Drugs: The Story of Pharmacology with Rod Flower

References and suggested readings:

• Rod Flower. 2026. Drugs: The Story of Pharmacology. Yale University Press.
• On the CIA and LSD: MKUltra wiki
• Aldous Huxley. The Doors of Perception and Heaven and Hell.
• “Celebrities Who’ve Shared Their Ayahuasca Experiences: From Chelsea Handler to Aaron Rodgers.” US Magazine.
• Freud’s monograph on cocaine: Sigmund Freud. 1894. Über Coca.
• Rod Flower’s faculty page

Transcript

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Lauren

Welcome to American Campus Podcast, a history of higher education. I'm your host, Lauren Lassabe Shepherd. On today's episode, we're talking about drugs, their history and the place of pharmacology in the university and in higher learning more broadly. 

Our guest is Rod Flower, Emeritus Professor of Biochemical Pharmacology at Queen Mary University of London. His new book is called Drugs: The Story of Pharmacology, and it's just out from Yale University Press. Rod Flower, welcome.

Rod Flower 

Thank you very much, Lauren, and greetings to everybody on the other side of the Atlantic from me.

Lauren

We have some listeners in the UK, too. We've got a couple downloads that come over from your neck of the woods. So let's begin with the conceptual question. What is a drug? And then from there, tell us what is the science of pharmacology.

Rod Flower

Yeah, well, that's a very good place to start, actually, because it's this terminological issue is something which is plaguing everybody at the moment. It's a word that's fallen into disrepute almost. If you say drugs to people, they automatically think, you know, cocaine, you know, crack cocaine in your car or something, being arrested by the police, that sort of stuff. But actually, as far as scientists go, and doctors, a drug is simply a chemical that alters the function of a living organism in some way or other. And that's obviously a pretty broad, you know, definition. And so mainly it refers to chemicals which act on living organisms in very, very low concentrations and in a very specific manner. And that excludes a lot of other stuff that's not really relevant. 

So a subset of drugs are suitable for use in humans and animal medicine. So we call those medicines. Not all drugs are suitable. They may have other purposes, but not necessarily as a medicine. The word medicine implies that it has a therapeutic and curative effect. So that's like a subset of drugs.

Pharmacologists are people who study drugs in the sense of trying to understand how they work, how they're metabolized by the body, and also how to make them better. And obviously if you're faced with a new disease or one which hasn't got any treatment at the moment, then you're on the lookout for ways of developing drugs to treat that particular disease.

Lauren

And in the UK and in the US, pharmacology is big business, right? Multi-million dollar industries.

Rod Flower

It's a huge industry, the pharmaceutical industry is huge. It's multinational and it's all dependent really on private capital. And I think the reason for that is the cost of developing a new medicine is about $2 billion US, which is a huge amount. you have to, so when you actually find a drug that's working and it's safe to use in humans, you have to recoup all that original money before you start putting anything back into the war chest to develop another drug. So you have to cover all your failures, all your future research and everything with the pricing structure. And I think that's one reason why people often think that the pharmaceutical industry makes excessive profits. I think one reason it appears that way is simply the enormous cost of developing new medicines, which is entirely borne by private individuals in some way or the other. Governments don't want any part of it.

Lauren

Well, in the US, I mean, we've got a pretty–I don't know how familiar you are with the system. I'm not super familiar, but I mean, I know we have a pretty complex web of like, patents and, you know, legal sort of hurdles that scientists have to overcome and that, you know, companies have to overcome before they can get their drugs to market, right?

Rod Flower

That's correct. The testing is rigorous and there are regulatory bodies. For example, in the US, you have the FDA, which–

Lauren

Is falling apart right now. Which is falling apart right now in the United States. Or being torn apart.

