Perhaps I did not immediately experience the typical positive second-day results because I was exhausted from a long night of sleeplessness and pain. I have been in pretty much constant pain since last spring, when I was felled with frozen shoulder, a disorder in which the capsule of the shoulder becomes inflamed and stiff, resulting in excruciating pain,*1 especially at night. Frozen shoulder comes on without warning and for no reason, and can last up to three years. It is debilitating and dispiriting, and it’s surely part of the reason for my current state of anhedonic desperation.
The symptoms of frozen shoulder are worst at night, and it has been a very long time since I got a decent night’s sleep. The pain keeps me from falling asleep, and wrenches me awake when I roll over. I have tried everything to relieve this pain, from physical therapy to acupuncture, ibuprofen to opioids.*2 In fact, nothing provided any relief until a doctor suggested I try medical marijuana. I resisted the idea at first. I have no interest in recreational drug use; I didn’t and don’t want to get “high.” But the doctor reassured me that I could purchase marijuana devoid of intoxicating effects. It is the chemical tetrahydrocannabinol (THC) in marijuana (or “cannabis,” as the bright young people at my local dispensary prefer to call it) that causes the feelings and mental effects we associate with the drug. Cannabis also contains a related but structurally different isomer, cannabidiol, or CBD. CBD has pain-relieving properties, and acts as an anti-seizure agent, but it doesn’t make you high. Since the decriminalization and popularization of medical marijuana, high-CBD strains have been engineered that all but eliminate THC.
I followed the doctor’s advice and tried the high-CBD cannabis; though the relief was by no means complete, it did substantially decrease my pain, if only at night, when I allowed myself to take it. How ironic. Addictive and dangerous opioids, fatal at high doses and yet freely prescribed by physicians,*3 did nothing to alleviate the pain of my frozen shoulder, but cannabis, still illegal under federal law and in many states, worked.
When I taught my seminar on the drug war, I began every semester by writing the question “What is a drug?” on the whiteboard. I divided the board into sections—medicine, drug, food—and then had students brainstorm, calling out every substance they could think of and debating where to place it on the chart. Coffee, which is a stimulant, is a food. What about a caffeine pill? Or nicotine? Are they medicines, foods, drugs? Oxycodone, an opioid alkaloid synthesized in part from the poppy, is a medicine. Heroin, an opioid derivative of morphine, also synthesized from the poppy, is a drug. Do these differentiations make any sense at all?
America did not always make such distinctions. In fact, for the first hundred years, citizens of this country were at liberty to alter their consciousness with any substance they pleased. Thomas Jefferson planted poppies in his medicinal garden at Monticello and may have used opium—supposedly to treat chronic diarrhea, but perhaps also for fun. The man was hardly a model of propriety. Only in 1875 was the first drug law passed, in San Francisco, and even that did not prohibit a drug but prevented a specific use: the smoking of opium in Chinese opium dens. It was an attack on emigrants from China, who smoked their opium, leaving the more typical American opium user, a middle-aged, white, Southern woman, to tipple from her bottle of laudanum (opium combined with alcohol) in peace.
During that time and up through the early twentieth century, opioids and cocaine were readily available and frequently used. The Sears Roebuck catalogue, the amazon.com of the time, featured kits with syringes and vials of heroin or cocaine, complete with handy-dandy carrying cases. Cocaine was the official remedy of the Hay Fever Association, and bartenders dropped it into shots of whiskey for a little added boost. Coca leaf and kola syrup were combined with cocaine to create what became, unsurprisingly, the most popular drink in the world. In fact, it wasn’t until 1929 that Coca-Cola became free of the drug, thereafter relying solely on caffeine to invigorate its customers.*4 Bayer pharmaceutical ads from the period advertise both aspirin and heroin. Mothers were urged to lull their cranky babies to sleep with the aid of tinctures containing all manners of opioids, including morphine and heroin. Opium, cocaine, and their derivatives were injected, granulated and sprinkled on open wounds, drunk and otherwise ingested by anyone who could afford them.
As a result of these patent medicines, addiction to opioids was at an all-time high at the turn of the last century. In 1900, a remarkable 2 to 5 percent of the population was addicted to these drugs. Only in 1906, when the Pure Food and Drug Act required manufacturers to start listing the ingredients of their products on the labels, did rates drop, perhaps because people became aware of exactly what it was that was hushing their babies so effectively.
But even then there was no particular stigma against drug use. Eighty percent of addicts were upstanding citizens, employed, with families and dependents. They thought no more of taking their laudanum or cocaine than we today think of having a glass of wine with dinner. The list of notable narcotic users includes Dr. William Stewart Halsted, the “Father of Modern Surgery,” one of the founders of Johns Hopkins Hospital, who first discovered that cocaine could be used as an anesthesia on his patients, and then took to enjoying its other effects on himself.
The first federal drug law, the Harrison Narcotics Tax Act of 1914, was ostensibly a regulatory act that required physicians to purchase a license to dispense narcotics, and to keep records of their prescriptions. However, because it prevented the prescribing of narcotics solely as a treatment for addiction without another underlying ailment, all of the upright individuals who were addicted but not otherwise ill suddenly found themselves bereft of legal sources. Some kicked their habits, but many others chose alternative paths. Dr. Halsted, for example, after a traumatic period of cocaine withdrawal, switched to legal morphine and heroin, which he used for the remainder of his life, all the while enjoying a prosperous and successful medical career.
Harking back to the good old days of ubiquitous drug addiction is a ridiculous way to make yourself feel better about having received a package of illegal drugs in your mailbox and embarking on a project that will strike many as lunatic. If I’m honest, the project seems crazy to me, too. I wouldn’t do it if I wasn’t desperate. Though I had not considered it before, I think it’s likely that the fact that marijuana—which, like LSD, is listed on Schedule I of the Controlled Substances Act “with no currently accepted medical use and a high potential for abuse”—helped my frozen shoulder, when dangerous and yet legal drugs did not, influenced my decision to try microdosing. It may be the one time pot has actually been the gateway drug that Nancy Reagan said it was.