Psychiatry & Psychotherapy Podcast - Blitzed: Nazi Germany, Hitler, Pervitin (Methamphetamine)- How Drugs Influenced World War 2

Episode Date: December 10, 2021

In a podcast episode with award-winning author and screenwriter Norman Ohler, Dr. Puder and Dr. Borecky discussed Ohler's recent book, Blitzed, about how the Third Reich used drugs to optimize performance during World War II and how it may have changed the course of history. By listening to this episode, you can earn 1.25 Psychiatry CME Credits. Link to blog. Link to YouTube video.

Hello and welcome to the Psychiatry and Psychotherapy Podcast. I'm here to talk about getting rid of burnout, increasing job satisfaction, and feeling like an expert in what you do. One thing that created a lot of burnout and angst for me was trying to get continued medical education right at the last minute. So why not join the CME membership and do CMEE while listening to this podcast. Go to Psychiatrypodcast.com, sign up, sign in, take the test, and the certification is email to you in seconds. our welcome back to the podcast before we begin this episode with norman holer and adam brecki i wanted to introduce the idea that we're going to be talking about today and give you some a little bit of scientific sort of knowledge before we start the episode so in this episode we're

going to be discussing methamphetamines nazi germany hitler we're going to be talking about war and how in war they used of methamphetamines and amphetamines to basically act as a performance enhancer. And we're talking about tablets of Purvitin, which are three milligrams of methamphetamine. And usually they would take three to five of these over maybe the course of a couple hours or a couple days. We know that 35 million dosages were ordered before the Blitzkrieg, which we'll talk about the details of that when Germany invaded France and three million German troops marched 22 miles per day under fire. So those 35 million dosages were split up between those three million German troops.

We also know that, and we don't really go into this in this episode, but General Eisenhower ordered one half million dosages of benzidrin sulfate, which is amphetamine sulfate. It's not methamphetamine, it's amphetamine sulfate. And these were in five milligram tablets and about 20 milligrams was consumed maybe per day. and, you know, this was used by American troops, in this case, to sort of break through German limes to increase a sense of power, to increase aggressiveness and to decrease fear. We will also talk about how, you know, other things were used,

like oxycodone, cocaine. And I think what's interesting, as I reflect upon this episode, is, you know, although these are lower dosages than may be used by people who are using it elicidly or chronically, which may be using 300 to 800 milligrams of methamagnamines per day, this is still something that enhanced and changed personality, changed behavior. I think just even at those low doses, you have incredibly increased confidence, aggression, and less fatigue. And so they were able to do things like March 22 miles while under fire per day

through the French lines. And then they were able to cut the telephone wires. So basically made the French armies up at the front completely without communication on what was going on. So we will get into more details. And if you stay towards the end, me and Dr. Brecki will have kind of a reflection on the episode. He's going to talk about some studies that he found

and sort of reflections that we have had since recording this. I hope this is of interest to you. And, you know, this is kind of bridging where something that influences the mind meets kind of an aspect that we're not used to, which is war. and thinking through addiction, thinking through how drugs are used. And so I hope that this is of interest to you. We also talk about Hitler and his use of all sorts of drugs,

including injecting them with like distilled testes of bowls and stuff like that. And, you know, we talk about complicated ethical issues like, was Hitler responsible for his ideology? Did his ideology predate his use of drugs, which we will discuss that, yes, it predated, his ideology predated his use of drugs. He was actually pretty clean early on. So, welcome to the episode. Welcome back to the podcast. I'm joined today by Norman Holer and Adam Brecki. Adam Brecki has been on previous podcasts like cognitive distortions. Norman Oler has written a book called Blitzed Drugs in the Third Reich, and I thought it would be interesting to have him on to talk about his book, his research in this, and kind of the psychology

of Nazi Germany, how drugs influenced both Hitler and the soldiers. So welcome to the podcast. Thank you. Good morning. It kind of seems like initially before World War II time, before Nazi Germany came to power, there was a lot of methamphetamines used in Germany. There was a lot of drugs used. And sort of the Nazi banner initially was, we're going to give you meaning and purpose outside of drugs. Can you speak to that a little bit? So drugs were commonplace in the Vimar Republic. Also culturally, they were used. Artists would use them. There was an against nightlife, for example, in Berlin. Berlin would attract tourists from all over Europe, actually,

for its crazy scene, a little bit like it was again in the 90s and in the first decade of the 21st century. And this all changed, actually, when the Nazis did take over. Hitler was portrayed as the first politician in Europe, basically, that enforced a strict anti-drug regime. The drug laws were not changed, so the old laws from the Weimar Republic were still in place, but now they were being enforced. The Nazis also formed a specialized police force to combat drug abuse and drug crime.

So in the beginning, the Nazis actually were very much an anti-drug government. You could even say that they invented the war on drugs because they did throw drug consumers, into concentration camps from 1933 onwards already. So in fact, they invented this particular aspect of the war on drugs, which is to use prohibitionist laws to suppress minorities. So they early on combined their anti-Semitic propaganda with anti-drug propaganda. saying that the Jews in Germany would use a lot of drugs, and you could see that they're not clean,

that they're poisoning the German people. So anti-Semitism and anti-drug laws went hand in hand. Hitler, as the German leader, was portrayed as also the leader in a healthy way of living. He was portrayed as basically a health saint, an anti-alcoholic, anti-smoking, he wouldn't even drink coffee. He didn't even lead a private life. He was portrayed, even though he did,