Rod Flower

Don't get me started on that. Yeah, you have the FDA. Over here, we have a similar organisation. And they actually lay down the rules and regulations that must be followed for a particular drug before it can become a medicine. So that might, for example, involve testing in humans initially, let's say 10 or 12 human patients initially, and then going up to maybe 100 patients as a sort of a secondary safety trial, going up to thousands for the sort of efficacy trial to make sure it really works in combating the disease in the way that you want. So these things are enormously expensive and difficult to organise. And this is another reason why it's become more and more expensive to develop drugs because the barriers have got higher and higher and higher as the years have gone on. Everyone's concerned about safety.

I know there have been gross lapses in various standards. I'm thinking of the opioid crisis which you guys have and we have the same thing over here which is caused–there's a multi-factorial cause for that scandal but part of it must be laid at the feet of the pharmaceutical company that was making the drug as well.

Lauren

Definitely. Let's go back to the pharmacologists. So your book is an extremely long history. I mean, you take us back to like, ancient times to talk about the people who have studied drugs historically. Can you say a bit about who these people are? What are their motivations? You know, of course, they're not all part of universities proper, but I think we can maybe retroactively apply the label pharmacologist to perhaps some of the ancients. What do you think?

Rod Flower

Yeah, I think that's reasonable, especially since, you know, we talk about ancient doctors and medics and of course the doctors and medics of two or three hundred years ago, what they practiced has got nothing to do with, you know, what's being practiced today in terms of medicine. So we can do the same with pharmacology, although pharmacologists, you know, 10, 20, 30 thousand years ago weren't university graduates working in medical schools, nevertheless, they had an empirical knowledge of plant drugs, especially. And most of the original drugs that mankind used were obtained from plants and they're all a particular type of chemical structure called an alkaloid. And so these plant alkaloids formed the basis of the sort of natural pharmacopeia, which just about every civilization on earth began to use a long, long time ago.

In fact, there's evidence that Neanderthals also used drugs and medicines, not necessarily always to cure diseases, but for religious purposes, for example to induce trances. All religions began as shamanistic belief systems and almost all of those used drugs in order to enter trances and things. So there's a long history of association between religion, magic, and pharmacology, which is very, very interesting.

These people really obtain their knowledge in different ways. think empirically, obviously if you're eating berries and leaves and things, you notice what happens to you and you might find, for example, one particular type of berry sends you off to sleep and you may then remember that and pass it down to the next generation who can use it as a sleeping drug or something like that. Another source, potential source of knowledge, is animals. So there's a lot of interest now in the way that animals use drugs instinctively when they have diseases of various sorts. And it's thought that early man may have copied animals in some respects. And had noticed what they were eating, you know, when they became ill and then they tried to do the same. And sometimes it was obviously successful. So I think it's very interesting. I obviously, you can't, we weren't there, so we can't say exactly what's going on, but lots of grave sites have plant remains buried with them. And these are not, almost certainly not foodstuffs because the plant alkaloids, which form drugs, really are too bitter to be eaten like that. So this is one of their defining properties that they're very very bitter.

Lauren

Can you say a word about bitterness? Because that actually appears somewhat in the book. I mean, you have you sort of theorize what bitterness is, how it works in teaching our bodies, or teaching our minds, what we should and shouldn't approach when it comes to food stuff.

Rod Flower

In terms of medicine, the practitioners use the taste of bitterness to gauge how ill you are. And when you're ill, you seem to have an increased desire for bitter things. This has been observed also in animals. There are various elegant experiments showing, for example, that chimpanzees, if they have a fever, will choose bananas which have been secretly spiked with antibiotics which have a bitter taste rather than normal bananas, but when they're well again, they will go back to choosing the normal bananas. And there are lots of experiments like that which indicate that bitterness is a sort of an indication of curative potential. I mean obviously it's not a foolproof one but within the context of early people's knowledge of these things.

Lauren

Yeah, so now I'm thinking of the Mary Poppins spoonful of sugar to help the medicine go down better.

Lauren

Do you want to share another story from the book?

