The Madness of Drugs

There is always a question of what is making the world so crazy. And it’s not exactly a new question. “Cancer, like insanity,” Stanislou Tanochou wrote in 1843, “seems to increase with the progress of civilization.” Or go back earlier to 1809, the year Thomas Paine died and Abraham Lincoln was born, when John Haslam explained how common had become this concern of civilization going off the rails: “The alarming increase in Insanity, as might naturally be expected, has incited many persons to an investigation of this disease.” (For background, see: The Crisis of Identity.)

Was it changes of diet with the introduction of sugar, the first surplus yields of wheat, and a high-carb diet in general? If not the food itself, could it be the food additives such as glutamate and propionate? Was it the pollution from industrialization such as the chemicals in our food supply from industrial agriculture and industrial production, the pollution in the air we breathe and water we drink, and the spikes of toxic exposure with lead having been introduced to new products? Was it urbanization with 97% of the world’s population still in rural areas at the beginning of the 19th century followed by the majority of Westerners having moved to the cities a few generations later? Or was it the consequence of urbanization and industrialization as seen with increasing inequality of wealth, resources, and power that put the entire society under strain?

I’ve entertained all those possibilities over the years. And I’m of the opinion that they’re all contributing factors. Strong evidence can be shown for each one. But modernity saw another change as well. It was the era of science and that shaped medicine, especially drugs. In general, drugs became more common, whether medicinally or recreationally, even some thing so simple as the colonial trade of sugar and tobacco. Then later there were hardcore drugs like opium and cocaine that became increasingly common over the 19th century.

The 20th century, of course, pushed this to a whole new level. Drugs were everywhere. Consider the keto diet that, in the 1920s, showed a promising treatment or even cure for epileptic seizures, but shortly after that the drug companies came up with medications and the keto research dried up, even though those medications never came close to being as effective and some of them caused permanent harm to the patient, something rarely admitted by doctors (see the story of Charlie Abrams, son of the Hollywood produce Jim Abrams). Drugs seemed more scientific and modern humanity had fallen under the thrall of scientism. Ascie Dupont’s advertising slogan went, “Better Living Through Chemistry”.

It was irrelevant that most of the drugs never lived up to the hype, as the hype was endless. As research has shown, the placebo effect makes each new pharmaceutical seemingly effective, until shortly later the drug companies invent another drug and unsurprisingly the old drug stops showing the same benefits it did previously. Our hopes and fantasies are projected onto the next equivalent of a sugar pill and the placebo effect just goes on and on, as does the profit industry.

That isn’t to dismiss the actual advancements of science. But we now know that even the drugs that are beneficial to some people, from antidepressants to statins, are overprescribed and may be harming more people than they are helping. Part of this is because our scientific knowledge has been lacking, sometimes actively suppressed. It turns out that depression is not a neurotransmitter deficiency nor that cholesterol is bad for the body. Drugs that mess with the body in fundamental ways often have severe side effects and the drug companies have gone to extreme lengths to hide the consequences, as their profit model depends upon an ignorant and unquestioning population of citizen-consumers.

This is not a minor issue. The evidence points to statins making some people irritable to the point of violence and there is a statistically significant increase of violent death among statin users. That is on top of an increase of neurocognitive decline in general, as the brain requires cholesterol to function normally. Or consider how some painkillers might also be disrupting the physiological mechanisms underlying empathy and so, heavy regular usage, might contribute to sociopathy. It’s unsurprising that psychiatric medications can change behavior and personality, but no one expects such dire consequences when going to the drugstore to pick up their medication for asthma or whatever.

We are living in an era when patients, in many cases, can’t trust their own doctors. There is no financial incentive to honestly inform patients so that they can make rational choices based on balancing the benefits and harms. We know the immense influence drug companies have over doctors that happens through legal forms of bribery, from paid vacations to free meals and supplies. It’s related to not only why patients are kept in the dark but so are most doctors. It just so happens that drug company funding of medical school curriculum and continuing education for doctors doesn’t include education for effective dietary and lifestyle changes that are inexpensive or even free (i.e., no profit). This is why most doctors fail a basic test of nutritional knowledge. That needs to change.

This problem is just one among many. As I pointed out, there are many factors that are throwing gasoline on the fire. Whatever are the causes, the diseases of civilization, including but not limited to mental illness, is worsening with every generation and this is a centuries-old trend. It’s interesting that this has happened simultaneous with the rise of science. It was the hubris of the scientific mindset (and related technological industrialization) that has caused much of the harm, but it is also because of science that we are beginning to understand the harm we’ve done and what exactly are the causal mechanisms behind it. We must demand that science be turned into a tool not of private interest but of public good.