but to the outside world, he was portrayed as this, yeah, they tried to portray him as this saintly figure who was just working for his people and who has no personal vices or personal interests even. And this was highly successful. successful propaganda and it was it was it was it was it was it was at the core of the nazi belief because the nazi the racism it the whole ideology always circled around this idea of health and and and being clean and being being pure it was this this race this ethnic ethnic this racist purity that was that was the

big goal and um so and uh Drugs like cocaine and morphine, which had played quite a big role in the Weimar Republic, were now basically eradicated. And the big irony is that in 1937, a new stimulant was developed, and this was methamphetamine. The reason for this were the Olympic Games in 1936 in Berlin, where the American athlete Jesse Owens had won six gold medals. And being Afro-American, this was seen as basically a contradiction to Nazi ideology, because Nazi ideology claimed that Afro-Americans were of an inferior race,

certainly inferior compared to the Aryan white superhumans. So how could an inferior person run faster and jump better than a white superperson. So the rumor was that Owens was using a benzodrine, which was an American product at the time, basically amphetamine. And the owner of the Berlin-based pharmaceutical company, Temler, advised his chief chemist to develop a better amphetamine, a German answer to amphetamine. So something like Owens winning all the gold medals would never happen again.

So this chemist, his name was Fritz Hauschild, developed methamphetamine, which was patented on October 30th, 1937, and came onto the market in 1938 and was not seen as a drug. It was seen as basically stimulants, illegal stimulant, like a cup of coffee in pill form. And this methamphetamine, which was labeled as pavitine, became a hugely successful product towards late 30s in Germany. Yeah, it seems to me that the psychology of how the drugs impacted the soldiers really did play a role in their early success, specifically, when there was that large march across France and there was this absolute disbelief that they could travel so far.

Can you speak to that a little bit and the early success of how these drugs played a role? Well, we have to understand that Nazi Germany during the late 30s was nothing, I mean, nothing more is not the correct term, but it was basically a performance-driven capitalist society where it was important to perform well, to be on the job, to be at your best. There was a Nazi slogan, Germany, wake up. And this methamphetamine helped people to actually wake up and stay awake and be alert and not be lazy. And was then taken to the extreme when the army physiologist, Professor Otto Ranker, responsible for performance enhancement of the German army, started reading the first reports that were done on methamphetamine by German universities. these reports were very positive.

They claimed that on methamphetamine, you need to sleep less. Your fear level is decreased. Your inhibitions are decreased. You basically become more active part of society. All these positive things he learned about methamphetamine, and then he made the conclusion that maybe this would be a good drug to also enhance the fighting capability. of a soldier. So he made tests at the military academy in Berlin before the war started with

young medical officers, gave them, basically made double-blind placebo-controlled tests in 1938, compared the effects of methamphetamine, caffeine, and placebos. It came to the conclusion that on methamphetamine, you need to sleep less. And this was actually his main, and other things. but this was the main conclusion that he that he came up with and sleep was his biggest enemy as the army physiologist he had been thinking for quite a while on how to prolong the hours that a soldier can fight without experiencing fatigue and on methamphetamine you can actually fight longer so he suggested to the surgeon general to supply the German troops officially with methamphetamine before the attack on Poland.

Surgeon General, who was kind of an old-school guy, had no idea what this professor Ranka, his physiologist, was talking about, kind of thought he was crazy or I didn't understand it or actually didn't respond to this suggestion. So when Germany attacked Poland, the methamphetamine use of the German army was still chaotic. since many soldiers, you know, being normal citizens just a week, a few weeks before, had known about pevitin because it was such a popular product in Germany. They had, they basically brought it with them to the battlefield and used it because they realized, you know, if I use a stimulant, I might be able to fight better. It might even save my life. So methamphetamine abuse or use was already quite prominent during the attack on Poland in,

The fall of 1939, Ranka made a survey among medical officers, asked every medical officer in the field to write a report back to him about the possible usage of pevitin. Many reports came back, which I found in the military archive of Germany and studied. And they basically painted a positive picture of methamphetamine. Most medical officers said with methamphetamine or men were able to fight longer. They had less fear to go into battle. So they recommended it. Wow. So before the attack now on France, which came about half a year later in the spring of 1940,

Lanka again wrote to the Surgeon General. And this time, his letter or his demand to supply pevitin as an official drug was accepted. And this had to do with the strategy. that Germany would adopt in this campaign. The problem with attacking France had been that basically the French and the British had a superior, those two countries combined had a superior army than the Germans. They had more soldiers, better weaponry. In a way, there was no chance for Germany to win this war because to lead a successful invasion,

you need to be superior in armament and manpower and all that. So Germany wasn't superior at all. So that's why Hitler's generals were very reluctant to attack in the West. But then three tank generals, one of them would become very famous, Romel. The other ones were Guderian and von Manstein. They had a meeting with Hitler in February 1940, and they said to him, we have to develop a completely new strategy. We have to not attack in the north of Belgium,

where the French and British forces were kind of waiting for the Germans to attack, just like the Germans had attacked in the First World War in the north of Belgium. But we have to go through the Aden Mountains, which is a mountainous eye of a needle a little bit south between, in the south of Belgium. We have to go through there, and we have to storm within three days and three nights all the way into French territory and capture the first French city, which is Cédon.

And Hitler thought this plan was amazing and said, that's how we're going to do it. So the only problem was, how can German soldiers fight for three days and for three nights without stopping? And if you have ever tried to stay awake for three days and three nights without sleeping, you might have found that it's impossible.

at least your performance level is going to drop immensely. So how would this be possible? Of course, with methamphetamine, it could be possible. This is why Ranker's idea to have methamphetamine be delivered to the German troops before they attacked was okayed by the Surgeon General and by the Army High Command. So Temler, the company who had developed methamphetamine, received an order of 35 million dosages in April. April 1940 and quickly delivered this huge amount to the German troops. So when they attacked the West on May 10th, 1940, they were all basically tripping on meth and were able to carry through with this quite unorthodox way of attack.

