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Dr. Nathan S. Kline, was one of the key researchers who revolutionized how society views and treats mental illnesses. He understood the importance of antidepressant drugs for treatment of people suffering from mental illnesses. At the outset he was treated with widespread skepticism among his peers. No amount of naysayers could stop him though.
Dr. Kline's development of antidepressants and tranquilizers paved the way for treatment of many patients who had been written off as untreatable. He believed the development of psychopharmacology reduced the public's discomfort with treating the mentally ill. 'If something can be treated with medication, he postulated, then the public views it as a legitimate illness.
As a pioneer in the field, Dr. Nathan S. Kline, believed that any form of drug should primarily be used for the prevention or the correction of pathologies that interfere either with productivity or the enjoyment of life, or might endanger the individual or endanger someone else.
Kline believed that Marijuana was a perfectly adequate sleeping medication and it's certainly a good deal safer than the barbiturates. On the other hand he was far less comfortable with amphetamines or something similar to them. While they may offer an elevated sense of wellbeing, the crash which occurs afterwards is notorious. His perception of drugs was less about the specifics of one vs another, but more about the general ideology regarding the purpose and development of future drugs.
Dr. Nathan Kline said in an interview, "I might make a general comment that one of our great difficulties in biology in general is that we're still stuck with the models of the physical sciences. And I think that because of the success of physics and chemistry, we tend to try to use models which are not fully applicable to biology. There are a number of reasons for it. One is that in physics and chemistry most of the matter with which they deal can be divided almost infinitely, at least down to the atomic level, and it remains the same. With biology you can't divide organisms more than once. That's the end of it. So that we're dealing in that sense with something quite different and the problem of analysis is utterly different.
The problem of psychopharmacology, is that when you're dealing with human beings you're not dealing with inert objects. You're dealing with conscious subjects. And to give you an example of how I think this would interact in pharmacology, we know that various drugs dispose people in various directions, but we also know that the expectations that people have about drugs, have an enormous effect on how they experience them. For instance, recently I was doing some work on the romantic poets and opium experiences. Thomas de Quincy wrote the liner notes for it. And it occurred to me that if one looks at Quincy and Coleridge and Wilkie Collins and various 19th century poets who took opium and one observes their reactions to it, one finds that what they describe resembles something far closer to what we would expect to get from a psychotropic than from an opiate. Opiates don't seem to affect 20th century people the way they affected de Quincy and Coleridge. Obviously their expectations had a great deal to do with their experiences. As do ours.
Opiates as Substitutes
The evidence is pretty strong, for instance, that around the year 1900, roughly 3% of the population of the United States was on opiates. It was included in most of the tonic medicines and it was also prescribed. And at that time the attitude towards it was much more like it has been in Iran, for instance, which is, that in a Muslim country where they're not supposed to drink, they use opiates in much the same way that we use alcohol. And it's not regarded as being a particularly horrible sort of thing. So that at that time there was no great concern about the opiates and many people used them and did not become deteriorated. In a particular study we found that people using opiates there are not necessarily from a particular socio-economic level. Many of them are from the highest levels in the country. So there are expectations regarding not only the effect of the medication but also its usage, part of what one obtains is determined by one's expectations.
There has to, however, be some kind of pharmacological action, otherwise I think after a while the so-called placebo effect wears off. And like the Emperor's new clothes you find that you're taking nothing at all. Pharmacologists have at times underestimated the importance of differences between individual metabolisms. There's a theory of drug addiction which is based partly on the discoveries around endorphins. It suggests that some, but by no means all the people who become addicted to heroin, are people who have almost a natural metabolic deficiency in endorphins and have been intuitively self medicating themselves.
The same individual doesn't maintain a necessarily steady state. It may be a steady state but it can vary so that there may be periods during which an individual is susceptible, let's say, to becoming addictive and other periods when they're not addictive at all. And this certainly I think interacts with social factors as well. The life situation may lead to alterations in the physiology and biochemistry of the body, just as the physiology can in turn lead to changes in life situations.
The Power of Belief
You can mislead yourself into believing you're dependent on drugs. You believe you can't write or can't perform without these drugs if you've been taking them for a long time. When actually that's not true. One of the things that happens is that writers tend to be very ritualistic people, they tend to ritualize that act of writing and give themselves some psychological cues and one of them is taking drugs. But I think if they were unknowingly given a placebo they probably would do just as well.
People using amphetamines overestimate how well they're doing. They may be working, their judgment is sometimes defective. Not always, but it can be. And the other is that most writers do a fair amount of writing. One of the ways to do it is to commit yourself to a chapter in a book or an article and then after a while your guilt begins working on you. It's really just a trick to get yourself to write. Many of these things are not simple medications at all. They involve the psychological and social factors as well as biochemical ones.
There is still a big difference though between controlling depression and stimulating creativity. They may be on the same continuum, but again research of pharmaceuticals are predominantly centered on helping individuals recover from pathological states of either depression or euphoria or medications which will prevent the occurrence of these states.
