Medical research; Drugs and their application

The following program is produced by the University of Michigan broadcasting service under a grant of aid from the National Educational Television and Radio Center in cooperation with the National Association of educational broadcasters. Drugs and their application. A program from the series human behaviors social and medical research produced by the University of Michigan Broadcasting Service. These programs have been developed from interviews with men and women who have the too often unglamorous job of basic research. Research in medicine the physical sciences social sciences and the behavioral sciences. OK generally you will hear what may seem like strange or unfamiliar sounds. These are the sounds of the participants office his laboratory or his clinic where the interviews were first conducted. The people you will hear today are Dr. John Kinross Wright of the Baylor Medical Center. Professor Gordon t high Stat of the University of Minnesota and Dr. in IC Calloway of the Langley Porter neuro psychiatric institute in San

Francisco and my name is Glenn Phillips. Research in drugs has produced dramatic results in the span of a decade. All of us are aware of the health giving properties of drugs when prescribed by the family physician or purchased from a local pharmacy at the suggestion of a competent pharmacist. There is still a second use to which drugs are being put in research today that could have far reaching effects on our behavior. I quote from a booklet entitled The national support for Behavioral Sciences beginning with sedatives and anesthetic drugs and dramatized at present by new tranquilizers and anti-depressant compounds. The field of psychopharmacology is developing with vast potential importance for understanding behavior chemicals are involved in brain activity and hormones affect behavior compounds exist which can produce temporary psychotic states or lower resistance to communication of confidential

information. Certain drugs when injected into animals or man can modify sexual behavior or subjective emotions. The fundamental significance of all this is that clues are rapidly unfolding which give us entirely new insight into the biological determinants of actions feelings and reasoning processes. The wide range of possible industrial and medical uses is apparent. This statement was issued by a committee of experts who were appointed by members of the national government to draft recommendations for future research. Let's look at some of the questions involved in the future of drugs suggested by this statement. Dr. Anna Callaway of San Francisco made this statement regarding the possibility of counteracting behavior. Certainly some of the drugs we have now do seem to have an effect on patients and do seem to help them.

There's a there are a number of problems involved in this and that we don't know the answer to. In the first place there are probably lots of different sorts of conditions that look quite the same to us on the surface. We're still in the stage of treating fever when we don't know what's causing it. We see a patient that we call it gets a frantic and we may find out later that this patient had a temporal lobe brain tumor or that he was poisoned by bromides or that he in fact had central nervous system syphilis or that he had lupus erythematosus which case we split the condition off and we say oh this really wasn't schizophrenia. I can even remember a case of a black widow spider bite that food me temporarily. Well with. This state of affairs we then begin to find that we but wonder whether thinking of schizophrenia as an etiological group of a single disease is reasonable at all. And then to think that there may be

some toxic substance that's floating in the blood that causes schizophrenia and if we can neutralize it it would cure schizophrenia it probably in any case not true of all schizophrenia even if we found such a substance and knew specifically how to neutralize it we might find that this would account for a certain percentage of patients and we would still be left with a wastebasket full of all the sorts of conditions at the moment the drugs we have seemed to reduce and alleviate Tara and many schizophrenia terrified. And so they get better with these drugs. The usage of the drugs is almost directly almost inversely proportionate to the number of skilled attendants that work with a patient. And if you've ever been scared you know that relating to somebody else can help you if you're terrified and so a human contact can perhaps play the same role that the drug plays. But Thorazine is cheaper than people let's face it.

Now. That's one. Aspect to it the other thing is that if we begin to learn about mental illness we may find that some of the things that look to us like illness are protective mechanisms and that relieving them may produce a somewhat more useful member of society but still fall far short of what we'd like to do. I think lobotomy may very well fall into that category. Some people simply wouldn't have function at all and at least get by after a lobotomy. But this is maybe a questionable therapeutic result. One thinks for example if you like to use internal medicine their production of blistering after the introduction of or after exposure to certain compounds. And it's been at least at one point was speculated that that if the blistering was prevented that they would be

actually more extensive tissue necrosis and that the blistering actually was serving to remove some of the toxic substances. Well. One doesn't know whether what looks like the illness to the physician may not be what's allowing the patient to survive. Recognizing then as Dr. Callaway described the medically helpful use of drugs to alleviate terror in some mentally ill people I wondered if it would be equally possible to produce mental illness by use of drugs. There are drugs that will produce changes in human beings that. Will imitate certain characteristics of the changes we see in people that get admitted to state hospitals. This is what you mean. Certainly practically any substance give and non physiologic amounts will make a person function less adequately than before and functioning less adequately is dissy is.

