The word (
) with
the root (K-M-R) means
“to cover”. The word is often used
for wine because it covers human consciousness; but
it includes all sorts of narcotics which induce drowsiness, sleep, stupor, insensibility
and exhilaration beyond control. According to
Hazrat Umar ‘Khumar’ means a substance which produces disturbance in the human
intellect.
In earlier times wine used to be the commonest narcotic. Thus the word ‘Khumar’ came to be used
for wine alone. But in modern age the
narcotics both natural and synthetic have emerged in a large number, and thus came under
the heading ‘Khumar’.
The holy Quran has prohibited the consumption of intoxicants. If we put together the Quranic verses related to
intoxication chronologically, we have a unique example of
a graduated, proclamation. In the
beginning we find:
“Oh ye
who believe! Narcotics and gambling,
dedication of stones and (divination by) arrows are an abomination - of Satan’s handiwork: eschew such (abomination) that you may
prosper.”
Here again
the use of intoxicants are included in the list of practices which deserve aversion or
disgust, which stupify human intellect and impair man’s faculty of determination as
well as stamina for work.
Alcohol
The deleterious effects of alcohol on the mental, physical, moral and social aspects of man are too well known, but it shall be worth-while if we describe in some detail its effects on man from medical point of view, because that would give a better picture of what the Quran describes as
“Its
deleterious effect is greater than its usefulness; and
also when it is said that it is and abomination.
Effects
of alcohol on digestion
Only 5% of the ingested alcohol is excreted while the rest of that absorbed from
the stomach and bowel amounting to 95% undergoes combustion in the tissue and thus
produces heat and energy. Therefore
technically it is a food but this does not imply that it is an advisable food in all
conditions. Alcohol taken in addition to the
carbohydrates and fat, which in turn is used to build up reserves of energy in the body. Alcohol itself cannot be stored in the tissue and
is therefore utilized in place of carbohydrates which are deposited as glycogen and there
is an increase of fat in the body which is a common observation in those who drink.
Persons
addicted to the use of alcohol are known to show less resistance in acute disease, and in
operations accompanied by shock, than the more temperate individuals, and in vary
intemperate cases the prognosis must be guarded in an attack which would ordinarily be
accompanied with little danger. Results in
experimental animals have invariably shown a greater susceptibility to infections and a
greater morality than in control animals, which had received no alcohol.
Aphrodisiac
powers
Alcohol is
generally credited with Aphrodisiac powers, that is, with increasing sexual desire,
although no less an authority than Shakespeare states that it prevents the consummation of
sexual intercourse. The unquestionable
tendency towards sexual excess observed in intoxication is due, not to any effects on the
generative organs, but to the loss of self-control, from the cerebral action of the
poison.
Use
of alcohol as a medicine
Externally
it is used in treating bedsores in which it is often applied in order to harden the skin. It is also used as a mild antiseptic. The indications for internal use of alcohol are
ill-defined, and cases which one physician would teat with alcohol often progress as
favorably without it in the hands of another. It
has been prescribed very largely in the past as a 'stimulant' but drugs are now available
which are far superior to alcohol in their stimulant action. The action which lends alcohol its value in
therapeutics is not its stimulant but its narcotic action, which allays the anxiety and
distress of the patient, promotes rest and sleep. But
again drugs much superior in their narcotic effect are available. Cases of hemorrhage, shock and other forms of
severe and sudden depression of the heart and central nervous system have been frequently
treated with alcohol but its beneficial effect in such cases has been much questionable in
recent years and the belief that it is of little value is certainly widely held at
present. Alcohol has a beneficial effect on
cases of 'chill' which is a sudden constriction of the blood vessels of the nose and
throat, as it causes dilatation of peripheral blood vessels, but there are other drugs
with the same effect such as volatile oils and comfier.
Alcohol may be used in cases of distress of mind from any cause, such as
grief, business anxiety or depression; alcohol acts by its narcotic action on the brain,
but the danger of alcohol habit is so great that most physicians refuse to take the
responsibility of prescribing the drug in such cases.
In Epilepsy, alcohol produces prolonged nervous disturbance, which is very
deleterious in such patients. In chronic
conditions of cachexia and loss of flesh in general, and during convalescence alcoholic
preparations are often advised simply as foods or stomachaches.