In Kline's book, Say It To Glad, he described one woman who went into Bloomingdale's to buy some dish towels and spent $12,000. She felt so good about buying the towels that she just kept on. When they feel euphoric they will often make very poor judgments, with devastating consequences. I'm sure that there are people who get married or start affairs or who go into business deals or do all kinds of things where their judgment is distorted by the fact that they feel just too good. It is difficult to distinguish a successful American from a hypomanic except by the results. If he's successful then he's a great, upstanding American and if the business, whatever it is he's attempting, fails, then he's judged to be hypomanic because his judgment was bad. And often it really depends on luck which way it falls out.
Expectations Stem from Experience
One sociologist actually measured the rates at which people walk in the streets and found that they walk about 40% faster in New York than most other places. The way one judges the norm depends on where you are, and I think, in part, the way people behave is also dependent on expectations of other people, so it's not only one's own expectation; it's other people's expectations, as well.
Perhaps as Kline articulates, the future of drug research is leaning toward fighting the aging process. We know that brain cells increase with age, and here, inhibitors would retard the production of brain monoamines. There's a legitimate use of pharmaceuticals to improve and extend normal processes. So if one started looking to drugs that, let's say, would prevent aging this would require a whole different order of research than most of the pharmaceutical companies are currently doing. You could set up research where you could compare a controlled group of animals and animals given a variety of different pharmaceuticals to determine whether they actually do prolong life and retain the mental functioning better than a controlled group does.
There are two ways of doing pharmacological research. One can, in fact, go very deeply into the biochemistry with the discoveries of endorphins and discover new principles that underlie the actions of whole categories of drugs, and then proceed to develop analogs of particular drugs for particular uses which, hopefully, will have predictable effects. Yet most pharmacological research, most real discoveries, have been made in a much more primitive method, more by trial and error. One can go through almost the history of science and see many accidents which have led to great advances. The process of vulcanization was discovered by Firestone when one of his assistants rather carelessly dropped some sulfur into the compounds they were working on. Kopft discovered the tubical basillus which he'd been looking for for years when his wife called him in for lunch. He was working in his backyard and he was drying a slide, and he forgot to turn off the gas underneath it. And when he came out the slide was ruined. It was obviously overcooked. But before throwing it away he had enough sense to take a look at it, which a lot of people wouldn't have done. And there was the tubical basillus he had been looking for. So at the end of the day, the two paths of research are not mutually exclusive, as long as we pay attention with equal value to what does work as well as what does not. A sort of serendipity exists to research discoveries.
But serendipity isn't totally an accident. And this is why I think that speculations about the future, although some of these may never be realized, prepare you to look for things which might otherwise be missed. But to be prepared-you must keep a very open mind. Once you're on to what looks like a new principle, then I think the other kind of research is equally essential. Then it becomes important to have the resources and the more intense biochemical pharmacological knowledge to really take advantage of where you've been led.
The use of marijuana by growing numbers of Americans probably implies something profound about our civilization, perhaps that we're no longer really an individualistic civilization, that we're a mass society, because marijuana is not that sort of disinhibiting drug. It doesn't break down barriers to conversations for instance. And it may actually create them. Now people are finding that our society is too crowded, people are feeling over-socialized rather than over-individualistic and are seeking a drug which helps them...and in part find a little psychic sanctuary from the world.
Marijuana Over Alcohol
Marijuana, in Kline's opinion is a far better alternative to alcohol which he believed is really very bad. Alcohol happened to be convenient and it's popularity was more an accident than anything else. It was easy to create for stone age chemists. You could store it and, it was a historical accident that it was what it turned out to be, and not something else. But I think that there are times when most of us need some relief from the kind of pressures we're under, and if we had a drug that was not addicting and didn't have the side effects that alcohol had. Marijuana is valuable contribution. From the medical point of view, not a moralistic one, when we talk about the needs that people have to maintain productivity, happiness and functionality.
We are in the middle of a great shift, away from alcohol and toward marijuana-and this is a decision which has not been made by government. It's not been made by doctors. It's not been made by any one specific group. I think that this is something where there's been a general acceptance and a trend in that direction. It may turn around and reverse itself but at least we're moving in that direction at the present time.
Certainly physicians should specialize and know these drugs which are capable of altering those things we label as pathological states. For example, some have speculated about a drug in the future that you could give to someone who had committed some kind of crime stealing or murder-and it would have the effect of making such a deep impression on them and creating whatever you want to call it, guilt or vivid memory, that they would never commit an act of that sort again. Or they could just watch Stanley Kubrick's A Clockwork Orange. If you could do it pharmacologically then you have a very nice question as to whether society would be satisfied to be reassured that that person would not commit that sort of crime again.
It's an interesting question. I don't think that I can make that decision by myself and I don't think that the Supreme Court can make the decision by itself. I think that that kind of a decision is something that a society and the individuals in it have to come to a decision about. And it isn't something you can send out as an amendment to the Constitution. It's something that has to be formulated over a period probably of many years. Just as the current trend in using marijuana is not something that came about by an intellectual decision overnight. There was a lot of experience involved in it and a lot of other things. And there's no one set course. So we must continue to fight the fight, until it is as available as alcohol.