It's kind of famous like the Blitzkrieg. In your research, did it seem as though there would be no Blitzkrieg without methamphetamine, like the two were kind of intertwined? There's a German medical historian, Dr. Peter Steincombe, who has this thesis, and he examined this before I did, and he helped me with my research. And he said that there's no Blitzkrieg without methamphetamine. It's obviously hard to say whether that's really true, but my findings that in Blitz show that this is actually the fact. I don't think the Blitzkrieg would have been possible without methamphetamine.

They still could have gone through the Arden Mountains, but they would have been much slower, which would have meant that the British and French forces would have been able to launch a counterattack. So the strategy to go through the mountains was brilliant, but without methamphetamine, it wouldn't have been so smooth. So there might still have been a blitzkriek, but I don't think the success would have been as smashing as it was. Yeah, I think about how when methamphetamines comes to American towns,

violence increases, horrible deaths increase, and the capacity for just very inhumane acts increases. And when I was reading your book, I was thinking to myself about this and about how the confidence in the soldiers must have been monumental. And you even talk about how they're willing to just die. And then I was reading as well, you were talking about kamikaze pilots

were often given methamphetamines as well. And just how it just kind of like... Yeah, I mean, there's reports that the troops were quite depressed on the day of the advance because they didn't want to fight. They thought we're going to lose again like in the First World War. but after they swallowed the methamphetamine pills, the mood changed. And they started to believe the propaganda that had been fed all this time,

that they were actually superior fighters. Because suddenly they didn't fear anything anymore. And they had one success after the other. They were like doped athletes that would, you know, win the game. But you don't necessarily, I mean, in a war situation, obviously you get more aggressive. They, Ranke had to write a so-called stimulant decree, which was issued to all the medical officers, which explained what the methamphetamine does.

And one of the side effects was aggressive behavior, which I suppose was a desired side effect in this case. And it's right, what you said, what you say, basically on methamphetamine, you do become more aggressive, but you just become, basically, you become more active while the drug lasts. I mean, even in America in these towns where, you know, the downtrodden white trash population lives. There's nothing left to do, basically. Then, you know, clean your garage for the 30th time. So you clean your garage and you think it's extremely meaningful what you do.

So it gives your life a meaning. And a soldier, I mean, the soldiers indoctrinated, you know, is being told. that such a great meaning to attack a foreign country and kill everybody, but still a hard thing to believe somehow. But if you are on methamphetamine, you're more likely to believe it. There was this book that actually references your book by Lucas Kamienski from shooting up the history of drugs and war. And he kind of implies, but didn't quite go all the way to say this, but he implies that meth may have lowered inhibitions and contributed to some of the atrocities,

especially like in Poland on the Jews there by the German soldiers. Did anything that you found support that hypothesis? Not really, because there's no studies on how did meth increase violence during battle, because you would have to compare it with soldiers in battle without meth. I mean, it's a fact that the more meth was used, especially in the campaign against the Soviet Union, where hundreds of millions of dosages of meth were being used, the violence increased.

And since the German universities, as I mentioned, have could prove that it lowers your inhibitions. It's quite plausible that on meth you commit, It's easier to commit war crimes and atrocities. But it's a speculation. But I think it's fair to say that it's a pretty solid speculation. But I haven't, for example, read any reports on concentration camp guards using crystal meth so they could cope with their job. There's a lot of reports on alcohol abuse by, for example, guards at camp guards.

and it was known at the time that alcohol and meth go well together. You can drink basically more when you're on crystal meth. You don't get as drunk. So these two drugs became the favorite drugs of the Germans during the war and certainly contributed to, I would say, atrocities that were committed. But I wouldn't say that they're the reason actually for these atrocities. the reasons were the racist policies of the regime.

But I do think it's easier to follow your orders when you're drunk and high on meth, when you're sober or maybe even stone and just want to listen to music or something. Yeah. Let's talk about Hitler and his personal physician, Dr. Morrell. it seems like you did a great job documenting both their relationship and how Dr. Morale kind of developed these very abnormal treatments.

As I was reading it, as I was reading your book, and he's injecting Hitler with all sorts of things, bowl, testicle, you know, like so testosterone, opiates, cocaine. it seemed like Hitler was having the effect of it because he was chronically using it. And as the chronicity increased, it kind of reminded me of some of the patients that I've seen over the years who end up in the psychiatric hospital. And then off of it, they just have this complete breakdown where they don't, they just do not function. So I'm curious, like, what are the strongest, sources that you found of data to support Dr. Morrell's use of these drugs and which of the drugs that are this that you're very sure Hitler was on? Well, the best source material are the notes of Morrell himself,

which are kept in the Federal Archives of Germany. Morrell was obliged to write down what he gave to Hitler. So he did. And he was quite detailed about. it. So you can look at most days between 1936 and 1945 in Morel's extensive notes and see what Hitler received on a particular day and under which circumstances and which sometimes also Morel writes what political things are happening on that day and why Hitler wants this drug or that drug. So the source material is highly interesting, fascinating because you get a fly on the wall perspective on the ongoings in the inner circle of the regime. For me, that was highly fascinating when I first read this.

So in Blitz, I tried to make this come alive. So the readers also have this experience of actually being in that most secretive room where Hitler discusses that now I have to go out to meet these stubborn generals who want me to change my strategy and I feel, you know, slightly depressed, but I know in 20 minutes I have to be on the top of my game. What can you give me? So I feel better and more self-confident.