* * *

The medications that change who we are
by Zaria Gorvett

They’ve been linked to road rage, pathological gambling, and complicated acts of fraud. Some make us less neurotic, and others may even shape our social relationships. It turns out many ordinary medications don’t just affect our bodies – they affect our brains. Why? And should there be warnings on packets? […]

According to Golomb, this is typical – in her experience, most patients struggle to recognise their own behavioural changes, let alone connect them to their medication. In some instances, the realisation comes too late: the researcher was contacted by the families of a number of people, including an internationally renowned scientist and a former editor of a legal publication, who took their own lives.

We’re all familiar with the mind-bending properties of psychedelic drugs – but it turns out ordinary medications can be just as potent. From paracetamol (known as acetaminophen in the US) to antihistamines, statins, asthma medications and antidepressants, there’s emerging evidence that they can make us impulsive, angry, or restless, diminish our empathy for strangers, and even manipulate fundamental aspects of our personalities, such as how neurotic we are.

In most people, these changes are extremely subtle. But in some they can also be dramatic. […]

But Golomb’s most unsettling discovery isn’t so much the impact that ordinary drugs can have on who we are – it’s the lack of interest in uncovering it. “There’s much more of an emphasis on things that doctors can easily measure,” she says, explaining that, for a long time, research into the side-effects of statins was all focused on the muscles and liver, because any problems in these organs can be detected using standard blood tests.

This is something that Dominik Mischkowski, a pain researcher from Ohio University, has also noticed. “There is a remarkable gap in the research actually, when it comes to the effects of medication on personality and behaviour,” he says. “We know a lot about the physiological effects of these drugs – whether they have physical side effects or not, you know. But we don’t understand how they influence human behaviour.” […]

In fact, DeRubeis, Golomb and Mischkowski are all of the opinion that the drugs they’re studying will continue to be used, regardless of their potential psychological side-effects. “We are human beings, you know,” says Mischkowski. “We take a lot of stuff that is not necessarily always good in every circumstance. I always use the example of alcohol, because it’s also a painkiller, like paracetamol. We take it because we feel that it has a benefit for us, and it’s OK as long as you take it in the right circumstances and you don’t consume too much.”.

But in order to minimise any undesirable effects and get the most out of the staggering quantities of medications that we all take each day, Mischkowski reiterates that we need to know more. Because at the moment, he says, how they are affecting the behaviour of individuals – and even entire societies – is largely a mystery.

10 thoughts on “The Madness of Drugs

  1. We must demand that science be turned into a tool not of private interest but of public good.

    It’s both, at the moment, which is why we’re seeing as much “double-movement” in this area as any other.

    We could be more specific, in this case. The science in question is chemistry (which you did mention) and the prescription and use of pharmaceutical products essentially represent chemotherapy, whether or not we think of it as chemotherapy. Such “chemotherapy” can be useful in treating chronic and terminal conditions by targeting the specific genes and proteins responsible for, say, cancer cells growing out of control. Unfortunately, healthy cells are not immune to such treatments, ergo why they have to be monitored so closely.

    drug companies have gone to extreme lengths to hide the consequences

    This I would have to disagree with just a bit. For now, at least, drug companies are still required to disclose any known side effects of the pharmaceuticals they market and, of course, many of them are brutal. (Aside: there was an hilarious late night show skit dedicated to this. A young man was skipping happily along in a park as the side effects of the medication he was taking were being listed by the “announcer” of the TV commercial spoof. As they grew progressively worse, so did he, eventually stumbling along until he finally face-planted in the dirt.)

    This we know. What we don’t have a handle on (aside from preventing the plethora of diseases we’re dealing with in the first place by, perhaps, not soiling our own nest) — for now — is why, if and how various pharmaceuticals are marketed; for how much; who is to pay for their research and development; etc., etc. The issue is far more complex than demanding science serve the public interest, which it already does. It involves all the mechanisms that got us to this point, including setting up doctors as infallible authorities that are not to be questioned under any circumstances.

    Deepak Chopra was once in this position and simply asked himself one day, “Why am I doing this?” (“This” meaning automatically writing out prescriptions related to the conventional treatment of the day for this or that rather than reflecting deeper.) As we equally know, his life soon took a very different track.

