[Book Sip] "Drugs Are Classified as Up (Excitement), Down (Happiness), and Hallucinogens"

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This is a drug guide introduced by an author who has examined 200,000 patients over 15 years in family medicine. Tracing the chain of drug production-distribution-sale-consumption, the book presents the history and current status of drugs, adding the author's experience as a treating physician. Between 2018 and 2020, the number of drug offenders in Korea increased by nearly 50%, and the number of marijuana offenders, which had been quiet until 2015, surged more than fourfold by 2022. The author points out that the government bears significant responsibility. Despite the need to simultaneously enforce crackdowns and punishments to block supply and provide treatment to suppress demand, the current government has made the mistake of selectively choosing one over the other. The author sharply criticizes the political sphere, which, entangled in ideology and political logic, failed to respond swiftly to the spread of drug addiction, urging an end to the unnecessary ideological war that defines drug addicts solely as criminals or solely as patients.

Pentanyl was truly a good medicine. Thanks to pentanyl, the most potent opioid analgesic, Mr. Kim Jeong-cheol was able to fulfill his last wish of "spending the holidays at home." Although pentanyl cannot cure the disease, if used carefully, it can reduce the patient's pain. When pentanyl was administered to Mr. Kim Jeong-cheol, there was no need to consider addiction because he was a terminal cancer patient. However, there are quite a few cases of addiction when opioid analgesics are used for non-cancer pain. - p.25, Part 1, Chapter 1

When learning about drugs, it is easier to understand them according to their effects and efficacy as up (excitement), down (happiness), or hallucinogens. Just as the same knife is a cooking tool when used by a chef but a murder weapon when used by a killer, it is helpful to divide drugs into those currently used medically but problematic when patients use them arbitrarily (opioid analgesics like pentanyl, tranquilizers, some diet pills, sleeping pills, propofol) and those classified as outright illegal (opium, cocaine, LSD, ecstasy, heroin). Additionally, drugs can be categorized by their addictiveness, dependency, and risk level into soft (marijuana, LSD, ecstasy), medium (alcohol, tobacco, tranquilizers), and hard (cocaine, heroin, methamphetamine, pentanyl) drugs. For example, alcohol is a down-type medium drug and legal, but methamphetamine (cocaine) is an up-type drug that is illegal from the start and a highly addictive and dependent hard drug. - pp.45-46, Part 1, Chapter 1

Relatively mild drugs like marijuana or propofol are dangerous because they serve as the first step toward stronger and more dangerous drugs. This phenomenon is explained by the gateway theory. In the past in Korea, drug addiction was called the "elite course," progressing from glue to gas, from gas to pills (Romilar), from pills to marijuana, and from marijuana to methamphetamine. In the U.S., the basic course starts with marijuana, then LSD, ecstasy, cocaine, and finally heroin and pentanyl. - pp.110-111, Part 1, Chapter 2

You are a drug addict. Due to tolerance, ordinary amounts no longer have an effect. You experience auditory and visual hallucinations, your vision is blurry, and your hands tremble uncontrollably. Moreover, you feel like you will die if you don't take the drug immediately. To buy drugs cheaper, you purchased 1 gram units instead of the usual 0.03 grams per dose, so you have to divide it into small amounts. It's not easy. In your urgency, you don't use a scale and roughly estimate the dose. You don't feel any effect, unsure if you took too little or if the drug's purity has changed. This time, you double or even triple the dose. When using drugs, the sense of time disappears. You can't remember if you took it just now or a day ago. You take it again and again. Like drinking alcohol until you lose count of how much you've consumed, you keep using drugs continuously. The result is overdose or death from drug side effects. - p.145, Part 1, Chapter 3

People who use drugs are both criminals and patients. They must never use drugs, but if they do, they need treatment. If you break a leg, you get surgery or a cast. You cannot walk just by willpower without any treatment. Even after removing the cast, you cannot immediately run as before. If you fall while muscles are weak, the barely healed bone can break again. To walk perfectly as before, rehabilitation treatment lasting six months to a year is necessary, starting with slowly applying strength. The same applies to drugs. You cannot quit by willpower alone. Professional medical treatment is necessary. If symptoms are severe, hospitalization for 2-3 weeks is required, followed by outpatient treatment. After about a year of abstinence, damaged brain and nerve structures partially recover. Various rehabilitation treatments are needed to restore relationships with family and resolve economic problems. Without such rehabilitation, relapse and injury are possible. Medical treatment and rehabilitation are essential. - pp.155-156, Part 1, Chapter 4