And then Morel says, well, we could give you this or that. And, you know, these are interesting, very interesting conversations and situations. So what did he give? What did Morrell give? Basically, Morrell was a vitamin pioneer. He was, he was, he was, he was. giving vitamins to wealthy clients on Kufusandam, which is the main boulevard of Berlin in the 30s, he was a private doctor, a doctor feel good, basically, one of the first ones of his kind,

a jovial, chubby house doctor with extremely trained skills in giving injections. He did not believe in oral applications, but in intravenous and intramuscular applications because that's faster. So he would give his patients high dosages of vitamins in, you know, shots. And also he used probiotics, which Hitler also liked. Hitler and Morel met through a mutual friend. Hoffman, who was the photographer of Hitler and who had been a patient of Morrell. And one day said, I have to introduce you to a good friend of mine, your methods of

treatment would highly interest this friend of mine and this friend was Hitler. So there was a dinner in 1936 in Hoffman's home where Morel and Hitler met for the first time and immediately got along well. Because Hitler had a big problem with his digestion, he had gas and he was suffering from bloating. And Morrell gave him probiotics and actually helped him. So Hitler appointed him as personal physician. and then Morel was basically with a dictator every day from 1936 to 1945, certainly spent more time with Hitler than anybody else and developed a very intimate relationship with him. They basically became codependent on each other.

And in the first five years until 1941, Morrell basically stuck to his guns and gave him vitamins and probiotics. And Hitler was quite healthy, never was ill. every day on the job they developed the concept of the instant recovery so if Hitler had to stand outside at a parade and it was raining

and he would always wear his thin brown uniform because he thought this is the best looking uniform he could wear even when the weather was not allowing for it basically so he would just receive like a huge doses of vitamin C

before he would go out into the cold and so he actually didn't get a cold or anything at all. Until 41, in August of 1941 during the attack against the Soviet Union, Hitler had dysentery, the so-called Russian flu.

He had to stay in bed. He had a high fever. And this came at a crucial point in time during the advance because his generals who always were in conflict, actually, with Hitler. They always,

it was never, you know, a good relationship between Hitler and the High Command of his army. So the army wanted, the High Command wanted to attack Moscow. Germany was quite close already to Moscow. Like it would have been possible to capture Moscow, but Hitler wanted to split the troops, go towards the north to Leningrad and towards the south, to the oil reserve of the Soviet Union.

He thought that was a better way to continue the campaign. So there was a huge conflict of interest and Hitler was ill. Yeah, to stay in bed. and he was afraid that the generals would move ahead without him because decisions had to be made. You know, decisions were made in the military briefing room. They were not made in Hitler's bed, basically. So he said to Morel, I need something stronger this time than vitamins, and he received an opioid for the first time, Dolanthine, the German product.

And it immediately eradicated his symptoms. He got out of bed and walked into the blood. briefing room and was able to, you know, continue dictating the advance. And from that moment on, the vitamin therapy and treatments were interspersed with other stuff. Not only opioids, because Morrell was reluctant with opioids, because he knew their habit-forming. But Hitler wanted more and more often, as the war against Soviet Union became more and more difficult, Hitler wanted. stronger stuffed than vitamins more and more often. So what morale in the beginning, or from 1941 to about,

1943 did, was give him steroids and these animal concoctions, these thyroid glands extracts and pigs, liver extracts, and bulls, testicle drops and weird stuff that he actually fabricated himself in his own, he had an own pharmaceutical company and farmland. and fabricate plant. So he experimented quite a bit on Hitler. And Hitler enjoyed that. He was ready to test new things.

And these were actually dangerous things because they were not really, you know, they were not tested. I mean, Hitler was the guinea pig in a way. So there was one episode when Germany had occupied the Ukraine, Morrell, tried to get and did get the monopoly on all the organs of all the slaughtered animals and all the slaughterhouses of the Ukraine.

These organs were shipped to his company in occupied Czech Republic, where he then turned these organs into all kinds of strange products that Hitler thought would increase his energy level and his performance level. So Hitler tried a lot of these things out. which I think led to his physical decline. And with this physical decline, that became more and more apparent, especially in 1943 and 1944,

Hitler needed even stronger medicines. And in July of 1943, before a decisive meeting with Mussolini, he asks Morrell again for a wonder drug because he feels depressed and doesn't want to take the meeting and Morel then after consulting with himself gives him quite a powerful opioid which was branded as Eucodal at the time. It was a German product by the Merck Company. It had the active ingredient is oxycodone or oxycontin, I think it's called now in the United States.

So it's the very drug that has led to the so-called opioid crisis or contributed to the so-called opioid crisis in the United States was at the time a German product and was given to Hitler not as a pill, but again as an injection of 10 milligrams on this day in July and Hitler responded probably like everyone else would have quite strongly to this, you know, very strong drug that was shot into his vein. It made him euphoric. It made him euphoric. It made, him clear-headed, it made him feel wonderful. And we can see that from that day on, the Eukoda is being used quite often. There's, for example, the month of September, 1944, where Hitler receives 20 milligrams

of Eikoda intravenously every second day, which is obviously habit-forming and turned him into what I call in my book a junkie, and it's certainly the strongest drug application that Hitler takes in the course of his political career and downfall. Okay, so what about cocaine or methamphetamines? Was there any hint? Because it sounded like with his teeth issues, that sounds more like methamphetamines. But were you not seeing that in the record? I mean, basically Hitler took a lot of drugs. There's over 90 medications that he used,

and he used a lot of them on the same days. His morale was not really concerned with, you know, cross effects of medicines. He was not really thinking about that. So Hitler was receiving quite a crazy cocktail. The opioids were the stronger. medicine that he used because they were applied in high dosages intravenously. But there was rumors that he also used methamphetamine. Since Morel wrote down every medication that he gave Hitler never writes, well, he writes methamphetamine twice. There's two times he mentions it.