    “More research is needed,” indeed. Unfortunately, pharmaceutical companies (among others) are prone to funding their own research on their own products, as we know, and using “arcane arts” to set their price points. (We might detect a little bias there.) An excellent first step would be to demand a stop be put to that and to divert some of those funds to, say, nutritional and other truly medical research.

    • Sure, it’s chemistry. But there is a lot less distinction between chemistry and all the rest. The entire world, in a sense, is chemistry. Refined carbs such as sugar is essentially a drug in the powerful effect it has on the body. And certain nutrients such as fat-soluble vitamins act like hormones in how they regulate diverse systems and so they too are indistinguishable from drugs. Our bodies are made out of chemicals and operate through chemicals. A drug is something that can be used to chemically alter the body. Many things fit this general description.

      For example, someone could go on a ketogenic diet to increase their ketones or they could simply take exogenous ketones. In both cases, ketone levels increase in the body where they are then used as not only a fuel but as a chemical that can dramatically alter how the body functions. The body doesn’t distinguish between an endogenous and exogenous ketone. Give it some time and the drug companies will alter the ketone structure in various ways to make them into patented drugs that are profitable, maybe causing side effects in the process. Then again, most drugs also originated from natural sources. The earliest drug factories that humans relied upon were plants, and even natural ‘drugs’ can have side effects, even dangerous or deadly if one isn’t careful.

      You write that, “The issue is far more complex than demanding science serve the public interest.” I don’t think it’s all that clear. There is some science serving the public interest, but not most science. This is largely because public funding has decreased. University researchers are increasingly dependent on corporate and other private funding, as is higher education in general. It’s hard to even know what public interest might mean in late stage capitalism where inverted authoritarianism has come to dominate the public sphere. I’m sure the corporatists, plutocrats, and technocrats rationalize their authoritarian social control as noblesse oblige, as concern for public interest.

      Let me try to illustrate this by coming at it from another angle. Instead of science, look to politics. We are so far beyond the point of mere revolving doors and regulatory capture. You might recall the research by Martin Gilens and Benjamin Page. It showed that politicians almost always do whatever the rich want them to do. The majority of the population effectively has zero impact on public policy. The only time the dirty masses happen to get what they want is when public opinion matches the interests of the rich. Democrats are slightly more responsive to the middle class, mostly the upper middle class, but neither party is responsive to the majority of the population in the lower classes, including lower middle class.

      I agree with most of what you’re saying, although I’d put a different spin on it. So, yes, “It involves all the mechanisms that got us to this point, including setting up doctors as infallible authorities that are not to be questioned under any circumstances.” But the issues is who set up this corporatist system of rigid hierarchy and authority. The same drug companies pushing the drugs for every disease have also gained control of the medical schools that produce the doctors and the various institutions that set medical and related policy (ADA, AHA, FDA, etc). Once again, what does public interest mean in this context where the public has been silenced and disenfranchised, propagandized and indoctrinated? In that case, whose ‘public interest’ is being represented? Certainly, not the public interest of the majority of the citizen-consumer-subjects.

      A rare doctor like Chopra wakes up from their sleep. But that becomes increasingly difficult. Most doctors now are forced to work for large hospitals and clinics. They are no longer independent businessmen running their own offices. And the laws, regulations, and insurance companies keep them running in circles while the drug companies offer them sweet bribes. The carrot and the stick keeps most of them in line. Those who don’t keep in line can be punished harshly and made examples of. Consider the numerous cases against doctors like Tim Noakes, Gary Fettke, and Shawn Baker who had to fight to get their licenses back because they went against the medical system of authority. These guys were able to fight back, but most doctors wouldn’t be capable of that. How many hundreds of doctors, nutritionists, dieticians, researchers, and other medical experts have been effectively silenced in the US alone?

      Drug companies fund their own research and industries in general increasingly are told by the government to regulate themselves. There is little oversight, transparency, and accountability in the system. Theoretically, drug companies have to report side effects, but they have ways of manipulating and controlling what gets reported and what the public sees. It’s not only, as public funding dried up, that drug companies do more of their own research. If a drug company doesn’t like the result of a study, they aren’t forced to report it to the FDA. They can do a study repeatedly until finally one gives them the results they want and that is what they send on to the FDA to get drug approval, even if a dozen other studies showed problematic or even harmful side effects. The FDA doesn’t demand to see those other studies, much less consider them as part of the side effects that get reported. That is one example among many in how drug companies game the system. Consider statins where drug companies suppressed the reporting of side effects and then doctors, corporate media, and government agencies spread that disinfo:

      “A new study finds the chemical war against cholesterol using statin drugs was justified through statistical deception and the cover up of over 300 adverse health effects documented in the biomedical literature.”

