Drug policy and rationality go together like hot fudge and anchovies. From marijuana to Salvia divinorum, from cocaine to "bath salts," from absinthe to Four Loko, panic precipitates and perpetuates prohibition. The process can be observed every day as activists, politicians, and yellow journalists conspire to keep the American public alarmed about the psychoactive substances other people are consuming. Sometimes their best efforts are inadequate, as illustrated by the marijuana stores that will start opening in Colorado next Wednesday. More often, horror stories about what happens when people are allowed to exercise dominion over their own minds and bodies help maintain support for the war on drugs and even to expand the list of enemies. Here are five of the year's most successful drug scares:
5. Red Bullshit
Reporters are suckers for the warning that energy drinks, safely consumed by millions of American every year, might kill you the next time you try them. That meme made my list of best drug scares last year, thanks mainly to the tireless fear mongering of New York Times reporter Barry Meier. This year the Monster Menace got a boost from a study that was widely cited as cause for alarm about energy drinks even though it did not document any harmful effects.
Using an MRI to scan the hearts of 18 subjects before and after they consumed an energy drink, researchers at the University of Bonn measured "significantly increased peak strain and peak systolic strain rates," indicating greater contractility, which is consistent with the observation that caffeine improves athletic performace. That result led to headlines such as "Energy Drinks Alter Heart Function, Study Shows" and "Warning: Study Shows Energy Drinks Can Change Your Heartbeat." The stories portrayed the study as worrisome, even though the effect it found is potentially beneficial.
A press release issued by the Radiological Society of North America encouraged the negative spin by quoting comments from a co-author of the study, radiologist Thomas Dorner, that ranged from misleading to flat-out wrong. "There are concerns about the products' potential adverse side effects on heart function, especially in adolescents and young adults, but there is little or no regulation of energy drink sales," Dorner said. "The amount of caffeine [in energy drinks] is up to three times higher than in other caffeinated beverages like coffee or cola. There are many side effects known to be associated with a high intake of caffeine, including rapid heart rate, palpitations, rise in blood pressure and, in the most severe cases, seizures or sudden death."
The implication was clear: Energy drinks pose a potentially deadly threat because they contain so much caffeine. Yet the drinks that Dorner and his colleagues gave their subjects contained 32 milligrams of caffeine per 100 milliliters, compared to 76 milligrams per 100 milliliters for Starbucks coffee. In other words, Starbucks coffee contains more than twice as much caffeine per milliliter as energy drinks, as opposed to one-third as much, as Dorner suggested. Dorner's whopper reinforced the general message that energy drinks, although objectively safer than coffee, are somehow scarier, possibly because of the shiny cans.
Next: Acid kills?
4. Acid Redux
Last March police in Charleston, West Virginia, accused Todd Honaker of killing his wife by dropping acid with her. The Charleston Gazette-Mail said Renee Honaker's death would be "the first reported acid-related fatality in the state and one of the few documented globally." That was literally true, since zero is as few as you can get, and no one has ever died of an LSD overdose.
As addiction specialist Paul M. Gahlinger notes in his 2001 book Illegal Drugs: A Compete Guide to Their History, Chemistry, Use and Abuse, "LSD is not toxic in the biological sense." According to a 2008 review of the scientific literature in the journal CNS Neuroscience & Therapeutics, "There have been no documented human deaths from an LSD overdose." So Renee Honaker's death would have been the first ever, had toxicological tests completed months later not determined that she did not take LSD after all.
Instead the tests detected an NBOMe compound, possibly 25I-NBOMe, which is often sold on blotter paper and passed off as LSD. The drug information website Erowid lists seven fatalities reportedly linked to 25I-NBOMe, which was first synthesized in 2003 and "has nearly no history of human use prior to 2010, when it first became available online." Erowid warns: "25-I-NBOMe is extremely potent. It should not be snorted! Insufflating 25-I-NBOMe appears to have led to several deaths in the last year and a number of hospitalizations."
