cent of young adults, followed by amphetamines (11 per cent), cocaine powder (11 per cent), ecstasy (10 per cent) and magic mushrooms (8 per cent), with heroin trailing at 0.5 per cent.² The consumption of drugs is relatively common among school-age children: almost half of all fifteen-year-olds in England say they have taken an illicit drug at least once, and one in twelve claims to use them at least once a month. Comparable patterns are seen in other countries, although the UK appears towards the top end of most international league tables of drug use.

Illegal recreational drugs are cheaper now than they ever have been and most of them are getting cheaper, which is further evidence that efforts to curb their use by suppressing the supply have not succeeded. A line of cocaine or an ecstasy tablet now costs little more than a cappuccino. And, of course, the use of legal drugs is vastly greater. Nine out of ten adults have used alcohol at some time, one in four is a smoker and virtually everyone consumes caffeine every day.

How does it feel?

You, dear reader, will have had your own experiences with recreational drugs – certainly with caffeine, probably with alcohol and conceivably with one or two more besides. Or perhaps not. Each drug is different and each individual responds differently to them. The subjective experience depends on the social situation in which the drug is taken, the expectations of the user, their past experience with that drug, and so on. The effects may be blissful, they may be indifferent or they may be dreadful.

The sensations generated by a recreational drug have two main components: the immediate effect (the ‘rush’) and the feeling of pleasure or euphoria that develops more slowly, perhaps over a period of hours (the ‘high’). The faster a drug hits the brain, the bigger the rush. The quickest way of getting a drug into the brain is to inject it, smoke it or snort it. Drugs taken by these rapid-uptake routes, such as heroin, cocaine and nicotine, tend to be more addictive than if they are absorbed more gradually.

Over the centuries, articulate drug-users have recorded their experiences for posterity, offering those who have never been there a vicarious sense of how it feels.³ Heroin is said to produce an orgasmic rush of pleasure followed by a warm afterglow. Those who have taken it intravenously often describe the sensation using terms like pleasure, excitement, warmth and relaxation. One former addict wrote of how his whole body quivered with pleasure and ‘tiny needles’ danced on his skin. Another felt so good she had to share the experience by talking as she had never talked before. For the rock musician David Crosby, heroin felt like a big, warm blanket. Robert Louis Stevenson, the author of children’s favourites Treasure Island and Kidnapped, recalled the first of his many encounters with opium in these glowing terms:

A day of extraordinary happiness; and when I went to bed there was something almost terrifying in the pleasures that besieged me in the darkness. Wonderful tremors filled me; my head swam in the most delirious but enjoyable manner; and the bed softly oscillated with me, like a boat in a very gentle ripple.

Cannabis, the most widely consumed illegal drug, leaves most users with a calming, relaxing sense of unwinding. Cocaine produces a very different reaction, which is often described as a sharp lift followed rapidly by a strong desire for more. The writer Stuart Walton has described how the first snort delivers a ‘cosy low-voltage buzz of electricity’, but the pleasure is fleeting, making cocaine the perfect self-marketing product.

The psychoactive drug experience can also be ghastly. William S. Burroughs, in his heavily autobiographical novel Junky, paints a revolting picture of trying peyote, the hallucinogenic Mexican cactus. He swallows the lump of peyote with great difficulty, washing it down with tea and gagging on it several times. Ten minutes later he begins to feel sick. Convulsive spasms rack his body but he is unable to vomit. Finally, the drug comes back up, ‘solid like a ball of hair’, clogging his throat. It is, writes Burroughs, as horrible a sensation as he ever stood still for. His face swells up and he is unable to sleep.

One state that no recreational drug is capable of producing by itself is happiness, as distinct from pleasure. We will return to the relationship between pleasure and happiness in chapter 8.

