Flashback Friday: Stimulants

Whether you’re into coffee, Coca-Cola or cocaine, there’s a world of difference between being up and being strung out.
Illustration by Carl Wesley

Published in the July, 1983 issue of High Times, the following is an excerpt from the book Chocolate to Morphine: Understanding Mind-Active Drugs by Andrew Weil, M.D. and children’s book author Winifred Rosen, which was originally written to educate young people and their parents about drugs.

Stimulants are drugs that make people feel more alert and energetic by activating or exciting the nervous system. There are many stimulant drugs in current use; some are plants found in nature, others are chemicals made in the laboratory. These different drugs produce somewhat different effects, lasting for varying lengths of time, but all of them raise the energy level of the nervous system in roughly the same way.

The individual nerves in our bodies communicate with each other both electrically and chemically. A nerve impulse is an electric discharge that moves quickly along the fiber of a nerve cell. The fiber may end at a muscle, a gland or another nerve cell, but there is always a tiny space between the end of the nerve fiber and the next cell. To bridge this gap, the nerve fiber releases small amounts of powerful chemicals called neurotransmitters that affect the next cell. Some neurotransmitters are strong stimulants that cause muscle cells to fire off electrical discharges. The most common stimulant neurotransmitter is a chemical called noradrenalin or norepinephrine. This chemical is closely related to the hormone adrenalin (or epinephrine) which is produced by our adrenal glands. (Adrenal is a Latin word meaning “on the kidney,” because the adrenal glands sit on top of the kidneys like little caps. Epinephros means the same thing in Greek. In America the Parke-Davis pharmaceutical company succeeded in registering Adrenalin as a trademark for their brand of adrenal hormone, and as a result American scientists have been forced to use the more cumbersome words epinephrine and norepinephrine. The British are not so constrained. They talk about adrenalin and noradrenalin, and so shall we.)

Stimulant drugs work by causing nerve fibers to release noradrenalin and other stimulating neurotransmitters. Although different stimulants bring about this release in different ways, the end result is always the same: the release of more stimulating neurotransmitters. So, the stimulation people feel when they take stimulant drugs is simply a result of the body’s own chemical energy going to work in the nervous system. The drug just makes the body expend it sooner and in greater quantity than it would ordinarily.

This release of chemical energy in the form of noradrenalin causes certain predictable changes in the mind and body. It makes a person feel wakeful, alert and, often, happy. It makes the heart beat faster and may cause the blood pressure to rise. Because it produces changes in blood flow, the fingertips and tip of the nose may become cold. It gives a feeling of butterflies in the stomach and may cause a laxative effect.

Some of these changers are mediated by a branch of the nervous system called the sympathetic nervous system. The main function of the sympathetic nervous system is to respond to emergencies by preparing the body for fight or flight. It does so by shutting down nonessential functions and speeding up vital ones. The sympathetic nervous system relies on noradrenalin as its chemical messenger.

Now, noradrenalin acts in many of the same ways as adrenalin, the hormone secreted by the adrenal glands, also in response to emergencies. Experiences that cause the adrenals to secrete adrenalin into the bloodstream produce feelings very much like those of stimulant drugs. The rush of excitement one gets on a roller-coaster ride, for example, may feel a lot like the effect of a dose of amphetamine, and no doubt both these techniques are popular for the same reason—because they give people a sense of increased mental and physical energy, and make them feel, temporarily at least, more alive.

In recent years scientists have begun to find out many interesting things about biorhythms, the cycles by which our vital processes wax and wane. The most obvious daily biorhythm is that of sleeping and waking. Production of hormones and neurotransmitters has its own ups and downs, and these cycles probably explain why people feel naturally stimulated at certain times and naturally lethargic at others. A common pattern is to feel energetic and able to concentrate well in the morning but to become tired and mentally sluggish in the late afternoon.

One reason that stimulant drugs are popular is that they give temporary control over rhythms of wakefulness and the ups and downs of mood. If you have a mental task to do at 3 p.m., when your brain wants to rest, you can mobilize it to concentrate by taking a stimulant drug and thereby forcing your nervous system to release some of its stored-up chemical energy. Or if you have to drive a long distance at night when your whole nervous system is ready for sleep, you can stay awake by putting a stimulant into your body. Or if you are feeling depressed when you have to go out and meet important people, a stimulant might brighten your mood for a while.

