ISSN (print): 2068-8040



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The Romanian Journal of Child and Adolescent Neurology and Psychiatry

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HISTORY OF DRUGS IN CHILDREN AND ADOLESCENTS FROM PREHISTORY UNTIL PRE-SENT DAY


ABSTRACT: (Hide the abstract)

The description of some practices that are known from prehistory of drug discovery and usage leading to addiction is an endeavour which we intend to make more systematically. We use many sources to present known drugs, important stages in the history of these substances and their effects, analysing the most used ones by children and adolescents. The article also covers the prevention and treatment of drug addictions.



 

HISTORY OF DRUGS IN CHILDREN AND ADOLESCENTS FROM PREHISTORY UNTIL PRESENT DAY

Man has discovered from prehistory the effects of strange plants and poisons, with sedative, sleeping, hallucinogenic and toxic effects. These substances have been used in rituals, hunting and as treatment in diseases. From the beginning habits and dependence on fermented liquids (alcohol), on fumigation, on toxic substances, etc. have been found. This topic is vast, it cannot be exhausted in a presentation due to the various known drugs and other substances that appear daily. At present, the majority of drug users start at younger ages when children and adolescents get to know cigarettes, alcohol, or nitro-thinners. Romania through the National Anti-Drug Agency (NAA), recognizes an expansion of consumers starting with the ages of 12-14-15 years. Young consumers declare the occasional or imposed initiations consisting in tobacco, spirits and “white death”, which means opium, cannabis (the most consumed), then ecstasy, hallucinogenic fungi, ketamine, cocaine, LSD, amphetamines, narcotics and ethnobotanicals. There are lists of the causes leading to the drug trap, but each case has its own history. Throughout the world, dealers, marketers, retailers mostly target children and adolescents for sales and capture into life reliance. Drug networks have many ramifications that permanently sacrifice human lives. A recent piece of news from our mass media announces that in Bucharest, in the Ferentari district, at the North Train Station, children aged 12-14 sell drugs, but there are other dealing places in other areas, too. The broad meaning of the notion of drug addict includes aspects such as familiarity with common foods such as: sugar, salts, with odours, but also dependence on objects, people, or virtual sources, etc. It is known that the selection of substances that some human organisms assimilate from the first encounter may be the beginning of a regular repetition and then of addiction.

Branches of the tree that would represent the current drugs can fill huge areas and would require a lot of space to be occupied by new drug inventions. Drug classifications are also multiple, starting with substances that are permanently and officially offered: tobacco, coffee, tea, alcohol, etc. Medical staff has daily contacts with ether, chloroform, nitrous oxide, benzodiazepines, etc.

Among the chemical substances used for medical purposes that become addictive drugs, we mention the general anaesthetics that abolish the CNS functions. They induce analgesia, sleep, suppression of visceral functions, relaxation of striated muscles: ether, enflurane, desflurane, halothane, curare, nitrous oxide, xenon, barbiturates, opiates: morphine, fentanyl, petidine, codeine, mihaline, fortral and nitroglycerin. Creating addictions to these substances primarily targets manufacturers, medical and pharmaceutical staff that use them. The process of conceiving chemical and vegetal drugs continues. Over the years the narcoculture stage followed, when people began to cultivate plants that had become known drugs. The practices of harvesting in growers of narcotic drugs (poppy, mushroom, hemp, etc.) threw light on the possibility of subjecting and directing the users of these drugs. Thus, we see a transition of the domination from tribes or small groups to ever larger populations. Practices of growing, production, marketing, use in increasing proportions have created addictive users, becoming endemic in different areas, even in larger populations. In the industrial age, productions in large series (textiles, metals, chemicals, weapons, etc.) have grown in Europe, thus market outlets became necessary. Large territories with massive populations such as India and China offered conquering prospects, with huge commercial potential. But Western expansion met with Qing dinasty’s distrust and denial of accepting European goods, claiming they live in peace and have everything they need. Negotiations did not progress, and the British, the French, Russians and Americans have sought an entry gate into the Chinese empire. K nowing that opium was used in China during the Ming dictatorship, and it was sought by over 15% of Chinese people, in 1781, the British began the opium sales in large quantities, and between 1821-1857 sales rose fivefold. The drug was produced under a British monopoly in the Bengal Land of India. The purpose of the English and Allies was to neutralize the Chinese population and army. British Foreign Minister Lord Palmerston initiated the First Opium War between 1839 and 1842 between England and the Qing Dynasty, which was won by the English, who occupied Canton, Hong Kong and Macao. This war was the end of China’s isolation and the beginning of modern Chinese history. The Second Opium War (1856-1860) between Anglo-French naval and land forces, supported by the USA and Russia, and the Qing Dynasty was also triggered by commercial and domineering motives. The poorly prepared Chinese armies, with no military equipment, were defeated, being also under opium dependence. Western allies called for the Qing Dynasty to open the entire Chinese territory for trade and occupied more strategic areas. Western victors have been able to take possession of the entire Chinese continent, including the Peking capital and the Forbidden City which was sacrosanct for the Chinese. After this war, over a quarter of China’s population was blocked by opium dependence. The strategy of making the Chinese population and the Chinese army dependent on drugs has defeated, and the Qing Dynasty has legalized opium trade. Access to silk and porcelain, to all riches, productions and Asian slaves was open.

