Chronicle Book Review: "On Speed: The Many Lives of Amphetamine," by Nicolas Rasmussen (2008, New York University Press, 352 pp, $29.95 HB)

Phillip S. Smith, Writer/Editor

Almost everybody knows about methamphetamine, that demon drug, that pharmacological equivalent of plutonium, stereotypically favored by toothless, uneducated white guys tweaking in trailer parks out in the sticks. Many fewer people are aware of Desoxyn, which is widely prescribed to treat Attention Deficit Hyperactivity Disorder (ADHD). And even fewer are aware that Desoxyn is nothing other than pharmaceutical grade methamphetamine legally prescribed by doctors across the land.

How can the same substance be both demon drug and miracle cure? Science historian Nicolas Rasmussen of the University of New South Wales in Sydney provides some answers to that question -- and much more -- in "On Speed." What Rasmussen is really interested in is the interaction between the pharmaceutical industry, the medical profession, and broader social forces afoot in Western culture, and amphetamines make a fascinating, if surprising, vehicle for his meditations.

As Rasmussen tells us, amphetamine was first tested on a human on June 3, 1929, when Los Angeles chemist Gordon Alles injected himself with his new concoction. As Rasmussen's reproduction of Alles' testing notes put it early in the experience, "Feeling of well-being." Later, he reported "a rather sleepless night" where his "mind seemed to race from one subject to another." Still, Alles reported feeling fairly well the next morning.

Pharmaceutical companies had a new product. Now, they had to figure out something to use it for. First off the mark was the Benzedrine inhaler, marketed for relief of nasal congestion. But by the 1940s, amphetamine tablets by the millions were being used by soldiers on all sides of World War II as energy- and morale-enhancers. Within a few more years, amphetamines were being widely prescribed for an ever-increasing array of "diseases," including obesity and neurotic depression. By the late 1960s some 5 million Americans were gobbling down amphetamines under a doctor's supervision, and another 2 or 3 million were using them as "thrill pills" outside the bounds of medical practice.

While Rasmussen provides lots of detail on the marketing strategies of various pharmaceutical companies, the needs of doctors to deal with patients complaining of low grade depression, malaise, lack of energy, and obesity, and the increasing clamor of Americans for pills that would make them feel more energetic, gregarious, and productive -- oh, what All-American desires! -- what is most fascinating for students of American drug policy is the way his narrative lays the blame for the creation of subsequent amphetamine abuse problems squarely at the feet of market-hungry pill makers, pill-pushing doctors, and, of course, the American military, which exposed millions of GIs to the pleasures -- and dangers -- of speed. But at some point, he argues, the "push" from drug companies and doctors was complemented by a "pull" from consumers who developed a liking for the drug and its stimulant effects.

As Rasmussen notes, a thrill-seeking speed subculture emerged almost immediately, beginning with University of Minnesota students in the 1930s who were given Benzedrine inhalers in clinical trials, decided they liked them, and took them home to party and study with. By the late 1940s, some of those millions of GIs exposed to amphetamines during the war had continued using speed and were bringing awareness of it to the general population. By the 1950s, Beat writers like Jack Kerouac and William Burroughs were enshrining it in a nascent counterculture, and by the 1960s, as legal amphetamine production reached record highs, speed abuse was identified as a serious problem, not only by doctors, researchers, law enforcement, and fear-mongering politicians, but also by the counterculture itself.

At the beginning of the 1970s, the federal government intervened, severely crimping the speed supply and -- voilà! -- the illicit speed industry took off. As Rasmussen puts it: "Naturally, once the national supply of pharmaceutical amphetamine was sharply cut by federal action after 1971, demand for home-made speed grew, driving down quality and strengthening the position of the motorcycle gangs. Making a popular drug illegal, without reducing demand, only spurred the development of organized crime to supply consumers -- with inferior and often dangerous products. It was the same with alcohol in the days of Prohibition."

In other words, meet the progenitors of today's meth lab cookers, thanks to prohibitionist actions. And although I don't recall Rasmussen mentioning it, the restrictions on legal amphetamine production came shortly before the reemergence of cocaine as a popular recreational drug in the late 1970s and 1980s. Ironically, amphetamine's trajectory from miracle cure to demon drug mirrored cocaine's earlier but similar trajectory. For some, amphetamines had replaced cocaine; now, perhaps, cocaine was replacing amphetamine.

These days, methamphetamine is a demon drug, but its close relatives in the amphetamine family, amphetamine-type stimulants differing from meth by only the addition or subtraction of an atom or two from the basic amphetamine molecule, are once again wildly popular at the doctor's office and on the street. The roughly 2.5 billion tablets of amphetamine-type stimulants such as Ritalin (for ADD and ADHD), Preludin (obesity), and Redux (ditto) now being prescribed annually is the same amount of speed being produced medically as at the height of the "amphetamine epidemic" of the 1960s. Ten million Americans are gobbling speed as you read these words, more than did so at the height of the "epidemic."

With widespread use of amphetamine-type stimulants, we can expect an increase in unhappy side effects, Rasmussen predicts, ranging from dependence to amphetamine psychosis, as well as the subsequent development of a market for "downers." In the past heroin and barbiturates played that role; now, he suggests, prescription pain pills will fill the need.

What is needed is not only more law enforcement to deal with the illegal meth trade, but harm reduction measures for amphetamine users and means to reduce demand, Rasmussen concludes. And more control over the pharmaceutical industry, including stronger restrictions on marketing and promotion, as well as tighter controls on the role of pharmaceutical companies in doing medical research for marketing purposes.

"On Speed" is a fascinating book for students of drug policy and drug use in the broader social, economic, and political context of the West, and the United States in particular. It is most helpful in aiding one to think clearly and broadly about how patterns of drug use emerge, the institutional factors behind them, and the way we respond to them. And it is a clarion call for reform of the US pharmaceutical industry, as well as a riveting social history of speed.