BY BRENDA CALDERON
Doctor, please, give me a dose of the American Dream
Put down the pen and look in my eyes
We’re in the waiting room and something ain’t right
All this is on you, we’re overprescribed
– “Kevin” (2015) Macklemore and Ryan Lewis featuring Leon Bridges
I’ve been going to church since I was 10 years old. Every service is the same. The pastor preaches a gospel written by apostles. The doctrine promises to fix to all of your problems. The idea becomes your dream, your high, your perma-haze. [2]
We’re getting high off of prescription drugs. In America, 52 million people have used prescription drugs non-medically.[i] 1 million have used them non-medically in just this past month. Our abuse of prescription drugs is rising at twice the rate we use marijuana.[ii] We abuse OxyContin®, Ritalin®, Vicodin®, Dilaudid®, Valium®…I could go on. We are the biggest offender.
We are 5% of the world’s population and yet consume 75% of the world’s prescription drugs.[i] But we aren’t the only abuser. The World Health Organization recognizes this as a global problem. According to the International Narcotics Control Board, the number of patients abusing prescription drugs globally is similar to those abusing heroin, cocaine, and other illicitly created drugs.[ii] The US, the UK, Australia, Canada, and New Zealand prevail in misuse.
By the end of today, 50 Americans will die from prescription painkiller overdoses.[iii]
They are killing us.
But who’s they?
Prescription drugs are like magic bullets, wonder pills that can cure a specific problem.[4] Dr. Elrich’s magic bullet was the first. It could cure syphilis in the 1950s.[3]
There was money to be made from discovering magic bullets. Big Pharma arose and with it the production of pills like Miltown, a mild tranquilizer that treats anxiety disorders, in the 1950s.
The existence of these magic bullets, however truly effective they were, created “magic bullet mentalities.”[iv] Magic bullets didn’t work on everyone. Some people saw no change on Miltown and other drugs. But because those who did find relief in these magic bullets testified to their counterparts of how effective these prescriptions were, expectations of future relief were still sown into their minds. The idea you can be cured by a pill can grow like a mustard seed. And with that Big Pharma wrote the gospel.
Now they had to disseminate it.
Big Pharma and the advertising industry were interested in creating a new patient base, “the walking wounded.”iv Tranquilizers, for example, were advertised not only for mental health patients but also for overworked stay-at-home mothers. Things that were once normal, the anxieties motherhood creates for example, became pathologized so they could sell you a prescription.
Big Pharma didn’t play fair in their advertising to doctors and later to patients. [4] Exhibit A: The FDA in 2003 issued a warning letter to Purdue Pharma, OxyContin’s manufacturer, for misleading ads. [5] Purdue Pharma was promoting the drug for unapproved uses beyond what it was approved for. They had also failed to mention the potential risk and danger of abuse.
Meanwhile, doctors became vending machines. Prescriptions rose 400% in just three years5 for anti-depressants.[iii] Some will convince you this is because we are now better able to diagnose these diseases. But studies show a great majority of those taking these drugs don’t need to be on them. A study of Baltimore patients on prescribed antidepressants showed 69% of them never had depression.[6]
Doctors might be overprescribing painkillers too. US doctors in 2010 prescribed enough prescription painkillers to medicate every American adult every 4 hours for an entire month. And with that doctors became pastors.
But the they who is killing us is our own minds. We subscribed to the doctrine. Our minds came to expect magic bullets, convinced us our normal was a problem, and made us feel we weren’t being treated unless we left the doctor’s office with a script. We are the parents who hound the doctor about ADHD medication for our child who might just be being a kid.[7] We are the patients who mislead doctors into giving us antibiotics for what is probably a flu. We convince ourselves it’s okay to take a friend’s Valium® to go on a plane. We make decisions to take Oxycontin® even if the pain isn’t that bad, knowing we can get addicted. We value what these drugs maintain; the high we get, the personality it gives us. So we take them daily and they become our routine and a part of our baseline identities. [iv] We allow them to hook us. And with that we become the faithful congregation.
Macklemore is right. We are overprescribed. The doctors are supplying us our drugs. Drugs Big Pharma created and want to make sure we take so their revenue keeps growing. But he is also wrong. All of this is not on just them. It’s also on how easily malleable our minds are, by both chemical and idea.
Brenda Calderon is a Junior majoring in Molecular, Cellular and Developmental Biology. She can be contacted at brenda.calderon@yale.edu
__________
Comments:
[1] Neon Cathedral is a term used by Macklemore in his 2010 song by the same name. He used the term to refer to liquor stores and bars. Here, I use it to refer to pharmacies with their neon open signs and big W’s attached to poles in the parking lots.
[2] Perma-haze is a term that refers to the high that is induced by marijuana.
[3] And yet syphilis still exists. Perhaps his magic bullet was not magical enough to pierce the social sphere these diseases exist in, as Alan Brandt wrote in “Not so Magic Bullet” published in 1988.
[4] Starting in 1997, direct-to-consumer advertising became legal.
[5] 2005-2008
[6] Moreover, 38% of them also don’t have generalized anxiety disorders, that these drugs are sometimes used to treat.
[7] There has been a 41% increase in ADHD diagnoses in the last decade.
References:
[i] “Popping Pills: Prescription Drug Abuse in America.” Drugabuse.gov. N.p., 02 Jan. 2014. Web. 12 Dec. 2015.
[ii] “Prescription Drug Misuse: Issues for Primary Care. Final Report of Findings.” WHO. World Health Organization, 2008. Web. 12 Dec. 2015.
[iii] Elkins, Chris. “Hooked on Pharmaceuticals: Prescription Drug Abuse in America.” DrugWatch. N.p., 29 July 2015. Web. 12 Dec. 2015.
[iv] Cowles, Henry. “Pills.” Minds and Brains in America Lecture. Yale Sterling Law Building Auditorium, New Haven, CT. 8 Dec. 2015. Lecture.
[v] “Timeline of Selected FDA Activities and Significant Events Addressing Opioid Misuse and Abuse.” U.S. Food and Drug Administration, n.d. Web. 12 Dec. 2015.
[vi] Takayanagi Y, Spira A, Bienvenu O, et al. Antidepressant Use and Lifetime History of Mental Disorders in a Community Sample: Results From the Baltimore Epidemiologic Catchment Area Study. The Journal of Clinical Psychiatry. 2015.
Yale Global Health Review 