Drugs/medical issues in T2k (includes 'Drug use & availability in the Twilight War')
 

Okay, I want to qualify this before I get started: I am not looking for a fight or a discussion about the current, real-world status or opinions on same of various controlled substances, impact, law enforcement issues or anything like that. I'm not extolling an opinion as to whether they should be legal, illegal, what penalties the law should employ or anything of that kind. I'm not fishing for a real-world fight, period.

Now with that said...

Putting aside any personal biases we might have either way, what are the opinions regarding the tacit legalization of some drugs at the very least for medical purposes in a post TDM US environment? I honestly couldn't see MilGov or CivGov really pursuing the matter at least for a decade (possibly more) given the at least relative utility of some of them. I mean, if you've got an injured person and it's a small dose of opium or nothing to keep him from screaming his head off, or people, for example fallout victims, chronic or terminal patients whose normal palliative medicine supplies are long gone who can have cannabis oil (or smoke pot) or nothing, I'd tend to think various governments would just say go for it.

Thoughts for in-game fictional purposes?

there is another thing HEMP can be grown for than just the smoking.. it's something that can create material cheap and durable cloth, or paper. it makes really good rope. A friend tells me that it's editlbe if done right. But in a Post-Apoc setting he said that the part you can smoke would be something 'extra' that could be cultivated so that NONE of the plant goes to waste. Because it grows pretty much anywhere, and can be used to create a really good bio-deisel. and it grows fast. i think you an grow three crops of hemp in the sme time you'd get one growth period for other plants to be used to make fuel.

hell, in my campaigns hemp was grown in large baches to make hooch (the fuel), make paper and clothing (shirts, pants and shoes).

As far as I know, boosting hemp's THC content has a detrimental effect on it's use as fiber - and inversely selectign for high fiber will ower the THC. Temperature seems to have similar effects, teh warmer the climate, the more THC and les fibers you get.

I'm also sceptical about bio-diesel : you need oil-producing plants to do that and I don't think hemp is the best plant fo that. colza and the like ar far better in that regard, though in post-nuclear conditions, with little fertilizers and pesticides , you might be betfer off with a low productivity-low maintenance plant like hemp than with colza or sunflower.

One advantage is that if you're brewing some cellulose-based alcohol, an oil-producing plant will let you fuel both diesel (the oil) and gasoline (the alchohol)engines.

logistics and climate
 

while hemp and its associated byproducts may be grown in the US, I'm not sure where coca or opium poppies might grow without lots of help and greenhousing.

To quote from a PBS special on opium:
"The flower is grown mainly by impoverished farmers on small plots in remote regions of the world. It flourishes in dry, warm climates and the vast majority of opium poppies are grown in a narrow, 4,500-mile stretch of mountains extending across southern Asia from Turkey through Pakistan and Laos. Heroin is also increasingly becoming an export from Latin America, notably Colombia. "

I use papaver somniferum/opium in my game as a substitute for morphine and codeine. Our medic has some to supplement his dwindling supply of modern medicines.

Biggest problem he has though is that he isn't familiar with doses. The purity of each batch is potentially very different as well and can lead to unexpected problems - or not enough effect.

old world issues
 

.. as opposed to the new situation post TMD.

In my humble opinion I think drugs of all sorts would be used - both recreationally but also medically. Finding a batch of heroin in an evidence locker would be grand for a community - a potent painkiller available in quantity. The same goes for cocaine that can be used as an anasthetic.

Opium is an old remedy for various ailments - and was sold until well into the 1900 century in the US as Laudum etc . Heroine was also commercially available before being branded illegal.

Without a steady supply of the pharamaceuticals medicinal practitioners are used to in the modern world improvisation would be necessary. Saving lives and easing pains would go before old legislation.

Hemp has recreational uses - it is probably alot more easy to make than alcholic beverages so its popularity would increase I guess. The other uses for the plant would also make it more popular - if enough seed was available.

What I often think about is antibiotics - before penicillin doctors used among other things Sulfa. It was quite widespread in use in various forms. It also has a longer shelf life than modern antibiotics. Could this be mass produced in T2K ?

Are there estockpiles of it in RL ?

As I understand it, sulfa type drugs are all synthetically manufactured so that means once industry is gone, the stockpile you have is all you're ever going to have. There is also a low percentage of the population that have severe allergic reactions to sulfa antibiotics
However the mineral sulphur/sulfur in its elemental form can also be used as a mild anti-bacterial medicine and has been used as the base for creams to treat skin conditions.

