The Cult of Pharmacology

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The
Cult of Pharmacology: How America Became the World's Most Troubled
Drug Culture

by Richard
DeGrandpre. Durhan, NC: Duke University Press, 2006. x + 294 pp,
ISBN 0-8223-3881-5, $25 (hardback).

Richard
DeGrandpre might be familiar to you as the author of Ritalin
Nation
. Ritalin comes in for much attention by detailed
comparison with cocaine. Both are said to produce the same mental
effects to the point where Ritalin is called "synthetic cocaine."
A main theme of this book is that Ritalin is considered an "ethical"
drug and an angel in dealing with ADHD, while cocaine is considered
a "street" drug and a demon; this artificial difference
had nothing to do with the pharmacology of the two drugs, but to
the conditions of use and the dogma on each, called "placebo
text." Both are dopamine reuptake inhibitors in the brain.

Methamphetamine
as "meth" or "speed" has been called by a federal
"drug czar" "the worst drug ever to hit America,"
and The New York Times wrote that it was "feeding an epidemic
of addiction that…rivals that of heroin and cocaine over the past
few decades." The same drug has been available as Methedrine
or Desoxyn for decades and is said to have "all the qualities
you could possibly want in an ADHD med — it doesn't cause anxiety,
it barely raises heart rate or blood pressure, it totally wipes
out depression and fatigue, and it lasts a full twelve hours…"
(p. 32). Angel or demon?

DeGrandpre
also notes that "demon" heroin, introduced by Bayer of
Leverkusen around 1885 as a non-addictive form of morphine, was
available without a prescription for about 25 years, and is not
nearly as addictive as US government officials have propagandized.
Doubters should be warned that loose claims are not found in this
book, and fully 52 pages are devoted to citations, mostly to medical
journals, appendices, and index. Provision of maintenance doses
of heroin and other street drugs in the UK and the Netherlands paid
by their national health services was noted as a far better solution
to a violent underground drug supply economy, which is the result
of the prohibition in the USA.

Quite a
good history of "mind-altering" drugs from Big Pharma
is given, including amphetamines, tranquillizers, etc. Prozac from
Eli Lilly came in for much attention. Not the first nor the last
SSRI, Prozac was at first considered as an antihypertensive drug.
"After the drug succeeded in not killing laboratory animals
in initial exploratory studies — although it turned cats from friendly
to growling and hissing…" Lilly responded to competition
by launching Prozac as an antidepressant (p. 53). DeGrandpre left
little doubt that that Prozac occasionally led to self-mutilation,
suicide and murder (p. 62). Prozac was used as an example of overpromotion
of a drug and drug class that lasted as long as the patents, then
a "newer, better" drug under a new patent would be promoted.
Of course, many other recent books with this theme exist; but The
Cult is not primarily a jeremiad against Big Pharma, but a window
into how much the pharmacology of a given drug, including nicotine,
is combined with the myths and prohibitions of a drug to confuse
its supposed benefits and risks.

The lack
of effect of nicotine levels on the addiction to cigarette smoking,
and the failure of alternate nicotine supply treatments to curb
addiction more than slightly was quite a shocker. The special status
of tobacco and alcohol because they were common farm products in
the USA was brought out. Prohibition of alcohol was a failure partly
because it was and is an excellent tranquilizer when not overdosed,
and only addictive in a small minority of users.

Gradually
the war on street drugs is shown to be similar to the current war
on supplements in that Big Pharma wants its most expensive stuff
used, and has gone to great lengths with both overt attacks, indirect
attacks by entities not identifiable as B. P., and control of government
and non-government agencies (Abramson, 2004; Cohen, 2001; Kauffman,
2006). "The cult of pharmacology must therefore have served
a different purpose than the elimination of dangerous drugs and
the sanctioning of psychiatric medications. …during the twentieth
century. The competitiveness of the drug market and the fact that
one or two successfully approved and marketed compounds could raise
a company from rags to riches almost overnight made for an increasingly
aggressive and reckless industry. The medicopharmaceutical industrial
complex that… emerged benefited directly from differential prohibition,
moreover, in that the demonization of certain natural substances
— marijuana, cocaine and opiates — helped set them apart from the
"ethical" pharmaceutical compounds, even if the latter
had equal or greater toxicity" (p. 241).

Very highly
recommended with the sole complaint that there was not a single
graph, chart, table or photo.

References

March
12, 2007

Joel
M. Kauffman [send him mail]
is Professor of Chemistry Emeritus at the University of the Sciences
in Philadelphia.

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