And I don't really see a reason why he would give it more often and not mention it, but it can't be ruled out, but he only writes about it twice. So I don't really think he was a meth addict. I mean, there was one. He received a vitamin preparation from Morel, which Morrell fabricated himself. And as Dr. claimed that in that fabrication also was methamphetamine, but there was never any proof for it. So I don't, if there's no proof, I don't really, I don't really know, you know, there's no proof. He did take cocaine at one point after the bomb attack on July 20th, 1940s.

when Stauffenberg tried to kill him in Operation Valkyri, Hitler was actually quite injured. He had hundreds of wooden splinters from this bomb blast in his body. And his eardrums were blown, both of his eardrums were bleeding and blown. So an ear specialist came into headquarters and prescribed Hitler cocaine for about a month. So Hitler did use cocaine, but it was more like during that special situation after the attack. But I mean, the doctor, this other doctor who came in and it was later interrogated by the Americans and gave this report that I studied about the cocaine. He was quite surprised how ready Hitler was to kind of jump into a new drug. He suddenly found cocaine.

He thought cocaine is the best drug in the world. And he was high on cocaine for over a month. But then he kind of realized. resorted back to his opioids. He was more than a opioid guy than a cocaine guy. Yeah, it seemed like when Germany is finally successfully being invaded and the supply lines are taken down and Hitler can't get access to a lot of these drugs and, you know, the drugs dried up, so to speak.

It seems like he had this huge come down and you document that in the book and sort of his angry rants that he goes on reminded me of some meth or just people detoxing, you know, how irritable they get. I don't know. Any thoughts about the sort of come down that he had and the days that it happened in? Well, morale doesn't give him the opioids anymore starting January 1st, 1945 so for four months Hitler is suddenly on no without his opioids a drug that he has become physically addicted to before so obviously he goes into withdrawal which probably was highly unpleasant because he was also in this terrible bunker underneath the earth in Berlin and he was losing World War II so he could

imagine that he felt pretty shitty. So this is the famous, you know, last weeks and months in the bunker where Hitler's just becoming this unbearable, also somehow ridiculous human wreck that just, you know, rants and shouts and screams and breaks down and is not able to, you know, conduct any, you know, sensible defense strategy against the advancing. the Red Army. So yeah, this is the last chapter of the life of the dictator and also of the, you know, the whole dictatorship, so-called Third Reich in Germany. There was in the last section of, as you're talking about that, like you have this quote

of, like, you know, Hitler could go on taking as many drugs as he liked to keep himself in a state in which he could commit his crimes. It does not diminish his monstrous guilt. And I love that because that's a question, you know, as psychiatrists that were always called in to testify on, is, did the drugs cause them to do the crimes or was it, you know, just a parallel process? And so kind of the story that I kind of see you painting is one of, you know, Hitler was already, you know, committed to these evil, rigid actions and the drugs might have just enhanced what was already present. Is that kind of what you intended to convey? Absolutely.

The drugs did not create his racist ideas or his, you know, the genocide against the Jews. This was all actually created in his head when he was quite sober and commanding all his senses. This was, this is already laid out in his book, Minkf, which he wrote when he was quite, young even before he became chancellor and later leader of

Germany but what the drugs did especially the opioids the euphoric making opioids was to kind of keep him on track and give him the artificial strength that he needed to not change his mind

and just keep going with this tunnel vision that he once had created so the drug kind of prevented him from breaking down, having second thoughts, becoming depressed and maybe, you know, stepping back, something like that, you know, other people might have, you know, stepped back once you lose the battle of Stalingrad, but Hittler just took more drugs and was, you know, and kept, kept on going and kept on being convincing and really was convincing. I mean, his generals were sure that he had wonder weapons up his sleeve

because he just told him in such a charismatic way that, of course, Germany would win the war, but this charisma was artificially enhanced by the drugs. Yeah. Yeah, I think about the chronic use of the drugs and how it changes receptor density and how in that process you get like, when you get off of it, you have decreased, you know,

normal amounts of impact of hormones like dopamine if you have you know the receptor density decreases you don't have the ability to normally have what would be normal confidence it would be like much lower and so you have this sort of deep profound insecurities um that often see in deep anxieties deep fears So I was thinking about that with like the German soldiers how they you know as the chronicity of the use of the drugs like methamphetamines for the soldiers kind of war as as that went on you know and kind of like what that led to was a soldier that's much less impactful. Did you see a breakdown in the general soldier's ability as time went on? with the drug use and the chronicity?

Well, the Wehrmacht became aware of this problem and tried to install a huge rehab program to examine and counter these effects, but this never really got off the ground. What did get off the ground was a program by the Luftwaffe. The Air Force, they installed special clinics for pilots that had been using too much methamphetamine, and were not able to continue flying missions, so they had to go into rehab.

So yes, this effect obviously took place in the German military establishment, try to deal with it as much as they could, but it was difficult. I mean, the whole war became so difficult that at one point it was just turned into chaos and other defeat. Yeah. Let's see. One more question we had was, what happened to drug use after the downfall of Germany? Well, there was still a lot of pevitin available. It came, it flowed from the supplies of the Wehrmacht, which no longer existed, onto the black market, which was ruling the economy in Germany right after the war. So Pavitin was available. It was used also to boost morale after the horrible defeat.