Overall I think there would be a shift towards the natural sources of drugs because it would be by far the easiest way to acquire such medicines. When you consider that most of the modern drugs we use are synthetic forms of naturally occurring agents found in plants, animals and minerals, anybody who knows the "folk remedies" would probably be the best person to create new stocks of medicines.

For example, Atropa Belladonna AKA Deadly Nightshade is toxic as hell but when prepared properly, it has been used to treat headache, menstrual pain, some forms of stomach ulcers, motion sickness and low blood pressure. The modern medical industry says there is insufficient evidence to recommend the use of Deadly Nightshade for anything but the reality is we have extracted the useful parts of the plant and synthesized them for modern medicines and cosmetics. One example of this is Atropine.

It would seem they got it slightly wrong...
There are opium fields within about 10 minutes of where I'm sitting right now in Tasmania. I can look out my window and see snow just 45 minutes away.
A few years ago I worked at Tasmanian Alkaloids (20 minutes away), a processing facility which I believe is the largest in the southern hemisphere.

The industry is HEAVY monitored and the processing facility has more security than the average prison. The fields on the other hand are protected by nothing more than a four or five strand barbed wire fence with signs every hundred metres or so indicating fines and possible imprisonment. The entire state is patrolled by just a handful of protection officers tasked with ensuring security of those thousands of acres of fields.

Tasmanian winters are WET. It's spring here now, but in the past couple of months we had three floods - this isn't unusual and most people arent' stupid enough to build on, or try to crop on the more flood prone areas. Still, all that rain does have an effect on the higher ground.

Therefore, provided seed can be found, it shouldn't be too hard to produce the poppies. Processing them into something like morphine, codeine or thebaine is another matter.

Some antibiotics, like Penicillin, are actually relatively easy to make. The guy who invented Penicillin did it by accident -- he was experimenting with bacteria and got called away for several days and when he got back, he found that the mold on the bread he was using as a growth medium for the bacteria was killing the bacteria. After that, other scientists began experimenting with molds and bacteria. Penicillin could probably have been developed a couple of centuries earlier, but no one recognized the mold for what it was. So to an extent, some antibiotic manufacture might continue.

The tricky problem we have in T2K 2000 (and IRL) is that there are so many antibiotic-resistant strains of bacteria. There are a lot of antibiotics that are almost never used anymore because they almost never work. (When's the last time that a doctor bothered to try simple Penicillin on you? I haven't been given Penicillin since I was a teenager.) And modern antibiotics, particularly the top-line ones, can't be made by simply growing them on some medium -- they're the result of long years of genetic engineering and selective breeding. Some of them aren't even the results of simple molds. And modern antibiotic manufacturing methods are required for their manufacture. No one will be making them in T2K 2000.

Another possibility?
 

I am an avid reader of Eric Flint's 1632 series. A short overview: town of 3000+ West Virginians are transported to 1630's central Europe during the 30 Years War. One of the most deadly wars EVER. Some parts of Germany had 70+% mortality.

In that series, the Americans are able to start production of an antibiotic called chloramphenicol. I have read a little about this drug. Very usefull for things like plague, typhoid and other NASTY little bugs. Downside, about 1 in 50,000 has fatal reaction. Americans also started with some sulfa drugs.

Americans were passing information about chloramphenicol and sulfa to other combatants in 1630's Europe

It seems to me that if 1630's Europe could start producing this drug, then whatever drug manufactoring is left after the Big Bang of 1997 might be able to start at this point.

My $0.02

Mike

Killer. i hadn't thought of that series (that i did the artwork for the rulebook of the RPG they put out for).

The upstream Americans (the people of Gainsville) had a denist and one of the downstream (the people of 1600s) Scottish cavalry leaders fell in love with the head of the high school cheerleading squad (who happened to be one hell of a sniper)... the dentist was also said cheerleaders father. He wouldn't ask her to be with him, because he was very self-concious of how bad his teeth where when compared to those of the 'upstream' American men. And he went through hell getting all the dental work done without ANY anesteasa at all... once that hell was over, he then asked her if they could date... and you know what happened after that. :)

i stopped reading after the second book (wasn't able to get a copy of it, hell... i don't get out even to the damn library anymore, how pathetic is that?).

