The future of; 26; Drugs as Therapy and Recreation

From WMUR found in Washington D.C. the future of another in a series of discussions of alternative futures. Your moderator is Joe coach of the world future society. Mr. Coates. Good evening this is Joe codes for the world future society presenting another in a series of discussions of alternative futures. The subject for this evening's discussion is the future of drugs as therapy and recreation. For many years one of the major chemical companies in the United States used the slogan better things for better living through chemistry. Well perhaps in the future we can cut out the middleman and just achieve better living through chemistry more or less directly to discuss the future potentials of drugs in both play and it's therapy we have is this evening Dr Cedric Smith who is head of the department of pharmacology at the School of Medicine the University of Buffalo. Dr. Smith is a graduate of Oklahoma in him and holds a doctorate in medicine from the University of Oklahoma. Well Dr. Smith what do you see as the future of drugs as therapy and recreation.

Well the wide variety of possibilities for the future how likely any of them are to come about as an open question. Certainly an extensive amount of research is underway for disease states and the use for drugs for sin and fun for the future is well known to everyone. I think the questions really are as to how far it will go before somebody blows a whistle on particular activities. Well perhaps before we get too far into the substance of it it might be a good idea to tell the audience what a drug it is. Well the drug is loosely defined as any substance chemical material which influences biological systems. Of course the ones we're interested in are really those that are substances that affect people either directly or indirectly. Well what's the present status in the use of drugs the present status of pharmacology with regard to dealing with disease states. Have

we licked some diseases are there some clear achievements that are forever and ever. Well there are a wide variety of drugs which have well-established roles in medicine and in treatment particularly of disease and in the prevention of disease states. And I would include the vaccines in as drugs in this instance which have been changed in a sense the whole character of mankind because of the prevention of specific disease states. Certainly the. Drugs for the treatment of pain have produced an untold amount of decrease in suffering and there are a great number of potentialities existing Freud to Caesars for which we still don't have a definitive or precise answer. So I thought. Such as cancer such as heart disease such as strokes own diseases

which are becoming more and more apparent because of the eradication particularly of infectious diseases the drugs and the vaccinations of whole populations. So the major major achievement in the use of drugs so far is any alleviation of pain and in the treatment of infectious or diseases or diseases caused by microorganisms. What do you see the victories for the next decade or two might be. I don't viral agents I think are real potentiality. Those that have been developed so far have not proven to be particularly effective. Certainly not effective against things like the common cold. Or against even the cancers that are may well be of viral origin. But I think that the enviro agents are a possibility. There is certainly the potentiality for much better therapy of parasitic diseases which are becoming more and more common in our.

Society. In part because of the people coming back from Vietnam with one of the other of the more tropical diseases that isn't really that's just a trending problem. No I don't think so because I think the fact is that the United States in temperate climates have been isolated in a sense from a the so-called tropical tropical diseases. But many in fact Press that it was eases are endemic in populations like United States for example AMA bias this is as well known to be quite common in northern cities such as Chicago and there are sporadic outbreaks of it's not what's known as amoebic dysentery. I mean places yes. What about heart disease have you. You see a hopeful future for drugs and dealing with it. I'm hopeful. I don't I'm not that familiar with the intimate research in the area. There are certainly already a number of diseases which ameliorate prolong life. The old remedy of digitalis is still

a standby in the treatment of chronic heart disease congestive heart failure and is quite effective and is makes life prolongs life span for a large number of individuals. So that I don't think that this is a I'm not being pessimistic but I think I think the Republicans read rest on how many people are trained to investigate drugs. How much money industry are the population via the food and via the government is willing to invest in the development of new agents. There are relatively few pharmacologist compared to other scientists hundreds thousands tens of thousands. Oh a lesson two thousand I would say the United States has certainly the largest number and any one country in the world. And these are involved not only in development of drugs but in the evaluation of the hazards of known drugs as well as known pollutants the

toxic effects of DDT for example. Well before we get into the pollution in the testing and the problem where do drugs come from. Do they literally fall from the trees or. What is a pharmacologist do to earn his bread. Well they come out of the trees perhaps. One is reminded of quinine which comes from the bark of a tree in the past certainly most of the drugs have come from plant origins largely and many of these were discovered and integrity such as the opium the poppies the digitalis the digitalis plant. But nowadays more and more drugs are being developed specifically for up to a certain purpose by chemists. The origin of the idea for the chemical structure frequently has arisen from plant origin but more and more compounds are being developed strictly by the synthetic organic chemists who looks at the biological system and its chemicals and devises