And there really is essentially no valid distinction between mind and body except in the way one looks at it and that one always finds mens sana in corpore isa know that if you know the cooperate if you make the body sick there's going to be some sort of mental reaction. It's very hard to be really well in the mind if you're sick in the body so that therefore any non physiological state in the body is going to be reflected some high in the mind and. There you are. Essentially. If I hold your head on the world long enough you will show some mental aberrations. In fact you may even become unconscious which is quite. Aberrant. And before you become unconscious you may show other deviant sorts of thought processes. And in that way what a psycho pharmacologic agent that

can produce psychosis. Well I mean if you extend definitions that far you say everything becomes kind of meaningless. I think what you're probably hinting at is that the last surgically acid diethylamide type compound that can produce rather strange changes in thought processes with very very microscopic dosages and these are very peculiar compounds. If then it will be possible to control or manipulate human behavior either now or at some future time. What are the ethical implications. This question was asked by Professor Gordon t hice dad of the University of Minnesota and Dr. John King was right to Baylor University professor his dad speaks first as our ability to control behavior through drugs. Increases. I think the ethical problems will become more acute more pressing.

But I don't think things ethical problems are basically any different. Than they are for any other method of controlling behavior. Every parent every teacher. It makes rather heroic efforts at times to control the behavior of children. We interpret our lives try to control the behavior of our associates and one way or another. And to some degree we succeed. The success causes. Concern in regard to the ethics of. Directing someone elses behavior. As we succeed more. The ethical problems might increase. But there would not be basically different. Whether we are doing it by drugs or by training by education by communication systems radio television and so forth. In a lot of these

cases we are attempting to control other people's behavior. And the ethical problems I think are basically the sign no matter what avenue we might choose to attempt thus control of our neighbor's behavior. And in Houston at the Baylor Medical Center Dr. Kinross Wright said this is a cause a very important question. I think we have to. To realize first that we can probably only can certainly at the present time we can only control a person's behavior to a very limited degree. All these drugs that we've been talking about will produce a marked mental disturbance in an individual but there. We can hardly control it so we can do is give him the drug and see what happens. And frequently what we get is is a gross disorganization of behavior and he gets into a state in which. He can't do anything of a productive nature. So really all we can do with a person

is to. Knock him out so to speak to where he ceases to be able to function as his normal self for a period of hours are in the case of some of the newer drugs for up to two or three days. The ethical implications. May become exceedingly important in the future in terms of those things as brainwashing. And. The control of populations. Perhaps as a method of conducting welfare. And. I think. The. Researches who are involved with this. Are quite concerned about this question though I don't have any answers for it. And I think that. We would like to make quite certain that the public is familiar with what we are doing and with the limitations of the changes that these drugs can produce. I think at the moment there is no danger that they could be used for. Motifs but this may become a distinct possibility in the future.

In the course of the discussion with Dr Ken Ross Wright the subject of a drug being produced for contraceptive purposes specifically an oral contraceptive came out and here is his answer to that question along with a further comment on the subject of human manipulation. Yes well this is outside my own field but I understand that considerable progress is being made upon it made in the development of an oral contraceptive. And that probably the This Is Just Around The Corner. The cause of the problem with this as with any other draggy is to get the get the patient to take it. And by and large intelligent people have little difficulty in controlling their families anyway it's they it's the less intelligent people who who present the problem in this area. A story might. Illustrate the last point that that where the last question that I was answering. And that is this drug LSD which was developed in Switzerland and which in

infinitesimally small quantities will produce temporary mental aberration in a person. Was kept under wraps by the Army during the World. They were afraid of the possibility that the enemy might manage to introduce a pound or two of this into the water supply of some city thereby completely disrupting life in that city temporarily. I doubt that this would actually have been possible with this particular drug for. Technical reasons. But. The possibility of cost looms up large in any future role and this is not only true of drugs but a lot of. But germs and bacteria at the nerve gases and so on. I think they are possibilities of controlling a population relatively simply by the use of AI various types of chemicals as. Is well within the realm of possibility. But. The question of what to do with this I think is involves much wider philosophical ethical issues than. Then.

