By Andrew Weil, M.D. and Winifred Rosen, Houghton Mifflin Company, 2004

Reviewed by Camilla Norman Field

With more than half of our country’s young people experimenting with illegal drugs by the time they graduate from high school and 44% of our entire population using at least one prescription drug each year, it is safe to say that drugs are everywhere and are here to stay (Johnston et al. 2004 and National Center for Health Statistics 2004). With use of both legal and illegal drugs so ubiquitous, it is incredible how few people have access to accurate information about the real health consequences of our most widely used drugs. The newly revised edition of From Chocolate to Morphine, Everything You Need to Know About Mind-Altering Drugs aims to correct that gross oversight.

Whether you think you know everything about drugs or have never taken anything stronger than an aspirin, the fourth edition of this book is a must read. When the original edition was published in 1983, it quickly became the authoritative guidebook for thinking people on legal and illegal mind-altering drugs, and that reputation remains. With each edition, more and more readers have recognized its value as an indispensable resource, with this latest version full of updated information about “old” drugs and the addition of some “new” drugs that have found their way into popular use.

With the intention of captivating a wide audience, authors Andrew Weil, M.D. and Winifred Rosen do a beautiful job of making information about mind-altering drugs completely accessible – particularly to young people who might be on the verge of, or in the midst of, experimenting with alcohol or other drugs.

Aside from the simple and straightforward writing style that explains scientific effects of drugs in layman’s terms, the book never renders judgment upon the drugs or its users. Instead, Weil and Rosen take this opportunity to lay out some universal truths, from which an open and honest examination of drugs can take place.

• Good drug education must include honest dialogue about drugs. A recent study showed that young people who took “virginity pledges” have the same STD rates as non-pledgers, only 40% of pledges used condoms versus 60% of non-pledgers, and 88% of those who take the pledge end up engaging in pre-marital sex. Although this study does not provide a perfect comparison, it does show that “abstinence-only” education is hardly successful, whether the topic is sex or drugs (Bearman et al. in press). In Chapter One, “Straight Talk From the Start,” Weil and Rosen demonstrate the importance of creating a, “climate of trust in which you and your child can communicate openly about difficult subjects like sex and drugs.” Whether you are a parent, teacher, or other adult in a young person’s life, good communication and accurate facts are key to effective drug education.

• Drug use is universal. In Chapter Two, “What Is a Drug?” the authors broaden our definition of a drug to include any substance that “produces changes in the body, mind, or both.” Under this designation, chocolate or coffee is as much a drug as heroin or cocaine. The importance of this is to demonstrate that, “every human culture in every age of history has used one or more psychoactive drugs.”

• Humans seek out altered states of consciousness. Starting with children spinning themselves around and around to feel dizzy, “human beings appear to have an inborn need for periodic variations in consciousness.” As shown in the example of children, drugs are not the only way in which people achieve altered states; for some, it occurs when enjoying live music, meditating, exercising, skydiving, or simply the high from a job well done. However the altered state is gained, it is clear that seeking such states is a natural part of the human experience.

• There is a difference between drug use and drug abuse. In Chapter Four, “Relationships with Drugs,” Weil and Rosen argue that drugs are neither good nor bad; instead, it’s people’s relationships with drugs that have the potential to be positive or negative. Much like people who become workaholics or sex addicts, there exists potential for problematic relationships with a myriad of life experiences, including, but certainly not limited, to drugs.

After delving into these universal truths, the following chapters focus on a specific types of drugs, including stimulants, depressants, marijuana, solvents and inhalants, deliriants, PCP and Ketamine, medical drugs, herbal remedies, and smart drugs, and begins with historical and cultural contexts of the drugs. This may include a harkening back to ancient Greece or a journey into the heart of jungles in present-day South America — each background providing the setting for how and why this drug is still prevalent in today’s world.