In the treatment of diabetes by the withdrawal of carbohydrates, alcohol has been
advised to maintain the supply of energy, which it does without increasing the sugar of
the blood and urine.
In regard to
the habitual use of alcohol by healthy persons, all authorities agree that it is a luxury,
that it is entirely unnecessary for the growth and maintenance of the body and that it
neither promotes greater healthfulness, nor in any way retards the onset of disease. It is true that it is utilized by the body as a
food but its value as such is limited because only small quantities can be taken without
disturbance of nervous system. The symptoms
of chronic alcoholism are very common. The earliest symptoms are generally observed in
the stomach, throat and larynx and consist of chronic catarrh. Fatty degeneration occurs in the liver especially
and also in the arterial walls throughout the body and favors the development of high
blood pressure. The heart undergoes fatty
changes accompanied by dilation and weakness. In
central nervous system its causes shrinkage of nerve cells and thus leads to impairment of
memory, self-control and other higher mental processes.
In worst cases, tremor, convulsive attacks, hallucinations and mania occur,
followed by idiocy and paralysis.
The
disastrous effects of the abuse of alcohol are seen in the statistics of the hospitals,
prisons and asylums in nearly all countries. A
large percentage of crime is admittedly done under the influence of alcohol or as a direct
result of alcoholic excess, which is also responsible for a large part of the poverty and misery of the lowest classes of the population. It must also be taken into account that only the
more extreme cases come under the categories of criminals and lunatics and an enormous
number of cases of disease caused or aggravated by alcohol escape recognition. Attempts have been made to demonstrate that the
effects of alcohol are hereditary, that the children of alcoholics supply a larger
proportion of cases of insanity and crime than those of the rest of the population. The deleterious effect of the alcoholic habit in
the parent on the nutrition of the offspring is, however, a well establishes fact.
One can
learn from the above description that, from the medical point of view, the beneficial
effects of the use of alcohol are too small as compared with the disadvantages and dangers
inherent in it. Of course, the moral effects
on the individual as well as on the society are far too deleterious. There are probably no passages in the Quran that
have been the subject of such a variety of interpretations as those, which deal with he
prohibition of wine. Some interpreters have
placed it in the list of unlawful objects, but as described already, the subject of (
) lawful and (
) unlawful carries an entirely different import. It is symbolic of one’s membership of the
Islamic social order. Only those things are
unlawful which the Quran has categorically described as unlawful and these are carrion
(dead animal flesh), blood, flesh of swine and that on which any name, besides that of
Allah, has been invoked. The order for the
prohibition of unlawful articles was not a graduated proclamation as in the case of wine. These were ordered to be stopped forthwith. The vise of drinking wine was deep-rooted amongst
the Arabs of pre-Islamic era. Thus its use
was gradually eliminated from the society by the graduated descent of Wahi; firstly that you approach not prayers with a
befogged mind.
Secondly
that the deleterious effects of wine are greater than its usefulness and finally, it is a
thing (alcohol) deserving aversion and disgust, a thing which lowers the human dignity and
a thing which debilitates the human mind and body. Thus
the believers in the Quran gradually and voluntarily forsook the practice of drinking wine
till it really became an object of hate amongst them.
So far, we
have dealt with the subject of alcoholic drinks only but there is a big variety of other
articles which come under the category of () and which produce befogging of mind or drowsiness or
unconsciousness depending on the amount consumed. In
medicine all general anesthetics and drugs used for the treatment of psychosomatic,
psychoanalytic, or psychoreactive disorders characterised by tension, excitement, unrest,
anxiety, sleep disturbances, irritabiliy, aggressiveness etc., as well as drugs used for relieving pain, come
under this heading. The medicinal value of
these drugs is great but there are also dangers inherent in their misuse. Some of the drugs like opium lead to habit
formation with dire consequences. Previously,
intoxicants were used only in the lowest strata of human society. But now even educated young men all over the
world, with high living and low thinking, are getting addicted to them, that is because
having dissociated themselves from divine guidance, their ideas about personal freedom as
well as about discipline have undergone perversion.
Other
narcotics which come under the heading of ()- Opium has been used in medicine since remote periods. Although many substitutes have been proposed for
it in later years, it still occupies a position of its own in therapeutics.
