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