1. The History of Methamphetamine: An Epidemic In Context
Patricia Case, Sc.D.
Harvard Medical School

2. Acknowledgements
This research is partially supported by funding from the National
Institute on Drug Abuse
The views expressed in this paper are solely my own and do not reflect
the views of NIDA or the institutions by which the author is employed.
I would like to express my gratitude to my tireless research
assistants Ari Reiter and Sean Ferriter and to brainybetty.com for this
PowerPoint template.

3. The past is never dead.
It's not even past.
William Faulkner

4. A Brief History
Amphetamine first synthesized in Germany
Methamphetamine synthesized in Japan
Amphetamine used as a substitute for ephedrine
Benzedrine (amphetamine) in OTC nasal inhalers
Benzedrine tablets available by prescription
Benzedrine used to treat ~39 other conditions
Gorell recommends Benzedrine for fatigued doctors
First published report of amphetamine addiction
First description of amphetamine psychosis
Eggleston: “there is not much danger of …addiction”
Critical wartime period as all sides go to battle on amphetamines

5. Medical Advance – Benzedrine 1930’s Wonder Drug

6. Wartime Benzedrine

7. Wartime Field Supplies
“About that time I discovered Benzedrine.
Loved those little white suckers. We could get a
sack full in those days. It sure didn't bother to get
up at 3:00 AM anymore. Pop a couple of pills
and you were wide awake ready to take on the
whole world. If it kept you awake, just take a few
sleeping pills. Boy! Isn't medical science great or
what!!”
from the memoirs of USAF Captain Bryant L. Smick on
flying missions over Italy
Everyone on the ship had taken two Benzedrine capsules when we reached bombing altitude – as if I needed anything to wake me up.
From the memoirs of Herb Bach on a bombing run to Japan

8. War Surplus and the Streets 1944-1948

9. Benzedrine Goes Bad

10. A Brief History – II
1951 Prescriptions required by federal law for amp containing products
1958 ~3.5 billion tablets of legal amp tablets produced
1959 First injection of Benzedrine extracted from inhaler reported
1959 OTC Benzedrine inhalers withdrawn from the market
First OTC methamphetamine inhaler hits the market
Early reports of illicit domestic production by biker gangs
Federal law requires prescriptions required for meth products
OTC Methamphetamine inhalers withdrawn from the market
31 million prescriptions written -- most to women
1970 ~10 billion tablets of legal amp/meth tablets produced

11. Selling Speed

12. The Hidden Agenda - Housework

13. Methamphetamine Goes Bad 1962-1969

14. Outbreak Emergence 1970 – 1975 (or so)

15. Power and Writing
1942 Hitler begins methamphetamine injections – perhaps
London newspaper claims “Methadrine wins the Battle of London” - maybe
Jack Kerouac, under the influence, writes On The Road
in 21 days on a single scroll of paper
British Prime Minister Anthony Eden “lived on Benzedrine”
during the Suez Crisis
JFK relies on injections of methamphetamine during the Cuban missile crisis
William Burroughs publishes “Speed”

16. Old Made New Again What Did We Know Then?

17. Early Epidemiology
1955: Newspaper estimates 3% of University of Md students using Benzedrine
1966: Sadusk estimated that 800,000,000 methamphetamine pills made annually and 50% distributed illegally
1970: Black surveyed 5,482 enlisted men, with 27% reporting drug use and of those, 37% reported lifetime use of amphetamines, 10% more than 100 times
1971: Chambers estimates 35,000 New York household residents use “speed” regularly – 30 percent without prescription (compared to 6,000 regular users of cocaine)

18. Association with Sexuality
1937: “Stated that he was able to have sexual intercourse following the administration of the drug but that orgasm was almost instantaneous”
1946: “A symptom which can regularly be observed in chronic alkaloid addicts is the homosexually toned perversion of their sex life”.
1947: “The drug enabled him to indulge in auto-erotic activity four times in succession, making it indescribably delightful.”
1952: [an addicted woman reported that] “an increase in sexual desire but a decrease in satisfaction”
1953: [methamphetamine treated schizophrenic] “This is great. My penis feels much longer”.

19. Lessons of History
Stimulant use is cyclic and endemic with outbreaks in the US. Stimulant cycles often followed by opiate/sedative/painkiller cycles.
The trajectory of an outbreak appears to be
1) exploratory
2) medicalization
3) concern and regulation
4) diffusion and criminalization
5) severe social impact
6) regression
New emergence and outbreaks with changes in technology, drug, economy or affected population group.

20. What is different now?

21. Methods of manufacture
Until mid-1990’s, the P2P method was used to produce D,L-methamphetamine -- a racemic mixture
P2P, a precursor, was regulated and subject to strict enforcement and arrest for possession
Producers switched to the easier Birch (so-called Nazi) pseudoephedrine reduction method, producing very potent D-methamphetamine
The Birch reduction produces better “product” – diffusion brings more reliance on home production, less reliance on imported finished supplies.
Importation of precursors and theft of precursors now rampant.

22. Key Differences The Internet
Diffused local production, less reliance on imports
Multi-drug use – no one uses only crystal
National outbreak
Varied sub-populations
More smoking
Strong association with HIV, hepatitis C, STDs
Community level responses to AIDS deaths, 9/11, war
National discussion

23. Meditations for the Conference
What is the role of social class, poverty, abuse and marginalization in the present-day methamphetamine outbreak?
Is it an outbreak or a continuation of an old pattern?
What strategies have and haven’t worked worked in the past to lessen the problems of methamphetamine use?
What are the “silences” – what population, what area, what pattern is not being discussed that needs to be?
How does the knowledge presented here relate to everything you know about what’s going on at home?

24. Meditation on the Future
What will happen with ProVigil, approved in 1998 and now used extensively by the military in Iraq?
Drug keeps pilots awake
By Peter Mucha, Inquirer Staff Writer
A much-ballyhooed anti-drowsiness drug made by West Chester-based Cephalon Inc. is taking off as the Air Force's new "go-pill.“
Provigil, also known by its generic name, modafinil, has been used more than 150 times this year by bomber crews to ward off sleepiness on missions of more than 12 hours.
2005 Projected Sales: $400 million

25. “Faster, faster, until the thrill of speed
overcomes the thrill of death”
-Hunter S. Thompson