It is the
dried juice of Papaver Somniferum, a poppy
which is grown chiefly in the
Indo-Pakistan
subcontinent, China, Egypt, Persia and Asia Minor, but has been cultivated in colder
climates and is said to produce a more powerful Opium there. Opium owes its activity to a large number of
alkaloids of which morphine, codeine, papeverine, narcotine and thebaine are the most
important. The action of opium is mainly due
to a large amount of morphine contained in it. Morphine
acts chiefly on the central nervous system but it also affects some peripheral organs such
as intestines.
Symptoms: In
man, small quantities of morphine (1/8gr, 8mgs) lessons the voluntary movements and
produces a drowsiness which soon passes into sleep, unless the patient is continually
aroused by his surroundings. As long as he is
kept awake, his actions and movements show nothing abnormal but it is impossible to keep
his attention directed to any one subject for long and as soon as he is left to himself
for a few moments, he sinks into sleep. After
small quantities there is no difficulty in arousing him, in fact, the sleep seems lighter
than usual and may resemble rather a state of abstraction.
In this condition (euphoria) the imagination is not depressed to the same
extent as the reason; the self-control and judgement are lessened and although the stream
of thought may seem more rapid and image is more vivid than usual, the logical sequence
and the ideas of time and space are lost and the condition may rather be compared to
dreaming than to a real increase of the intellectual powers. This stage of abstraction is not by any means
generally observed and soon passes into sleep, but the unchecked imagination may still
persist in the form of dreams. Even in this
early stage, pain is felt acutely, the respiration is slow and the pupils contracted.
In larger
quantities (1/4-1/2gm, 15-30mgs), morphine produces deep dream-like sleep from which the
patient is still easily aroused, but which returns at once when he is left undisturbed. As the dose is increased, the sleep deepens into
torpor from which he can be awakened only with difficulty and eventually all efforts to
arouse his attention are fruitless and he sinks into a coma, which may be reached very
soon.
Cannabis
The hemp plant, especially when cultivated in warm climates as in the Indo-Pakistani subcontinent, Egypt or
the southern United States, adds to the development of products, which induce marked
derangement of the central nervous system. Known
in Punjab as “Bhang”, it is frequently used by Fakirs living in graveyards. The active principle of Indian hemp has been found
to be a red oil or resin boiling at a high temperature, which they term cannabinol. This was found to induce the typical effects of
cannabis in man and animals.
Symptoms: The effects of cannibis Indica are chiefly due to
the changes in the central nervous system in which it induces a mixture of depression and
stimulation similar to that seen under small doses of morphine. Its action is much less constant, however and
seems to depend very largely on the disposition and the intellectual activity of the
individual. The preparations used also vary
considerably in strength and the activity of even the crude drugs seems to depend very
largely on the climate and season in which it is grown.
Soon after administering the drug, the patient passes into a dreamy
semi-conscious state in which judgement seems to be lost, while the imagination is
untrammeled by its usual restraints. The
dreams assume the vividness of visions or of boundless extravagance and of course, vary
with the character and pursuits of the individual. The
eastern races seem to take the drug generally out of an amorous nature.
An
imaginative believer sees the gardens of paradise and finds himself surrounded by troops
of “hoors” of unspeakable beauty,
while the less imaginative person finds himself unaccountably happy and feels constrained
to active movement, often of a purposeless and even absurd character. Ideas and all measurement of time and space are
lost. True hallucinations may appear but are
often absent. The chief feature of the
action being merriment, comfort, well being and self-satisfaction. Often less present thoughts obtrude themselves,
however, such as the fear of impending death or of some imminent indefinite danger. During this period the consciousness is not
entirely lost, for the patient often feels that his dreams are unreal, his satisfaction
unfounded and his movements ridiculous, but he cannot restrain them. He can give a coherent account of his condition
when aroused and answer questions intelligently. The
sensation of pain is lessened or is entirely absent and the sense of touch is less acute
than normally.
Later the
dreams alternate with periods of complete unconsciousness from which the patient can be
aroused easily and the symptoms eventually pass into tranquil sleep from which he awakens
refreshed and as a rule, without any feeling of depression or nausea.
History
of the development
On account
of the lack of control over the use of opium, morphine, heroin and cocaine gradually in
the first two decades, drug acts were introduced, to place control over the manufacture,
sale and distribution of a variety of substances. During
the same period of history, representatives of law enforcement and the courts in major
urban areas began noticing an increasing number of narcotics and its users. In response, researchers in the medicine, law and
social sciences began to examine the sequential patterns of drug use and crime, attempt to
answer these questions – Is crime the result of a special set of life circumstances
brought about by the addiction of narcotics? Conversely, is addiction pre se, some deviant
tendency characteristic of individuals already prone to criminal activity?