So for people to gather some kind of energy to rebuild their country, Pave teen was still being used. So Paveteen continued to be a popular medication or drug during the late 40s and 50s and was only kind of declining in popularity during the 60s when new drugs, like the psychedelic drugs or marijuana became more popular. I think you wrote about, like, they're giving it to, like, women as it is there, like, sifting through the rubble, trying to, like, you know, rebuild. Is that kind of indicative of the use of that reconstruction there?

These women were the so-called debris women, the trummer-frawen, they were there kind of a myth in Germany that these women, you know, cleaned all the rubble and rebuilt the cities, which is, you know, partly true because the men were all dead or, you know, too weak to do anything. And these women apparently used quite a lot of heavy team to be able to, you know, keep on going for 12, 14 hours a day. Tell us a little bit about your interest. Like, how did you get interested in this topic? I was approached by a friend of mine who was,

friend had found old pavitine pills in an old apartment in Berlin. They were 70 years old and they tried them, not being adventurous Berliners. And they... Oh, wow. ...stimulating effect. And when he told me this, I started researching because I thought that story is too peculiar not to be looked at. And then I found a topic for my book. Nice. Well, thank you so much for your time. And, you know, if you're listening to this and you're curious, I think the audible version of your book Blitzed is very, very easy to get through. It is full of more details. And if you listen to this podcast, I think you would be interested in, you know, normally when we think of drugs of abuse, we think of, like, black market.

We don't think of nations prescribing, utilizing it for war. And so I think this is a helpful or just kind of an eye opening. I don't know. It's kind of dark at the same time as I read it. It's like it's like reading sort of the dark side of mankind and what we're capable of. So it's important to understand that to be able to not allow history to repeat. Any closing remarks, any closing thoughts that you have? Well, I think we just should try to use our influence upon our governments to stop the war on drugs because it's just a senseless endeavor that creates suffering and is not really helping.

Neither the sick nor the so-called healthy members of our society. So let's just stop this stupid war that a president called Nixon once started. Yeah. Okay. If people wanted to read more of your works, where can we find you online? We can have a look at Normanola.com. There's another book that I wrote called The Bohemians, which is about resistance against the Nazi regime in Berlin during the late 30s and 40s. So you can also check that one out.

Okay. All right. Well, thank you so much for coming on. I really appreciate it. Appreciate your time. Thank you. All right. So I am really glad to have Adam Brecky here with me. And we're doing kind of a post-episode analysis. And I thought, Adam, you could kind of start to talk about where amphetamines came from, the history of it a little bit. Yeah, I think it's a good place to start. We're going back in time. So Los Angeles, the year is, you know, early 20th century. There's this chemist working in the back room of a pharmacy who's working on various treatments for the common cold looking for decongestants specifically.

Because, you know, like pseudofed, ephedrin, things that constrict the blood vessels, dry up or runny nose. He came up with some chemicals, you know, in his little O-Kim lab, and tried one on himself. and he was up for three nights straight and thought it was the greatest thing ever. So that was one of the first times that amphetamine was ever tried in a human. And then pretty soon after that, he got a big drug company called Smith Klein and French to kind of buy his patent and they would sell amphetamines as inhalers. But then pretty soon that kind of expanded.

And a lot of us don't know this in the mental health field, but amphetamines were literally the first marketed antidepressants ever, you know, way preceding, you know, tri-cyclics or really anything else. Yeah, because, you know, it's almost instantaneous when you take it. You feel a more confident. You feel some euphoria, increased sex drive, increased activity, decreased fatigue. So a lot of these things for the short term make sense on like, oh, this is helpful. The problem is, is like, kind of the escalating dose over time and the abuse and misuse,

which is hard to not enter into. Okay, keep going. So, I mean, most people, most clinicians have an association in their head between, you know, stimulants like Ritalin, amphetamine, adderol, and ADHD. And so I think it's just worth mentioning kind of where that came from. There's this psychiatrist in Rhode Island named Charles Bradley. And in the late 30s, he's working in this home for like, you know, troubled young boys. And he's experimenting, experimenting, and tries out benzodia, which is, you know, amphetamine.

And lo and behold, he found that the week after he's given him this drug that these troublesome boys are really well behaved. They're focusing. They're less. They're fighting less. And that kind of really begins the use of stimulants as a treatment for ADHD. Yeah. And so use the word benzodrin. And I mentioned earlier in the intro that benzodia was used by U.S. troops, and it was usually around 5 milligrams of tablet.

Tell me a little bit about what's in benzodrine. Yeah. So when we use the word amphetamine. We're really talking about a molecule that's an ion. And that can really be synat. Like it kind of binds to various other ions to form a salt. So like Adderall, for example, is if you prescribe the generic version, it won't be called Adderall.

It'll be called mixed amphetamine salts. So there's four different kind of variance of the amphetamine molecule matched up with a different salt. So benzodrine is amphetamine. It's pure amphetamine, but in, if you remember your organic chemistry, you have anantomers. So you have the dextro and the levilevo versions of the same molecule. So benzodrin is a perfect, or they called recimic or 50-50 split of the right-handed de-emphetamine and the left-handed L-amphetamine. So, This was the first one on the market. And what they eventually found out that was kind of interesting was that for some reason,

the D amphetamine was much more potent. So people got a little bit more of a rush from it. They got a little bit higher and it's more effective in ADHD. So Adderall, for context, unlike benzodia, it's 7525D to L. And then even today, you can prescribe pure D-amphetamine, and that drug is called desidrine. Yeah. So just to reiterate, so you have this benzene ring, ring of six carbons, you know, with some double bonds, single bonds, and then you have a carbon coming off of that, and then another carbon. and then you have like a nitrogen, an NH2 group, and then another carbon.