Agree that hemp (Cannabis sativa) is a very versitile plant. There are two types of hemp also, one referred to as industrial that has very low THC (the compound that gives the buzz) to the point you'd have to smoke the whole plant to get a buzz (allegidly). The second is C. sativa, indicus, which is high in THC. SOoooooo it depends on the seed you got to start with whether it has any 'medicinal' use. Also there are male and female plants, and it requires both to get viable seeds from what I understand, but one male can pollinate several female. Don't ask me, I don't know for sure, but google it if your more interested, Hemp is an ancient crop too, about 4-5000 years it has been cultivated, primarily for fiber.. it makes excellent fiber.. the English long bow string used hemp and linen, preferring the hemp for it's strenght.
FB

While picking my son up at high school, I chatted with his chem teacher, according to her, sulfa drugs were first made in 1906...her opinon was that any decent college chem lab was capable of making them (ditto for chloramphenicol). It seems that I'm not the first player to ask this question, so I've got phone numbers for three new players!

And again, finding the components of a decent college chem lab may be problematic--the glassware, bunsen burners, etc can be found or improvised, but the purity of the base chemicals would generally be suspect.

To which I would draw attention to this thread again:
http://forum.juhlin.com/showthread.php?t=2984

A lot of the base chemicals can be produced using early 1900's tech, even if not in large amounts. I need to update the document some though...

SCORE!!!!! :D

OK, weird...on my last message in this thread, there's now what I think is Targan's avatar (the kangaroo having a beer) where the edit/delete message button was...is someone trying to tell me something?

OK, it's now happening on all my posts...even weirder...

Far out. It's not me man, I swear. Must be ghosts in the machine...

Yeah, right. You know I'm mentally ill and you're trying to push me over the edge, aren't you? Into a rubber room with a straitjacket? Then you'll come to my house and get all my stuff? Hmmm? Then I'll spend the rest of my life in that rubber room yelling "TARGAN!!!", and no one will know why...

I know from experience that dope is pretty dang easy to start growing. Years ago in my wilder days, my roommate &I tossed our seeds off the balcony. About 4 weeks later there were little pot plants growing under our apartment.

In Hawaii, pot grows wild in many places. You just have to know where to look -- including, Law, Ulupau crater...

Which of course you promptly ripped out and destroyed as the good citizens you are. ;)

Sadly, the yard guys did before we had the chance. I guess we just waited too long.

drug Use and Availability during the Twilight War
 

i've been wondering about the availability of tobacco during T2K and while considering this it made me think of other things how easy would it be for characters to procure access to certain drugs and how from a GM perspective to handle their use. examples such as:

1. while combat was at its heaviest i can see some support elements taking speed in various forms to keep up with the pace of their operations(this is based off of how during the surge in OIF several motorpool's would often pop hot for speed and meth and this excuse was cited to get the soldiers off with a summary article 15)

2. the VA and other institutions have been experimenting with various drugs including but not limited to marijuana and LSD to treat PTSD i can imagine several soldiers self medicating even if it doesn't actually work

3. the recreational drug users people who were drafted while addicted to such substances or who picked up the habit while serving

4. actual honest medical purposes as regular medical supplies dwindled some medics may make do with what they can get

are there existing(canon or homebrew) rules to deal with these effects?
while synthetic drugs are obviously going to be R/R at best(see point 4) what about the other stuff?

I'd imagine weed would be fairly easy to find.

Meth will probably be almost as easy to get as weed, at least for a while. Once the chemicals for making more run out...? With a breakdown of law and order, I'd think meth labs would be popping up all over. And exploding all over, too, at least until Amateur Hour has come and gone.

Crack and coke I think you can pretty much forget. Opiates too, unless someone starts growing the right kind of poppies domestically after the collapse.

IDK about LSD, though.

There are plenty of natural substitutes for some of these substances (esp. LSD; I can think of at least two plants that can give a similar effect without having to search teh interwebz), so while the use of the particular drug might drop off, between the sorry state of the world and the need/desire to turn alcohol into fuel rather than booze, as well as the fact that it seems like it's always the scumbags and gangers (redundant, I know) that survive, I'd expect drug use overall will probably increase. At least as far as 'drug users as a percentage of the population' goes.

All I know is it would suck to be an addict in the post twilight world. Especially the ones that require chemicals to produce. Once they run out and you cannot find a substitute you will be in for a hard ride.