The answers
varied. Many commentators and analysts spoke
of a Criminal mode of drug abuse in which they suggested that addicts ought to be the
objects of vigorous police activity because the vast majority were members of the
dangerous and criminal classes.
Drug use was
but a better phase in their already developed career in crime. By contrast, there were those who argued for a
‘medical model of drug abuse’. Addiction,
they contended, was a chronic and relapsing disease and the addicts, they continued,
should be dealt with as any patient suffering from some physical or psychological
disorder. Methods of “demand reduction” and “supply
reduction” have been used.
Demand reduction essentially involves treatment for the user, education or
prevention for the would be user and research to determine how to best develop and
implement plans for treatment, education and prevention.
Supply reduction involves federal interdiction and foreign assistance initiatives
aimed at intercepting drugs before they reach US shores, or eradicating them at their
sources. Supply and demand reduction
strategies, of course, are not mutually exclusive, for they tend to overlap in numerous
areas.
Relation of Drug abuse in America
The drug problem as it is understood in 1990, has a relative short history:
Although
marijuana, opium, coca leaf and other organic substances with psychoactive properties have
been known for thousands of years, their use, on a large scale, for the enhancement of
pleasure and performance, spans for less than two centuries. The abuse of drugs as such can be traced in a
number of factors – advances in chemistry and medicine, the discovery of raw
intoxicants and a variety of social and political changes, all of which combined to make
drugs readily available for the relief of many ills, both physical and psychological.
Opium and its derivatives
The specific beginning of drug abuse in the USA are probably buried in antiquity,
but in great part, were tied to the introduction of over-the-counter patent medicines
during the early 1700s. Opium was a common
ingredient in these preparations and by the close of that century medications containing
the narcotics were readily available throughout the urban and rural America. The narcotics were sold in pharmacies, in grocery
stores, at travelling medicine shows and through the mail, marketed under various names. Many of these remedies were seductively
advertised as painkillers, cough mixtures, soothing syrups etc. Others were promoted for the treatment of
diarrheas, dysentries, colds, fever, teething, cholera, rheumatism pelvic disorders,
athlete’s foot and even baldness and cancer.
The medical profession also fostered the use of opium. Yet the mere appearance of patent medicines in
America was only minimally related to the evolution of drug taking, other more potent
social forces had been of considerably greater significance.
Remedies
were shipped to the colonies from London, as were most of the medications of the period. When trade was disrupted with England during the
Revolutionary war, a patent medicine industry emerged in the USA, while for the longest
time opium had been the only known product of the Oriental poppy. In 1803, a young German pharmacist,
Fredrick
Surturner isolated the chief alkaloid of opium, Morphine, named after Morpheus, the Greek
god of dreams. It had a profound effect on
both medicine and society; for morphine was and still is the greatest single pain reliever
the world has ever known. Furthermore,
hypodermic syringes were invented and the use of morphine by injection in Military
medicine during the civil war and Franco Prussian war granted the procedure legitimacy and
familiarity to both physician and the public.
Cocaine
Beyond opium and morphine, the patent medicine industry branched even further.
Although
chewing coca leaves for their mild stimulant effect had been a part of Andean cultures of
South America for perhaps a thousand years, for some obscure reasons the practice had
never become popular in either Europe or the United States.
Moreover,
the full potency of the coca leaf remained unknown until 1960, when cocaine was isolated
in pure form. A young Viennese neurologist
Sigmund Freud, suffering from chronic fatigue, depression and various neurotic symptoms,
tried cocaine himself.
He also
offered it to his colleagues, urging that they use it for both themselves and their
patients. It became an all-purpose wonder
drug. Gradually, though, the increasing
number of reports of its compulsive use and undesirable side effects came to the surface.
Research into the mysteries of opium during the 19th century lead not
only to Serturner’s discovery of Morphine in 1806, but also to the discovery of more
than two dozen other alkaloids including codeine in 1831.
