Drugs of modernity – Amphetamines

November 19, 2015
Issue 
US troops in Vietnam consumed more amphetamines than US and British troops took during WWII.

The use of the drug ice in Australia is said to be at “epidemic'' levels. There is nothing new in this claim for both Australia and much of the rest of the world.

Epidemics have accompanied the use and misuse of stimulants since the late-19th century. John Rainford traces that history in the second of this three-part series.

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Although German chemists were experimenting with thousands of chemical compounds in the late 19th century, not all of them made it to the marketplace. Some of those that did were quickly withdrawn when their ill-effects became obvious. Others never made it beyond the laboratory, being left on the shelf for want of profitable purpose.

Such was the fate of the drug that came to be called amphetamine, first synthesised by the German pharmacologist L Edeleano in 1887. In the same year, the Japanese chemist Nagayoshi Nagai, who had spent 14 years studying chemistry in Berlin, isolated the alkaloid ephedrine from the Chinese medicinal herb ma huang.

Ma huang, derived from ephedra plants, had been used in Chinese medicine for 5000 years for the treatment of colds, asthma and low blood pressure. But it was only in 1926 that ephedrine was approved as a drug by the pharmacy and chemistry council of the American Medical Association, following clinical trials for asthma treatment at the University of Pennsylvania and the Mayo Clinic.

Commercial exploitation

Its commercial exploitation followed so quickly that one manufacturer attempted to monopolise the supply of ephedra plants from China, which in turn prompted research on a synthetic substitute.

One was developed by the chemist Gordon Alles and tested in the pharmacology department of the University of California at San Francisco in 1927 and 1928. These results were passed on to the laboratories of the pharmaceutical company Smith Kline and French (SKF) in Philadelphia, where similar research was being conducted for a nasal decongestant.

The new drug was given the name amphetamine and in 1932 SKF marketed its freebase, an oily liquid, in the form of an inhaler called Benzedrine that was recommended for the treatment of asthma and nasal decongestion. Speed was out of the blocks.

By 1937 amphetamines were available in pill form, soon known as bennies or pep pills. Together with related stimulants, they were marketed as useful for a wide range of medical conditions including depression, epilepsy, schizophrenia, bed-wetting, obesity, Parkinsonism, narcolepsy, and drug and alcohol addiction. Methamphetamine hydrochloride was marketed in Germany around the same time.

The bewildering number of amphetamine-related stimulants on the market led to some confusion with terminology until it became accepted that “amphetamines” (in the plural) refers to amphetamine, methamphetamine and dexamphetamine.

In the Australian vernacular it is usually called “speed” or “goey”.

Use in warfare

Not long after amphetamines were released into the marketplace, the world was convulsed from 1939 by a conflict much bloodier than the one that had ended just 21 years previously. The British were aware of the use of amphetamines by German troops in World War II and responded by distributing 72 million pills to their own military forces.

The US combatants who entered the war following the Japanese attack on Pearl Harbour in December 1941 managed to get through 200 million pills in less than four years.

Amphetamines increase heart and breathing rate and raise blood pressure. This helps boost energy levels and alertness, making the drug ideal for those fighting in the field as well as those back at headquarters directing the action.

From his position at the rear, German Chancellor Adolf Hitler was in the habit of taking Vitumultin tablets, which consisted of amphetamines combined with a vitamin preparation. After the fall of Stalingrad in early 1943, Hitler aged rapidly and received amphetamine injections on a regular basis.

British Prime Minister Sir Anthony Eden found the drug particularly useful in keeping a stiff upper lip during the Suez crisis in 1956. US President John F Kennedy also found it helpful during stressful periods in the early 1960s. Both he and his wife were reported to be “strongly addicted” to amphetamines, which they took on medical advice during his presidency.

The use of amphetamines by US forces continued during the Korean War, and in the Vietnam War they consumed more amphetamines than the US and British troops between them took during the whole of World War II. In one form or another they are still used in combat to this day.

As well as an aid-to-combat and in medical practice, amphetamines, almost as soon as they were introduced, were used recreationally and as self-medication. They were particularly associated with the prominent American beat generation writers of the 1950s and 1960s, William Burroughs and Jack Kerouac.

Recreational use

Kerouac's most famous work, On the Road, was written on a single scroll of paper 36 metres long in the highly suggestive speed of three weeks.

