5/26/2004 06:19:00 AM|W|P|projectpeace|W|P|To the Editor, Annales de Médecine Interne Re: article “Intoxications par champignons hallucinogènes” : A Critical Commentary In reference to the article “Intoxications par champignons hallucinogens” (Supplément B, Octobre 2000): The authors of this article, (Marc Pierrot, Pascal Josse, Marie-Françoise Raspiller, Michel Goulmy, Marie-Odile Rambourg, Jacques Manel, and Henri Lambert), perhaps without realising it, have illustrated an oddly compartmentalised although common modern standpoint concerning the use of certain age-old psychoactive plants. I should like to comment on this article in view of the increasing European acceptance of harm reduction strategies as a response to drug use, strategies which have been proving their great superiority to the futile prohibitionist doctrines and policies that have been an unfortunate legacy of post-WW II American influence. If we are to fully implement such strategies for the advancement of public health, we must overcome the many decades of embedded prejudice and historically-ignorant thinking that drug prohibition has caused, evident even in the terminology scientists and medical practitioners today employ concerning drug use. The oddly compartmentalised view of which I speak concerns the apparent intellectual dissonance, one might even say confusion and ignorance in many segments of professional communities when it comes to the subject of drug use for non-medical purposes. Most obviously, the use of nicotine, caffeine, alcohol (as a drug rather than a beverage), cocoa, and other age-old legal psychoactive products hardly merits recognition as “drug use” whereas the moderate use of other, now-illegal products, even though that use may be quite harmless compared to tobacco-smoking, for instance, is widely denounced by moralists and scientists alike. Thus, due to the collective intellectual warping that prohibition has produced, even when a scientist or physician mentions the term “drug use” he inevitably adopts a position far more loaded with moral baggage than scientific description. Such observation has been published time and again, yet has had little effect in changing the collective viewpoint of modern western society or of its professional communities. This represents a significant Orwellian double-think smack in the middle of our supposed “age of science and reason,”  for such a situation in which the use of some but not other products of a common class is approved can be supported on grounds of perceived morality, or on behalf of cultural and religious prejudices, but the attempt to do so from a scientific standpoint inevitably proves disastrous for one’s scientific objectivity and credibility. Indeed, it is exceedingly difficult to find any solid scientific evidence that the prohibitionary approach to the control of drug use in society delivers any of its purported benefits or goals, and quite easy to demonstrate precisely the opposite: prohibition routinely and reliably exacerbates the harms resulting from drug use and even drug production and distribution. The inevitable conclusion that history teaches is that prohibitionary policy is thus neither based on nor justified by the findings of scientific and medical research, and indeed, that such findings would, if their obvious significance were acknowledged by politicians, require immediate and complete repudiation of prohibition as effective and rational policy. How then can a scientist or medical practitioner support prohibitionary policy or subscribe to the prohibitionary paradigm without disqualifying his scientific objectivity? Surely it must involve an “odd compartmentalisation” of one’s thinking, a double-think, to fail to recognise when one’s viewpoint represents not science but morality, and a very dubious morality at that, considering its source in the Puritan Temperance movements of 19th Century America. The support of the prohibitionary paradigm in professional literature is often less than obvious, however. It can be (1) disguised underneath a flurry of professional jargon, (2) implied through one-sided descriptions of drug use, (3) smuggled in by the use of certain terminology, (4) or revealed by an illegitimate if strategic shift from scientific to moral arguments and judgements. Thus to the discerning reader of an article such as “Intoxications par champignons hallucinogens”, the authors seem more prohibitionist than scientific, as moral entrepreneurs or preachers rather than objective professional observers. This must seem a harsh criticism, but let us take a closer look at what the authors say, for their article employs all four techniques mentioned above. At first the article seems to proceed objectively and informatively concerning the historical, epidemiological and pharmacological aspects of “intoxication” by agarics of the genus Psilocybe. A few