So it's like, does that NH2 group go, you know, in a right-handed or a left-handed formation? And then if you have on that NH2 group another carbon coming off of that, that makes it a meth, an extra meth group. So that's methamphetamine. And so that's how you get the different right and left-handed. things. So remember when you have four different things coming off of one place, it could be right or left-handed. So that's what's going on there. Okay. So then what else did you find, as you were kind of looking at this, in terms of like what makes the difference between methamphetamines and amphetamines? Yeah, it's worth like answering this in detail just because I can't tell you how

many times I've been asked by a parent. I'm trying to, you know, prescribe a stimulant to an ADHD kid, and they want to know the parent wants to know what the difference is between, you know, methamphetamine, somebody's going to use on the street and the drug, the Adderall, that I'm trying to give them. So, you know, short answer is the methyl group you just mentioned. Something magical about that group makes these, you know, different than amphetamine. So it's amphetamine plus a special methyl group. you get methamphetamine. So a couple of things, and it's a little bit mixed. Well, let me just add one more thing in there.

The simple answer is orders of magnitude of amount. That would be my simple answer to parents. So, for example, even in the military, these German soldiers are using three to five tablets, which is 9 to 15 milligrams of meth. And some are reported as high as 100. Okay, so that was kind of the max that I could see. Whereas like on the street, 300 to 800 milligrams per day is kind of what's being used.

And so there's that. There's also the speed of delivery on the street. They're injecting it, which gets it in so much faster. So and snorting it. Yeah, no, that's really it. the two things. Root of administration, you want to bypass the first-pass metabolism, so it gets in the brain quicker. And that's really what's correlated with getting high, right? So any drug can

kind of get, that's stimulating or produces dopamine or an opioid effect, is more addictive if it's shorter acting and the time from injection to brain is shorter. So you smoke meth, you inject meth, it gets going way quicker than if you were to take it poorly. Yeah. And it's like a 25, they're using, people on the street are using 25 times the amount, you know, on a, on the, is we prescribe for ADHD. So that's certainly worth paying attention to the, you know, the poison is in a dose, if you will. The neurotoxicity, you know, I mean, you have lots of studies of people who use these ADHD medication for ADHD. And they have lower rates of car accidents. They have lower rates of other drug use. they have you know they're doing a lot better in school so there's there's evidence that these can be

helpful at low doses for people with ADHD the other thing about methamphetamines i wanted to mention was the mechanism of action so adam explain the mechanism of methamphetamines for those who are listening yeah so it's the amphetamine molecule similar to the methamphetamine molecule competitive inhibitor and it's kind of a pseudo-substrate for the norpenephrin transporter and the dopamine transporter, which are just kind of chilling in the, you know, the presynaptic membrane with what's responsible for, you know, bringing this stuff back into the neuron after it's released. So if it inhibits that, you're going to have more nooprenephrine nor dopamine in the cleft. So for this post-synaptic action, that's where you get the

high. However, it, it's high. Doses, so we're talking about addiction range here, it's actually transported into the presynaptic dopamine terminal. And that's when it actually competitively inhibits the VMAT2 receptor, which we may remember from one of the tardite dyskinesia drugs, as well as Parkinsonism. So it actually displaces dopamine within the VMAT, you know, vesicle. And then you have this flood of dopamine that just surges into the synapse. And because you have such a huge difference in concentration, the dopamine transporter reverses directions.

So suddenly the concentration floods out into the synapse, which causes insane, let's like a feedback thing. So insane concentrations hitting the post-synaptic receptors, reading to kind of euphoria, psychosis, you know, all the good, but also all the bad things associated with it. Yeah. So essentially the way that I understand this is you're like, you're not bringing the dopamine back in

for another normal, pleasurable thing, you know, connecting with others, accomplishing something, that sort of thing. You're not bringing the dopamine back into the pre-synaptic neuron. Instead, you're just pushing that dopamine out of the vesicle, which are in that pre-synaptic neuron, and then out of the dopamine transporter. So instead of the dopamine transporter,

bringing it back into the cell, it's actually pushing it out so that you have this intense, intense surge of dopamine for extended periods of time that brings incredible pleasure in the short term. And often these patients that I see who are coming in crashing, they're sleeping, they're irritable,

they're not happy, they have no pleasure. And they just look like just tired and worn out and like the lights aren't quite on. And so, you know, when you have 500, 600, 700 milligrams a day of methamphetamines, it just causes this chronic damage to the brain. And, you know, you could see pictures of people's brains that are damaged. There's all sorts of studies on different areas of the brain

that get damage from long-term use. And it causes all sorts of issues. Did you find anything else in your research on, for example, how people are abusing Adderall in schools? Yeah, so that's really kind of one of the questions that Norman Oller's book brought up was, is there like an upside to recreational use, right? So I think most med students out there at least know people that are using Adderall to cram for tests and things like that, stay up a little late, do these crazy study sessions.

It's really interesting, right? So we can talk about risks a little bit later, but in terms of just who is using it and why, there was this interesting 2008 review of the misuse of prescription stimulants. So they reviewed 21 articles over the course of 10 years. They found that 16% of children in a sample of, this is grade school. So this is grade school. We're asked to either give, sell, or trade their Adderall when they were prescribed in. A bunch of it, like 4% had their med stolen. When we get, like, college-age students, it's really interesting because you have the people that are misusing them.

or the ones that are buying it from their friends, they're overwhelmingly likely to have ADHD symptoms, even though no formal diagnosis. So in other words, they're getting ADHD meds from their friends to treat potentially undiagnosed ADHD. But here's the weird thing, right? So amongst those who do misuse, in other words, they don't have a prescription for it.

