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Tuesday, February 28, 2012

Are We Living In a Cult of Pharmacology or a Cult of Personality?

Richard DeGrandpre holds a doctorate in psychopharmacology, was a fellow of the National Institute on Drug Abuse, and wrote the 1999 book Ritalin Nation. In his next book (2007), The Cult of Pharmacology: How America Became the World's Most Troubled Drug Culture, DeGrandpre tells the story of how, as one legal drug after another fell from grace, new pharmaceutical substances took their place.

Whether Valium or OxyContin at the pharmacy, cocaine or meth purchased on the street, or alcohol and tobacco from the corner store, drugs and drug use proliferated in twentieth-century America despite an escalating war on “drugs.”

DeGrandpre denies that drugs are chemically predestined to be either "angels" or "devils." He states “drug use and drug outcomes are ultimately artefacts (things made by man) of culture, not of the inherent pharmacological properties of drugs.”

DeGrandpre argues that the determination to treat the medically sanctioned use of drugs such as Prozac or Seconal separately from the illicit use of substances like heroin or ecstasy has blinded America to how drugs are transformed by the manner in which a culture deals with them.

DeGrandpre points out, during the last century or so, there have been radical shifts in the substances subjected to differential prohibition. Once you could get cocaine in Coca-Cola at the corner drugstore (in trace amounts). You could buy heroin from the same company, Bayer, from which you purchased aspirin. Heroin itself was originally introduced as a “cure” for morphine addiction: it began its life as an "angel" but fell from grace

In De Grandpre's own words:
"As a drug ideology derived from the eternal notion that psychoactive compounds contain a unique spirit or essence, the cult of pharmacology legitimized the belief that these spirits bypassed all social conditioning of the mind and by themselves transform human thought and action. Unlike other worldly modes of influence on mind and human experience, and despite many advances in the pharmacological sciences in the twentieth century, psychoactive substances continue to be treated in the main as spirits that could enter into a body and take possession of it. Yes, soul was transformed into mind and spirit into biochemistry, giving the appearance that science and medicine had done away with the myths surrounding what had come to be called 'drugs.' Drugs were not demythologized, however, but rather remythologized. Psychobabble and biobabble replaced magical explanations of drug action, creating what had become by the end of the century a new, molecular pharmacologism."
The "cult of pharmacology" can be seen as an attack on government authorities responsible for drug regulation and the policies formulated with respect to so-called illicit drugs. DeGrandpre argues that various powerful interest groups hoodwinked the public into accepting the orthodox view. These interests include: “the pharmaceutical industry, the tobacco industry, modern biological psychiatry, the biomedical sciences, the drug enforcement agencies, and the American judicial system."

Any battle against an American industry," DeGrandpre writes in his chapter on Big Tobacco, "even in the name of public health, [is] also a battle against those in Washington who protect that industry, regardless of the public health."

DeGrandpre sees addiction as a matter of setting, the user’s personality and background, and the meaning assigned to certain substances by powerful, self-interested, sinister groups.

My Take On Addiction

Of course, I believe addiction can't be defined strictly in terms of the addicted human organism and a chemical substance. Research supports that compulsive drug use can never be isolated from cultural and other contextual factors and from the situation of the actor. (DeGrandpre, R. J., & White, E. 1996. Drugs: In the care of the self. Common Knowledge.)

Reseach also supports that environmental factors ultimately determine drug use, including the very addictiveness of a drug's appeal and the urge to continue compulsively consuming the substance. (Peele, S. 1985. The meaning of addiction: Compulsive experience and its interpretation. Lexingtron, MA: Lexington.)

But, also one must consider that people don't plan to become addicted. Alan Leshner, PhD, director of the National Institute on Drug Abuse, calls this the "oops phenomenon." It happens when occasional use of a drug turns into weekly use, then daily use, and then eventually into a surprising realization: "I'm addicted."

