It should come as no surprise to anyone trying to get or fill a prescription for a controlled substance that our drug laws are nuts. But you probably don't fully appreciate how nutty they really are. This article just scratches the surface of the nut. But that's still plenty.
If you're done sorting Skittles – be careful, they cause cancer but only if you eat them in California – and if you have nothing better to do, perhaps you'd like to take a look at a different version of government-backed insanity: the drug laws that our DEA enforces. If you're in the mood to do so, I have some great news! The laws, which come from the Office of the Law Revision Counsel of the United States House of Representatives, are up to date as of May 14th of this year. There may be some crazy s### in there, but at least it's current crazy s###. Pages and pages of it. In the interest of not exceeding even the most optimistic prediction of my lifespan, I'll stick to the beginning: §802: Definitions, (Squiggly thing ----> § means section), which bears the pithy name "Title 21-Food And Drugs Chapter 13-Drug Abuse Prevention And Control Subchapter I-Control And Enforcement Part A-Introductory Provisions." Squiggly 802 begins with a definition of terms. Some are mind-boggling.
§802. Definitions (getting off to a fast and judgmental start)
- §802 (1) "The term "addict" means any individual who habitually uses any narcotic drug so as to endanger the public morals, health, safety, or welfare, or who is so far addicted to the use of narcotic drugs as to have lost the power of self-control with reference to his addiction."
Isn't that interesting? If you're addicted to something, it might endanger public morals, whatever they are. Who wrote this? Ben Franklin? That's my guess because the last time the term "public morals" was even muttered, let alone applicable, must be 200 years ago. Public morals? Pffft. Ask George Santos.
Also, note how it's only narcotic drugs that endanger public health. Perhaps it should be noted that there are about 10-fold more fatal vehicular accidents caused by alcohol (about 17,000 per year) than drugs. Somehow DUI deaths apparently do not endanger public health—strange system.
And, isn't it interesting that Schedule V drugs – the least addictive of the five classes of scheduled drugs (examples are Robitussin AC, Lomotil, and Lyrica) are deemed controlled substances while alcohol and nicotine are not, especially since both are on the list of the five most addictive drugs in the world? This apparent contradiction is "explained" below.
- §802 (6) "The term 'controlled substance' means a drug or other substance, or immediate precursor, included in Schedule I, II, III, IV, or V. The term does not refer to distilled spirits, wine, malt beverages, or tobacco, as those terms are defined or used in subtitle E of the Internal Revenue Code of 1986."
Isn't that a bit strange? The DEA enforces laws about potentially addictive prescription and illegal drugs, while the Bureau of Alcohol, Tobacco, Firearms and Explosives regulates other very addictive drugs like alcohol and nicotine. And another thing, those functions – alcohol, tobacco, firearms, and explosives – don't really fit naturally together. Why not chuck in the space program, minting coins, and animal husbandry as well?
- §802 (18) "The term 'opiate' or 'opioid' means any drug or other substance having an addiction-forming or addiction-sustaining liability similar to morphine or being capable of conversion into a drug having such addiction-forming or addiction-sustaining liability."
Now, this is revealing. One sentence about opioids and opiates mentions "addiction" four times, but there is not a single word about analgesic properties. Nope, the DEA doesn't care that these are vital medicines, only that they are potentially addictive or can be abused. Is it any wonder that these guys are kicking in physicians' doors as if they were raiding meth labs? It would seem that the DEA cannot discern the difference between drug dealers and pain doctors, so the two groups get pretty much the same treatment.
And the DEA doesn't want you partying with anabolic steroids, either, with one medically egregious exception.
- §802 (41)(A) "The term 'anabolic steroid' means any drug or hormonal substance, chemically and pharmacologically related to testosterone (other than estrogens, progestins, corticosteroids, and dehydroepiandrosterone."
The last, dehydroepiandrosterone, aka DHEA, gets a free pass. That's the egregious exception.
It would be difficult to cram more bad science into one sentence. Here's why. First, a steroid is defined by its chemical structure (Figure 1), not by its pharmacological properties. Since there are different steroids with different properties, it makes perfect sense to exclude estrogens and progestins (contraceptives), and corticosteroids (potent anti-inflammatories) from the controlled substance list. But dehydroepiandrosterone (DHEA) is also excluded. Why? This is madness.
Figure 1. (L) The chemical structure that defines steroids, regardless of function. (R) The chemical structures of dehydroepiandrosterone (DHEA), androstenedione, and testosterone are nearly identical, differing only by the oxidation state of two carbon atoms (red and green circles). Note that the three drugs are interconvertible within the body, as shown by the red arrows.
The madness of dietary supplement laws infects DEA policy
Although the three drugs in Figure 1 are all anabolic (muscle-building) steroids, DHEA can be sold (without a prescription) in a supermarket while, at the same time, you can (theoretically) be prosecuted for giving someone a shot of androstenedione or testosterone. If you're wondering why it's legal to sell DHEA, which is converted in your body to two illegal steroids, you're not alone. But it's true. While DHEA is given an exemption, both testosterone and androstenedione are found on the DEA list of controlled substances.
Does this make any sense?
Scientifically, not one bit. But neither do our drug laws. Perhaps the worst offender is DSHEA, the Dietary Supplement Health and Education Act of 1994, something I've written about numerous times, including here and here. Scientifically it is a big fat joke. Why? For starters, let's look at the definition of a dietary supplement according to DSHEA:
"Congress defined the term 'dietary supplement' in the Dietary Supplement Health and Education Act (DSHEA) of 1994. A dietary supplement is a product intended for ingestion that, among other requirements, contains a 'dietary ingredient' intended to supplement the diet."
But it gets worse
"Dietary supplements are regulated by the FDA as food, not as drugs."
A few minor problems here:
- DHEA is not found in foods, so it is difficult to see how your diet could be lacking in it, thus requiring supplementation.
- It's a chemical with the following technical name: (3aS,3bR,7S,9aR,9bS,11aS)-7-Hydroxy-9a,11a-dimethyl-2,3,3a,3b,4,6,7,8,9,9a,9b,10,11,11a-tetradecahydro-1H-cyclopenta[a]phenanthren-1-one. and it's made in factories by organic synthetic processes such as this, mainly in China.
- Does that sound like a food?
- Not really, although I guess it's possible:
Vinnie: "Hey Joe, I'm just not bulking up fast enough in the gym. Mind if I munch on your adrenals?
Joe: "Sure, perhaps we can do each other a favor. My doc told me that my testosterone level is low. Mind if I munch on your #####?
I'm not going to (once again) write about the story of how an anabolic steroid got to be classified as a food supplement, but you can probably guess: politics, money, and lobbying from the dietary supplements industry. A 2005 New York Times article, "How One Pill Escaped the List of Controlled Steroids," spells this out in great detail. It's good lunch reading. Maybe Joe and Vinnie should give it a try while they're sorting out their dietary arrangement.
Even considering these few examples, it becomes apparent that our laws concerning drugs (also chemicals, foods...) are not only not based on sound science but sometimes contradict it entirely. This is how we end up with mindless laws and policies like these. The DEA considers both marijuana and heroin to be Schedule I drugs (high addictive potential, no approved human use) while at the same time, states are making cannabis legal. An anabolic steroid, which isn't a dietary supplement by any definition is not only exempted from a DEA list of dozens of controlled anabolic steroids but is treated as a food by the FDA.
Crazy? You bet. Our drug laws are just that.