The Fallacy Of Drug Scheduling

And by drug scheduling, I mean that of the United States Food and Drug Administration. And by that of the United States Food and Drug Administration, I mean listing drugs as schedule I (i.e. ‘no medical uses’).

This is not a political rant, for even prescription drugs (in the wrong hands) can be illegal, and there are good reasons for making substances illegal. But just because a substance should not be used recreationally, does not imply that it has no medical uses. We know this, of course, from the legal (yet recreationally abused) drugs such as hydrocodone, oxycontin, Adderall, etc.

Drugs, by their very nature, affect body chemistry to elicit a response. Whether this response is the elevated awareness after a cup of morning coffee, or the stark opposite of a late-night’s beer, drugs are meant to change the way we feel about the world. To label any drug as having ‘no medical uses’ is to change the definition of drugs. While I may digress into philosophy, the Hedonists of ancient Greece would support the claim that all drugs are medicines, and are we truly so knowledgeable as to say we know every possible use for a single substance?

Okay, I sound like a hippie. I apologize. This is not where I mean to lead. Instead, I am arguing for more research on drugs, even illegal drugs. While ‘no medical uses’ may be the FDA’s criterion for schedule I, I argue that the new criterion should be ‘no medical uses yet discovered. This criterion emphasizes that many compounds, in the right context, may have the ability to change lives for the better. By scheduling some compounds as illegal, we frighten researchers into avoiding life-saving chemicals.

Perhaps the most apt example of this is the recent upsurgence of medical marijuana, and its active compounds THC and CBD, the latter of which provides no ‘high’, but can still medicate many ailments.

Even further, Anxiety and PTSD are extremely prevalent ailments to our nation, and the drugs used to treat them are not always effective. PTSD has been shown to be treated with MDMA, but its legal status renders it nearly impossible to study, let alone administer. And while no illegal drugs have been found to alleviate anxiety as a blanket disorder, there are of course subsets to anxiety disorders. One of these, most often found in advanced stage cancer patients, is the anxiety associated with a fear of death.

A recent 2011 study observed the effects of psilocybin, the active ingredient in psychedelic mushrooms, on anxiety levels of advanced cancer patients with a fear of death. The results showed a significant reduction in the patient’s anxiety over the evaluated period as shown by the STAI (an anxiety test), which was sustained over 6 months from only a single treatment.[1]

Along with that, in 2010 a population of twenty individuals suffering from medium-to-severe PTSD were half given a placebo, and half given MDMA (the pure form of ecstasy/molly), and then participated in psychotherapy sessions. The control group was later allowed to participate in the MDMA-assisted sessions two months after the set of initial trials. There was a greater than 30% decrease in CAPS scores (a PTSD test) for MDMA-assisted psychotherapy, and the few who had earlier not been able to work because of PTSD were able to work after the study had finished.[2]

Both of these drugs are serotonin agonists, which means they bind and activate receptors in the brain that serotonin would have normally bound to. As such, realizing that these are treatment options for anxiety-related disorders can tell us something about anxiety itself: that it may result from specific brain regions having low serotonin levels. It is well-known that other anti-anxiety drugs also include serotonin agonists, but regardless, we see the positive effects of schedule I drugs on patients as well as their effects on increasing our knowledge of psychological disorders. It is for just this reason that I argue to, at the very least, change the criterion for scheduling drugs, and allowing more research to be performed on them.

The fallacy by which I title this post is as follows: An illegal drug is illegal because it has no medical uses. Because the drug is illegal, it cannot be studied. Because it cannot be studied, we cannot know if it has any medical uses. Therefore, it should be illegal.

Circular reasoning. Good job FDA.

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[1] Grob, Danforth, Chopra, Hagerty, McKay, Halberstadt, Greer. Archives of General Psychiatric. 2011.

[2] Mithoefer, Wagner, Mithoefer, Jerome, & Doblin. Journal of Psychopharmacology. 2010.