Another reason people like stimulants is that they suppress hunger, making it possible to think about something other than food, and concentrate better on the task at hand. Not eating, moreover, tends to further increase one’s energy and sense of alertness. The reason stimulant drugs suppress hunger probably has to do with the preparation of the body for emergencies. In emergencies, all digestive functions become nonessential compared to such processes as blood circulation and speed of muscular response. Under stress, therefore, the body shifts energy away from the stomach and intestines to the brain, heart and blood vessels.

Because the nerves and muscles receive more attention under the effect of stimulants, these drugs may improve certain kinds of physical and mental performance for a time. They may enable people to concentrate longer and better, or to perform physical work more efficiently and with greater endurance. This probably explains why these drugs are especially popular with students and athletes.

Of course, not everyone is affected by stimulants in the same way; some people find their effects unpleasant, just as some people find roller-coaster rides unpleasant. Far from making everyone cheerful and alert, these drugs make many people anxious, jittery and unable to sit still. Some people are so sensitive to stimulants that they cannot sleep at all, even 12 hours after taking a small dose. Others get such distressing symptoms as heart palpitations, diarrhea and urinary frequency. Instead of automatically improving physical and mental performance, stimulants sometimes just give people a false sense of confidence in what they are doing. There are famous stories of college students who wrote what they imagined to be brilliant final exams under the influence of amphetamines, only to find later that they had written the same line over and over or scribbled the whole exam on one illegible page.

Still, at first glance, stimulants sound attractive: they can make you feel alert, happy, wakeful, energetic, strong and resistant to hunger, boredom and fatigue. But one of the greatest lessons of life is You Never Get Something for Nothing (or, There Is No Such Thing as a Free Lunch), and stimulants are no exception to this rule.

The most serious problems with stimulant drugs result from the way they work. For, instead of miraculously delivering free gifts of cosmic energy, stimulants merely force the body to give up some of its own energy reserves. So when the effect of a stimulant wears off, the body is left with less energy than usual and must replenish its supplies.

People experience this depletion of energy as a “down” or “low” state, marked by the very same feelings they take stimulants to avoid: namely, sleepiness, lethargy, laziness, mental fatigue and depression. The price you pay for the good feeling a stimulant gives you is a not-so-good feeling when the stimulant wears off.

Now, if you are willing to pay this price and let the body recharge itself, there is nothing wrong with using stimulants now and then. The trouble is that many people are not willing to let their bodies readjust; they want to feel good again right away, so they take another dose of the drug. It’s very easy to fall into a pattern of using stimulants all the time in order to avoid the down feeling that follows the initial up.

Unfortunately, when they are used in this way, stimulants quickly produce dependence. People who take stimulants regularly find they cannot function normally without them. They need them just to open their eyes in the morning, move their bowels, work or do any of the tasks of everyday life. Without them they just don’t feel like doing much of anything.

Kinds of Stimulants

Coffee and Other Caffeine-Containing Plants

Caffeine, the most common natural stimulant, is found in a number of plants throughout the world. The drug was first isolated from coffee in 1821 and was named for that plant, but the effects of coffee and caffeine differ. In many ways coffee seems to be more powerful than refined caffeine or other caffeine-containing plants.

A shrubby tree native to Ethiopia, coffee is now cultivated in many tropical countries throughout the world. Its bright red fruits, called cherries, each contain two seeds or beans. The raw beans are gray-green, but when roasted they turn dark brown and develop the odor and flavor with which we are familiar. Legend has it that coffee was first discovered long ago by Ethiopian nomads who noticed that their domestic animals became frisky after eating the fruits of the trees. When people tried eating the seeds, they got frisky too, and eventually they learned to make a flavorful drink of the roasted seeds.

More than a thousand years ago, groups of Muslims in the Middle East began using coffee in religious rituals and ceremonies. Groups of men would meet one night a week, drink large amounts of coffee and stay up all night praying and chanting. These mystics confined their use of coffee to these ceremonies, but as coffee became more widely known, other people began to use it, not for religious reasons but just because they liked its stimulant effect. When people started to drink coffee every day in large amounts, many of them found they couldn’t stop.