Examples of the drug invasion that began in America in the 1500s by conquistadors were applied in the nineteenth century in Asia, but continue to bear fruit to other human populations, becoming a global threat. A particular path in the history of drugs has been cocaine that has been used for centuries by American populations. Prof. O.C. Mungiu presented us in 2016 “Cocaine Odyssey”, a drug that circulated around the world under the name of “wonder drug”, but also known as a “dirty drug”. Europeans met the first Erithoxylum coca called also “Topa Coca”, “Mama Coca” after the year 1500. This plant grows in the Andes Mountains in South America (Peru and Bolivia, Colombia). Here the coca leaves were used long before our era. By chewing these leaves, the Incas did not feel the harsh pain since coca had anaesthetic effects, neither did they feel fatigue, or sunburn, and they did not need sleep. The conquistadors imposed this plant to the Amerindians to force them to work without delay on the gold and silver exploits. The cocaine has continued to be used after that period. In the Middle Ages and then in the world wars and in the current wars, cocaine was and is being given to the military to start the attack.

We must mention S. Freud who experienced cocaine on his own body, saying that “the substance improves the mood”. Suffering from a neoplasm of the tongue, S. Freud noted that “in small doses cocaine counteracts depression and indigestion” and he used it until the last day of his life. Other celebrities were August Rodin, Jules Vernes, H. G. Wells, Thomas A. Edison, actress Sarah Bernhardt, US President W.M. Kinley, Albert Einstein; the French poet Baudelaire who was also dependent on relationships with women, composer Hector Berlioz who composed the Fantastic Symphony describing hallucinations with the sufferings of a drug addict who lives his own funeral on the music of a funeral march. In the 20th century, cocaine has become the “main” drug, being used increasingly, either as a little loafs of bread or as powder for inhalation or in combination with wine. Many high-ranking personalities used it: ministers, Queen Victoria of Great Britain, the king of Spain, the queen of Portugal, and even Pope Leo XIII, who always had his “Mariani’s wine” with him.

Cocaine promoted itself as “replacing food, turning coward into hero, the silent into an eloquent” and making the sufferer feel insensitive to pain. Of course, cocaine addicts who used rising doses appeared. Some have tried to get rid of this addiction, such as Sigmund Freud, who used morphine for the rest of his life. In the last years of the nineteenth century, cocaine was present in beverages, ointments, even margarine. Mariani’s cocaine wine in Europe and of the pharmacist John Stith Pamberton from Atlanta, USA were trendy. Pamberton later replaced the wine with a solution of extract from cola nuts. This extract contained caffeine. Thus a new combination of cocaine appeared. As pure powder, cocaine is used for sniffing or smoking, mixed with marijuana.

After 1975, the “crack” pow der appeared, that is a fastabsorbed concentrated powder with a high potential for dependence. Cardiovascular, hepatic and psychiatric toxic effects were found: paranoia, hallucinations, anti-social behaviours with aggression and crimes. In 1914 and 1920, cocaine use was banned in the United States, which increased drug prices and the development of black trade. Combinations of cocaine with alcohol: “cocaethylene” have emerged. This formula is very neurotoxic and hepatotoxic. In the years 1976-1978 the crack spread across the USA, then to the other continents. “Crack” is quickly absorbed in a large amount, having a rapid addictive potential. In the 20th century, a combination of cocaine and heroin was developed with the same rapid toxic and addictive effects. Specialists know that cocaine aggression continues without knowing how to stop it. Through the care of chemists, cocainerelated substances have invaded people’s freedom. At the end of the 19th century, Amphetamine was synthesized and used as sympathomimetic, and since 1933 drug addiction and dependence have been described: it has euphoric stimulating effects, removes the feeling of fatigue and lowers the appetite, symptoms that lead to a pattern of compulsive consumption. Tablets, powder, injectable, or “ice” smoking, with different names like “crazy medicine”, WY, ice, all coloured and flavoured, are marketed. Amphetamine separates the consumer from daily, school, service, family obligations. In evolution, the consumer requires the increase in the dosage, being dominated by the dependence and the state of “craving, i.e. the intense desire to relive the amphetamine effects.