Aside from examining which cultures used the various drugs, Weil and Rosen explore the evolution of how the drug has been used and how that might affect the drug’s potential for abuse. For example, when considering coca leaves, the natural drug from which cocaine is derived, compared with cocaine sold on the streets, there exists an enormous difference in the concentration of cocaine (0.5% versus 60%). The result of this difference is that Indians who chew coca leaves in South America rarely develop problems with the drug, whereas those who use the isolated and refined version of cocaine run a much higher risk of entering into an addictive relationship with the drug. Methods of administration is also an important factor. Those who inject or smoke the stimulant, methamphetamine, have a greater tendency to acquire a problematic relationship with the drug than those who consume it orally because the more rapidly the drug enters the bloodstream (smoking and injecting being the fastest), the greater the rush and the shorter the high, leading to higher consumption rates in both amount and frequency.

Each chapter then moves on to examining the basic pharmacology of the drug, providing scientific information about how the drug affects the body, especially vital organ functions. This discussion is followed with “Some Rules for Using [Drug “X”} Safety.” Opponents of honest drug education will certainly declare that providing information on how to use drugs safely encourages drug use, but considering the fact that in 2000 the leading causes of death in the U.S. were tobacco (435,000 people), poor diet and physical inactivity (400,000 people), and alcohol (85,000 people), while illegal drugs caused 17,000 deaths, it would be irresponsible not to include ways in which harm from drug use can be diminished (Mokdad et al. 2000). Following this informative and realistic list of “cautions,” the chapter closes with a thorough list of suggested readings for those who wish to examine the drug further.

After conducting a thorough and enlightening investigation of a number of drugs, the authors turn their attention to, “Problems with Drugs.” They focus on uncertainty of dose and quality when it comes to illegal drugs; the potential for health problems, including death, if drugs are mixed; health consequences (both physical and mental); social, behavioral, and developmental problems; risks of taking drugs when pregnant; legal problems; and, of course, dependency and addiction.

After listing some of the very real problems drugs can cause, the next chapter is devoted to, “Alternatives to Taking Drugs,” a proactive strategy when considering how to convince young people not to experiment and risk problematic relationships with drugs.

Each chapter also includes positive and negative anecdotes from people who have had actual experiences with the drug being discussed. These short insights further strengthens the book as a believable resource, and enhances its readability. For those interested in these stories, the end of the book includes an entire appendix, “First Person Accounts and Comments.” The appendix is followed by a short glossary, valuable for both novice and experienced readers.

Overall, the book does a magnificent job of presenting technical, scientific information on drugs’ basic pharmacology, methods of administration, and trends of use in an straightforward and user-friendly manner. By doing so, Weil and Rosen directly challenge the accepted way in which drugs are currently depicted as evil elements of our society. By refusing to use common scare tactics when describing drugs, the information presented is credible and offers real advice on how to avoid problematic relationships with all kinds of drugs.

The final words offered from Weil and Rosen sheds light on why after decades of “scare tactics” and “propaganda,” drugs continue to be abused in our society: “The truth about drugs cannot do harm. It may offend some people’s sensibilities and disturb those who do not want to hear it, but it cannot hurt people. On the other hand, false information can and does lead to people to hurt themselves and others.” A cornerstone of any sound, realistic drug education, From Chocolate to Morphine, should be on the shelves of very school library, available in every school’s nurse’s office, and be the primary resource of every good school-based drug education program.

References

Bearman, P., Moody, J., Stovel, K., & Thalji, L. (in press). Social and Sexual Networks: The National Longitudinal Study of Adolescent Health. In M. Morris (Ed.), Network Epidemiology: A Handbook for Survey Design and Data Collection. Oxford: Oxford University Press.

Johnston, L. D., O'Malley, P. M., Bachman, J. G. & Schulenberg, J. E. December 21, 2004. Overall, teen drug use continues gradual decline; but use of inhalants rises. University of Michigan News and Information Services: Ann Arbor, MI. Available: www.monitoringthefuture.org; accessed 02/28/05.

Mokdad, Ali H., PhD, James S. Marks, MD, MPH, Donna F. Stroup, PhD, MSc, Julie L. Gerberding, MD, MPH. 2004. Actual Causes of Death in the United States, 2000. Journal of the American Medical Association 291, no. 10 (March 10): 1238, 1241.

National Center for Health Statistics. 2004. Health United States, 2004: With Chartbook on Trends in the Health of Americans. Hyattsville, MD.