Today amphetamines and methamphetamine are more prevalent than ever in spite of a crush of new legislation and special attention lavished on the problem by law enforcement. One of the most recent sets of federal laws to come down the pike came in the form of the Methamphetamine Anti-Proliferation Act of 2000 (MAPA), which addressed the fundamentals of clandestine production. Cold medicines that didn’t come in blister packs would have their potency dramatically reduced. Perhaps of greater significance, the Act addressed the discrepancy in penalties for those caught with large amounts of precursor chemicals and those caught with the finished product. If it looks like you’re about to make methamphetamine, then, in the eyes of the law, you’ve made methamphetamine.
Ironically, much of the news today concerning the molecule has to do with the few remaining legal and “legitimate” applications. The most contentious example is the case of methylphenidate, the drug more commonly known by its trade name, Ritalin. What isn’t so widely known is that Ritalin’s molecular structure has an “amphetamine backbone,” and produces an effect similar to that of amphetamine and methamphetamine. As such, it has been listed as a Schedule II drug. Perhaps most surprising of all in light of these facts is that Ritalin is chiefly prescribed to pre-adolescent children for attention deficit disorder (ADD), and attention deficit hyperactivity disorder (ADHD).
The drug’s popularity has skyrocketed in recent years, alarming some in the medical field, as well as educators and parents, and creating something of a backlash. Children who take it are often said to be zombies, and the parents who allow it are accused of being intolerant of typical unruly behavior. (One of the Columbine shooters is widely rumored to have been on Ritalin.) The doctors who prescribe it, say some detractors, have obviously been corrupted by the pharmaceutical industry.
But the controversy didn’t quash the drug’s popularity. Figures published in an article in Forbes magazine in 1996 indicated a fourfold increase in the rate of Ritalin consumption in the five years from 1989 to 1994. Indeed the trend has only reinforced itself. Two years later the United Nations released a report that claimed ten to twelve percent of all male school children in the United States were taking the drug. According to the National Institute of Mental Health approximately three to five percent of the population has either of the disorders.
These days, Ritalin is no longer the only drug of choice for ADHD. In 2002 the FDA approved Strattera (atomoxetine), a nonstimulant, and the first new drug in three decades for treatment of symptoms of ADHD. But Ritalin and its variants remain the most-prescribed medications.
In prescribed doses Ritalin’s effect on children with ADHD has a calming effect, allowing them to focus their attention more readily. But in adults it behaves more like old-fashioned amphetamine, and as a result a disturbing trend inevitably developed with parents taking their children’s Ritalin. Some have even tried dissolving the tablets in water in order to inject the drug as they would methamphetamine. The result is most unpleasant. The insoluble fillers used in the tablets block small blood vessels, causing painful damage to the lungs and retina of the eye.
Ritalin has found a home in professional sports as well, especially baseball. Yankees pitcher David Wells claims that some major leaguers use the drug for its stimulant properties. An even more commonplace substance in baseball, however, is ephedra, the over-the-counter amphetamine-like herbal supplement that has many of the same characteristics.
On February 16, 2003, Baltimore Orioles pitcher Steven Bechler showed up for a spring training workout in Fort Lauderdale. Within a few hours he collapsed in the Florida heat. His temperature spiked to 108 degrees, at which point his organs began to fail. The following day he died. The heatstroke, it is believed, was in part brought on by the pitcher’s use of ephedra, a dietary supplement containing ephedrine.
Bechler had been taking the supplement in order to lose weight, a problem he had wrestled with all his life. Although it had been banned by the NCAA, the NFL, and the International Olympic Committee, it was still permitted in major league baseball. With Bechler’s death the Food and Drug Administration moved to require the products to bear warning labels that ephedra can cause heart attack and stroke. The news hit the supplement industry hard. The Nutrition Business Journal estimated that $1.3 billion worth of supplements containing ephedra were sold in the United States in 2002; the following year’s totals came to a mere $500 million. Although there have been reports of at least 155 deaths linked to ephedra use, for years the FDA claimed it didn’t have proof that it is sufficiently dangerous to be brought under strict federal regulation – a result of the dietary supplement industry’s successful lobbying efforts. The American Medical Association has felt differently about ephedra, favoring, as they have, an outright ban of the product. In the spring of 2004 the FDA abruptly changed course and followed suit, finally instituting just such a ban.
Not surprisingly, the supplement industry responded. In April of 2005, Nutraceutical Corporation, a Park City, Utah, nutritional supplement manufacturer, won and appeal against the FDA ban. A federal judge lifted the ban and sent the case back to the agency for revised rulemaking in accordance with the court’s decision. Unfortunately for Nutraceutical, the federal appeals court ruling upheld the ban. The case went all the way to the U.S. Supreme Court, which in May 2007 announced that it would not consider the appeal. As of June 2007, the sale of ephedra-containing dietary supplements remained illegal in the United States due to their health risks.
The real perception problem for the government concerning amphetamine lay in the military application of the drug. This dramatically came to light in the night skies over Afghanistan on April 18, 2002. The little known but longstanding use of amphetamine in the form of Dexedrine made headlines when two U.S. Air Force F-16 pilots, Majors Harry Schmidt and William Umbach of the Illinois Air National Guard, saw flashes on the ground and thought they were being fired upon.
The tragedy unfolded with an air of arrogance and incompetence. Initially, Schmidt asked permission to unload cannon fire on the target, but was told to hold fire until the target could be identified as friendly or hostile by AWACS (Airborne Warning and Control) planes in the area. A few minutes later Schmidt abruptly declared “self-defense,” and fired.