Rod Flower

One which I really liked actually was the guy who discovered LSD and I devoted a whole chapter to this because I think hallucinogenic drugs are very interesting. One reason is that they seem to alter your conception of yourself. It's difficult to put it into words but you know your entire reality is distorted by these drugs and, in such a way that it helps you to understand how the brain works, you know. So for example, the man in question was a chemist. He was working in his laboratory in Switzerland and he was doing a routine chemical reaction and just as he completed it, he began to feel a bit strange, a bit restless and a bit disorientated. So, you know, stopped, he closed down the fume cabinet where he was working, finished the experiment and told his assistant and said, you know, I'm not feeling very well, I'm going to go home. So his assistant said, well, I'm going to come with you, make sure you're OK. And then they cycled back to Hoffman's house. But by the time he got there, he was in a completely different state. Everything was distorted. Everything looked grotesque and huge. The woman who came next door to lend a hand appeared to him to be a witch, you know, with a malignant intent. His furniture turned into strange monsters and they called his wife back and they called the doctor. 

But eventually, he fell asleep and the next day he said, he felt a lot better. And the substance he'd made was of course LSD and it was prepared from a substance called ergot which is a naturally occurring fungal toxin which has got some quite interesting pharmacology. Anyway, LSD. And then he then went and tried it again under strictly controlled conditions. So this is another thing which goes through the history of pharmacology and other sciences, too. And that is this thing about self-experimentation. Most people are, most scientists are very always happy to experiment on themselves. And he was no exception. And he tried it again. This time he told everybody what he was doing. And he had pretty much the same experience. He kept detailed notes and subsequently the drug became, well, he foresaw that it could have very important implications in psychotherapy because he could see that, you know, it gave a sort of a way of looking into the brain. The way the brain went wrong when this drug was taken, told you something about the way the brain normally functions. And so this was very, very important for psychiatry as well as for biochemists. 

And in fact, the drug was actually released for a while for trial and it was actually a lot of tests and trials were undertaken. For example, it was tried on prisoners to see if they became more socially conscious and aware of their crimes. It was tried on people who were addicts of various sorts, alcoholics, to see if they reformed, as well as to see whether it promoted the classic Freudian sort of psychoanalysis process. So there were some encouraging results, but unfortunately the FDA pulled the plug on it after a while, largely because of its adoption by the counterculture. You know, you're thinking about people like Timothy Leary and you know, the whole sort of flower power generation, which adopted LSD in a rather uncontrolled fashion.

And this, I think, led the government of the day to think that it might actually be a moral hazard, this drug. And so they decided to stop funding it and to shut it down, shut down, which was a great shame in a way. It's only now recently that the drug has now been partially rehabilitated and it's possible to try it again under strict medical supervision. And there have been some

significant positive studies showing that it can cure long-term depression, or at least can mitigate long-term depression, which is one of those things which has been very, very difficult to treat up till now.

And the reason why it works is because it's very similar to a neurotransmitter in the brain called serotonin. And so you can work out from the structure of LSD and the structure of serotonin, how the brain normally functions and why it goes wrong during depression and how the LSD then can correct it. So I think it's a major breakthrough in psychotherapy and let's hope that it eventually comes onto the shelves. I mean it's not going to just be available in your pharmacist, you know, to take twice a day.

Lauren

In the US, who knows? Right now. I mean, honestly, it's so interesting the way, you know, our countries sort of regulate this stuff. I mean, I have been in the UK before and actually tried to buy Tylenol and, you know, had to speak to a pharmacist before I could do that. In the United States, you can get it at the grocery store or the gas station. It's just, you know, you can buy as much as you want.

But on the regulation question, going back to LSD, so I know the United States made it illegal. But in the UK or in other states, was it made illegal around the same time? Or was it, has it ever been illegal?

Rod Flower

Yeah, it was. The UK tends to follow the FDA in many, many, many, many cases. And I think that they also thought the same. And so it was classified as the highest category of hazardous pharmaceutical, which meant it could only be given to people under special licence with special dispensation.

