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This article, reprinted from the Spring 1969 issue of the Journal (vol. 2, issue 2)–when it was still the Journal of Psychedelic Drugs—is among the first to describe high-dose, intravenous methamphetamine abuse in the Haight-Ashbury District of San Francisco. Methamphetamine use was increasing in 1967 and 1968, sometimes orally as an adulterant of psychedelic drugs or as a primary drug of abuse, but it was increasingly being abused in an intravenous, high-dose binge pattern that proved pernicious, not only to the users, but to the hippies and other members of the Haight-Ashbury community. Even among drug-using Haight-Ashbury subcultures, the high-dose methamphetamine abuser was marginalized, but became increasingly visible and unavoidable because of violence associated with dealing methamphetamine and because of the users' hyperactivity and paranoia. Methamphetamine was not a new drug. Oral methamphetamine, under the pharmaceutical trade name of Desoxyn®, and methamphetamine, in oral tablets and in ampoules for intravenous administration under the trade name of Methedrine®, had been available for years. Injectable Methedrine was prescribed for treatment of heroin addiction by a few San Francisco physicians and that created concern among San Francisco's medical community and law enforcement. Clearly, prescribing a stimulant for treatment of heroin dependence was not a good idea, repeating Sigmund Freud's misadventure treating his friend's morphine addiction with cocaine. But there was little evidence that prescription methamphetamine use was creating a major public health problem. Increasing restrictions on methamphetamine's medical use and eventual withdrawal of Methedrine from the pharmaceutical market decreased availability of prescription methamphetamine and increased the market for illicit methamphetamine, known variously as "meth," "crank" or "speed." In the late '60s, Dr. Roger Smith, a criminologist who was the Director of the Amphetamine Research Project at the University of California Medical Center, led a team of researchers who conducted interviews with drug users in the Haight-Ashbury. In this important early paper, he clearly describes the social contexts of intravenous methamphetamine use and the recruitment of new users by friends. This presages later waves of methamphetamine abuse within the gay community and the otherwise inexplicable continued abuse of methamphetamine to the present despite its obvious destructiveness to users. The article is being reprinted here because of its historic importance. —Donald R. Wesson, M.D. [ABSTRACT FROM AUTHOR]

The 1960s were a time of social upheaval, wars, vibrant creativity and missed opportunity. Mainstream culture and a psychedelic drug-using counterculture shared a belief in "better living through cheniistry' but they disagreed about the particular chemistry. The Vietnam war and the cold war with the Soviet Union, racial discrimination, and gender roles fueled political activism. "Yes we can" was not a slogan of the time but political activists clearly believed they could change the beliefs, attitudes and behavior of mainstream culture; and they did. Hippie counterculture on the other hand was largely alienated and strove primarily to develop a separate culture with its own mores, beliefs and lifestyles. Although there was some overlap between hippies and activists, hippies didn't generally have the same sense of political empowerment. Hippie enclaves developed in New York; Boston; Seattle; Austin, Texas and elsewhere; but the epicenter was arguably the Haight-Asbury District of San Francisco. Psychedelic drugs, marijuana and the Vietnam war were among many wedge issues. This paper conjures up a personal history related to the evolution of the hippie counterculture, changing drug use patterns in the Haight-Ashbury, and the origins of a technique of withdrawing patients from barbiturates and other sedative-hypnotics using phenobarbital variously known as the "Phenobarbital Withdrawal Protocol, or the "Smith and Wesson Protocol." [ABSTRACT FROM AUTHOR]