Amphetamines, from there to here

On speed: the many lives of amphetamine.

Nicolas Rasmussen. New York: New York University Press, 2008 (ix + 351 pp). ISBN 978 0 8147 7601 8.

Amphetamines are highly topical in the Journal — recent articles have discussed the controversies of prescribing them for attention deficit hyperactivity disorder, and their associations with violence in emergency departments and criminal offending. This book situates current concerns about stimulant use in a historical context and, in doing so, crosses swords with the pharmaceutical industry. But Rasmussen also has insights into the past roles of military medicine and social concerns that might be exploited to increase market share for drugs that are sold for “aspirational” goals.

The author’s background is in history and philosophy of science. His book is at times irritating, particularly with repeated and unconvincing efforts to calculate past consumption of stimulants in the United States. These quibbles are minor, however, for the scope of his work is provocative and applicable to other areas in which social mores and medicine interact. His premise — that amphetamines have been marketed and remarketed for dubious indications and social woes, rather than for medical problems — is appealing and his research painstaking. However, most intriguing is the discussion of marketing, of efforts to rebrand addiction as habituation, and of the evolution of life problems seen as warranting psychopharmacological intervention. Rasmussen makes a good case that patent medicines and their promises have been supplanted by amphetamines and related drugs.

This is a well referenced and easily read book, which reminds the reader that uncritical acceptance of drug marketing is unwise. The book is not as tendentious as the works of David Healy or Peter Breggin, and for that is all the more compelling. Nevertheless, any doctor will be challenged by the ease with which novel drug indications are accepted and by the shifts in prescribing patterns, which remain so similar. Moral panics about drugs are reinvented by every generation, and Rasmussen admirably provides the historical setting for current anxieties about stimulants.

Melbourne, VIC