As a general anesthetic, propofol acts on the brain’s GABA receptors, which cause inhibitory neurons—those that quiet other circuits—to fire; that’s how it induces unconsciousness. Propofol also increases levels of the feel-good neurotransmitter dopamine, triggering a sense of reward not unlike sex or cocaine. Some patients experience euphoria, sexual disinhibition, and even hallucinations, followed by a feeling of calm and an upbeat mood. Since propofol is so widely used—it revolutionized ambulatory anesthesia, allowing a physician to knock someone out in seconds to perform, say, a colonoscopy, and have them up and about after only 10 minutes—scientists have had no shortage of subjects able to describe the experience. About one third don’t remember a thing, and another third say they dreamed, but don’t recall specifics. The rest experience “vivid, strange dreams, sometimes of a sexual nature.”
Its followers include not just ordinary citizens, but also members of the military, police, and trafficking organizations locked in a four-year war that has cost some 28,000 lives. At a time when the cartels have scared much of the Mexican media into submission—when papers like El Diario de Juárez feel compelled to publish front-page pleas to the cartels to “explain what you want from us”—the narcoblogger, like a journalistic masked crusader, has stepped into the void.
Consider the excitement over cocaine vaccines. Composed of a bacterial protein plus a molecule that is a coke look-alike, they train the immune system to produce antibodies against both. The antibodies also bind to cocaine, preventing it from entering the brain and causing a high. The good news is that the vaccine makes crack less pleasurable, notes Meg Haney of Columbia University, who led a 2010 vaccine study. That suggests the vaccine indeed kept the drug out of the brain. The bad news is that the level of antibodies in the volunteers (55 coke users in a 2009 study, 10 crack users in Haney’s) varied widely. Only 38 percent of the coke users produced enough antibodies to dull the effects of cocaine, and, of those, only half stayed clean more than half the time.
In contrast, a 2008 analysis of 34 studies of behavioral treatments for addiction to cocaine, marijuana, and other drugs showed impressive efficacy. “There is still no generally effective [medication]” for coke, pot, and meth addictions, notes psychiatry professor Kathleen Carroll of Yale University. “But the behavioral therapies we have are quite good,” bringing a 67 percent improvement. Yet that research gets the response of the proverbial tree falling in an empty forest.