Recent history: the last few thousand years

Most of what we know about humanity’s consumption of recreational drugs is confined to the relatively recent past, spanning a mere few thousand years of history. Opium was used by people living in southern Mesopotamia (present-day Iraq) more than five thousand years ago. The language of that region, Sumerian, denoted the opium poppy as ‘the plant of joy’. Opium was even more familiar to the ancient Greeks and Egyptians, who took it orally and rectally as a sedative and to alleviate pain. The Greeks were aware of opium’s potential to create addiction, and in the fifth century BC the great physician Hippocrates was criticised for giving too much of it to his patients. Homer’s Odyssey, written in the seventh or eighth century BC, refers to a potion called nepenthe (literally, ‘one that chases away sorrow’) which Helen of Troy used to banish grief. Historians believe that nepenthe was probably made by dissolving opium in alcohol.

Imperial Rome was a hotbed of opium consumption. The emperor and philosopher Marcus Aurelius, who ruled during the second century AD, was a regular user. According to the physician Galen, the emperor habitually started his day with a portion of opium the size of a bean, dissolved in warm wine. A census carried out in the city of Rome in AD 312 catalogued 793 separate retail outlets from which opium could be bought. Between them, these opium shops generated 15 per cent of all tax revenues – one of countless examples of the age-old relationship between recreational drugs and lucrative taxation.

Cannabis, or hemp, was cultivated in China six thousand years ago and was being consumed in Egypt and Greece more than three thousand years ago. The women of Thebes in ancient Egypt were famous for making a hemp-based potion which rivalled nepenthe in its ability to banish sorrow. Cannabis may also have been the pharmacological secret behind the Oracle of Delphi, which was probably established in the eighth century BC. The priestess who presided over the Oracle would sit over a hole in the ground, from which wafted the miraculous fumes that enabled her to deliver her prophecies. Some historians believe that these inspirational fumes were generated by burning a narcotic herb, probably hemp. In the fifth century BC the historian Herodotus recorded the recreational use of cannabis by the Scythian people, who lived on the northern shores of the Black Sea:

There is a plant growing in their country called cannabis, which closely resembles flax.… The Scythians take cannabis seeds, crawl in under the felt blankets, and throw the seeds on to the glowing stones. The seeds then emit dense smoke and fumes, much more than any vapour-bath in Greece. The Scythians shriek with delight at the fumes.

Cannabis was used by the Romans, both recreationally and as a medicine. Galen describes how it was customary in the Roman world to give hemp seed to guests at banquets, to promote ‘hilarity and enjoyment’.

The use of cannabis in Britain is of more recent vintage. Even so, it can be traced back several centuries. Hemp was listed in The English Physitian, a medical text written in 1652 by the botanist and physician Nicholas Culpeper, where it appears among a dizzying array of exotically-named plants including Clowns Woundwort, Stinking Gladwin, Rupture-wort, Spleen-wort, Melancholy-thistle, Bastard Rhubarb, Blites, Loosestrife and (my favourite) Arsesmart. Hemp was widely used as a remedy for aches and pains. In his 1653 tome The Complete Herbal, Culpeper wrote:

The seed of Hemp consumes wind, and by too much use thereof disperses it so much that it dries up the natural seed for procreation; yet, being boiled in milk and taken, helps such as have a hot dry cough.… The emulsion or decoction of the seed eases the cholic, and allays the troublesome humours in the bowels, and stays bleeding at the mouth, nose or other places … It is held very good to kill the worms in men or beasts; and the juice dropped into the ears kills worms in them; and draws forth earwigs, or other living creatures gotten into them.

As far as I know, there have been no recent criminal prosecutions in Britain for using cannabis to dislodge unwelcome earwigs from ears.

Cannabis was probably being used as a recreational drug when Shakespeare was writing, and he may have made cryptic references to it in his work. In Sonnet 76 he refers to ‘a noted weed’ and ‘compounds strange’ in the context of aiding his own creativity:

Why is my verse so barren of new pride,

So far from variation or quick change?

Why with the time do I not glance aside

To new-found methods and to compounds strange?