The beats had an illustrious predecessor in Graham Greene who wrote many acclaimed works. In the 1950s alone he wrote The Quiet American, The Third Man and Our Man in Havana. In 1938, with the aid of a bennie for breakfast and another at lunchtime he was able to complete a spy novel in a mere six weeks, although The Confidential Agent is not among his better-known works.

The “poet of the thirties”, W H Auden, began taking bennies when he migrated from England to the US just before World War II to take up an associate professorship at Michigan University. He was still taking them when he was appointed Professor of Poetry at Oxford University in 1956. His period of amphetamine use, which lasted from 1939 to 1957, has been held by some to coincide with his best poetry.

During World War II, widespread amphetamine use in civil society first emerged as a problem in Sweden. In 1943, 200,000 Swedes — around 3% of the total population — were using the drug regularly, although the number of “problematic users” was estimated by researchers at no more than a few hundred.

A drug which in low doses increases energy and alertness, enhances self-image and induces a state of euphoria has obvious attractions. Unfortunately though, repeated use builds up tolerance, so that more of the drug is required to produce the same effect, and excessive use can lead to a condition known as amphetamine psychosis.

By 1954, 55,000 people in Japan were estimated to be suffering from methamphetamine psychosis as military stocks came onto the black market and were supplemented by over-the-counter sales. The number of Japanese injecting methamphetamines at this time has been estimated at between 550,000 and 1.5 million.

From the 1950s, amphetamine use in several countries occurred in what have been described as epidemics that typically continued over a decade. Epidemics occurred in Sweden in the 1950s and 1960s, in Britain in the late 1950s and 1960s, and in the US in the late 1960s and early 1970s. The Australian epidemic in the middle- to late-1960s was said to be less severe than in other countries.

The one thing that they all had in common was that they were iatrogenic (physician-induced). In Sweden, amphetamine pills had been a prescription-only drug since 1939; in Britain since 1954; and in the US since 1951. The 1960s epidemic in Australia was accompanied by a large increase in the prescription of the drug by GPs.

While doctors were busy scribbling, pharmaceutical companies were just as busy cranking up production. In the US alone, the number of tablets manufactured went from 3.5 billion in 1958 to 8 billion in 1966 and 10 billion four years later.

The growth of the illicit market was just as impressive. By 1971 it was so well established that attempts to control it — by restricting the prescription of amphetamines to two medical conditions — narcolepsy and attention-deficit hyperactivity disorder (ADHD) — were unsuccessful. The market continued to operate, and eventually expanded.

The illicit market benefited from the increased production of the drug companies, with somewhere between half and two-thirds of the pills produced in the US before 1971 distributed through illegal networks that had their origins in California. Bikie gangs, through the adroit application of violence and intimidation, controlled the production, distribution and much of the sale of speed in the state. In time they would dominate the trade in other parts of the country and in other parts of the world.

Prescriptions

The other continuing source of speed is the on-selling of the drug by people who have acquired it by prescription. Here there are two user groups. The first is those suffering from the rare syndrome of narcolepsy — uncontrolled fits of sleep — and this seems a reasonable enough use of a drug which keeps its users awake.

The second is much more controversial: ADHD in children. On the face of it, it does seem rather odd that a drug that is prohibited for adults because it is considered too dangerous is regarded as safe for children.

The discovery that amphetamines can have a beneficial effect on children with behavioural problems was made by accident at a residential home for children with severe behavioural disorders in Rhode Island in the US in 1937. The director of the institution, Dr Charles Bradley, prescribed Benzedrine for some of the children to raise their blood pressure in an effort to cure the headaches they were suffering from. It did not do much for the headaches but it did improve their behaviour and scholastic performance.

From the 1950s methylphenidate (an amphetamine derivative) was marketed under the brand name Ritalin. Together with dexamphetamine, it became a common treatment for ADHD sufferers by the 1970s.

Although this treatment is controversial, Australia has been consistently ranked among the top countries in the world for prescriptions of what is sometimes referred to as “kiddies' cocaine”.

For reasons that are not entirely clear, children in Western Australia are prescribed the drug at a much higher rate than children in any other state. Prescribed “dexies” are then on-sold to fellow students and adult users. Truly the state of excitement, dependent only on your schoolyard supplier.

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