cases of such “intoxication” are described in detail (with a flurry of medical terminology), and without specialised knowledge of the ethnobotany of these fungi or of the extensive research with psychedelic drugs that was accomplished in the 1950s and 1960s, nothing might seem amiss. A somewhat more careful reading, however, begins to show that a curious mix of ideas has been at work in producing the article. The altered state of consciousness that these mushrooms typically elicit is constantly referred to as an “intoxication” or even a “poisoning.” A close look at the references shows that a curious mix has been chosen here as well: most reflect the “toxic-poison” paradigm, yet works by Roger Heim, Albert Hofmann, and R. Gordon Wasson are mentioned, and if the authors had thoroughly understood and acknowledged the work of these pre-eminent  authorities on the subject of psychedelic plants and drugs, they would surely have had great difficulty in calling the substances “poisons,” and their descriptions of the psychological effects of the substances would have had to go far beyond seeing them as “hallucinations.” Such terminology is not merely unscientific in this case, but revealing of the authors’ (perhaps unwitting) subscription to prohibitionist convictions. If the authors had been writing in English, they might even have foolishly called the substances “narcotics” as do the leading U.S. “authorities on drug abuse,” all prohibitionists in the extreme. They do, however,  employ that favourite French condemnatory label for illegal drugs, “stupéfiants.” In fact, the viewpoint that results from a familiarity with psychedelic research and the long history of religious and heuristic use of such substances reveals that except in the case of extreme overdose, psychedelic drugs are not toxic and thus not capable of producing “intoxications,” and they certainly are not “poisons.” Neither do they “stupefy,” a word that might be far more appropriate for that silly state of incoherence brought on by a little too much beer. True, psychedelic plants produce radically altered states of consciousness, but do so through the catalysis of inbuilt psychological mechanisms of the mind/brain. Thus meditation, fasting, breathing exercises and other age-old “non-drug methods” are capable of producing exactly the same states of consciousness, and such states even occur spontaneously in many normal individuals. Note, by comparison, that a state of consciousness similar to stupefaction with alcohol is not ever experienced spontaneously in healthy individuals, nor is it one that is inbuilt or inherent in human consciousness: it is the direct result of ingestion of a rather high dose of a crude toxic solvent (ethanol). If psychedelic states of consciousness (or intensive meditation, for that matter) produce psychological, emotional or existential conflict in an individual, this is not something that is “caused” by either the drug or an alternative method, but by dissonance between the individual’s world-view and the reality revealed by the changed consciousness. This conflict can, of course, occasionally be dramatic and unsettling, and lead even to panic in rare cases. Since pre-historic times, however, these experiences have been revered as one of life’s most important learning processes, and not merely in “primitive” tribes whose legacy to modern times might be considered inconsequential: the ancient Greeks, whose civilisation must surely be admitted to be the direct precursor of our own, and whose heights were not re-attained in many ways until the age of enlightenment, practised a religion in which a psychedelic potion was consumed at a yearly celebration that took place every autumn for nearly 2000 years. All the great names of Greek antiquity participated, and were singularly laudatory in their appreciation of these initiations. In fact, the psychedelic potion employed at the Eleusis celebration contained amides of lysergic acid nearly identical in structure and effect with LSD. [1,2] Thus it represents a strange and illegitimate disconnect with the entire evolution of human societies and consciousness to view the use of such natural plant drugs as a perversion, a mere “intoxication,” something to be demonised and repressed by every means available. The authors of “Intoxications par champignons hallucinogens,” I fear, leave no doubt in the reader that this is their position. With prohibited substances, of course, the Clinician´s Illusion runs riot. Since medical practitioners who come into contact with the user of a prohibited drug usually do so in an emergency situation, and prohibition itself, being a moral and not a scientific position, easily infects the perceptions of an entire society with the conviction that a prohibited substance simply cannot have beneficial uses, the clinician therefore has little motivation to think that