Why write I still all one, ever the same,

And keep invention in a noted weed,

That every word doth almost tell my name,

Showing their birth and where they did proceed?

Some Shakespearian scholars suspect this to be a veiled reference to cannabis. At the beginning of the twenty-first century, scientists discovered possible chemical residues of cannabis in the remnants of seventeenth-century clay pipes that were recovered from the site of Shakespeare’s house in Stratford-upon-Avon. There were also firm traces of nicotine and cocaine. Whilst this discovery does not prove that Shakespeare himself took these drugs, it does at least confirm that they were being used in England at that time. European settlers took the practice of using cannabis with them to America, where George Washington later grew it for his own medicinal use. Cannabis was widely used in Victorian England for medicinal purposes. Queen Victoria herself took tincture of cannabis to relieve her royal period pains.

The nineteenth century witnessed a rapid expansion in the variety of psychoactive drugs available and in the social attitudes towards them. The international opium trade was hugely profitable and imperial Britain was at the heart of it. Britain fought two naval wars with China to defend its economic interests by enforcing the lucrative trade in exporting its Indian-produced opium to that country. When the Chinese tried to stop Britain from trafficking the opium, the British enforced it through military might, fighting and winning the First Opium War of 1839–42 and the Second Opium War of 1856–58. The second war resulted in the complete legalisation of the opium trade. By then, British opium exports to China were worth more than China earned from exporting tea and silk.

The use of opium in China at this time was widespread. The Chinese emperor himself is said to have used the drug and many Chinese government officials were regular opium-smokers. According to contemporary accounts, the proportion of people who smoked opium in certain parts of the country ranged between a quarter and half the population. An Englishman who had worked in China for many years during this period commented that when it came to the morality of selling and consuming opium, he could see little difference from alcohol. Both drugs were harmful if taken to excess, but they did little damage if used moderately. The only difference he had noticed was that the opium-smoker ‘was not so violent, so maudlin or so disgusting as the drunkard’.

Morphine was first produced in 1805, when a German chemist extracted it from opium. Commercial production began in the 1820s. The drug is named after the Roman god Morpheus, who was the god of dreams. Morphine was originally taken by mouth. However, the development of the hypodermic syringe fostered a fashion for injecting it, which produced a bigger rush. The American Civil War, in which intravenous morphine was widely used as a battlefield analgesic, created large numbers of morphine addicts. The stable of opiate drugs further expanded in 1898, when the German pharmaceutical company Bayer synthesised diacetylmorphine, a derivative of morphine. They named it heroin, after the Latin for hero, because of its potent psychological effects. Heroin was initially hailed as a wonder drug which offered the therapeutic power of morphine without the risk of addiction. This claim was later dropped when experience revealed that heroin was anything but non-addictive.

Cocaine became popular after yet another German chemist perfected a method for isolating it from coca leaves in 1859. The ready availability of cheap cocaine in the late nineteenth century triggered a global surge in its recreational use.

Sigmund Freud has the dubious honour of being a pioneering and enthusiastic advocate of cocaine. In 1884 Freud published a notorious paper entitled ‘Über coca’ (‘On Coca’), in which he claimed that cocaine could alleviate or cure a wide range of disorders including indigestion, nervous debility, wasting, alcoholism, morphine addiction and impotence. He confidently asserted that the drug’s therapeutic benefits far outweighed any possible risks from excessive use. Freud practised what he preached, taking large quantities of cocaine himself and prescribing it to many of his patients and friends. One of them was Ernst von Fleischl-Marxow, whose morphine addiction Freud attempted to cure with cocaine. Unfortunately, Freud succeeded only in transforming his hapless friend into a cocaine addict and, subsequently, a corpse.