  2. “Then later there were hardcore drugs like opium and cocaine that became increasingly common over the 19th century.”

    I’m not sure about usage rates as opium use was steady from the 16th century onward though I’ve read analysis of importation charts that show the rise of opium in the Uk reached massive levels in the 19th century (in a few cases hitting over half a million tons per year).

    Regardless opium (which should be “opium” as it is a signifier that includes mercury which along with opium were principal methods for “treating” syphilis which was pandemic so we end up with – syphilis+opium+mercury+imperial trade-colonization) was everywhere and used by everyone.

    Many years ago while doing a lot of reading on the 18th century I noticed a lack of comment on opium in histories and biographies of the key figures and events.

    In literary studies one has Coleridge and “Confessions of an Opium Eater” and it comes up often.

    But walk over to the history department and despite George Washington’s diaries offering blatant evidence of opium use to treat his syphilis, it goes unmentioned (because it’s bad for business to discuss old George shagging whores;-))

    After several years of reading and sifting data (including extant editions of early medical books – an interesting subcategory) I realized the question wa snot who was taking opium but who wasn’t.

    The answer is that every key figure from around the 16th century until the early 20th was gorked on the bud.

    Suddenly things like imperialism take on a whole new/different gloss.

    Crucial decisions by people in power which seemed or seem in retrospect to be strange become just as strange but now with some better or wider context.

    One example: While arguing with a knob about a famous battle I realized that the story about the Duke of Wellington “forgetting” where he had parked a division of men could be explained by his being in an opium fog.

    A search of his letters reveals his asking his doctor for more “tincture” for his steady use of laudanum – due of course to his syphilis.

    Cross-referenced with the old medical texts we also find that laudanum/opium was used to “treat” everything from migraines to upset stomachs.

    Why, for example, did Washington lose his teeth?

    Because he was following doctor’s orders and taking mercury baths in which he sat in a box over heated tubs of mercury.

    The vapors were supposed to break up the tumors (“Gumas” in the latin parlance of the era) because, following Galen, they believed mercury as the essence of movement would break up the mass which they believed resulted from improper movement of the blood and flow of the life force.

    All of this in turn existed within the narrative of imperial policies designed to secure opium and mercury from colonies.

    The definitions then of right and wrong, of madness and sanity, of appropriate and inappropriate are all recast as issues of ignorance and then the culture of the drug and the chemicals – from that in turn we have issues of sex, of gender, of bigory, of power, and so on each seemingly a single point but in truth each one a signifier of an entire epistme.

    • “Regardless opium (which should be “opium” as it is a signifier that includes mercury which along with opium were principal methods for “treating” syphilis which was pandemic so we end up with – syphilis+opium+mercury+imperial trade-colonization) was everywhere and used by everyone.”

      That is one hell of a combo. No wonder insanity seemed to be spreading. The population was not only drugged up but also poisoned. Imperial trade would have made such things increasingly available and cheap for consumption of the masses.

      “After several years of reading and sifting data (including extant editions of early medical books – an interesting subcategory) I realized the question wa snot who was taking opium but who wasn’t. The answer is that every key figure from around the 16th century until the early 20th was gorked on the bud.”

      Opium or “opium” would have followed a similar trajectory as sugar. Although available in the West somewhat earlier, sugar didn’t become a significant trade good until colonial imperialism. A rare commodity became less rare, but it still was mostly limited to the wealthy.

      It was rather late in colonialism that sugar was cheap enough that the average person could use it in recipes. So, it’s expected you’d see both opium and sugar consumption among key figures going back many centuries. But the madness of the 19th century was because all of this became part of the mass consumption of modern capitalism.

      “The vapors were supposed to break up the tumors (“Gumas” in the latin parlance of the era) because, following Galen, they believed mercury as the essence of movement would break up the mass which they believed resulted from improper movement of the blood and flow of the life force.”

      Ah, Galen again!

      “…each seemingly a single point but in truth each one a signifier of an entire epistme.”

      And that is the world we still exist within. Instead of mercury and such, we now poison ourselves in new and wondrous ways. But as always, it’s part of so much else.

      • Historiography in its current form is really a disaster unless we rephrase it as a feature and not a bug of the system and the system is of course the capitalist Borg cube.

        Every public debate is both reflection and the face of isolating narratives.