the emergency cases he sees might be anomalies rather than the rule. Not only do such practitioners generalise on the basis of their clinical experiences, necessarily one-sided due to prohibitionary policy, but they find it convenient and easy to exclude carefully-considered views and research that represents a radically different paradigm for understanding drug use. If alcoholic beverages had been prohibited throughout the world  for many decades, it would be entirely probable that a clinician who would then see the down-and-out problem drinkers of illegal hooch at their emergency rooms would conclude that alcohol was a vicious, addictive, toxic, hallucinatory, and deadly poison, even if he were dimly aware that Catholic Masses were still celebrated in secret with genuine wine, or that Italians in remote mountain valleys still consumed wine with meals with no apparent tendency to fall immediately into delirium tremens. As an analogy, the preceding will seem a silly exaggeration to some, but to one who has fully seen through the prohibitionist fallacy and crowd madness, the position of many of today’s professional clinicians concerning psychedelic drug use is no less absurd. The truth of the matter, as fantastic as it may sound to one who has not studied the literature and also critically evaluated the absurdity and Inquisitional nature of the present prohibitionary crisis, is that “normal” consciousness is in some ways more of a hallucination than the states of consciousness that can result from careful and educated use of psychedelic drugs for spiritual or heuristic explorations. There is a great wealth of literature amply demonstrating this claim, (see the extensive collection of articles in my internet library at http://www.psychedelic-library.org/ ) and for any modern scientist or physician to ignore or reject this information merely demonstrates his inability to adopt a truly scientific outlook beyond the prejudices of his time, his inability not to fall into the “herd mentality” he would no doubt ascribe to the uneducated masses. This position of wilful ignorance is his own special hallucination. So much for the authors’ use of jargon, one-sided descriptions of “drug use” and smuggled-in prohibitionist terminology. Their most egregious fault however, is to be found in their last three paragraphs. Here they become as prohibitionist as the most infamous of U.S. anti-drug fanatics by calling for a “war on these intoxications” employing the full force of the police, customs, and judicial systems. In the context of historical perspective, this is an Inquisitional stance little different from the wars on heretics and witches of the middle ages. And their position perfectly illustrates technique (4) mentioned above: the illegitimate shift from scientific description to moral lecturing. True, the authors recommend “education” about psychedelic drugs but insist that must include “condemnation” of their use, much as witches and heretics were said to be in need of “education” to convince them of their great error in subscribing to anarchic and dangerous beliefs. It is always curious to see moralisers and prohibitionists recommend “education” concerning drugs and drug use, for if that education is to be complete, and include the works of pre-eminent psychedelic researchers, the one thus educated can hardly fail to see the absurdity of the moralist and prohibitionist stance on these matters. In the present case, this must surely lead to the conclusion that if such a moralist is also a scientist or physician -- as we cannot fail to believe given the credentials listed for these authors -- he has either not read the literature himself, or has failed to see that his moral convictions will not allow him to recognise scientific truth when he sees it, in both cases monumentally unscientific positions in which to find oneself. As Andrew Weil and Ronald Siegel [3,4] have both forcefully demonstrated, the seeking of altered states of consciousness is a human universal, perhaps even an instinctive drive for much of the animal kingdom as it is known that non-human species also seek out plants which alter consciousness. At least 98% of Homo sapiens’ time on earth has been spent in close partnership with mind-altering substances, and practically without exception the possibility to undergo such altered states has been the most precious and valuable opportunity known. If these substances had been “toxic” and “poisonous” rather than beneficial, uplifting, inspirational, and treasured, it is doubtful their use would have so long persisted. One would think from modern views that a mere few generations exposed to these “harmful” products would have led to our extinction. If we wish to believe that today we are “modern” and have nothing to learn from the practices and traditions of 98% of our ancestors, or that we can ignore and repudiate