When coffee spread throughout Europe in the 17th century, it became extremely controversial, stirring up great opposition as a new and unapproved drug. Authorities tried to prohibit its use, but of course their efforts were to no avail; coffee soon established itself all over the world. In Europe, coffeehouses sprang up in all cities, and whole societies became dependent on the drug almost overnight. Johann Sebastian Bach is rumored to have been a coffee addict. He extolled the virtues of the new drink in his famous Coffee Cantata. The French writer Balzac could not work without coffee. He drank larger and larger amounts of brews so strong they looked like thick soup, and then complained of the stomach cramps they gave him.

Today coffee is a thoroughly approved drug—so approved, in fact, that many people who drink it regularly are surprised to learn it is a drug at all, let alone a powerful drug that can cause dependence and illness.

The truth is that coffee is a strong stimulant, one that is hard on certain parts of the body. It is irritating to the stomach, for example, and many people who drink a lot of it have indigestion most of the time. (In the United States, where coffee is regularly consumed in large quantities, there are nearly as many brands of antacids as there are brands of coffee.) It is also irritating to the bladder, especially in women, and is a frequent cause of urinary complaints. Coffee makes many people shaky by upsetting the delicate balance between nerves and muscles.

Today dependence on coffee is very common in Western society. Many regular users cannot think clearly in the morning until they have had their first cup. Without it they can’t concentrate, move their bowels or do their work. Also, they suffer real withdrawal symptoms—severe headaches, for example—if they stop using coffee suddenly. Such problems all come from using coffee too frequently so that the body never gets a chance to replenish its stores of chemical energy and comes to rely more and more on the external drug.

Coffee and caffeine have been accused of causing birth defects. There is no agreement on this possibility among scientists, but pregnant women should remember that coffee and caffeine are drugs and should not consume them in large amounts. Recently, medical researchers have found evidence linking coffee (but not other caffeine drinks) with cancer of the pancreas, an untreatable form of cancer that has been on the increase among Americans. The evidence is still weak, however, so it would be premature to give up occasional cups of coffee for fear of developing this disease. Coffee drinkers should watch for further information on this possible health risk.

Other caffeine beverages don’t seem to be as powerful or as toxic as coffee—even though they may contain as much caffeine or equivalent drugs. Tea is not nearly so irritating to the body as coffee, and cases of dependence on tea are less common. This is probably because coffee contains other substances that, by adding to the effect of the caffeine, make it a stronger drug. (Pharmacologists call this kind of interaction “synergism.”)

Of course, tea is a stimulant, and if you drink it in large amounts or make it strong enough, you can get powerful effects, including jitteriness and insomnia. In England, tea drinking has been a national pastime and habit ever since the early 17th century, when it was introduced from the Orient. In Japan, the tea ceremony is a very elaborate ritual built around the consumption of a special green tea powder that is whipped with water into a bitter, frothy drink.

Cola is a caffeine-containing seed, or nut, from a tropical tree, the cola tree. In some African countries cola nuts are so valuable they are used as money. The nuts have a bitter, aromatic taste, and people chew them for their stimulating effect. Bottled cola drinks have very little cola nut in them and do not taste like cola nuts at all. Though they do contain caffeine, it is usually synthetic caffeine or caffeine extracted from coffee or tea. These soft drinks are also drugs, and people can become dependent on them, as with coffee. Also, they contain a lot of sugar.

The combination of sugar and caffeine seems to be especially habit-forming. Many people drink enormous amounts of cola, and though they may think they are merely quenching their thirst, they are also consuming calories, enough sugar to damage their teeth (and possibly upset their metabolism), not to mention large doses of caffeine. Like other stimulants, cola drinks are not unhealthy if used in moderation; people who like them should just be aware of their nature and their potential for abuse.

In other parts of the world, people use a number of less well known caffeine plants. The national drink of Brazil is guaraná (pronounced gwah-rah-NAH), made from the seeds of a jungle shrub. It contains more caffeine than coffee and is often made into sweet, carbonated drinks. Recently, tablets of guaraná powder have appeared in health-food stores in the United States under such brand names as ZOOM and ZING. These are being marketed as new organic stimulants from the Amazon jungle.

