Psychiatric Medications, Illicit Drugs, & Alcohol

Bruce Levine

The article titled
“Pay Attention: Ritalin Acts Much Like Cocaine” was published in August 2001 in
the Journal of the American Medical Association (JAMA). It’s not
likely you’ve heard about it. Pharmaceutical companies do their best to ensure
we hear something altogether different, something like this: “Psychiatric
medication—just like insulin—restores the chemical imbalances that cause mental
illness.” To get that message across, they spend billions of dollars on TV
commercials. They also spend billions of dollars on drug representative visits
to doctors’ offices, advertisements in medical journals, and seminars for
doctors. Pharmaceutical companies even help fund the American Psychiatric
Association, the National Alliance for the Mentally Ill, and other mental health
institutions. Nearly one in four American adults are taking prescription
psychotropic drugs, while America’s “war on drugs” has led to more people
imprisoned in the United States (in total and per capita) than any other
industrialized nation.

If psychiatric
drugs are chemically similar to illicit drugs and alcohol, and if all of these
substances are used for similar purposes, then hypocrisy has created two ongoing
tragedies: (1) an unfair incarceration of millions of Americans (mostly poor and
without health insurance) for using illicit drugs, and (2) a denial of the
societal realities for why millions more Americans (mostly not poor and with
health insurance) are using psychiatric drugs. Do psychiatric medications in
fact restore chemical imbalances that cause mental illness? Are psychiatric
medications analogous to insulin? Or are psychiatric drugs more like illicit
drugs and alcohol?

While we know
insulin can temporarily restore a chemical imbalance for a diabetic, we have no
such scientific knowledge that any psychiatric drug restores a chemical
imbalance for someone having emotional difficulties. We don’t even have
scientific proof that mental disorders are caused by chemical imbalances. In
1998 the National Institutes of Health acknowledged that there is no known
chemical imbalance—or any known biological basis—for attention deficit
hyperactivity disorder (ADHD); and in 2000 the American Academy of Pediatrics
confirmed this. Your doctor will tell you that neither a lab test nor a physical
exam is used to diagnose ADHD, which is in fact determined on the basis of
behavior checklists. The chemical imbalance theory of ADHD is just that—a

For years we’ve
heard that depression was caused by neurotransmitter imbalances. We were told
that depression was linked to too little norepinephrine, and that drugs like
Tofranil and Elavil would restore this imbalance. But in the late 1980s,
selective serotonin reuptake inhibitors (SSRIs) such as Prozac (and later Zoloft
and Paxil) hit the market. We were then told that depression was caused by too
little serotonin. Recently, there’s been a TV commercial blitz for a non-SSRI
antidepressant Wellbutrin, which enhances the neurotransmitter dopamine. Why
this jumping around? Science has not linked the cause of depression to any
biochemical imbalance, as was made abundantly clear by Elliot Valenstein,
professor emeritus of Neuroscience at the University of Michigan, in his book
Blaming the Brain
(1998). Comparing psychiatric drugs to insulin is like
comparing apples to oranges. No one disagrees that psychiatric drugs can
sometimes temporarily provide relief from symptoms. However, so do illicit drugs
and alcohol—which, according to Ethan Nadelmann, director of the Lindesmith
Center (a drug-policy research institute) “represent a form of self-medication
against physical and emotional pain among people who do not have access to
psychotherapy or Prozac.”