We can go into at this this time although it is not possible to report experiments on humans. Professor heisted demonstrates how it is possible to achieve very behavioral patterns through animal research. In the case of the animal research. Exploring the possibility. That one of the effects. Of many of these drugs. Is merely to create norms specific changes in the internal environment of the learning organism. Let me backtrack just a bet. And explain that we view behavior. As being responses to stimuli stimuli which may be external to the organism or they may be internal. By using drugs we can very greatly change the patterning of the

internal environment. If we create a new internal environment with drugs or with any other physiological manipulation this might constitute a different stimulus so that the organism having learned to respond to one stimulus know no longer has that stimulus to respond to the internal environment has been changed. And as a result is a previously learned response patterns or habits are interfered with because the appropriate stimulus is not there it is changed it is different as a result of the drug. To illustrate this we have trained animals. In simple emotional responses and have found in some of our experiments at least that if the animal learns the emotional response in the not normal state that is without drugs we can get drugs which will eliminate or

markedly reduce the strength of his learned emotional behavior. At the same time if the animal has learned the response under the drug if we now remove the drug we find that the emotional learning learning is no longer in evidence or has been reduced. In other words taking the drug away from the animal may have the same effect as we can obtain by giving the drug. We can use drugs that have been called tranquilizers. Either to increase or to decrease a learned fear response. These terms manipulation and ethical implications suggests a need for some kind of machinery perhaps a board to oversee the use of drugs and prevent their falling into the hands of an incompetent person. This is what Dr. Kinross Wright felt about the need for a Board of Control.

But I think on an individual basis. The responsibility should lie as it always has done in the hands of the individual physician. I think that when we get to this question of control of whole segments of the population this transcends the doctor's responsibility. And presumably has a responsibility of the government. I think it should bear responsibility of the whole. People. And I think this is one reason why the public needs to be much better informed than they are on the. On the very nasty possibilities which seem to lie just around the corner. I think it's quite possible for the public to be informed much better than they are about this plot of course. Very complex technical questions are involved. I don't think it's a totally impossible to explain the general nature of. These new findings in science to the public in a way which they can understand and comprehend. And particularly grasp of the

implications of them so far as the future of. Of themselves and as society is concerned. I think I would be completely remiss if I had not asked Dr. King Rosa right to elaborate further on what he meant by the very nasty possibility that is just around the corner and I'm not thinking so much here in terms of the drugs which I've been working with but. Some of the newer nerve gases. Most of which I'm sure. Most of which I know very little about because they all seek top secret information. But. Even the nerve gas is that we do know about are capable of being introduced. Without a population without a city's knowledge into the air. And of causing a very high percentage of deaths and major casualties. This sort of thing is something that one reads about from time to time in the newspaper but I think the average person just takes the attitude. This can

happen to us. Well it can happen to us and it could happen without any. Without any warning. And. I think the best way to. To handle. To deal with this kind of prospect and the many other. Unpleasant things which could happen in the areas of biological and psycho pharmacological welfare. Is for the public to recognize that. That the affection of the techniques of applying these methods has now reached a point where. It's really too late to turn back. There's no way of preventing the development of these these techniques they are here. The only way is to for the public to become informed to the point where they have that they are able to prevent their ever being used. It remains obvious that probably the best way to control the Misuse of Drugs is

prevention. That is making sure that there are inherent safeguards caused by the prior knowledge about drugs and their potential. Dr Kinross Wright illustrates this by his answer to the question what research on drugs is being conducted. Well Mr Phillips. I research is covering a pretty wide area in this field. The field of psychopharmacology as it's often called. Run large part of Iris said chin Babs the development and testing. I have a variety of new drugs which I developed in. The laboratories of the drug houses and in other places. Many of these drugs of course the public never sees and the few of them which stand up to. All the tests and which are not dangerous for. Clinical use. May come on the market but many others of them are tested and for one reason