60% said they're using to study, 48% said alertness, about 31. said to get high. And then another 30% just were like, hey, I want to experiment. And then another interesting thing about this study was a lot of those who did, you know, misuse it. Almost 60% met criteria for conduct disorder and another 75% for substance use disorder. So if you find adderall misuse, if you keep fishing, you're very likely to find, you know, other substances as well. Yeah, whenever I prescribed it to someone in college, I always said to them, don't tell any of your friends that you have it, number one.

And number two, just realize it's illegal to sell it or to give it to someone who doesn't have a prescription. And I would not want anything bad to happen to you. So I think that my worry, as I like listen to this book and think about some students and their behaviors, is that you could literally stay up for multiple days. using these substances. And I think that is inevitably toxic on the brain. Like our brains were not meant to stay up for several days straight. Think about just how toxic that could be to just not sleep for several days straight

and just be going, going, going. When I read the book, it kind of made sense that their confidence was really, really high. you take a bunch of naive people and you put them on this and you tell them to march and it's like they're already in great physical shape they already believe this sort of dogma that they've been fed their whole lives and then you put them on these these drugs and then they just it just takes them to that next level right where it just pushes them to do things that you wouldn't expect I think part of me was like you know we have this kind of distaste for for not Nazi Germany, obviously. But then as I was like reading this further after this book, I realized, oh, they were giving, you know, amphetamines to American soldiers. How do I feel about that? Oh, yeah. Yeah, no one, no one is innocent of substance enhancement. But, you know, it's, it's fun knocking on the Nazis, though. Well, it's, it's easy, right? It's like, if you don't like someone,

you compare them to a Nazi somehow. All right, that's like, that's like an insult of sorts. Okay, so big takeaways, any big takeaways from this whole sort of saga? Yeah, I think like for me, one principle of prescribing is just that like what goes up must come down. So if you're using something like Adderall, like you're essentially dealing with borrowed time. So if you're a student and you're doing the Adderall thing, you're using up neurotransmitters that will have to be rejuvenated at some point. So being on just as the Nazi soldiers would march for three days, and it worked because France was able to literally fall in just a few days. But as we saw

in the Russia part, where it's taken literally months, the whole meth-induced Blitzkrieg really failed. So just a word of caution for the long-term use is there are consequences. Yeah. Yeah. And I would I would say that, you know, think about the orders of magnitude for, you know, people who are using it on the street versus people who are using it in a classroom. I think it's good to be cautious with our prescriptions to not just hand it out, but really consider does this person need it? We know that performance will be enhanced, period, like whether you have ADHD or not. and the alertness will be enhanced, ability to study longer, focus. But there's been a number of people that I've seen over the years where I've actually slowly got them off of this

or got them off of the dose that they were on. And part of it was just to get them back to a healthier place. So I think there is kind of some nuance and like a sweet spot with some of these things where it's like too much will not help them. them, you know, and sometimes they don't need it, right? So some people get misdiagnosed with ADHD when there's other things going on. Sometimes it's like chronic stress, you know, it's like, okay, what do we do with someone with chronic stress? Do we give them ADHD so they can perform in school? It might help a little bit, but it might also be better just to treat like what's

the underlying issue of being underneath the chronic stress. Same with like sleep problems, you know, sleep apnea. You have a lot of the same symptoms of inattention, lack of focus, but you just want to solve the underlying issue as opposed to just bandating the fatigue. Yeah. Yeah. And then one of my thoughts with the Hitler, I know we haven't talked about him too much at the end here, but, you know, you have someone who had some really bad ideas, and then I think the drugs allowed him to kind of not question how bad his ideas were. So, like, for example, in his conversation with Mussolini, having taken, what was it, cocaine and stuff right before, elevated him to such an extent that he was able to convince Mussolini to keep going in the war. You remember that probably better than I do.

Yeah. There were so many points in which the whole Nazi project was, there were these critical junctures where it all could have ended way earlier with. almost millions of loss of lives, but drugs kept him going. So I'm not sure I'm as ready to say that drugs were responsible for his ideology, but I certainly think that they propped up, they propped up his resolve to kind of finish what he started. Yeah, it's awful. You know, and so part of us, it's like we can almost like try to create some laughter around this to try to defend against the awfulness of it all. But I think we have real questions about how we want to operate in this world in the future, you know? Like, I'm very concerned that someone who is on

something like, you know, methamphetamines or adderol, like, they're just going to be more violent. They're just going to be more confident. They're going to be overly confident. They may even, you know, hypersexual. Like, I've had a number of clients who, behave in sexual ways on these drugs in ways that they normally wouldn't and they hurt themselves. I had one patient to get HIV when he used meth during kind of like a sex binge of sorts. And so, you know, I think there's real pause that we should have as we sort of think about this class of medication and the class of like uppers and how they're used and abused. and the real side effects that exist.

All right, we will leave it there for today. We will be putting some of these notes on the website, Psychiatrypodcast.com. You can eat in the resource library. I really do hope you pick up his book because I think it was wonderful. We will link his book. And the Audible is very easy to get through.

I know a lot of you are commuters. And so, yeah, let me know your thoughts. If you get through it, if you have different thoughts than we have, I'd look or the same thoughts, you could let me know. Sometimes when people sign up for the resource library, they just jot a little note down to me on something and I appreciate it. So, thank you, Adam. We'll leave it there for today.