Amphetamines In America
Nicolas Rasmussen (Professor of History and Philosophy) gives expert video advice on: How were amphetamines marketed to the general public after WWII?; How did amphetamines become a popular weight loss drug?; Why was weight loss considered a psychiatric disorder to be treated with amphetamines? and more...
How were amphetamines marketed to the general public after WWII?
War's over and business is ready to get back to normal in the second half of 1945. Smith, Kline and French, the company who still owns exclusive rights to amphetamine in the US, launches a very heavy marketing campaign for depression in all the general medical journals to try to get general practicioners, family doctors, to recognize depression which they say is much more common than has been previously thought in general practice. So you have ads of people who are suffering from prolonged bereavement. Their wife dies, they have grief. Maybe they have depressions of try amphetamine. Same with post natal depression. Sometimes women get depressed after having a baby, maybe they need an amphetamine. So there was this heavy marketing campaign aimed at general practicioners featuring the kinds of depression that are said to manifest themselves in general practice. The sales are quite strong.
How did amphetamines become a popular weight loss drug?
When it got approval from the MA to market it as a diet drug. Dieting was actually the main market of these generic imitators because the fad doctors had picked up on this stuff even though it was not being advertised, it was sort of represented as a dodging medical use of amphetamine in the early 40's. It was known that amphetamine would restrict people's eating and help them lose weight. So there was a big booming business in those generic knockoffs that caused weight loss but could not be advertised by a legitimate drug company. They used nothing approved by the MA's counsel and pharmacy. The MA's counsel and pharmacy is this body experts that would look at clinical trial results to show that a drug was safe and effective and if they were convinced that it was safe and effective for a particular use, it could be advertised for that use under this voluntary system of regulation. Now by this time actually the federal system of regulation had started to kick in, Federal Government now required evidence that a product was safe before it could be marketed. The efficacy regulation was not in place, but was still the MA's responsibility.
Why was weight loss considered a psychiatric disorder to be treated with amphetamines?
Because they had established this reputation of amphetamine as a psychiatric medicine, they had this angle, and psychiatry was really big. Everyone was reading Freud, particularly in the US. It's widely believed that neurotic, which is to say mild psychiatric disorders, are very widespread in the population. The typical estimate would be that 1 in 10 Americans suffered from a psychiatric disorder at some stage in their life. So, naturally, the GPs are prepared to look out for people who have mild psychiatric disorders in general practice. Amphetamine is the only drug for depression officially recognized. And for weight loss, they pushed the angle that overweight as a very often symptom of an underlying emotional illness, so that makes sense to have a psychiatric medication for weight loss.
How quickly did amphetamine use increase after the 1940's?
After 1949, not only do you have all those methamphetamine competitors, you have all these amphetamine competitors, we know fairly well from this lawsuit that it was 800 million tablets in 1945, and we know from FDA manufacturer surveys that by 1962 it had reached about 8 billion tablets. So we're talking about on a total population basis in 1945, the mid 40's, about 6 tablets per person per year in the US population, including children to 50 by 1962. So you can imagine a really sharp growth in consumption then over that period.
What is the difference between amphetamine and methamphetamine?
Amphetamine & Methamphetamine were approved for all the same medical uses, back when they were both regular prescription drugs, because they work basically the same. Amphetamine & Methamphetamine affect the mind in essentially the same way. And experienced users, and abusers, can't tell the difference in a blind tasting if the doses are comparable.
What is 'amphetamine psychosis'?
For a long time, the defenders of amphetamine were saying, "That only occurred in people who already had a hidden case of schizophrenia," "They took too much amphetamine," "They had a florid psychotic episode." But there was a definitive study done by a psychiatrist named Connell in England. Awareness that amphetamine's dangers have always seems to have been greater in England. Americans seem to like it better, or to be more attached to it, as another way of putting it. There is a cultural attachment to it, to that amphetamine effect in the U.S. This psychiatrist, Connell, looked at a large number of cases of amphetamine psychosis, looked at their backgrounds. These people had very little in common in terms of personality type. Some of them had been recreational users, but many of them had become, basically, just heavy medical users, and become addicted. When you take amphetamine for its psychiatric effects, for its mood lifting effect, you need to take more and more, same with weight loss. Tolerance builds up fast, you take more and more. After a year or two, you may have taken enough that you just go completely mad. The American Medical Association never acknowledged amphetamine's addictiveness right through the 60's, and they tended to regard amphetamine psychosis as exceptional or associated with recreational use.
What was amphetamine consumption like from 1950 to the early 1960's?
Right through the 50's competition was driving the medical consumption of amphetamines up and up and up. This is the era before the kind of information gathering research that the drug industry now has developed to a very high extent but we know something about the sort of the profile medical amphetamine consumption by the late 50's from some particularly studies done in Britain on the city of New Castle. Now New Castle was not an area where there was sort of an expansion of recreational use at the time. Amphetamine pills were big in some parts of England around 1960 you know the Mugs were using them a lot the film Quadrophenia were taking these pills.
Why did doctors keep prescribing amphetamines in the 1960's after the dangers were exposed?
By 1960 the scene has changed a little bit. Amphetamine Is an old drug, there's many brands out there, there are newer antidepressants. Amphetamine is still the best and recognized the best, dominant, diet drug. And the experts are saying, "hey, there's better antidepressants now," and psychiatrists and so on are telling general practitioners you should be using these different ones. There's evidence out there that it is addictive in the medical population, let along, abusing populations. Abusing populations came to sort of notice that the medical world with that in 1947 study of ex-service men, was widely abused in inhaler form because it was so cheap you didn't need a prescription. It was big among the beatniks, jazz musicians, and widely know that it was abused in inhaler form. Pill for...the addiction, even among non-abusers was getting to be know. But prescribing, it's never declined. I think it was driven by patient demand. The patients didn't want a different drug. Amphetamine was the drug that helped them, sort of, meet the demands of their daily lives.