In Argentina the most popular caffeine drink is maté (pronounced mah-TAY), which is made from the leaves of a holly plant. Some kinds of maté taste like smoky tea. Maté leaves can be bought in most health-food stores and are ingredients in some herbal tea mixtures, such as Celestial Seasonings’ Morning Thunder.

One of the most famous sources of caffeine is chocolate, also made from the seeds of a tropical tree. Chocolate, which contains a lot of fat and is very bitter, must be mixed with sugar to make it palatable. It, too, contains a stimulating drug, and cases of chocolate dependence are easy to find. You probably know a few “chocolate freaks.” People who regularly consume chocolate or go on chocolate-eating binges may not realize they are involved with a drug, but their consumption usually follows the same sort of pattern as with coffee, tea and cola drinks. (Do you know any vanilla freaks or butterscotch freaks?)

Cacao was known to the ancient Aztecs, who considered it a sacred plant and used it in religious rituals. In moderation, chocolate is a pleasant and interesting addition to the diet, but overuse is not wise, especially since the combination of sugar, fat and drugs can be so habit-forming. People who tend to gain weight easily should be especially careful about their intake of chocolate.

Coca and Cocaine

Coca, a shrub native to the hot, humid valleys of the eastern slopes of the Andes, has been cultivated by the Indians of South America for thousands of years. Today the plant is legal in Peru and Bolivia, where millions of Indians still chew coca leaves every day as a stimulant and medicine. (Coca, by the way, is not related to cocoa.)

Coca contains 14 drugs, cocaine being the most important. The other drugs are present in smaller amounts and seem to modify the stimulating effect of the cocaine. In addition, coca leaves contain many vitamins and minerals that are probably important in the diets of Indians who use them. There are several varieties of coca: some taste like green tea, some like wintergreen. Coca is used by putting the dried leaves in the mouth and working them into a large wad. People suck on this wad for 30 minutes or so, swallowing the juices, after which they spit out the residue. To get an effect from coca, a tiny amount of some alkali, such as lime (the mineral, a white powder) or ashes, must be added to the wad of leaves.

After a few minutes of chewing coca, the mouth and tongue become numb; then people begin to experience the usual effects of stimulants. Unlike coffee, however, coca soothes the stomach and doesn’t produce jitteriness. It may also be more powerful than caffeine in producing a good mood.

In the late 1800s, coca became very popular in Europe and America in the form of tonics and wines. Coca-Cola began as one of these early preparations. At the same time, scientists isolated cocaine from the leaves and made it available to doctors in the form of a pure white powder. As the first local anesthetic, cocaine revolutionized surgery, especially eye operations, which had formerly been terribly painful and difficult. In the 1880s doctors began to prescribe cocaine for all sorts of medical problems, including dependence on opiates and alcohol. It soon became apparent, however, that this kind of treatment was not a good idea, because many patients suffered ill effects from cocaine, and many became dependent on it. So, in the early 1900s, laws were passed against the widespread use of coca and cocaine. The Coca-Cola Company took cocaine out of its drink (it still contains a drug-free extract of the leaves as a flavor). Other coca products swiftly disappeared from the shelves of drugstores. Safer local anesthetics were invented in laboratories, and today doctors use cocaine only for certain operations in the eye, nose, throat and mouth.

Meanwhile, a huge black market has developed to supply cocaine to the many people who like the feeling it gives. All illegal cocaine comes from leaves grown in South America, where it is refined. It is always cut (diluted) with various substances before reaching consumers here. Most people snort cocaine; that is, they snuff the powder up their noses. Used in this way, the effects of cocaine come on very fast, are very intense and are very short-lived. Some people shoot cocaine, that is, inject it intravenously, which gives even faster, more intense and shorter effects; and some people smoke a special form of cocaine called freebase in water pipes. Freebasing has become popular recently. It puts cocaine into the bloodstream even faster than intravenous injection and gives similar effects—very intense and very brief. Few people take cocaine by mouth, even though it works and is actually much safer that way.

Coca and cocaine are very different, and the difference is a good illustration of how it is easier to form good relationships with natural drugs than with isolated and refined ones.

