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Pills-A-Go-Go: A Fiendish Investigation into Pill Marketing, Art, History & Consumption

Pills-A-Go-Go: A Fiendish Investigation into Pill Marketing, Art, History & Consumption

by Jim Hogshire

A cultural study of pills and pharmaceutical culture.


A cultural study of pills and pharmaceutical culture.

Editorial Reviews

Publishers Weekly - Publisher's Weekly
As the editor of an eponymous underground 'zine devoted to celebrating pills "from the point of view of unrepentant drug takers," Hogshire seeks to demystify the contents of our medicine chests. Calling pills "the quintessential icon of Western Civilization," he bemoans the fact that America's attitude toward pills is ambivalent at best, and blames this state of affairs on both an elitist medical profession and public information campaigns that create undue hysteria about the consequences of recreational drug use. Dividing the book into such chapters as "Another Clean-Cut, All-American Speed Freak," "Amphetamines and Football," "I Raided Tom Clancy's Drug Stash" and "Great Pharmacist Authors," he mixes cheerfully blistering rants against doctors, pharmacists and the FDA with overviews of the history, uses and side effects of various widely taken medications. Readers are told what security measures to take when breaking into a pharmacy, what combination of meds is most likely to prevent jet lag and how to forge a prescription. Brash, lively and lavishly illustrated, this is a fun and often informative read, although some of Hogshire's pollyannaish conclusions about the benefits of pills should be taken with a grain of salt, if not a dose of Valium. (Oct.) Copyright 1999 Cahners Business Information.

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Read an Excerpt

Chapter One

The Pillhead in Society (or, "You gotta bad attitude, boy!")

In high school I had a friend who just loved pornography. Of course, I liked it too, but I lived out in the suburbs where hardcore porn wasn't available. Besides, I was too scared to buy the stuff. Not my friend; he would brazenly take a bus to the porno store and buy whatever he wanted. The magazines could get pretty pricey, but he financed his porn habit by doubling the price and reselling them to this pudgy guy who became incoherent when Gary pulled out the raunchiest, most explicit fuck books.

    One day, the summer before I went to college, Gary came by my house with four grocery bags filled with porno.

    "I'm giving this to you," he told me. "I've got a girlfriend now and I'm never gonna jack off again. Those days are over."

    The porno was worth almost $2,000. It didn't matter that Gary was back in less than a week begging for some of his old collection (the girlfriend thing didn't pan out). I kept 'em. And of course I brought them with me to college.

    It soon became known around the dorm that I had stacks and stacks of hardcore (and my own softcore stuff). The guys' initial reaction was to ridicule me as a pervert. "God, man, whaddya do—jack off alla time? I never seen so much porno!" they'd say, the whole group feigning disgust, shaking their heads and laughing.

    One by one, though, they all found a reason to drop by my room and ask to look at the porn. And, "Hey, d'ya mind if I just borrow this one for awhile? Y'know,this is kinda interesting."

    Soon I had to institute a lending policy and kept records like a library. My porn circulated all year through the dorm. Nevertheless, I was "the porno guy." Because the other dudes only borrowed (and sometimes failed to return) my porno they felt detached from it—maybe even a little superior. After all, they didn't have the obvious perversion I had.

    It's the same with being "the pill guy." Because I make no secret about my fascination with pills, keep large stocks of pills around and read everything I can about them, people have come to know me as some kind of a pill pervert.

    Even people who smoke dope, snort cocaine or even (in some cases) shoot heroin, view pillheads as morally bankrupt.

    Most pill references in popular culture are derogatory—"Mother's Little Helper," the confessions of Kitty Dukakis and Betty Ford, the movie I'm Dancing as Fast as I Can (in which Jill Clayburgh gets all mellowed out on Valium overdoses. then abruptly stops taking them, sending her into a manic anxiety jag). Part of their negative image comes from being viewed as the drug of the establishment. Pills are made by staid pharmaceutical companies, after all. When Mick Jagger sings about Valium, he's clearly jeering at this harried woman who seeks relief from the drudgery and pain in her life through a pill. The very fact that such an unenviable character as Sonny Bono took pills is bad enough. But when they get around to copping to their pill-love, it's usually in the midst of some kind of public purging of their "demon" pills.