If Renee Honaker was killed by an overdose of an unfamiliar, little-tested substitute for nontoxic LSD, her death is yet another example of how prohibition makes drug use more dangerous. It creates a black market where consumers have a hard time verifying that they are getting what they think they are getting, and it steers people away from relatively safe, well-studied drugs toward novel ones with unknown hazards. Instead of charging her husband with murder, Roane County Prosecuting Attorney Josh Downey should reflect on his own role in enforcing laws that lead to entirely predictable tragedies like this one.
Next: If legalizing pot sends the wrong message, why aren't teenagers listening?
3. Smoke Signals
Prohibitionists commonly warn that it's dangerous even to discuss legalizing marijuana, whether for medical or general use, because such talk sends "the wrong message" to the youth of America, encouraging them to smoke pot. If so, you might expect that the legalization of marijuana in Colorado and Washington, approved by voters more than a year ago, would have a noticeable impact on marijuana use by teenagers. Yet the latest data from the government-sponsored Monitoring the Future Study, released earlier this month, indicate that teenagers observed the momentous events in Colorado and Washington, absorbed the deleterious message supposedly sent by legalization, and continued smoking pot at pretty much the same rates as before.
Looking at annual, past-month, and "daily" use (meaning use on 20 or more of the previous 30 days) among eighth-, 10th-, and 12th-graders, you can see there were some slight increases and slight decreases, but none of the changes was stastistically significant. "These findings should put to rest any claims that reforming marijuana laws and discussing the benefits will somehow contribute to more teens using marijuana," said Mason Tvert, director of communications at the Marijuana Policy Project. "It's time for prohibition supporters to stop hiding behind teens when debating marijuana policy."
Tvert should have known that expectation was unrealistic. "Young people are getting the wrong message from the medical marijuana and legalization campaigns," drug czar Gil Kerlikowske told USA Today when the survey numbers came out. "If it's continued to be talked about as a benign substance that has no ill effects, we're doing a great disservice to young people by giving them that message." Many news outlets picked up on this theme, running headlines like "Synthetic Marijuana Use Down, but Real Pot Use Up Among Teens" and "U.S. Teens Smoke More Marijuana, but Back Off Other Drugs: Survey."
It is true that marijuana use among teenagers has been "drifting higher in recent years" (as the University of Michigan researchers who oversee the Monitoring the Future Study put it). But this upward drift began around 2007, whereas the first medical marijuana law (California's) was enacted in 1996. In between, past-month use among high school seniors went up and down, but it did not exceed the 1996 rate until 2011, 15 years after cannabis was first legalized for medical use. It certainly does not look like marijuana reform is driving increases in adolescent pot smoking. If you dig a little deeper, comparing cannabis consumption trends in states with and without medical marijuana laws, there is little evidence that such legislation boosts pot smoking by teenagers.
Next: Vaping gives politicians the vapors.
2. No Smoke, Yet Ire
Last September the CDC noted with alarm that the percentage of teenagers who had tried electronic cigarettes doubled between 2011 and 2012. "Many teens who start with e-cigarettes may be condemned to struggling with a lifelong addiction to nicotine and conventional cigarettes," CDC Director Tom Frieden worried. In a Medscape interview a few weeks later, Frieden suggested that fear had already materialized, asserting that "many kids are starting out with e-cigarettes and then going on to smoke conventional cigarettes."
The CDC's data, which came from the 2012 National Youth Tobacco Survey (NYTS), did not support that claim. In fact, nine out of 10 high school students who reported vaping in the previous month were already cigarette smokers, suggesting that the increase in e-cigarette consumption might signal successful harm reduction. Last month the CDC reported additional NYTS data that further undermine Frieden's claim, showing that smoking among teenagers fell as vaping rose.
Between 2011 and 2012, when the share of middle school students who reported using e-cigarette in the previous month rose from 0.6 percent to 1.1 percent, the share reporting past-month consumption of conventional cigarettes fell from 4.3 percent to 3.5 percent. Among high school students, past-month e-cigarette use rose from 1.5 percent to 2.8 percent, while past-month consumption of tobacco cigarettes fell from 15.8 percent to 14 percent. Although these trends do not necessarily mean e-cigarettes are responsible for the decline in smoking (which is part of a long-term trend), the numbers hardly seem consistent with the story Frieden is eager to tell: that the availability of e-cigarettes is leading to more smoking than would otherwise occur.