Coca leaves contain low concentrations of cocaine (usually only one half of one percent), which are combined with other drugs that modify the effects of cocaine in a good way, and with valuable nutrients. The cocaine is highly diluted by inactive leaf material. What’s more, getting stimulation from coca takes work: you have to chew a mouthful of leaves for half an hour. In this natural form, small amounts of cocaine enter the bloodstream slowly through the mouth and stomach.

Relatively pure street cocaine may contain 60 percent of the drug, which, when it is put directly into the nose, lungs or veins, enters the bloodstream all at once. The stimulation, or rush, is therefore very intense, but it lasts only a short time—usually disappearing within 15 minutes to a half hour—after which the user feels very down: tired, sluggish, unhappy. Because cocaine feels so good for so short a time and not so good immediately thereafter, people tend to go on using it, trying to get back the good feeling. Many people can’t leave it alone if they have it, even though all they get from it after awhile are the unpleasant effects characteristic of all stimulants used in excess: anxiety, insomnia and general feelings of discomfort. Besides, snorting too much cocaine leads to irritation of the nose, while smoking it may be bad for the lungs and is even more likely to lead to overuse and a stubborn habit.

Indians in South America, on the other hand, rarely have any problems with coca leaf. They can take it or leave it, continue to get good effects from it over time, and use the stimulation to help them work or socialize. They also use it as a medicine for a variety of illnesses, especially digestive ones. Among South American Indians there is little abuse of coca leaf.

In recent years, cocaine has become very fashionable in the United States. It is now very expensive, costing upwards of $100 a gram or $2,000 an ounce. (The smokable freebase form is even more costly.) A few people can easily go through a gram of cocaine in a single evening, and heavy users may develop habits costing $15,000 a year and more. Occasional snorting of cocaine in social situations is probably not harmful, but one should be aware that the possibility of using it to excess is very real, and that the abuse of cocaine can have ill effects on physical and emotional health as well as on productivity.

It seems a shame that the laws and policies on drugs in our society have led to the disappearance of coca along with knowledge of its uses and benefits. At the same time, by outlawing something that many people want, they have made it profitable to smuggle the concentrated drug, and so have encouraged the growth of a vast black market in cocaine.

Amphetamines are synthetic stimulants that were invented in Germany in the 1930s. Their chemical structures resemble those of adrenalin and noradrenalin, the body’s own stimulants. Their effects resemble those of cocaine but are much longer-lasting. A single oral dose of amphetamine usually stimulates the body for at least four hours.

Amphetamines are more toxic than cocaine and, when abused, cause worse problems. The body has a great capacity to metabolize and eliminate cocaine: the liver can detoxify a lethal dose of cocaine every 30 minutes. It cannot handle amphetamines as efficiently. At the same time, people can establish stable relationships with amphetamines more easily than they can with cocaine, probably because the intensely pleasureful but very short effect of cocaine is more seductive and invites repetitive dosing.

For many years after their invention, amphetamines were tolerated and their use was even encouraged by authorities. Soldiers in World War II received rations of amphetamines to make them march longer and fight better. The governments of several countries, among them the Soviet Union, experimented with giving amphetamines to factory workers, hoping to make them more productive (which, in the long run, they failed to do). Doctors in this country have prescribed them in great quantity for even less justified reasons.

In the 1950s and 1960s, the U.S. pharmaceutical industry manufactured enormous quantities of amphetamines, many of which turned up on the black market. The companies urged doctors to prescribe their products for depressed housewives and people with weight problems.

There are a number of different amphetamines, but all have the same basic effect. Plain amphetamine (Benzedrine) was the first to become popular. Dextroamphetamine (Dexedrine) and methamphetamine (Methedrine) are effective in lower doses but otherwise are similar to the parent compound. A few other drugs—methylphenidate (Ritalin), for example—resemble amphetamines in effect even though they have a different chemical structure.

Today we know that regular use of amphetamines, especially by people who are neurotic, depressed or fat, is not a good idea. Not only do the drugs fail to help their problems, they often complicate matters by creating another kind of dependence. Most of the cases of amphetamine abuse in the past 30 years have involved legally manufactured and prescribed drugs. Beginning in the 1970s, criticism of the promotional practices of pharmaceutical companies and of the prescribing practices of physicians brought about severe restrictions on the medical use of these compounds. Today amphetamines can be prescribed for only a few conditions.