our inbuilt biological and psychological heritage, we would be foolish indeed. A word needs also to be said about the authors’ position concerning the treatment of emergency-room cases where users of psychedelic drugs have come for help with perceived psychological problems, the “existential conflicts” I mentioned above. In describing one particular case the authors mention that after consultation with the Centre Anti-Poisons de Nancy, the patient was left resting in calm surroundings, and treated with diazepam. Lester Grinspoon, author of Psychedelic Drugs Reconsidered, [5] has remarked about the use of drugs for such treatment, “While there is little experience (certainly none that has been archived in any way) about using the so-called new antipsychotics for this purpose, I would be as skeptical about their usefulness as I am about the use of any psychotropic drugs with the possible exception of the benzodiazepines.” [personal communication] Reassuring the patient and keeping him calm is, however, the best approach, and it seems that the authors have got something nearly right in their ideas about emergency-room procedures. But the routine use of even diazepam is not to be encouraged, for according to Stanislav Grof, a medical practitioner who has perhaps more experience with the use of psychedelic drugs in psychotherapy than any other person today, “The use of tranquilizers in the middle of a psychedelic session is a grave error and may be harmful. It tends to prevent the natural resolution of the difficult emotional or psychosomatic gestalt and to ‘freeze’ the experience in a negative phase. The only constructive approach is to provide basic protection to the subject, and support and facilitate the process; the least one can do is to not interfere with it.” This quotation is from an article that should be read thoroughly by any medical practitioner concerned with emergency-room instances of the difficulties that may arise with unsupervised or ill-considered psychedelic use: “Crisis Intervention in Situations Related to  Unsupervised Use of Psychedelics,” Appendix I of LSD Psychotherapy : Hunter House Publishers, Alameda California, 1980, by Stanislav Grof, M.D. Appendix I of this book may be accessed online at the URL: http://www.psychedelic-library.org/grof2.htm In the spirit of harm reduction and for its effective implementation, European professional communities must play an important role in bringing about change both conceptual and political. Politicians can be dragged in many unproductive directions by both national and international forces, and cannot be depended on to take the initiative in these matters. This is especially so when scientific knowledge must take precedence over long-standing tradition and prejudice, situations in which public opinion should not be allowed to lead policy but rather must be educated by it. As it should be in a world where the advance of science and technology will necessarily play an increasing role in saving us from the false doctrines, the follies and stupidities of the past, not to mention the abuses and ignornaces of the present, the scientific and medical communities must go beyond their routine duties and functions, beyond the well-worn texts and accepted knowledge that formed their education, to play a leading role in preparing western civilisation for the revolutionary changes that will be necessary to bring some order and coherence to not only drug policy but to the very way in which we understand the role and function of such substances for the entire history of humanity. The public will not do it, for they lack the knowledge and the means. And politicians will not do it, for without great pressure from the scientists and physicians, they lack the incentive. “Drugs will not be brought under control until society itself changes, enabling men to use them as primitive man did; welcoming the visions they provided not as fantasies, but as intimations of a different, and important, level of reality.” Brian Inglis [6] By Peter Webster 2001 References 1.      WASSON RG, HOFMANN A, and RUCK CAP: The Road to Eleusis. Harcourt Brace Jovanovich, 1978 & Hermes Press 20th Anniversary Edition, 1998 2.      WEBSTER P, PERRINE DM, and RUCK CAP: “Mixing the Kykeon” in Eleusis: Journal of Psychoactive Plants and Compounds, New Series 4, 2000. 3.      WEIL A: The Natural Mind: A New Way of Looking at Drugs and the Higher Consciousness. Boston: Houghton Mifflin Company, 1972 4.      SIEGEL RK: Intoxication: Life in Pursuit of Artificial Paradise, New York: E.P. Dutton, 1989. 5.      GRINSPOON L, and BAKALAR JB: Psychedelic Drugs Reconsidered, New York: The Lindesmith Center, 1997 6.      INGLIS B: The Forbidden Game, A Social History of Drugs: U.K.: Hodder and Stoughton Limited, 1975. (this essay was published in 2001) |W|P|108557765871583923|W|P||W|P|projectpeace@gmail.com