If you want to
compare apples to apples, compare psychiatric drugs to illicit drugs and
alcohol. JAMA‘s proclamation in 2001 that “Ritalin Acts Much Like
Cocaine” shouldn’t have been a revelation. Thirty years ago, the World Health
Organization compared Ritalin to cocaine. Why? ADHD drugs such as Ritalin,
Adderall, and Dexedrine affect the same neurotransmitters as cocaine; and ADHD
drugs and cocaine are both classified by the DEA as Schedule II psychostimulants
(Schedule II drugs are legal drugs that have the highest potential for abuse and
addiction). Researchers have also confirmed that the clinical effects of these
ADHD drugs are indistinguishable from cocaine if both are similarly
administered. A Primer of Drug Action (1998) notes this about the ADHD
drug Dexedrine: “Individuals who have used cocaine have difficulty
distinguishing between the subjective effects of 8 to 10 milligrams of cocaine
and 10 milligrams of dextroamphe- tamine [Dexedrine] when both are administered

Many are upset to
discover that SSRI drugs such as Prozac, Zoloft, and Paxil have much in common
with Ecstasy. SSRIs enhance serotonin—also enhanced by Ecstasy (which increases
serotonin by a somewhat different mechanism and has a quicker and more intense
“pop”). Throughout the 1990s we were told by drug companies that SSRIs were
neither dangerous nor habit forming. However, in 2000, Harvard Medical School
psychiatrist Joseph Glenmullen reported that SSRIs are linked to neurological
disorders indicating potential brain damage, and he noted: “Withdrawal
syndromes—which can be debilitating—are estimated to affect up to 50% of
patients.” Thus, not only is there no evidence that SSRIs (or any other
psychiatric drug) restore chemical imbalances, the withdrawal effect of these
drugs is actually evidence that they create chemical imbalances.

The withdrawal
effects of the benzodiazapine tranquilizers such as Xanax, Ativan, or Klonopin
are exactly the same as those of alcohol (e.g., shakiness, loss of appetite,
muscle cramps, memory and concentration problems, insomnia, agitation, and
anxiety). Not only are the clinical and withdrawal effects of benzodiazapines
the same as alcohol, so are the biochemical effects, as both work on the body’s
GABA system.

When psychiatric
drugs produce symptom relief, they work the same way illicit drugs and alcohol
do: They “take the edge off.” When you are taking prescription psychotropic
drugs like Ritalin, Paxil, or Xanax, or you are using illicit psychotropic drugs
or alcohol, your emotional experience is dampened. Your boredom, frustration,
hurt, and anger are less intense. You care less about what you are feeling and
you care even less about what others are feeling. For some people, this helps
them function. If you talk to an honest psychiatric drug user, an honest illicit
drug user, or an honest alcohol user, you’ll hear the same thing: “It worked,
for a while, by taking the edge off.” However, you’ll also often hear this:
“Eventually, I needed more to achieve the same ends.”

companies have spent billions of dollars attempting to convince us that
psychiatric drugs are just another kind of medicine and to accept their version
of what’s reasonable. Their version goes something like this: “While some
medicines do turn out to be dangerous and other good medicines can be
over-prescribed, it is extremist to say that psychiatric medications don’t have
their appropriate use.” This version of what’s reasonable would be correct if we
were talking about nonpsychiatric medications. However, the history of
psychiatric drugs is far different than the history of nonpsychiatric
medications. In the history of psychiatric drugs, all are ultimately found to be
either (a) highly addictive, as evidenced by withdrawal; (b) highly ineffective,
compared to a proper placebo; (c) highly dangerous, in terms of short-term or
long-term adverse effects; (d) all of the above. When one realizes that
psychiatric drugs are—chemically and clinically—in the same category as illicit
drugs and alcohol, then the pharmaceutical companies’ version of what’s
reasonable becomes unreasonable.

psychiatric drugs medicine while at the same time labeling illicit drugs and
alcohol as poisons is a triumph of sorts. It is a triumph of marketing over
science and a triumph of injustice over compassion. It is also a triumph of
denial and evasion. By this hypocritical labeling process, we can deny the
devastating societal impact of a corporate hegemony that worships markets rather
than life, because we’ve been “enabled” to evade this question: Why do
increasingly more of us need to take the edge off?         Z


Levine is the author of
Commonsense Rebellion: Debunking Psychiatry,
Confronting Society—An A to Z Guide to Rehumanizing Our Lives (New York:
Continuum, 2001).