The rules of engagement require that pilots wait for clearance. Schmidt, however, simply went ahead and acted on a hunch, dropping a 227-kilogram laser-guided bomb. Thirty-eight seconds later the AWACS patrol came back with the devastating conclusion that they had just bombed friendlies; Canadian forces were currently on the ground conducting live-fire exercises on the ground. Four soldiers of the Edmonton-based Alpha Company, 3rd Battalion, Princess Patricia’s Canadian Light Infantry, had been killed, and eight wounded.
To the shock of the American and Canadian publics, it was learned that the pilots were on amphetamines in the form of Dexedrine that night. Moreover, the pilots claimed they felt obligated to take them. Were they to decline they felt they might be scrubbed from the mission. The amphetamines, they said, impaired their judgment, making them impatient and overly aggressive. The aggression, the U.S. government countered in its case against the pilots, was more of the order of “failure to exercise appropriate flight discipline.”
Air Force guidelines generally clear pilots for amphetamine use on any mission over eight hours in duration. Schmidt’s and Umbach’s mission was to last fourteen, so they were not only free to use Dexedrine, but, as they claim, they felt compelled to do so. In fact, amphetamine use is something of an open secret in the Air Force. In Desert Storm, for instance, a full two-thirds of the aviators used amphetamines during their deployment. Sixty percent of them said it was “essential” to their mission.
At first glance the pilots’ story might seem reasonable. But as the background of the circumstances came into relief, another story emerged. This came in the form a report produced jointly by Brigadier General Stephen T. Sargeant of the U.S. Air Force and Canadian Brigadier General Marc Dumais. By their lights the tragedy had very little to do with Dexedrine.
According to the report the doses were tiny. Umbach had taken one 5-milligram “go pill” two hours before the accident, and Schmidt a 10-milligram pill just an hour before – doses that would be similar to drinking a few cups of strong coffee. (The DEA, by comparison, has cited speed freaks who have injected several hundred milligrams of methamphetamine in a single sitting.) The pills taken by Schmidt and Umbach are hardly potent enough to have produced the kind of amphetamine psychosis their defense suggested.
When the personal dynamics between the two pilots were revealed, a more plausible story came into focus. The report claims that Major Umbach was known as an “average pilot,” whereas Schmidt was a much-decorated Top Gun flight school instructor, and was nicknamed “Psycho” by his fellow pilots. Unfortunately Umbach was the flight commander that night, and Schmidt is noted for having little regard for Umbach, leading to a critical breakdown in flight discipline.
The rules of engagement in Afghanistan dictated that it was the commander’s job to order Schmidt to take normal defensive action that night by simply flying out of harm’s way until he received clearance to drop the bomb. Incredibly, it typically takes but five minutes for AWACS planes to investigate such sightings and either grant or deny clearance to attack what is suspected to be an enemy ground position; Schmidt, however, waited only two minutes before dropping the laser-guided bomb. In the end both pilots were brought up on bad-conduct discharges, with Schmidt also being charged with failing to exercise appropriate flight discipline, and failure to comply with the rules of engagement.
The tragedy’s broader impact has to do with the military’s use of “go pills” and “no-go pills,” the latter of which they have used more recently in the form of zolpidem (Ambien) and temazepam (Restoril).
And yet the military may at some point be writing off amphetamines for good – but not because they find them ineffective or detrimental to a pilot’s or soldier’s judgment. Rather, they have found something potentially superior in a relatively new class of drugs called “eugeroics,” which merely means “good arousal.” In 1998 the FDA approved modafinil (made by Cephalon and sold under the brand name Provigil) to treat narcolepsy, which had typically been treated with Dexedrine. What modafinil does is boost wakefulness by aping the brain chemistry of a well-rested person.
The need for such drugs in the Air Force is pretty straightforward: sleep-deprived pilots make more mistakes. But so too do pilots with amphetamine-induced jitters. Modafinil causes wakefulness, but unlike amphetamines, it doesn’t produce hyperactivity in the form of the shakes. Research conducted by the U.S. Army has shown that pilots on modafinil have been able to fly two forty-hour missions, separated by only one night of sleep. Their performance was roughly on par with that of fully rested pilots for the eighty-hour duration.
Modafinil has also shown itself to be remarkably nonaddicting, working as it does with a tiny number of neurotransmitters in the hypothalamus – specifically, norepinephrine – the very wheels and gears of our body clock. Where amphetamines wake up the brain as a whole, modafinil is extremely specific. The drug may prove so revolutionary that some have speculated that advances in such drugs could make sleep unnecessary. The latter may be unrealistic, since sleep performs a breathtaking array of necessary functions, some of which are still not fully understood. Decades of research have shown that sleep deprivation prompts immune dysfunction, depression, and other disorders; non-human animals tortured in sleep deprivation experiments have died of massive bacterial infections of the blood. Even so, widespread use of eugeroics could revolutionize the workplace and society as a whole.
But modafinil is very complex, and amphetamine and methamphetamine very simple. They, or something very much like them, will be with us forever. The addict is in pursuit of euphoria, something modafinil doesn’t deliver. Mother Nature herself has made it so tantalizingly easy for us. And so has progress, which, it can be argued, has delivered western civilization to the brink of mass annihilation and madness.
The unguarded proliferation of information and technology has lent the world a new combustibility, for ours is an age of the super-empowered individual. Given a few minutes, one can find instructions on how to build a nuclear device, develop a colony of anthrax, or make vast amounts of powerful drugs in one’s bathtub. For the first time in human history the individual has it within his or her reach to wreak catastrophe across large swaths of human populations. The brave new world is a dangerous new world, and the methamphetamine phenomenon is its soul.