Later by combining various acids with Morphine, diacetyl morphine was discovered,
noting that it was highly effective in the treatment of cough, chest pain and discomforts
associated with pneumonia and tuberculosis. Anti-biotics
were not discovered so far. This drug was
claimed to have stronger sedative effects on respiration than morphine or codeine. Then it came to be marketed under the trade name
Heroin (meaning heroic and powerful) by Bayer.
Habituation with Heroin, has been noted in a small percentage of the cases and none
of the symptoms which are so characteristic of chronic morphinism have even been observed. Secondly, since the drug had a greater potency
than that of morphine, only small doses were required for the desired medical effects,
thus reducing the potential for the rapid onset of addiction. Third, at the turn of the 20th century,
the medical community did not understand the dynamics of cross-dependence – which
means that among certain pharmacological related drugs, physical dependence on one will
carry over to all others.
Given the endorsement of the medical community, with little mention of its
potential dangers, heroin quickly found its way in to routine medical therapeutics and
over the counter patent medicines.
Early drug control measures. –
By the early years of the 20th century, the steady progress of medical science
had provided a better understanding of the long term effects of the drugs they had been
advocating. Sigmund Freud had already
recognized his poor judgement in the claim he had made about cocaine, the addiction
protection and abuse liability of morphine had been well established, and the dependence
producing properties of Bayer’s Heroin were being noticed. Yet these drugs – cocaine, morphine and
heroin – often combined with alcohol, were still readily available from a totally
unregulated patent medicine industry. The
drug controls started in 1906. By 1912, most
governments had enacted legislative control over the dispensing and selling of the
narcotics but the combined effects of stigma, social pressure, the Pure Food and Drug Act
and state controls had served to create an underworld of drug users and black market
drugs. Some came to the conclusion that
selling ‘dope’ is a very profitable business.
These individuals have sent their agents among the gangs frequenting city corners,
instructing them to make friends with the members and induce them to take the drug. The plan has worked so well; that there is
scarcely a poolroom in New York that may not be called a meeting place for dope friends. The drug has been made in candy and sold to
schoolchildren.
It was an
underworld population composed principally of heroin and cocaine users, who had initiated
drug use as a result of association with other criminals.
Thus it would appear that the emergence of criminal addicts was probably the
results of the effects of legislation combined with the creation of a new class of users,
who were already within the underworld.
Marijuana
By 1939 the national concern over the use of drugs was not focussed solely on heroin, for another substance was considered by some to represent another greater evil.
The new drug
was marijuana, the “devil drug”. Marijuana,
typically referred to a century ago as cannabis or hashish, was introduced to the American
public in essentially the same manner that opium, morphine, cocaine and heroin were. Marijuana, a derivative of Indian Hemp plant
Cannabis Sativa, appeared among the patent medicines and was sold as a cure for
depression, convulsions, hysteria, insanity, mental retardation and impotence. Because of its insolubility, the drug quickly
fell into disfavour.
Whatever the
ultimate causes of the drug revolution of the sixties might have been, America’s
younger generation, or at least noticeable segments of them, had embraced drugs.
In Basel, Switzerland, in 1938, Sandoz Research Laboratories isolated a new
chemical compound, known now as LSD. The
researcher was Dr. Albert Hoffman.
On April 16,
1943, after absorbing some LSD through the skin of his fingers, Hoffman began to
hallucinate. In his diary, he explained the
effect as follows –
“With closed eyes, multihued, metamorphosing, fantastic images overwhelmed me. Sounds were transposed in to visual sensations, so
that from each tone or noise a comparable coloured picture was evoked, changing in form
and colour Kaleidoscopically”.
By 1963, LSD
had achieved its reputation.
Amphetamines. – Throughout the 1960s, heroin remained the most feared drug and
by the close of the decade, the addict population in America reached 500,000.
As the 1970s
began, the amphetamines were the first item on the government’s agenda for drug
reform. The amphetamines were not new drugs
but their appearance on the street had been recent: the first use amongst Americans had
not come until World War II.
Thousands of
servicemen in all of the military branches had been issued Benzedrine, Dexedrine and a
variety of other amphetamines, as a matter of course to relieve their fatigue and anxiety. Later, amphetamine drugs became more readily
available and began to be used by students cramming for examinations, for truck drivers
and others who need to be alert for extended periods of time, in weight control programs
and as nasal decongestants. Yet for their
effects similar to those of cocaine, in time, they became popular drugs of abuse.
(References
– “Hand Book of Drug Control in USA” – by James A. Inciardy).