"Every drug user starts out as an occasional user, and that initial use is a voluntary and controllable decision," Leshner writes. "But as time passes and drug use continues, a person goes from being a voluntary to a compulsive drug user. This change occurs because over time, use of addictive drugs changes the brain--at times in big dramatic toxic ways, at others in more subtle ways, but always in destructive ways that can result in compulsive and even uncontrollable drug use." Leshner, A. "Oops: How casual drug use leads to addiction." National Institute on Drug Abuse web site,www.drugabuse.) 

The fact is, drug addiction is a brain disease.  Leshner says. "While every type of drug of abuse has its own individual trigger for affecting or transforming the brain, many of the results of the transformation are strikingly similar regardless of the addictive drug used. The brain changes range from fundamental and long-lasting changes in the biochemical makeup of the brain, to mood changes, to changes in memory processes and motor skills."

These changes refer to specific alterations in the structure and function of the brain. In simple terms, drugs (a) change brain structure, (b) alter brain function, and (c) hijack the brain's reward system.

Recently, scientists have discovered new insights into the role heredity plays in addiction. These findings may actually identify people at risk for addiction and prompt them to learn behaviors that prevent the disease.

The so-called "cult of pharmacology" theory that Richard DeGrandpre presents begs many questions. The composition of a drug does not, inherently, make it a "devil" or an "angel." I agree. However,  people place the primary blame for the damage done by a drug on the last stop in the delivery of the product -- the people who abuse it.. Of course, they are ultimately responsible for their own dependency, addiction, or overdose. But, are there times when the addicts, themselves, have been abused? And, are the biggest abusers of drug dependents working in the fields of pharmacology and health?

For example, in the case of OxyContin abuse, the public sees firsthand the tremendous availability of the drug and the deadly effects of misuse, so their primary blame falls upon the visible, continuous, illegal activity between the dealer and the addict. They cry, "Just say no!" and "Lock up the criminals on the street!"

They have been conditioned to believe in the good of doctors, pharmacies, pain clinics, and any other of the sanctioned, traditional players in the Oxy pain relief business. Pain is bad; the pain patients trust the professionals' concern for their health, so the public thinks that "angelic" professionals administer only "angelic" medications with "angelic" care.

To most folks, drug addiction is a consequence suffered by expendable souls who live on the fringes of damnation and eventually take the plunge into the chemical "pit." Why? Most believe that drug abusers are pathetically weak and totally devoid of moral upbringing.

How does the public assume the process works? The means of delivery in the eyes of the public is the dealer. Since the "devil" dealer sells the "devil" product to the "devil" addicts, the consumption of the "devil" pill delivers the final "devil" destruction. Case closed and lesson learned -- "Stay away from the devil druggies, boys and girls."

Unfortunately, people begin to see Oxy, a once-advertised rx "angel" pill for pain, as a "devil" drug only on the streets. Instead of tracing the problem with the drug all the way back to its roots and questioning the true intentions of the company and the professionals who support it, the masses choose to say, "It's not the pill, so blame the people who take it."

Damn it, people, wake up! We know the abusers are ultimately responsible for their addictions. A fool could understand that. The concern is elsewhere. As rx drugs kill in increasingly greater numbers than illegal drugs, something must be done. It must be done now, without hesitation, because rx drugs are currently killing 15,000 people a year. (Centers for Disease Control and Prevention, 2011)

Let's all pressure the FDA and the drug manufacturers to stop Pharmageddon. Illicit drug is just a term used to describe chemicals that are illegal under present policy. In fact, many of today's prescription drugs need to be more tightly regulated. Some (oxycodone varieties) need to be taken from the market until the true damage they cause is properly studied as it relates to the rx epidemic in the United States.

I don't care which drugs are "angels" or "devils" according to an outdated historical perspective. I know what is happening in America in the 21st century -- Big Government and Big Pharma are reacting far too slowly and, thus, contribuing to a terrible killing field. Please, pray for better protection of future generations.
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