One of the more controversial uses still permitted is the control of hyperactivity in young children. For unknown reasons, amphetamines (and other stimulants) have calming effects on young children. Unfortunately, the diagnosis of hyperactivity often falls on children who simply misbehave or don’t pay attention in school. Giving them amphetamines not only fails to get to the root of the problem, it introduces young people to powerful drugs and encourages the false notion that all of life’s problems can be solved by taking pills.

As legal supplies and uses of amphetamines dwindled, black markets in them grew, and as so often happens, this change promoted abuse. In the days of legal pills, most users took them by mouth. Today many people snort powdered amphetamines in the same way as cocaine, and some even inject them intravenously.

Intravenous use of amphetamines first appeared in the late 1960s. Young “speed freaks” who fell into this pattern of use experienced very bad effects on their bodies and minds. After only a few weeks, they became emaciated and generally unhealthy; they stayed up for days on end, then “crashed” into stupors. They became jumpy, paranoid and even psychotic. The drug subculture itself, realizing the dangers of shooting amphetamines, warned people about it with the phrase “speed kills.”

A number of people find amphetamines useful for specific purposes. For example, some college students use them to study for or take exams. Some writers take them to work. Truckers and other drivers sometimes take them for long-distance travel on highways, especially at night. Athletes, such as football players, sometimes use them to play big games. Actors and dancers take them occasionally to perform. Used in this way—that is, taken by mouth on occasion for specific purposes or projects—amphetamines do not usually cause problems, especially if people rest afterward. Problems arise when people take amphetamines all the time, just because they like the feeling of stimulation.

Some Rules for Using Stimulants Safely

Because stimulants are so common, most people will use one or another at some time. If you become involved with any stimulant, here are some rules that will help you stay in a good relationship with it:

1. Limit your frequency of use. All trouble with stimulants arises from using them too often. If you like the feeling a stimulant gives, it is all too easy to let your frequency of use creep up. Set limits! For example, never take a stimulant two days in a row.

2. Use stimulants purposefully. Taking these drugs just to feel good will not help you limit your use. If you are going to take a stimulant, you should use the stimulation for something—a physical or mental task, for instance. One side-benefit of such purposeful use is that the satisfaction of accomplishment will offset the letdown when the drug wears off.

3. Do not take stimulants to help you perform ordinary functions. You should be able to get up in the morning, move your bowels and make it through the afternoon without drugs. If you cannot, you should change your patterns of diet, sleep and exercise. Relying on stimulants for everyday activity leads to too-frequent use and dependence.

4. Take stimulants by mouth. Putting these drugs more directly into the bloodstream (as by snorting, smoking or shooting) accentuates the letdown following the up and encourages frequent administration. It also increases the harmful effects on the body.

5. Take dilute forms of stimulants rather than concentrated ones. The more dilute the preparation of a stimulant, the easier it is for the body to adjust to it, and the more gentle the letdown at the end. Preparations of plants such as coffee and tea are naturally more dilute than refined or synthetic drugs, and are easier to stay in good relationships with.

6. Maintain good habits of nutrition, rest and exercise. Remember that stimulants force your body to give up its stores of chemical energy. Whenever you use stimulants, especially if you take them with any regularity, it is important to let your body recharge itself. The healthier you are, the less you will feel you need outside stimulation.

7. Do not combine stimulants with depressants or other drugs. Combinations of drugs always complicate matters. Some people can’t sleep at night because they take too many stimulants during the day. So they take depressants at night. Then they can’t get moving in the morning and have to take more stimulants. This pattern of drug-taking quickly leads to trouble.

It should not be difficult to use stimulants wisely and stay in good relationships with them. They are not answers to the ups and downs of life, and taking them to try to avoid the downs only leads to problems. Nor do they give anything for nothing. Users pay later for any energy and good feeling stimulants give them. If you remain aware of what stimulants are and how they work, you will be able to avoid the trap of becoming dependent on them.

© 1983 by Andrew Weil, M.D., and Winifred Rosen. Reprinted by permission of Houghton Mifflin Company. All rights reserved. Featured illustration by Carl Wesley.

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