In the years 2014-2015, mass-media in England described the practice of sex marathon, a new sexual raid that was raging in London. The UK National Health Service has described cases of “assimilation of dangerous drug quantities” followed by sex parties up to 72 hours with multiple partners. Cocaine and amphetamine or methadone powders are used on the vulva and vagina of the girls, which produces an excitement and satisfaction, called chimsex, followed by whole days in which they have sex with 5 or more partners, while the girls neither sleep, nor eat. These situations have arisen from sexual prac tices due to the consumption of concentrated spirits from previous years. There are also cases of chimsex that cause mental complications, resulting in anxiety disorders, depression, seizures and hallucinatory psychoses. Paranoid psychotic disorders, aggressiveness, stereotypes, skin hallucinations, etc., occurring in decreasing doses or withdrawal, which induces the use of benzodiazepines for tranquillity. The use of amphetamines in pregnancy can lead to birth defects.

Methylphenidate (Ritalin, MFD) is a substance very similar to cocaine, having identical but stronger effects, acting through the same mechanisms of dopamine release in the brain. Methylphenidate - MFD – was discovered by chance in 1955 by the chemist L. Panizzona. Because the first test of the effects was made by the discoverer’s wife, Rita, the substance was named Ritalin. The main effect is contrary to expectations, soothing and nootropic. MFD is a drug that creates psychic and physical addiction, and withdrawal syndrome. In combination with little alcohol MFD induces coma and death. Ritalin was considered a panacea of psychic life. Localities and islands were created where it was used as the universal medicine of happy life. According to official estimates, in the US, 330 million Ritalin tablets are taken daily. Close to methylphenidate, with similar mechanisms of action is Atomoxetine (Straterra), which is presented by Alexandru Trifan (2006) as a specific noradrenaline recurrent inhibitor, similar to the nonfluorinated fluoxetine structure, having extensive efficacy in ADHD and liminal intellects. Straterra is not reported as addictive drug but produces depression and suicide risk in adolescents as well as repercussions on the heart and liver. Caffeine is also extracted from plants. It was an expensive rarity in the European Middle Ages. Coffee beans were brought from the Arab world along the Silk Road. Today, the beans are harvested from large areas of culture, coffee is a stimulant of mental alertness and physical performance, so it is a CNS tonic.

Children and adolescents should be kept at a distance from this stimulus that produces habit demanding effects and increased dose dependence. The substance extracted and purified from coffee beans and chemically synthesized, Caffeine is found in many medical preparations or as a white crystalline powder, being sought for use as such or in combination with other drugs. Caffeine produces vigilant state and disturbs the sleep/wake cycle producing insomnia. It also induces tachycardia, irritability and dissociative behavioors.

It is known that the effect of caffeine acts by “deactivating (occupying and blocking) adenosine A1 and A2 receptors in central neurons unable to distinguish between the caffeine molecule and adenosine molecule.” There are American, Japanese and European studies about the role and disadvantages of using caffeine; all these studies draw attention to caffeine dependence, especially in combination with phenacetin and/or paracetamol. We know people who use 10-20 tablets / day of antineuralgics, fasconal, etc. All these addicts begin to use caffeine from adolescence or youth. Caffeine-like effects are encountered by users of ephedrine. Searching for and using the drug was a necessary step for many children and young people with difficult times of life. Continuing the ancestral inhalation practices of various fumigations, many users from all over the world have used inhalation of volatile substances starting with the smell of urine, oil, burning and exhaust gas, then volatile nitro thinners which were put in bags or plastic bags. Between 1980 and 1996, there were many such inhalers on our streets. We know that some inhaling children have become inhaling adults. Nitro - thinners are used from the “Aurolac” bottles, therefore these inhalers have been named “Aurolaci”. In sports life, many drugs have been used: of which the most stimulating doping is achieved with Medonium - which leads to exclusion from sports.