I mean, having said that, when I first joined a pharmacology lab, it was in the fridge. I mean, we used to use it as a chemical blocking agent. So, you know, it was always there. Nobody touched it. So, it's interesting attitude towards things.

Lauren

Well, what has been, what's caused the return of the study of psychoactive drugs? Or or maybe, you know, as you say, it's in the fridge and it never really went away. But I mean, why, why now are we hearing so much about ketamine and, you know, what is it, God's mushroom? God's fungus? Why the return?

Rod Flower

That's it, yeah. Well that was another thing Hoffman discovered actually and that was the active principle of the so-called magic mushroom is a drug called psilocybin. It's impossible to spell, so do you want to try? So this drug has almost sacred properties amongst some cults in Mesoamerica and when he'd synthesized it and made it into a pill he went and gave some to a local sort of village wise woman in a village in Mexico he had contacts with. And she said the spirit of the mushroom is in the tablet you gave me. So for her, just a pure drug he'd made in the lab, recreated the entire experience that they used to ascribe to the mushroom god or the spirit of the mushroom, which I thought was a nice, you know, validation of his work. 

But also there's a feeling amongst people who work in this area that maybe taking hallucinogenic drugs was the beginning of religion because when you take them, you have experience, or you appear to have experience, of different planes of being, and different types of animals and people. You can have demons, angels, strange mythological beasts, they just appear. It may have been taking these hallucinogenic plants that first gave people the idea that there may be other worlds apart from ours, and therefore this is one of the basis of religion. So I think that's something which a lot of people think, although they're of course very difficult to prove. 

But yeah, getting back to your question, I suppose one reason is that we've had sort of conventional antidepressants around for a long time now. And these were generally speaking drugs which altered the serotonin levels in your brain. But there was always some sort of discrepancy between their onset of action and the changes of serotonin in your brain. And so nobody was completely satisfied with that particular idea that that's how they worked. And then when it turned out that LSD interfered with the actions of 5-hydroxy-teratamine, serotonin, then people saw this as an opportunity maybe to try out some of the early drugs which also act in a similar way to serotonin. And so they tried, they went back to try LSD and psilocybin.

And so far, there's been some outstanding successes. But I have to say that they're always done with somebody else present to act as a sort of a facilitator, and this seems to be very important because otherwise, you know, in the sort of beat generation language if you have a bad trip you know you can go quickly off the rails it's very important you have someone there to guide you through the process. And in ancient cultures, that would have been, you know, a sorcerer, a witch, or a wise woman, or a wise man, or a shaman, or something. It would have done that for you. Today, it's a medical professional that sits with you and guides you through the process. So I think it's very interesting.

Lauren

A medical absolutely. Yes. I mean a medical professional who is not just trained in the medicine, but trained in administering it and first aid and you know all the things that could go wrong. Yeah. I mean bringing this story up to today, or at least since 2020, do you see the I mean, I you are a scientist, so this has always been in on your horizon, but like for someone like me who is

I don't know anything about the science, but as a historian, I'm super interested in the culture around drugs. Do you see the sort of the popular interest in alternatives to SSRIs, for example, as being sort of like, almost a crunchy right-wing Silicon Valley, I want to live forever, alternative medicine, sort of MAHA approach? How do you see that intersecting with the interest in drugs?

Rod Flower

Yeah, it's a difficult one, isn't it? I suppose people don't trust the pharmaceutical industry very much, which I think is a great shame. So there's always on the lookout for alternatives. And a lot of these alternatives are often very, very useful. The problem is that they've never been tested and the dose adjusted, and all those other things that have been done in normal drugs, are tested on animals, tested on humans in low doses, on high doses, over a number of years to make sure that they're as completely safe as you can make them. 

So the problem with the sort of alternative medicine approach is, you know, you get these advice, come along to my stylus, you know, my magic mushroom retreat and sample magic. I mean, exactly.