a chemical compound that will in fact either mimic or block or alter the chemicals of the biological system so that in the future it will I am sure see less and less reliance on the natural products of plants of bacteria fungi for example the penicillin from molds and many antibiotics from various other molds but rely more and more on the synthetic organic chemists to make new compounds novel compounds. Are you saying that the state of the pharmacologic science is that an investigator from. An understanding of first principles so to speak can play and design and build a drug that will have some useful effect. Well this is true but he is still limited by with the knowledge of the biological system with which he works so that as the bio chemists develop more and more knowledge of the intricate biochemical systems

the dedication of specific enzymes pathways change in the cell he will be able to chemists in the sense will be able to develop compounds which would alter or manipulate change this chemical process. We still are not so far removed though from the serendipitous chance finding to rule out just the simple observation and testing of a compound new compound for its effects on this biological system for the on that biological system. When you talk about testing that's a bit vague. Could you perhaps very succinctly tell us two or three principal stages in taking something from the laboratory and finally making it a saleable product. What is involved in the testing. Well if the combat has a specific reason for existing for example if it were designed to inhibit a reaction in liver cells this would be studied first but most commonly the compound is injected

into an animal such as mice. The effects on the mouse is observed. Then based on this as more specific tests on isolated organs such as a piece of intestine or lungs or heart are examined and then very particulate matter structures are studied and then pieces of cells as it were are examined for their drug effects on all of these different components. It's obvious one the obvious corollary here is that one cannot examine all of the things that one would like to do with every drug and so you have to partly by guess and partly by analogy with what is known from other compounds. Look at those things where it is more likely that the drug will have its action. Yeah the result is that you have to test it for its effects in man and for no reaction that I know of are any in the animal species including chimpanzees

a very useful test system for predicting precisely the action in man there's a there's enough differences of man in the animals that makes it imperative that any compound cannot be with any kind of a surety tested in animals and so this is what it does and what it will do. And when a man takes it if a man has to be also the ultimate test animal for drugs does this have any substantial influence on the availability of new drugs on the availability of new therapies with diseases. I think this is one of the perhaps the most important point. That one could raise and that is with the increasing concern of society for its safety with new drugs particularly stemming from the Book of the jungle by Sinclair and recently the thalidomide disaster has made people much more concerned that they do not take compounds or

receive substances which might have hazardous or untoward actions. The consequence of this is very simple and that is that the industry are the government must test the compound much more thoroughly before it's ever put on the market as a consequence. This costs more and it's less likely that one will have a new compound introduced into into medicine and it will but see a strop limitation on the rate at which new substances will be available. It's obvious that industry also will not spend the amount of money required to develop a new compound for a disease that doesn't the fact a large number of people for example. The only way a new anti epileptic drugs will be developed in this country certainly would be by public funds or by private foundation fund millions for headaches but nothing for epilepsy. That's right. That's exactly right. By the way are we making any progress with the headache. I understand it is a new British society for the Study of the headache and I may be appropriate for the British

but I don't know that. I'm not aware of any industry program for example for developing specifically new drugs for the treatment of headaches. I am personally quite interested in the area and I think there are a number of promising leads but to my knowledge no one is explicitly directing their attention to new drugs for that headache against this background of what drugs are and how they come about in the problems of testing and evaluation. What do you see as the major benefits of the major risks perhaps for the next generation of drug and drug users. Well when you use the word drug users you imply that the people that are taking the drugs by their own volition as opposed to those that are taking drugs under a physician's letter driveways. The new drugs are likely to come along for the therapy I think are. There are a number of areas that there is an intensive amount of work going on and it's very

difficult to know which will yield results most rapidly. In the other area the drugs taken by the individual for his own use over the counter or under the counter sales of the well I think there's not much question that the general trend is for more and more use by the public of more and more drugs. And this is fostered and supported by drug advertisements themselves on TV implying to the population that every everything that ails mankind can be cured by the appropriate pill and by the underground press that that caused every individual to explore whatever is inside of him down to his very molecules. So I think more and more exploration will be done. And more and more drugs will be explored and these will lie largely in the area of those that change the way people think or that or their attitudes and

views towards the world around them that make them either happy or depressed make them feel like they're accomplishing more or escaping from society or from themselves. Isn't there already is substantial use of these for therapeutic purposes the cloak room scenes of various psychic Energizers and various tranquilizers. I understand they comprise a substantial portion of the prescriptions. A fantastic market isn't sense of prescription but there's an interesting thing about this that they could divide these drugs divide themselves rather nicely into if you will into two big groups one a group are those that people tend to take themselves and to take a larger and larger dose or get doses or to take more often and those which the individual if given is free rein does not tend to take more than is prescribed and the. Major tranquilizers those of the female thighs in the corporate machine or