Before long, Freud was being accused of unleashing a new and dreadful type of addiction. When another of his patients died from an overdose of cocaine, Freud eased off administering the drug intravenously, although he continued to give it orally. In a paper published in 1887, he insisted that cocaine addiction was not an inherent property of the drug itself, but rather of the individual who took it. One of the few medical applications for which cocaine could be used safely was as a local anaesthetic. However, Freud failed to recognise the clinical significance of this at the time, leaving one of his Viennese rivals to take the credit and win international fame. Despite clear evidence that cocaine did not cure addiction, but was itself highly addictive, Freud continued to take the drug for relief from his migraines and a painful nasal condition. In letters to friends, he wrote of how applying cocaine to his left nostril had helped him ‘to an amazing extent’ and of his need for ‘a lot of cocaine’. Some uncharitable sceptics have suggested that Freud’s now largely discredited theories about the nature of the human mind might have been inspired by his consumption of this psychoactive drug.

A largely forgotten feature of the nineteenth-century drug scene was the widespread use of medical anaesthetics for recreational purposes. One of the many discoveries made by the great English scientist Sir Humphry Davy was nitrous oxide, otherwise known as laughing gas. Davy pioneered its use as an anaesthetic. He also liked to entertain himself and his friends by getting high on it. In 1800, he described how inhaling the gas produced a feeling of detachment that lifted him from his earthly cares and caused him to pass, ‘through voluptuous transitions’, into sensations that were completely new to him. Davy’s friends even contemplated setting up a ‘nitrous oxide tavern’, in which punters could inhale the gas as an alternative to getting drunk on alcohol. Some London theatres offered patrons a blast of nitrous oxide to put them in the mood before a show. Much the same happened with chloroform, which was being used for purely recreational purposes barely a year after it had first been employed as a medical anaesthetic.

Ether was another anaesthetic that enjoyed a vogue as a recreational drug. During the second half of the nineteenth century it became especially popular in Ireland, after Catholic temperance campaigners decreed that it was an acceptable alternative to alcohol – ‘a liquor on which a man might get drunk with a clear conscience’, as one priest put it. Up until 1890, when ether was classified as a poison, the Irish were drinking more than 17,000 gallons of the stuff each year. The occultist Aleister Crowley (of whom more later) liked to drink a morning ‘bracer’ consisting of half a pint of ether, brandy, kirsch, absinthe and Tabasco sauce.

When swallowed, ether has an intoxicating effect comparable to that of alcohol. The intoxication is short-lived, however. It disappears within half an hour or so, leaving the drinker sober. Some ether-drinkers regarded this as an advantage. Others did not. Drinking ether could also be hazardous. The boiling point of ether is lower than body temperature, so it vaporises on contact with the inside of the mouth. Drinking it therefore tends to generate highly flammable belches and farts. In an age when drinkers were surrounded by naked flames, this could prove life-threatening. According to an account from Russia, where ether drinking was popular, one such explosion killed six people. The social attractiveness of ether-drinkers was further diminished by the drug’s side-effect of generating rivers of saliva. This led some users to inhale its vapours in preference to drinking it.

Many more new drugs appeared on the scene in the twentieth century, including LSD and a host of other hallucinogens. LSD, otherwise known as lysergic acid diethylamide, was first made in 1938 by a Swiss chemist who was searching for new medicines. Its brain-popping psychedelic effects only became apparent a few years later. During the 1950s and 1960s, extensive research was conducted into the possible therapeutic uses of LSD and other hallucinogenic drugs. Psychiatrists prescribed LSD to tens of thousands of patients to help them overcome a range of mental health problems. One of these patients was the Hollywood star Cary Grant, who later said that LSD had helped him deal with the trauma of his marriage break-up. Evidence from several hundred medical studies published during this period suggests that, for some patients at least, hallucinogenic drugs could assist in the treatment of some forms of addiction, psychosomatic illness, anxiety disorder and post-traumatic stress disorder.