I'd heard - from an article P.J. O'rourke wrote when he visited Eastern Europe just months before the fall of the iron curtain - that some Poles cook down poppy field stubble to render out a base for opiates to take :(

Depressing (not as depressing as Krokodil - DO NOT GOOGLE, NOT SAFE FOR YOUR SOUL).

Wow, that Krokodil stuff sounds really grim.

I doubt that hard-core psychoactives like LSD (and drugs with similar effects such as magic mushrooms and mescaline) would be very popular for recreational use in the post-apocalyptic world. You have to be in a good headspace for LSD to be enjoyable and I think most people in the T2K universe would've seen and be carrying too much psychological trauma for "tripping" to be fun.

You can get a pretty good analogue for LSD by making a batch of rye bread dough or a loaf of cooked rye bread. Spread it out and let it rot for about a week to two weeks in cool, damp, dark place. If you get the correct fungus to grow on the rye (not a sure thing), you will have a small batch of ergot fungus growing on the bread. And like LSD, a little goes a long way.

Ergot has been implicated in many historical incidents of "witches," possession, and suchlike; it's also been used by shamans and witch doctors for about as long as rye bread has been around (and ergot will grow on a few other organic materials as well).

IIRC, ergot poisoning also tends to make extremities (fingers, toes, ears, noses, and other dangle-y bits that are near and dear to our hearts) lose circulation and fall off. This is not a side-effect you'd be wanting to deal with just for any theraputic hallucinatory effects of the fungus, unless you just don't care what happens to the person you'll be freaking out.

As for cannabis leaves, they're just one side benefit of growing hemp! Hemp was grown throughout Colonial America (northwest of Lancaster, PA, is a township called "East Hempfield") for use in cordage (hemp ropes and cables were preferred for ships' rigging) and canvas (again, preferred for sails). Since the petrochemical and synthetic fiber industries are going to be long in coming back, I'd imagine that somebody, probably one of the surviving students of nature and organic farming, decided that hemp would be a good crop to bring forth.

Opium poppies may be a little more problematic; I not sure if the seed heads of normal domesticated (Eschscholzia Californica. California Poppies; Papaver Paeoniflorum; Papaver Laciniatum) poppy heads contain anywhere nearly enough sap as the Opium Poppy (Papaver Somniferum) to make a decent production run.

Opium poppies are cultivated by gardeners for the flowers, though. They'd tend to be out there, being grown, by groups where someone -- avid gardner, medical professionals, pharmacists, well-read junky -- knew enough to identify the seeds for the proper species and get cultivation online. The poppies themselves aren't hard too demanding once you get the seeds in the ground, and very hardy (they grow like weeds in Afghanistan, making me believe you could probably also grow them on the face of the moon . . .)

How much processing could be done with resulting opium would be limited by both expertise and available chemicals. Opium itself and Laudanum are easy enough that they'd be very common. Morphine and heroin aren't super complicated -- they are, after all, produced in bulk in clandestine labs in A'stan, SE Asia, and Mexico every day. However, I don't know how much personal expertise or written references are floating around in the mid-90's in the US or Europe, especially after the nukes fly.

No ideas on pricing, but I'd think availability would be something like:

Marijuana V/V or C/C
Hashish C/C or S/S
Opium, Laudanum S/S or R/R
Processed Morphine or Heroin/Diamorphine R/R

Of course it is entirely possible that in various locations some group would have a monopoly on some of the above (poppies more than marijuana, I'd think, as well as on production of the complicated derivatives), which would effect price, availability, and possibly provide gaming ideas. I could see New America as part of their survivalist prep thing making sure cells had access to opium poppy seeds and the know how to use it to make both medical grade morphine and recreational heroin, for instance (the better to control the restive non-white masses and all that).

Coca isn't grown anywhere outside the Andes, I don't think, and unlike opium poppies, possession of coca bushes in Europe and the US is a criminal offense. I could see some very limited continued importation to the US after the nukes (i.e. if you're going to risk trade all the way from northern South America to CONUS, it's only going to be for goods worth their weight in gold), but availability would tend to be -/- with acquisition being specific to some sort of gaming scenario.

Alternately, some New America cells could also be growing and processing coca as part of the same keep the masses high and subordinate plan. I could see them, as presented in the T2K universe, having sufficient connections and protection from politically powerful patrons to manage importation of coca bushes and their covert cultivation in CONUS. (Hell, maybe New America and it's secretive patrons in the US government are the reality behind the "CIA started the crack epidemic" meme from back in the 80s -- and New America being involved in the drug trade might help explain their funding -- all things PCs might learn along the way.)