All this is because of money. Cocaine that cost 5 million won per kilogram in Colombia rises to at least 70 million won and up to 120 million won in the U.S. Upon arrival in the U.S., the price jumps 14 to 20 times. One gram of cocaine costs 150,000 won, twice as expensive as gold at 80,000 won per gram. White gold, or rather, more expensive than gold, is cocaine. But it doesn't end there. When cocaine reaches users, its purity is generally about 50%, so the quantity can be doubled. Also, crack, made by mixing cocaine with baking powder to be smoked like cigarettes instead of snorted, can increase the quantity by about 5 to 30 times depending on the ratio. Crack costs between 70,000 and 130,000 won per gram. Selling one gram of cocaine as crack yields 3 to 10 times more profit. - pp.182-183, Part 2, Chapter 1

North Korea's top product is not nuclear weapons or missiles but drugs, especially methamphetamine (meth). Meth crystals are transparent like ice and called "ice," "ice," or "crystal," and in China and North Korea, they are called bingdu (the Chinese pronunciation for poison ice). North Korean meth boasts the highest purity worldwide at 98-100%. The reason is simple. Synthetic meth is usually produced on a small scale by a few individuals or groups using pseudoephedrine, a cold medicine ingredient. However, in North Korea, Ph.D.-level personnel professionally produce meth under state orders in Workshop 5 on the second basement floor of the historic and traditional Heungnam Pharmaceutical Factory. The quality cannot be poor. - p.227, Part 2, Chapter 2

While issues about OxyContin were being raised, on September 11, 2001, Al-Qaeda hijacked planes that crashed into the World Trade Center in Manhattan, New York. Nearly 3,000 people died, and at least 6,000 were injured. The 9/11 terror attack destroyed the World Trade Center but saved one company. "Due to this national tragedy, OxyContin was removed from the front pages of newspapers nationwide," said a sales representative from Purdue Pharma at the time. The U.S. declared a "war on terror" instead of a "war on drugs." As a result, tens of times more people died from drugs than from the 9/11 attacks. However, lawsuits and concerns about OxyContin's dangers could not be completely stopped by 9/11. In January 2002, the FDA held an advisory committee meeting with the nation's top pain experts regarding OxyContin. However, 8 out of 10 pain experts present were spokespeople for Purdue Pharma or other pharmaceutical companies or were paid lecturers. The conclusion was as expected. - p.262, Part 2, Chapter 3

To briefly summarize the U.S. drug crisis examined so far: A corrupt pharmaceutical company blinded by money spread OxyContin in the U.S. in 1995. This was the first wave of the OxyContin crisis, peaking around 2010-2011. As OxyContin supply decreased, addicted people switched to heroin. This was the second wave of heroin, starting in 2010 and peaking around 2015-2016. The Mexican cartel promptly produced pentanyl. Thus, the third wave of pentanyl began in 2013, with deaths rapidly increasing since. Currently, in the U.S., one person dies from pentanyl every seven minutes. Worse, this wave has not yet peaked. - p.278, Part 2, Chapter 3

Conservative forces tend to highlight drug and crime issues when they come to power, especially early in their administration. This likely means "the righteous conservative government will eradicate the crimes and drugs that increased due to the previous administration's mistakes." Past precedents show that strong crackdowns, such as Roh Tae-woo's war on crime in 1990 or the intense drug crackdowns before the 2002 World Cup, temporarily reduced drug offenders for 2-3 years. However, history proves that pressing the balloon (crackdown) without releasing the air (demand) only restores it to its original state after a few years. ... The U.S., which started the war on drugs with impure motives like Richard Nixon and has continued it for 50 years, has effectively lost the war. No one knows how many more will die. Meanwhile, Rodrigo Duterte, who gained popularity through the war on drugs as a prosecutor and rose from prosecutor to mayor to president, personally succeeded in his war on drugs.

Will Minister Han Dong-hoon and the conservative government, who declared war on drugs, be able to win the war? On June 26, 2023, the Ministry of Justice established a drug offender rehabilitation team. In a subsequent interview, Minister Han declared a firm commitment to the war on drugs: "We will arrest many, punish strongly, and provide proper treatment." He may be dreaming of Rodrigo Duterte's success but must never forget Richard Nixon's failure. - pp.321-322, Part 2, Chapter 4

Supply creates demand, and demand creates supply. While blocking supply, distribution, and sales that connect supply and demand, demand must be reduced. When demand decreases, prices naturally fall. If drug demand falls and prices drop, there is no reason to risk supplying drugs. Many jump into "high risk, high return," but no one enters "high risk, low return." Famous American progressive scholar Noam Chomsky also said:

"The drug problem fundamentally stems from demand, not supply. This deduction is common sense. Therefore, the root of all problems lies in the U.S., not Colombia." - p.329, Epilogue

The Mind of Drug Users, The Society Selling Drugs | Written by Yang Seong-gwan | Hippocrates | 368 pages | 18,000 won

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