One of the pioneers in this field was the psychiatrist Humphrey Osmond, who coined the term psychedelic (as in ‘consciousness-expanding’). Osmond thought that powerful hallucinogenic drugs such as LSD might enable addicts to view their situation in a totally new way, creating a strong motivation to transform their behaviour and quit their drug or alcohol habit. In the 1950s, Osmond and colleagues had some success in using single doses of LSD to treat alcoholics. In one of their studies, two-thirds of the alcoholic patients stopped drinking for at least eighteen months following a single dose of LSD – an outcome that compared favourably with more conventional treatments for alcoholism.

LSD became illegal in the late 1960s. Before long, research into its potential therapeutic applications ground to a halt, as scientists found it increasingly difficult to obtain permission or funding to work on the drug. Pharmaceutical companies were not attracted by such research, because LSD and other hallucinogens were unprotected by patents. Moreover, the drugs were administered only once or a few times, not taken daily over long periods, which meant they had limited potential to make money.

More recently, research into the therapeutic potential of hallucinogenic drugs has been showing some signs of revival. One of the few studies to be published since the 1960s looked at the use of hallucinogens for treating cluster headaches. Individuals with this debilitating condition suffer from strings of excruciatingly painful headaches, driving some of them to commit suicide. Anecdotal evidence suggested that some sufferers obtained relief, lasting up to several months, from a single small dose of LSD or psilocybin. The doses were insufficient to cause full-blown hallucinations. When researchers from Harvard Medical School interviewed a large sample of people who had sought relief in this way, the results were startling: 85 per cent of those who had taken psilocybin reported that it stopped their headache attacks and 80 per cent of LSD-users found that the remission periods between attacks became longer. LSD and psilocybin appeared to be more effective at staving off further attacks than conventional migraine medicines.

The seven sisters of sleep

A unique historical perspective on humanity’s use of recreational drugs can be found in The Seven Sisters of Sleep, a remarkable book written in 1860 by an English scientist named Mordecai Cubitt Cooke. Lewis Carroll is thought to have used it as a source for the psychedelic episodes in Alice in Wonderland.

Cooke presents a scholarly survey of the seven principal narcotics of the world. These were, in descending order of popularity at the time, tobacco, opium, cannabis, betel nut, coca, thorn apple and fly agaric. (Note the absence of alcohol.) According to the best information then available, the estimated numbers of people around the world using these drugs ranged from 400 million for opium to fewer than 10 million for fly agaric. We will take a separate look at tobacco – arguably the most rubbish drug of all – in chapter 11. Meanwhile, here are some of Cooke’s observations, starting with fly agaric.

The fly agaric toadstool, Amanita muscaria, was the recreational drug of choice for the nineteenth-century inhabitants of Siberia and Kamchatka. In those icy wastelands there was no prospect of cultivating poppies, tobacco, coca or any of the other conventional sources of chemical pleasure. Consequently, wrote Cooke, ‘the poor native would have been compelled to have glided into his grave without a glimpse of Paradise beforehand, if nature had not promptly supplied an indigenous narcotic in the form of an unpretending-looking fungus or toadstool.’

Elsewhere in the world, the fly agaric toadstool was – and still is – regarded as highly poisonous. Its name reflects its use as a fly poison. However, by dint of drying the fungi and saturating them with salt, before cooking them, the people of Siberia and Kamchatka could eat them with impunity and enjoy the mind-bending effects. They would roll up the toadstool and swallow it like a big pill. A single gulp would provide a ‘cheap and remarkably pleasant’ day’s worth of intoxication. Fly agaric was to the Siberians what opium and cannabis were to pleasure-seekers in sunnier climes. The fungus has another useful property that made it even more attractive to its cash-strapped users. Its psychoactive ingredients survive being excreted from the body and can be recycled by drinking the consumer’s urine. How the Siberian fun-seekers discovered this useful recycling procedure is unknown. Anyway, they made good use of this boon, as Cooke relates:

A man having been intoxicated on one day, and slept himself sober by the next, will, by drinking this liquor, to the extent of about a cupful, become as intoxicated thereby as he was before. Confirmed drunkards in Siberia preserve their excretionary fluid as a precious liquor, to be used in case a scarcity of the fungus should occur. This intoxicating property may be again communicated to every person who partakes of the disgusting draught, and thus, also, with the third, and fourth, and even the fifth distillation. By this means, with a few boluses to commence with, a party may shut themselves in their room, and indulge in a week’s debauch at a very economical rate.