Lauren

For five thousand dollars in one weekend, let's go to Las Vegas.

Rod Flower

 And I mean, you know, I've spoken to people who have done that and some of them had really interesting experiences. Others have just been, you know, sick for most of the time. But the thing is, the problem is actually with all drugs that come from plants anyway, it's very difficult to get the dose right. Plants don't have a standard amount of drug to please medical practitioners. It varies with the season of the year, how much water the plants got, how well other nutrient factors. It even varies with the phase of the moon because of the various changes in the you know, flow of water around. 

So, often what happens is people take these plants, then they extract the substance. They don't know exactly how much they're taking, so they may have a very good experience, they may have a very, very bad one. They may get into very serious trouble. And I think that's my... It's not an objection, but it's a caution, which I would put out there for everybody, really.

Lauren

Yeah. I think what made me ask the question is I'm thinking in the US of like, celebrity ayahuasca experiences. Megan Fox and Machine Gun Kelly are two American celebrities who like, famously went on this ayahuasca trip. But yeah, I mean you mentioned earlier, when people are are taking these alternative forms of medicine, they're doing it under the supervision of someone who can can guide them. And of course celebrities have access to that that you know normal people probably don't can't can't afford. 

But thank you. Yeah this i find this so so interesting and i and i think that listeners will too. So historians out there, this is an accessible book of the history of pharmacology that I I think will appeal to lots of readers.

Rod Flower

Yes, I think, well I hope it is. I mean, it's difficult to pitch books like that because I wanted it to appeal to general readers, but on the other hand I didn't want to make it sort of a Walt Disney production, know, you know, I wanted to put a bit of science in there and so people could see that all the original stuff that went on for thousands of years converged on a couple of very key experiments, which led people to the idea that there were targets in our body which these drugs bound to and that's how they worked. And I know that sounds ridiculous because everyone knows about them now, but of course that was a big conceptual leap. And it wasn't until the 1950s really that people really fully accepted that idea. 

But now of course we know that all these, that around the body, all tissues, all cells speak to one another by releasing chemicals. And these chemicals are recognized by receptors, as they're called on the cell surface. And these are translated into information for the cell and it can then talk back. And these signals may be things like glucose coming, you know, prepare for glucose influx or something like that. Or it may be nerve impulse coming, prepared to relay it along or almost anything. Because we are essentially colonies of different types of cells working together. We're sort of an ensemble really of different types of cells and not all of them human. I mean in our guts is a huge bacterial sort of subcolony which are very, very important in keeping us healthy and digesting our foods. So, you know, we're a mixture of different cells, different organisms. We just appear to be singular and unique because of our way of looking at the world.

Lauren

Well, well done. I think that explanation is sort of a good preview for listeners about the accessibility of this academic trade crossover. I think you did it well.

Rod Flower

Thank you.

Lauren

Do you want to share what you're reading now?

Rod Flower

Yes, I'm very interested in Freud because when he started out he was a neurologist and he did a lot of work on cocaine. It's another horror word these days of course but…

Lauren

On cocaine, meaning he did his work while he was on cocaine, or his work was focused on the drug?

Rod Flower

Well, both really. In those days, you have to understand that people didn't understand really the concept of drug addiction. I mean, they didn't understand why drugs were addictive and or how you became addicted to them or what to do about it if you did. So there was a lot of ignorance. 

So Freud became interested in cocaine and he published quite a lot of work. He published a classic review of cocaine's actions, actually based largely on work that came out of the US. Probably for geographical reasons, a lot of the original medical work on cocaine was done in the US because, of course, it comes from Mesoamerica. Whereas in Vienna, it was difficult to get hold of.

However, he became fascinated by the drug and he managed to, he tried some on himself and found it to be, produce interesting changes in cognition and so on. He eventually became what we would say dependent on it. Although in those days, they didn't recognise that. 