The more processed drugs along the lines of LSD, PCP, Meth or other forms of amphetamines, synthetic opioids, etc., are probably a thing of the past entirely by 2000, unless somebody managed to stockpile chemical precursors and such in mass quantities. Which might not be too implausible -- in the post-TDM chaos, a group of bikers or somesuch could have been doing focused raids and thefts to acquire mass quantities of sudafed and other necessary chemicals. While not commonplace, it's another potential gaming storyline -- a large enough group of bikers to carve out some stable enclave and using continued access to crystal meth both as a super high end trade good.

Over in the "Drugs in t2k" thread I started many moons ago, it was posited that, at least in the CONUS, there'd be a healthy amount of stuff in police evidence lockers and warehouses. Now, of course, by late 2000 early 2001 when the troops begin to come home I'd wager most of that stuff is gone, and all that's easily accessible is pot.

edit: Here we go -

http://forum.juhlin.com/showthread.php?t=3119

turns out there's a LOT of "Drugs in T2k" threads...! HMM...

Perhaps some thread merging is in order? Any objections?

Not from me. A pharmaceuticals megathread might help prospective GMs find out what medicines they might get in the ol' Howling Wilderness (be it back home or in Europe).

i agree merging is in order(and please put it in the resource map):D

Ergot is nasty stuff. While it does cause hallucinations eventually, it's because the brain is being bled. Yes it does cause the blood flow to extremeties to be blocked. During the Crimean War the Russian forces lost a sizeable percent of their cavalry horses and men due to ergot poisoning from contaminated rye. It was one of the reasons we never grew the stuff on the farm. It can affect other grasses too, but rye was the worst of the commercial grains affected. Ergot looks like rat turds in the grain. I have seen some samples where there were more ergot than rye kernals. It can and is sold to companies for pharacutical use as blood thinners and RAT POISON. You'd have to be stupid.. oh wait we are talking about dopers here right... to take it voluntarily.

As for hemp, there are TWO stains, European and Chinese (Oriental). The THC is highest in the Oriental and is the 'drug' variety. European is much lowerin THC and is the basis for 'Industrial' hemp that is making a comeback in the US. You'd have to smoke one heck of a lot of it in short order to get a mild buzz from what I've read. You still need a special permit to grow it, and the major pest of the fields are two legged idots that don't believe the signs that say it is not the type that makes you high.

Just my two cents.

Yeah -- I read about a research farm in the UK that was growing acres and acres of low-THC content hemp. The first year they were in operation there was a major problem with fence jumpers trespassing and harvesting the "weed" they were growing. The second year and thereafter, not so much -- any locals who were excited about the sight of acres and acres of hemp having learned their lesson the first year.

THC boost
 

Out of the foggy depths of my college memories come mention of an Isomerizer--a device which concentrates the THC from low-buzz weed into better-buzz tarry blackened residue. I have no clue as to the details, but a friend's druggie housemate was a Chem major, so this was an example of homework paying off! It involved alcohol and an elevate temperature, and that's the extent of the explanation I received when inquiring about this miraculous machine. I do remember some housemates thought they were going to turn pigs ears into silk purses, but you can't turn stems and seeds into much more than they originally were. The entrepreneurs did some heavy marketing and hard-sell on the weird-looking result, and some people were stupid enough to be caught up in the sell.

That's how you make hash oil. Ether works best in that process but, as with many similarly dodgy endeavours, many who try it end up with burns and at least a blackened work area, at worst a charcoal shell where the building used to be.

Natural Remedies
 

We've talked about drugs, but what about basic first aid? Here are some old 1920-1950s "home remedies"..

Honey: you can spread some on a burn or smear on a wound and then lightly wrap. Its used to quickly heal and prevent infection, it causes bacteria to burn itself out by multipling too fast, or so my grand mother always claimed!

Salt: Yes pouring salt on a open wound is painful, but it will kill an infection, this one was used in the Greeks and Romans as a specific against gangrene.

Blackberries are an old specific against diarreha.

Potato Peels: case of irritated or inflamed eyes, place grated peelings on a piece of gauze and cover the affected eye.

Spider Webs can also be used to help cover a wound.