Thorazine type people tend not to take any more than this prescribed for them. Do they get so tranquil that's too much trouble to reach for the bottle. Well this is hard to say why it why it is certainly one's own subjective reaction to these agents are one that's not is rather neutral. They tend to decrease the amount of activity that one undergoes tends to make things less troublesome perhaps around the surrounding environment. But they they do not produce what people perceive to be a particular desirable state. Then there's a whole class of agents which are by certain people used the use of word to excess but they certainly tend to use them over and over again and do use larger and larger doses. And these are commonly called Drugs of dependence drugs of abuse. So I guess. The bobber traits of the classic example weeping pill sleeping pills. Is that the principal

domestic villain these days. Well I think alcoholism is obviously the mother the principal domestic villain if you're going back to our original definition of pharmacology or drugs as being chemical substances that affect biological systems. And but in the same group with alcohol are the are the barbiturates and the sleeping medications. Well and perhaps the alcohol is the reason for us now to take a look at drugs as recreation because you have a word or two on that. Well I think that if one extrapolates from the present day that there isn't any question that a large number percentage of the population will be using some kind of drug induced change in the way they view the world. In addition to alcohol marijuana is extensively used and shows no indication of the. Increasing rate dropping off certainly

LSD was rather widely used and suffered some decline but is now again this from all evidences increasing in advance of its use. What would you say that is it was 2 percent 12 percent 30 percent. I think in the total population behind for me judging makes so much like college you've got college population I think it's much easier to say I would guess that by and large I think these surveys are summarized by Dr Yola said that the National Institute of Mental Health are probably better than my own and I don't remember precisely his figures but I think a rough figure of 15 percent of the college students using marijuana is in the right. But I've used it once or more ago I using it use it on some routine basis. That's right. What about LSD LSD. Well two or three years ago this use rate that is people who had used it for Hap's more than once was around 1 in 2 percent. I would guess my own and this is just off the top of one's head that this

is climbing out of the 3 and 4 percent recognizing that there are wide variations in the rates of use of any drug including marijuana and alcohol at different colleges and at different times. And these are go by the way of. Patterns of fads and change almost as rapidly so that it's clearly a social phenomena cultural phenomena local localized phenomena even within a given college. The patterns of usage by different groups define any way you wish. There are markedly different. So this is do you see any likelihood that marijuana in particular but other psychometric drugs or mentally affecting drugs will become socially acceptable. Well in certain parts of the society there are already so I wanted a status of alcohol but where they acquire the legal status of alcoholics and open open question I

think this certainly the trend is in this direction almost all those who have spoken publicly with some influence in this area have proposed that the that the marijuana laws are much too harsh and are inconsistent with the other regulations. I think most everyone would probably be happy to have marijuana and LSD treated in the same fashion and much with much less high harsh penalties than those attributed to the opiate narcotics are to such things as cocaine or even the and better means. You see then that there is some reasonable likelihood of these becoming. Generally socially acceptable. Oh well even alcohol isn't generally socially acceptable I think that you have to recognize that almost all of the intoxicant drugs have different ways of usage and different culturally

accepted use ways of usage. The use of beer and the beer blasts of the college students which is a quite accepted pattern of use might not be extended in some locales and some situations to hard liquor use. So that and many areas even in the kinds of alcohol are not condoned or are used so that I would expect to have. Pockets if you will are marked differences in the degree of acceptance among different cultural groups even the United States I think this perhaps may be a external sign of the diversity of the society and the fact that it's composed of groups of rather markedly different standards of behavior. This is true among the drugs I don't really see this becoming widespread extensively accepted by all the groups within the society. This I think is unrealistic.