And then he had this experience. We’ll he had two experiences, actually. One was he had a colleague working with him from the Institute of Ophthalmology and they were doing lots of experiments together on things like cocaine and muscular strength to see whether it increased your strength because it gives you that sensation that you could do anything, you know. He wanted to try and objectify that. 

If you've ever tried to chew a coca leaf, which you can do quite safely, and I recommend it if you get the chance, you'll find that it numbs your lips. So for a very, very brief period, your lips will begin to tingle and then they'll go numb and your gums will go numb. And so what's actually happening is you're getting a sort of a local anaesthetic action on your gums.

So his colleague, whose name was Carl Kohler, thought, well, that's not a bad idea. I could use that for patients with eye surgery, undergoing eye surgery. And one of the problems with surgery at that time was there was no anaesthetics. There were no local anaesthetics for sure. If you gave a patient general anaesthetic, was something pretty gross like chloroform or something and this caused patients to retch and so of course, if you're trying to operate on the eye and patients are heaving around and thrashing around you know you can't just simply can't do it. 

So one weekend Freud had gone off to visit his fiance and Karl Kohler said you know, I've had a good idea, let's try putting it into the eyes and see what happens. And so he got together with a friend of his and they dribbled it into each other's eyes and found that it completely abolished sensation. So he thought this is ideal, I can now use this for eye surgery, which he did. And he was responsible for introducing cocaine into Western medical practice. And that was the first topical anesthetic that we ever had.

And other drugs based on it like Novacaine and Bipivucaine and things like that are what your dentist used today if you go and have a filling or something or minor dental work of any sort. When Freud got back he was very happy in a way that Kohler had done this and he called him Coca Kohler because that was his pet name for him, because he used the coca leaf extract and produced this silicon ascetic. 

But then Freud himself had a difficult, he did something which he regretted later on. He had a friend who was a morphine addict. He damaged his hand in an accident and he was in great pain and he was taking morphine and had you know, habituated to it. And there was some literature suggesting that cocaine could reverse the addiction to morphine and so he gave cocaine to this guy and he seemed to get better but then of course you can guess what came next. He became addicted to cocaine. So this was a complete failure and Freud after that he realized he'd made a mistake and he regretted it for the rest of his life and he completely abandoned all his sort of pharmacological studies and went on to do other things. 

The reason I'm reading it, I wonder whether his early experiences with cocaine affected his later views on the unconscious mind, on the psychoanalytic process and so on. So I'm sort of combing through some of his biographies to see if I can find anything. So that's the sort of personal.

Lauren

Are you think are you thinking of writing about this or is this is just a personal curiosity?

Rod Flower

I might well do, yes, yes. In fact, I've already got something, I've sort of started writing. So, in fact, I've got quite a bit which I couldn't squeeze into the original book. So I thought I might try and put that together with it and publish something else.

Lauren

you do yeah please keep me posted on that. Yes, well thank you so much. How can listeners keep up with you, especially for this future book or article on Freud that you may have?

Rod Flower

Well, I don't do any lab work anymore because I retired a few years ago, but you can follow me on Amazon. I don't have any social media outlets at all for various reasons, but I'm available on Amazon. You can always get in touch with me at Queen Mary or, you know, I think my email's on on there somewhere. Or if anyone has any urgent questions, maybe they could direct them through you, Lauren, if you want.

Lauren

Perfect. I'm glad to be the messenger. Well, Rod Flower, thank you so much. I enjoyed this conversation and I enjoyed the book.

Rod Flower

Well I enjoyed it too. Thank you very much, Lauren. Pleasure meeting you.

Lauren

And thank you, listeners. Check out the show notes to find Rod's book and all the other references from our conversation. Thanks, Patreon supporters, for helping with the cost of creating the show. You can help out for free just by sharing this episode with someone or by leaving a review. Another big thank you to the Albert LePage Center for History and the Public Interest at Villanova University. And as always, thanks, producer Fletcher. See y'all soon.