or another are rejected. And we do this testing both on animals in our laboratories and when they pass these tests then we try them out on small groups of patients and then on large groups of patients. Another area of our research involves trying to understand how these drugs work. And we do this in laboratories again using animals and also the patients that we. Are using for the testing of these drugs. Another area involves the possible relationship between the levels of trace elements by trace elements I mean things like copper and manganese and cobalt which occur in every normal human being. And changes in that person's behavior. And we're working both in normal subjects. We use medical students and psychology students and so on and mentally ill people. And we're. Using patients both in our hospitals here and also in the penitentiary up in Huntsville Texas.

Another area of our research involves the effects of different drugs upon the electrical activity of the brain the so-called brain wave test. Has been refined very considerably and is capable of giving a great deal of information about the sites of action and the kind of action that a drug is having. Another area of research with drugs involves a study of the hallucinogenic drugs. These are the drugs which produce a temporary aberration of behavior in people almost like a psychosis a mental illness. There are quite a number of these drugs now. The first one was known as LSD. And there any creasing number of them coming out. Some of them are being tested in the treatment of existing mental illness is a sort of shock treatment as it were. Others of them are

being tested to help the psychotherapy of have a patient enabling him to recall forgotten memories that he otherwise would not be able to bring to the surface. And in particular this group of drugs is being tested for. That. For the light that they may throw on how mental illness develops because some of the changes in behavior produced by these drugs are very closely parallel the set of mental illnesses that we see occurring naturally in people are not exactly the same. Either a distinct difference is that they closely resemble them enough so that they provide us with a very important tool for research purposes with drugs. There is the unfortunate possibility of addiction. This is demonstrated by a report released by the National Mental Health Committee due to the widespread

use of barbiturate. One of the most significant findings in recent drug research was the determination that barbiturates may be addicting drug. And when withdrawn from the patient who is clinically intoxicated. Characteristic withdrawal symptoms and Sue. I asked Professor high stat if there was a chance of addiction or immunity with other type drugs. Yes I think there is more than just a chance of less. There is growing evidence that at least one of the so-called tranquilizers has a definite possibility for producing addiction and it is one of the tranquilizers that has been very very widely used. On an outpatient basis among non hospitalized patients. Now I should say that the dose of the drug necessary to produce true drug addiction is considerably higher than most

physicians would ever recommend for their patients. But this is true of almost any other addicting drug. And the other narcotic. It becomes a danger with respect to addiction. Only when the patient exceeds the recommended dose. So the problem with addiction is a current very pressing one with regard to this. Ron very well-known and widely used tranquiliser. The problem of patients becoming immune to drugs is also one that concerns us as we deal with drugs in therapy. It's a very common occurrence that a patient may respond very favorably to a drug at first and then relapse and apparently show no further benefit from the drug. At a descriptive level than we might say that the patient has become immune. At least he fails to can show sustained improvement even though he may

show initial improvement with the drug. To what extent this may prove to be a serious limitation on the use of drugs. I don't think we can say at the moment. It is a distressing thing to the physician and to anyone who has been using the drugs perfectly to see so many patients respond very nicely at first and then. The race. The favorable response disappears with time. Even though the drug is continued. That was Professor Gordon high stead. We've also heard today Dr. Inuk Callaway and Dr. John Kinross write discussing drugs and their application. Next week you will hear two of the world's foremost authority on the viruses. Dr. Jerome t Sivert an of the University of Minnesota and Dr. John F. Ender's of Harvard University

as they discuss the viruses on the next program from the series human behavior social and medical research. The consultant for this program was Dr. James Miller of the University of Michigan's Mental Health Research Institute and School of Medicine. Glenn Phillips speaking asking that you join us next week and thanking you for being with us at this time. This program has been produced by the University of Michigan broadcasting service under a grant in aid from the National Educational Television and Radio Center in cooperation with the National Association of educational broadcasters. This is the NEA E.B. Radio Network.