DRUGS AND DRUG ADDICTS ON THE TERRITORY OF ROMANIA

There is a lot of information about the use of drugs on Romanian territory. The Geto-Dacian rituals consisted of fumigations of fir incense or cannabis seeds (in closed tents). It was well known that it was not good to sleep in a hemp field beside mown hemp. The milk squeezed from hemp, mixed with the leaves of this plant, is also called “fulfa” even today, and this juice is now used in the villages for the preparation of the “martyrs”. Writer Andrei Oişteanu published materials about the use and dependence of the Dacian ancestors on the wormwood (absinthus oficinalis) which is a powerful and stimulant hallucinogenic drug, and is currently used by the rookie dancers (in Romanian=calusari), because it allows them to make great efforts and jumps. It is known that folk practices used plants with a psychotropic effect, of which the most famous is the lavender which can be both stimulating and a lethal poison. The Atropa Belladona extract was used in history as an antispasmodic medicine as well as to provide girls’ mydriasis or for poisoning. From the beginning of the second millennium, especially dur ing the great migrations and invasions of the East, several peoples such as the Scythians, Mongols, Slavs, Goths, Visigoths and other Germanic tribes passed through the territory of our country, the turanic peoples: Polovtiens, Turkish-Tatars, Huns, Hungarians, Gypsies, etc. Each of these peoples had their drugs and left or imposed habits and practices of using wildlife preparations.

During the Pharariot period, Greek rulers named by the Sultans brought Axion’s custom, that is the use of opium. It is known that Prince Grigore Ghica II died of overdose. It is known that Turkish janissaries used to drink opium for courage in fighting, the same drug was received by Moldavian soldiers. The Renaissance ruler Dimitrie Cantemir used to drink Axion all his life. From rural culture, it is known that gypsy witches offered extracts from lily bulbs and seeds or from a plant called “navalnic” for the sexual excitement.

From the inter-war period (1918-1942) and further we have written testimonies about drug users from us. Mircea Eliade came from India with drugs “for the relief of thought: cannabis and opium.” Alexandru Odobescu was a morphinist since his youth, using laudanum (opium dissolved in alcohol) for which he committed suicide. Macedonski, a Craiova poet, smoked hashish with the pipe, being the first to describe his drug addiction; Mihai Eminescu was treated by Dr. Alex Şuţu with morphine; Mateiu Caragiale described in the novel “Crai de Veche Curte” the use of marmalade with stimulants; poet Ion Barbu (Barbilian) together with Tudor Vianu and Ion Vinea used ether and cocaine “weekly”; actor Emil Botta and poet Nichita Stanescu were alcoholics and morphinists, and Mircea Cărturescu and the famous poet Emil Brumaru are caffeine addicts from the “Ness-cafe” era. Among the known physicians, we mention Gh. Marinescu who tested the bromides, which were considered panacea during his life. He became addicted and had the power to give up when symptoms of bromism occurred. In Paris, Ed. Pamfil used briefly some doses of mescaline in order to describe drug-induced pathological experiences, possibly identical to those in psychosis. Between the 1960s and 1970s, the LSD with the Hippy movement came to us and co-opted teenagers and university students. In the years 1970-1985, young Romanians students were not allowed to travel to the West, but visitors from Germany came here, especially in Timisoara, Sibiu and Brasov. From them, the custom of taking benzodiazepines (napoton and diazepam) with alcohol (vodka) was taken. CNS blocking effects, hallucinations, practice of uncontrolled sexual acts, digestive, hepatic and respiratory complaints were obtained. We have been involved in stopping these practices from expanding, but we know some of the former students who left for the GFR being addicts for life, and died of drug abuse.

FLIGHT OVER A DRUG’S NEST

We start from the official NAA finding that drugs are consumed in Romania at an ever-younger age. The drug centre from Romania is known but cannot be abolished. We refer to the great Roma neighbourhood called Ferentari of Bucharest, where the current drugs are sold and used. There everything is masked by garbage and insane barracks, and the authorities never penetrate. Of the locals no one works. Living conditions are miserable, adults and unskilled children, smoke, stand on the road and wait for drug customers or parties in “bawdy” barracks with little girls, girls and women ready for talks and performance. Every dealer or caretaker praises his merchandise, which was washed and multiplied with flour or talc, even with dust. Many sellers are 12-14 year old (no criminal responsibility, they “play” the sellers). Prices are fixed and are very high, with no discounts. Only old and well-known customers are entitled to bargaining. The “Dom Perignon” drug is highly sought after as a mixed and expensive product, like the new “Ab-Chininaca” drug. During the day, there are card playing, barbot, smartphones are handled, and in the evening, distilled alcohols are consumed in dark pubs. Often there are clan squabbles. The most famous branch of Ferentari is at Bucharest North Station, then the Old Centre, Baneasa, Herastrau, Roman Square, Crângaşi, Drumul Taberei, Militari districts.

