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  •   Sending Mixed Messages On Drugs

    By Courtland Milloy
    Washington Post Staff Writer
    Wednesday, May 6, 1998; Page B01

    The new media messages about drugs are really blowing my mind.

    On the radio, you can hear an anti-marijuana spot warning that the evil weed causes memory loss. That's bad.

    At the same time, you can read in news magazines that some legally prescribed antidepressants also may have adverse side effects, such as memory loss. But that's okay, because a new pill to enhance memory is in the pipeline.

    Cocaine and heroin are bad, we are told, because they artificially stimulate or block natural biochemical functions. However, mood drugs such as Zoloft and Prozac are good, even though they do the same thing.

    Just say no to drugs, the media messages say, except to those made by pharmaceutical companies.

    It is estimated that 10 percent of the U.S. population suffers from chronic or acute anxiety. Much of that is the result of wrongheaded thinking -- the refusal to accept the things we cannot change or the lack of courage to change the things we can, or so we were told during the "war on drugs," which has sent hundreds of thousands of drug users to prison for failing to show they have the wisdom to make a change.

    These days, we are being told that U.S. pharmaceutical giants are able to identify specific receptors in our brain cells and manipulate them to good purpose. In the old days, we called that "getting high." And that was bad. But now that Pfizer and Eli Lilly, et al., are in control, it's called "lifestyle enhancement." And that's good.

    The thinking seems to be that just because we have the power to tamper with nature, we should -- as long as it's legal. Take the biochemical phosphodiesterase 5, or PDE 5, which has the sole function of working against male sexual arousal. The new impotency drug craze, Viagra, supposedly works by blocking PDE 5. Here is a biochemical with such an important function, and yet virtually no man had ever heard of it until some drug was created to destroy it.

    We haven't even had time to ask ourselves why we were born with PDE 5 in the first place. For all we know, the chemical is triggered when we don't take enough time to talk with or embrace our mates before trying to have sex. PDE 5 may be naturally occurring when men are confused about the difference between making love and having sex.

    Viagra, as we all know by now, was initially conceived as a drug to alleviate angina, chest pains caused by the blockage of blood vessels that lead to the heart. That didn't work, but the drug did have the side effect of causing erections.

    Now it's all the rage, and impotence has suddenly become a physiological rather than psychological problem, as if there is a clear distinction between the two.

    Ruth Westheimer, the sex adviser, is probably right when she says, "Even if a man has an erection from floor to ceiling and can keep it that way for an hour, it will not be pleasurable for a woman if he is not sexually literate."

    According to a 1992 National Institutes of Health conference study of the problem, impotence includes anything from "inability to get an erection" to "unsatisfactory sex performance."

    I could tell you about some other drugs that probably would enhance sexual stimulation and no doubt cost less than Viagra. But if you got caught buying some, say at the corner of Seventh and T streets NW, you could end up in prison -- maybe under some mandatory minimum drug sentencing law -- for the next 10 years. The street drugs are said to be addictive and have side effects that include paranoia, irritability and loss of appetite. That's bad.

    Viagra, on the other hand, causes only headaches, blurred vision, blackouts, coital coronaries and something called priapism, which is an erection that lasts four hours or more and, if untreated, can lead to tissue damage and even impotence.

    But that's okay, because it's legal.

    According to a recent issue of the Journal of the American Medical Association, more than 2 million Americans become seriously ill every year because of toxic reactions to correctly prescribed medicine -- and 106,000 die of those reactions.

    Bruce H. Pomeranz, the University of Toronto neurophysiologist who initiated the study, was quoted as saying, "We're not saying, 'Stop taking drugs.' " What the study was saying, he said, was that there ought to be more research into the problem.

    It would be hard to imagine a similar reaction if 2 million Americans had overdosed last year on drugs produced in Colombia or Mexico.

    "The important message," said Michael Friedman, acting commissioner of the Food and Drug Administration, "is not to be afraid of your medication but to be respectful of the possibility of side effects."

    The finding came with a statement from pharmaceutical manufacturers warning against overreacting to the numbers, noting that the study made no effort to measure the benefits of their drugs. Imagine the same courtesy being granted to, say, the Marijuana Growers Association of America.

    © Copyright 1998 The Washington Post Company

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