The leading recreational drug in much of the rest of the world at this time was opium. The poppy from which opium is extracted was a major crop in India, Persia, Egypt and Asia Minor. Opium was produced throughout the Islamic nation of Persia. The finest-quality Persian opium was said to come from Isfahan and Shiraz, which was also famous for its wine. Opium was consumed in many different ways, according to local customs. In India, it was dissolved in water or rolled into pills. The Sikhs were forbidden by their religion to smoke tobacco. They found a ready substitute in opium, which was consumed throughout the Punjab. In China, opium was eaten or smoked, while in Java and Sumatra it was mixed with sugar and the ripe fruit of the plantain.

In Britain, where an estimated 35 tons of opium were consumed in 1858, the drug was easily obtained from local pharmacists in the form of pills, or dissolved in alcohol to form tinctures or cordials. The many opium-based products included laudanum, which was about one-twelfth opium by weight, Scottish paregoric elixir, English paregoric elixir (which was a quarter the strength of the Scottish version), Black Drop and Battley’s Sedative Liquor. These products were bought for ‘medicinal purposes’ but were consumed mostly for their pleasing psychoactive effects. They were also widely used for keeping infants and young children quiet.

Opium wrecked many people’s lives. However, some individuals took it for years with apparent impunity. Cooke cites several such cases, including an old lady in Leith who died at the age of eighty having taken half an ounce (14 grams) of laudanum every day for nearly forty years. An ‘eminent literary character’ who died in his sixties had regularly consumed large amounts of laudanum since the age of fifteen; his daily allowance had been more than a litre of liquid comprising three parts laudanum to one part alcohol.

The Fen country of eastern England was a veritable hotspot of opium abuse. Cooke discovered from official documents that in the Cambridgeshire market town of Wisbech more opium was sold and consumed per head of population than in any other part of Britain. The Fenlanders’ taste for opium is depicted in Alton Locke, an 1849 novel by Charles Kingsley. In it, a yeoman tells the hero that any locals who do not drink spirits take their pennyworth of ‘elevation’ instead – especially the women. ‘Elevation’ is opium. The yeoman explains that if you go into the druggist’s shop in Cambridge on market day you will see dozens of little boxes lined up on the counter. Every passing Fenland wife will call in to collect one of these boxes, which contains her week’s supply of opium. The drug makes the women ‘cruel thin’, says the yeoman, but it keeps them quiet and cures their ague.

Cannabis was used recreationally in many parts of the world during the nineteenth century, including Muslim countries. It was smoked, dissolved in drinks or eaten in combination with other substances. Hashish, the term then used in the Middle East for any cannabis-derived drug, was consumed throughout Syria and in parts of Turkey.⁴ Cooke describes an unusual method used by the Bechuana people of southern Africa for smoking theirs. They would make two small holes in the ground, about a foot apart, place a stick between these holes and mould clay over it, then withdraw the stick to leave a channel connecting the two holes. The cannabis was placed in one hole and lit. Smokers would then take it in turn to lie with their face on the ground, inhaling deeply from the other hole. Cannabis was similarly popular in the USA, where it was often combined with betel nut to form a lump, or ‘quid’, for chewing, in the same manner as tobacco. In India, cannabis resin was collected by men wearing leather aprons. They would run through the hemp fields, brushing violently against the plants. The resin would stick to the leather, from where it was later scraped. It was said that in Nepal the collectors dispensed with the leather gear and ran naked through the cannabis plants, collecting the resin on their skin.