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Physicians Respond to DAMIT

As members of the Medical Department concerned with student health, we want to comment on the pamphlet “Drugs at MIT: A practical guide for the intoxicated engineer”, published anonymously and distributed to students in our community.

The pamphlet is a thoughtful and well-informed document. The authors provide accurate information on the chemistry, pharmacology, and effects of most of the mind-altering substances available to students here and elsewhere. The editorial position taken by the authors is responsible, stressing the value of safety and health. We share the authors’ position that the substances, if used at all, should be used carefully, and that knowledge is the best protection from their potential harm.

With this in mind, we would like to make some specific and general points. We agree that cocaine and heroin cannot be used safely for recreational purposes and should be avoided completely. LSD and other powerful psychadelics have unpredictable effects. Even when used in the company of friends, they can precipitate self-destructive impulses. In recent years, almost half of the successful suicides at MIT have been associated with LSD. Ecstasy may very well cause brain damage, the pamphlet says. The authors suggest Prozac may protect against this potential damage. But it is too soon to know whether the SSRI medications are indeed protective or whether long-range effects may still occur. Other more esoteric substances described in the pamphlet are certainly risky to take as the authors indicate and should be avoided.

General information about a substance cannot predict its impact on an individual. Drug quality, the presence of contaminants or excipients, and user factors like fatigue, body weight, and nutritional status, can alter the effects of any of the agents (including alcohol) described in the pamphlet. It is even more important to know that the drugs are often taken by students for relief of stress, depression, anxiety, and other forms of psychological distress. As physicians, we are concerned about vulnerable people. The pamphlet underestimates the potential negative effects of mind-altering substances when they synergize with a preexisting emotional disturbance. For example, the authors dismiss the “amotivational syndrome” associated with marijuana as not valid. Yet we see students whose primary problem is depression turn to marijuana instead for relief and render themselves dysfunctional. The same is true of alcohol. Students who are familiar with current concepts in medicine know diseases are as much due to the vulnerability of the host as the virulence of the agent.

Our mission is to help students get the most out of themselves and MIT. To us, the use of powerful mind-altering substances for recreational purposes and self-medication constitute an unacceptable risk. We also know that risk-taking may be less of a concern for some young people than it is for us and that all too many people think that adverse events occur to others but not to themselves. So we believe a guide to responsible drug use is not complete without a friendly warning from us that what is sauce for the goose may not be sauce for the gander, and that you, the individual student, may be the gander.

Peter Reich, M.D.
Mark Goldstein, M.D.
William Kettyle, M.D.