Should drugs be legalised for recreational purposes. Are there any particular social or other obstacles economic obstacles perhaps that would have to be realigned or accommodated. I think the one of the problems Pippi with the psychedelic agents and with marijuana is it the hazards are not clearly recognized. Most people in examining this expect the hazards of these agents to be analogous or similar to those with the drugs that they know better such as opera hall or barbiturates. And it's obvious that these drugs do different things and that the hazards if they exist are clearly in other domains and if we look for an impairment of conventional motor muscle skill such as occurred with alcohol after such things as marijuana or LSD we won't find it. But what will occur are changes in attitudes changes in the way people view the world. The tendency or the propensity towards certain thinking patterns such as

magical versus a more rational analytical approach. These will be the the sources of the hazards if you will with these drugs and I think the full measure of this hasn't been taken well will it educate grow up. You anticipate and they're used in the same way that we have an etiquette about smoking and etiquette about alcohol. Oh I think that these drugs all have serious hazards in the society and that this is right. This is well recognized by the user group and what will grow up is a societal control system that will tend to minimize the degree of Hazard and maximize if you will of the utility to the group of the drug. How this will occur precisely I think is not easy to say. But I do believe that it won't grow up and this will be a controller which will not only be perhaps legal in its final manifestations it will be social both in the local sense and the small group the interpersonal

transactions that go on will be governed by a certain kind of etiquette I take your word etiquette as an appropriate one because it does denote the fact that that the agent. And individual interact and that there is a need for some kind of ground rules for behavior and what is accepted and what is not accepted which will tend to protect the individual from the drug and from the interpersonal interactions that may occur under the drug. One frequently hears perhaps more bizarre proposals for drug use. Perhaps they're only more bizarre because they're unfamiliar. Perhaps drugs that would allow us to eat limitless quantities without becoming all the drugs that would give us the the memory capabilities of a Houdini. Do you see that this is something that is either plausible or should be cause for attention. I think that there the potential is there for drugs that change memory and that change learning ability that changes sexual responses

that changes the amount of sleep needed or the nature of the sleep that are much more specific and dealing with mental processes than most of them. Most of the drugs that are available at the present time how specific one can get and dealing with in biological systems is not known and you will never know this I don't believe it's one of those non normal things because you never know when you can develop a new agent which will have a greater degree of specificity. So I think these are all potential. I would think nothing intrinsically than prohibiting them no matter the elucidation of biological biochemical mechanisms and then the attempt to tailor something to fit that. I think this is true and if one stops for a moment thought this raises some potentials of the threat to the society equivalent to a nuclear weapons. And I might I would propose in many ways that there is a real need for a group of people to be concerned in this area to perhaps monitor it to be

sensitive to rate of change perhaps of use of drugs by a particular populace or the potentiality of particular drugs to alter the society. This kind of group. I do not see exist today. It should be sensitive to rate of change rather than to the actual magnitude of the change itself. Oh I don't think society and its government has responded for example appropriately to the to the increasing rate of use of psychedelic drugs just developing a factual base on which to make rational decisions. Well there seems to be two different things you suggesting first a mechanism to develop information and facts about what may be of social interest. But I'm more concerned with your kind of proposal who are official or semiofficial Cassandra's. What really might they do. What influence might they exert. Well I think the major concern here would be the identification of those areas which deserve particular immediate attention with

respect to research efforts. One can collect data until it comes out one's ears but there's a real need to identify those areas for which precise information is needed now so that you can make a decision which will benefit everybody five years from now. Well Dr. Smith if you could look at your crystal ball or your crystal ball of alternatives for the next generation what would be the major changes in influencing the quality of an individual's life that you might see resulting from drugs new drugs more drugs but even drugs that were better controlled with respect to one the magnitude of their effects and the quality of their effects. So there be less hazard and greater effectiveness. Oh thank you Dr. Smith. This has been another in a series of discussions presented by the world future society. The objectives of the society are to encourage the serious investigation and reasoned awareness of the future to explore and to develop methods for the Study of the future and to increase the public's understanding of the potential consequences of these future oriented endeavors. Those of you who are interested

in learning more about the society are invited to write for a free copy of our journal. The Futurist. You may write to me care of this station or to the world future society. Post Office Box 1 9 2 8 5. Post Office Box 1 9 2 8 5 Twentieth Street Station Washington DC 2 0 0 3 6. Thank you and good night. Listening to the future on another in a series of discussions of alternative futures with Joe coats of the world future society. The preceding program originated from the studios of WUOM American University Radio Washington D.C.. This is the national educational radio network.