        We never discuss how it’s x+y+z but we get “experts” discussing “x” in “detail” as if it does not include the other issues.

        as to “mercury” a great example is that in the middle of a war, bounaparte proposed a deal with the Spanish court in which their chief lieutenant (Gadoy) who owned several mercury mines, would join a joint Franco-spanish expedition to Mexico to secure silver to pay for an expansion of the mercury trade which would have made France’s enemy – Spain – an enemy of Spain’s ally – Britain – while they all fought each other.

        Of course they were all waked on opium so I’m sure it made perfect sense.

    • I came across something in a previous post that related to the Galenic view. It’s not about mercury, but it is about how another substance, tea, was thought useful to promote movement of ‘blood’. Now put a drop of mercury in your tea and that should really get things moving. 🙂

      An Essay on Diseases Incident to Literary and Sedentary Persons (1768)
      by Samuel Tissot

      “There is another kind of drink not less hurtful to studious men than wine; and which they usually indulge in more freely; I mean warm liquors [teas], the use of which is become much more frequent since the end of the last century. A fatal prejudice insinuated itself into physic about this period. A new spirit of enthusiasm had been excited by the discovery of the circulation: it was thought necessary for the preservation of health to facilitate it as much as possible, by supplying a great degree of fluidity to the blood, for which purpose it was advised to drink a large quantity of warm water. . . The prejudice has at last been prevented from spreading, and within these few years seems to have been rather less prevalent (m); but unfortunately it subsists still among valetudinarians, who are induced to continue these pernicious liquors, upon the supposition that all their disorders proceed from a thickness of blood.”

      • It’s really extraordinary how one could write a history of medicine as a history of poisoning.

        Then again you could rewrite so much of any number of narratives by keeping the facts but changing the context or the definitions of the facts.

        Imerpailism as a drug war and the drug war as a medical boon-doggle (though “quakery” was necessarily on purpose as some of the “doctors” really believed what they were doing) and so on.

        And of course how much of that is still going on now.

        Eat this vs don’t eat that or too much of x is bad until someone says it’s good, etc.

        • The whole Galenic angle is endlessly fascinating. Why did it take hold when it did, as Europe headed toward modernity? It seemed to coincide with the shifts going on: Renaissance notion of an individual/psychological self, Protestant Reformation that destabilized the sociopolitical order, disruptions of Black Death and the Little Ice Age, conflicts such as Peasant’s Revolt and English Civil War, and then the rise of colonial imperialism.

          The need for social control became paramount. But there was also a sense of something gone wrong and diet definitely played a role. In Galenic thought, that is where ‘blood’ comes in as so important. A well-nourished peasant class would be too threatening and so something like red meat needed to be carefully controlled, especially during potentially rowdy events like Carnival. You didn’t want the masses to get their ‘blood’ up. That continued to be a concern into more recent history, such as the Seventh Day Adventists worried about moral decline and how it might be reversed through a proper Medieval peasants’ poverty diet of grains devoid of animal foods.

          At the same time, the upper classes, literary and sedentary persons, were feeling the effects on the other side of changes. They were the first to have reliable and ready access to all these colonial trade goods. It was a two-edged sword. The changes in diet were causing health problems, both physical and mental. Their new lifestyle was much more taxing with the rise of a professional class and a much more demanding capitalist economy. They needed uppers (sugar, caffeine, nicotine, etc) to get their ‘blood’ moving and downers (‘opium’) to even out the anxiety from stress. Promoting self-control was as important as social control. The emerging modern identity needed constant management and maintenance.

          All of this continues to this day. And that is why medicine/poison and nutrition/malnourishment remain the twin forces of the system. We no longer talk about ‘blood’ and other Galenic ideas, but the essential ideology and agenda remains the same.

          • Regarding the need for control, needless to say, Foucault would agree.

            Caffeine, sugar, tobacco etc had a profound impact.

            Opium was used a a “treatment” but also produced effects like insomnia which then required more “treatments” in a downward cycle.

            Essentially anyway we look at it the whole system is a mess of bad information and wrong conclusions drawn from the bad information and in a sense it’s a wonder anyone survived.

            there’s definitely something about the rise of the individual and advances in optics and precisions measurments and the rise of all of the bad/wrong ideas about health.

            not sure what exactly but it’s obvious there’s something there.

            A truly vast area of research because it takes in almost everything.

            I agree about the ideological consistency.

            Most people have never heard of Galen and have no clue they sound similar.

            Of course that’s true for a lot of other things as well;-)

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