High Price

watched their images change from those of healthy, vibrant individuals to faces marred by open scabs, droopy skin, and hair loss. They were told that these were the physiological effects of using methamphetamine. Ninety percent of individuals who tried methamphetamine once, they were also told, would become “addicted.” How could such inaccurate information be given to naive students, let alone be reported on NPR, I thought.
    There is no empirical evidence to support the claim that methamphetamine causes one to become physically unattractive. Of course, there have been the pictures of unattractive methamphetamine users in media accounts about how the drug is ravaging some rural town. You may have also seen the infamous “meth mouth” images (extreme tooth decay). But consider this: methamphetamine and Adderall are essentially the same drug. Both drugs restrict salivary flow, leading to xerostomia (dry mouth), one proposed mechanism of meth mouth. Adderall and generic versions are used daily and frequently prescribed—each year they are among the top one hundred most prescribed drugs in the United States—yet there are no published reports of unattractiveness or dental problems associated with their use. The physical changes that occurred in the dramatic depictions of individuals before and after their methamphetamine use are more likely related to poor sleep habits, poor dental hygiene, poor nutrition and dietary practices, and media sensationalism. With regard to the addictiveness of methamphetamine, the best available information clearly shows that the majority of people who try methamphetamine will not become addicted. 17
    The media and general public were not the only ones caught up in the methamphetamine hysteria. Many scientists were also bamboozled. From 2006 to 2010, I was a member of an NIH grant review committee. The committee was composed of about forty scientists with diverse expertise. One of our main tasks was to evaluate the scientific merits of research grant proposals submitted by drug abuse scientists. We frequently reviewed proposals seeking funds to study methamphetamine. Many of the proposals argued that the drug produced brain damage, while others pointed to the cognitive impairments caused by methamphetamine. They seemed to have accepted, as a foregone conclusion, that any use of this drug was destructive. These arguments were compelling to some on the review committee. The problem was that they were not supported by evidence; instead they were misrepresentations of the data. I am not suggesting that the scientists who wrote the grants did this intentionally. I don’t think they did. I do believe, however, that the scientists understood quite well the mission of their proposed funder—National Institute on Drug Abuse (NIDA)—and this understanding shaped their grant proposal.
    NIDA’s mission “is to lead the Nation in bringing the power of science to bear on drug abuse and addiction .” Drug abuse and addiction are only limited and negative aspects of the many effects produced by drugs. Of course, drugs like methamphetamine produce other effects, including positive ones such as improved cognitive performance and mood, but that isn’t a part of NIDA’s mission. And scientists seeking research money from NIDA are well aware that they must emphasize the negative effects of drugs in order to get funded. Upton Sinclair’s famous quote aptly describes this situation: “It is difficult to get a man to understand something when his salary depends upon his not understanding it.” 18 Consider also that NIDA funds more than 90 percent of all research on the major drugs of abuse. This means that the overwhelming majority of information on drugs published in the scientific literature, textbooks, and popular press is biased toward the negative aspects of drug use.
    I am not suggesting that the negative consequences of drug use shouldn’t be the focus of research funded by NIDA. Focusing on the pathological aspects of drug use is extremely important for developing effective treatments for drug addiction. But the current disproportionate focus on the bad effects of drugs tends to leave us with a skewed perspective. It has helped to create an environment where certain drugs are deemed evil and any use of these drugs is considered pathological. As I have repeatedly pointed out throughout this book, most people who use any drug do so without problems. This is not an endorsement for the