Does the gateway effect Frieden fears—a switch from e-cigarettes to conventional cigarettes among people who otherwise would never smoke—show up after high school? Not according to a recent survey of college students, in which only 3.3 percent said e-cigarettes were the first form of nicotine they'd tried. Of those, only one (2.3 percent) later started smoking conventional cigarettes. "It didn't seem as though it really proved to be a gateway to anything," the lead researcher said.
Yet politicians calling for a crackdown on e-cigarettes commonly cite the CDC's survey numbers, ignoring the continued decline in smoking by teenagers. When the New York City Council voted to ban the use of e-cigarettes in public places last week, one of the main rationales was preventing an increase in underage smoking. Councilman James Gennaro, a co-sponsor of the ban, warned that "just seeing people smoking things that look identical to cigarettes in subway cars, colleges and public libraries will tend to re-normalize the act of smoking and send the wrong message to kids." As usual, the kids don't seem to be listening.
Next: You thought the cannibalism drug was bad…
1. Krokodil Sightings
Last year my pick for top drug scare involved "bath salts," quasi-legal stimulants that supposedly turned a guy in Miami into a flesh-eating zombie (although it turned out that he had not actually consumed any of the drugs blamed for his vicious assault on a homeless alcoholic). Recently various media outlets have been hyping a drug that cuts out the middleman and does the flesh eating all on its own: krokodil, a homemade version of desomorphine that originated in Russia as a heroin substitute. Last September health officials in Arizona reported two cases of krokodil use there, which gave USA Today an excuse to recycle accounts of the drug's icky side effects under the headline "Flesh-Rotting 'Krokodil' Drug Emerges in USA."
"When it's injected," USA Today reported, "the concoction destroys a user's tissue, turning the skin scaly and green like a crocodile. Festering sores, abscesses and blood poisoning are common….The average life expectancy among krokodil addicts in Russia is two to three years, according to Time, which called the narcotic 'the most horrible drug in the world.' Gangrene and amputations are common, and the toxic mix dissolves jawbones and teeth."
But the tone of the USA Today story was almost restrained compared to the comments of a Drug Enforcement Administration official quoted by the Deseret News in October. "While methamphetamine and heroin are guaranteed to give you a slow, painful death, if you want to speed up the process, take this drug," said Sue Thomas, supervisory special agent for Utah. "If you just want to speed up and horrify the death process a little more, take this drug. It will rot you from the inside out, leaving you with gaping wounds that will leave bones exposed, horrible abscesses, and it's a horrific death."
The effects described in these accounts are not caused by desomorphine, which was patented in 1932 and marketed as a painkiller in Switzerland under the brand name Permonid, with nary a report of rotting patients from the inside out. Rather, the abscesses and necrosis are caused by a combination of caustic contaminants and unsanitary injection practices. What drives Russian heroin addicts to take such risks? According to USA Today, "krokodil became popular in Russia because heroin can be difficult to obtain and is expensive." Meanwhile, codeine, the opiate used to produce krokodil, is relatively cheap and available over the counter there.
Since neither of those conditions holds in the United States, where heroin is plentiful and codeine can be legally purchased only with a prescription, why would krokodil ever gain a following here? It almost certainly hasn't. One krokodil sighting after another has proven to be spurious.
The DEA says it is "tracking the nationwide reports of alleged abuse of the controlled substance desomorphine that is found in the drug krokodil, a homemade substitute for heroin invented and used in rural Russia, Georgia, Ukraine, and Kazakhstan." The agency is "investigating the matter by acquiring samples alleged to contain desomorphine, interviewing drug abusers, and monitoring intelligence reports." But "to date, none of our forensic laboratories has analysed an exhibit found to contain desomorphine."