Drugs come from China, the Near East, but also from Tunisia or Venezuela. According to NAA, in Bucharest, about 4 kg of drug is consumed in one day. Adolescents and young people in Romania say that over 25% of them have tried drugs. The most consumed and accessible is cannabis, called “grass”, followed by Ecstasy, hallucinogenic fungi, ketamine, cocaine, LSD, etc. According to the NAA, the reasons why 12-14-year-old children and adolescents fall into the drug trap are family problems, the influence of entourage, and the desire to try and live strong sensations. The KAT drug comes from Somalia on the route Ethiopia - Greece and has a very high price in Bucharest. This drug requires to be taken several times a day - it produces rapid addiction and irreversibly destroys the CNS and the other viscera. The other channel is Morocco-Spain-Netherlands-Romania.

PREVENTION AND TREATMENT OF DRUG USE

Child protection for children and adolescents requires a national and global strategy in the framework of social and educational measures coordinated by state and international organizations. These measures are hard to achieve because producer and trader organizations, having money and information networks, annihilate anti-drug laws and measures. Although the WHO has stated that drug addictions are diseases, specific treatments have not yet been found for this vast chapter. In recent years, addictions have expanded to electronic devices that have created multiple virtual dependencies. China produces the most number of laptops in the world, so the youth and the population have access to new and complex generations of equipment.

There are also the most dependents in the world for these devices. Thus, access to electronic devices brings out more and more dependents from schools, universities and the labour market, a phenomenon which consumes social assistance money, so the state is deprived of it. Military Hospitals have been established that “treat” hard, privately, but also take care of the education of young addicts. The results of these medical-military institutions are poor, although hospitalization lasts between 6 months and 2 years. We note that in 1932 Bayer’s syndrome (German physician) was discovered describing drug-induced symptoms. This syndrome consists of delusional and confused state of mind, irritability, psychomotor acts followed by amnesia leading to thefts and aggressions. Our practices of medical psychology, psychiatry of children and adolescents, sociology, psycho-pedagogy and the school age schools cannot solve these severe disabilities, different from one subject to another. We are empowered to find solutions for each case according to the age, place and quality of the family or nursing staff in the territory. One of the possible measures in our country would be removal from the urban environment and relocating to the quiet, rural environment, without groups of drug addicts, under the protection of family or relatives. Trials of sleep therapy, sophrology measures, hypnosis, behavioural psychotherapy, or yoga are being tried in many situations that require a very active, affective, emotional support. From a drug point of view, it has been attempted to double and replace a drug with a lower-dose of of a drug from another class, but it has come to double the dependence. According to Monica Georgescu’s article of May 18, 2017, at the 5th edition of the National Conference of Addition organized by NAA, the Romanian Society of Addition and UMF Carol Davila Bucharest on the subject of “Psychotropic Substances - Risk of Abuse and Addiction” from 20-22 April 2017 , at this Bucharest event “a number of factors that make it possible to differentiate between people at risk of consumption and drug addicts” were discussed. According to the quaestor Sorin Oprea, NAA director, “this consumer risk can be identified from the early childhood, from personality traits or temperament that place certain children at increased risk to develop consumer behaviour.” During a special session moderated by Dr. Cristina Hudiţa, representative of the Romanian Society of Addiction and Dr. Ileana B. Antonescu of the National Centre for Mental Health and Anti-drug Bucharest, there were analysed risk and protection factors among adolescents. According to a study by these specialists, it has been determined that “individually, boys have more chances to develop addictive behaviours.” Specialists in child and adolescent neuro-psychiatry know that young people with diagnosis of disabilities using both analgesic and sedative treatments and those with varying degrees of mental retardation are addicted children and adolescents who require specialists and treatments specific to the respective health status. This kind of interventions is a starting point in the literature as well.

Since 2009-2010, we also use the partial agonist and antagonist opioid related to cerebral receptors, with slow reversible effects called Buprenorphine, an alkaloid, offered in sublingual tablets, which wipes out the immediate and brutal need for opioids. Doses are adjusted to subjects who need to be monitored after treatment, too. We do not yet have data on the effects of these substances. As new drugs keep appearing, it would be time to use medical drugs with anti-drug effects as well. New attacks with substance or virtual drugs that create immediate dependence (Krack or Blue Balen) warn us that there are destructive and murderous tendencies of these producers that address the world’s population.

CONCLUSIONS

The production of known drugs and new drugs continues. Chemical drugs, toxic substances from the industry, and recent virtual drugs are scheduled to rapidly produce addictions and create many users, so that a human genocide trend takes contour by using strategies that have so far been tested. We await the humanitarian response of governments, specialists and even the army to stop the advance of the “white death” on earth.



Correspondence to:
magdalena.sandu@gmail.com