    Pills are also viewed as cheating. Using pills—even to deaden physical pain—is seen as the resort of a wimp, somebody who can't even take a little pain. Taking pills for relief of psychic pain or, God forbid, enhancement of mental faculties, is even more indicative of moral weakness.

    Even people who take pills regularly feel compelled to condemn them—especially when they're used by somebody else and even more especially if they take them "for the wrong reasons." Of course, Mick Jagger has consumed plenty of mother's little helpers in his lifetime. So has everyone else. Even people who claim to "never" take pills, take pills. Just ask 'em what they do for a headache. Well, in that case, they take a pill, they'll tell you. If you press further and ask which pill, you'll find they often have a preference. Within moments of declaring they never take pills, you can coax most folks into admitting they like Advil better than Tylenol or aspirin.

    So much for their stoic freedom from devil pills. If you wanted, you could probably wheedle them for the other pills they take, but why embarrass them? Let 'em live in their fictional world where only the morally deficient depend on pills for help.

    Except, of course, they don't stay in that fiction world. Like my prono-seeking friends, they sought out the pillhead to ask advice, or more frequently, pills. I won't say that it galls me, but I sometimes give them a little bit of the business, warning them of their imminent entry into the vortex of pilldom in all its degenerate squalor.

    I've noticed, almost without exception, people who are introduced to the wonders of pills eventually come around to liking them. All my girlfriends, for instance, who have started out with a leery attitude toward pills, wondering with mild disgust how in the world I could look to a pill without a doctor's permission, eventually realize the truth: They work just fine without the sanction of an M.D. Pills work just fine for more things and in more ways than you're supposed to know.

    Suddenly a new and taboo world opens up to them. Galaxies of pills, tools for better living become available—at least theoretically if not practically. Once the lure of a better life becomes apparent it is impossible to turn back. From that time on, another pillhead is added to the population. Of course, the new pillhead will go on to spread the word of pills and increase our numbers—even if some decide to remain "in the closet" and hide their pill-love.

    Thus, pillhead's relationship to society is almost by definition insidious. Promoting a practice so wrapped up in conflicting opinions means one must take a clear stand. Pills are good. Saying that pills make good sense and do good things is heretical in American society. Everyone uses pills to some degree, so it is socially retarded to absolutely argue against them with the vehemence a pillhead might argue for them. Pills have proven more useful, cheaper, and versatile than the scalpel in treating disease. To argue against pills would be lunacy. Yet actively promoting their use is considered just as loony.

    Society cannot reconcile its ambivalence toward pills. Instead of attacking the healing creations of science, society launches its ridicule and torture upon the pillhead whose undisguised enjoyment of the pill tears paternalistic ritual and hypocrisy to bits. It's a sin to smile in church.

A Short History of Pills

Our word "pill" comes from the Latin pillula, meaning "little ball." In ancient times and for centuries that followed, pills had but one form—the little round ball. Even today, nitpickers cringe when they hear the term applied to any other sort of "solid oral dosage form," like, say, a tablet or a capsule. The pill's earliest ancestors emerged from ancient Egypt, where docs mixed active ingredients with clay or bread to form the little balls to concoct a standard dose and a convenient method of taking medicine.

    Pill's ancestry is worth noting because ancient Egyptian medicine followed an entirely different methodology than contemporary medicine. According to Worth Estes, professor of pharmacology at the University of Boston and author of the book Ancient Egyptian Medicine, "about the only thing the two systems had in common was the view that disease existed and the goal was to make the patient well again."

    Ancient Egyptian medical theory believed all bodily energy and health centered around invisible tubes running from the colon. They viewed the laxative as the most critical medication and shitting the most important bodily function. Drilling holes in the head or bloodletting and other Egyptian medical practices are alien to modern medicine. Only one thing from their medical arsenal survived the millennia—pills.

    In modern times, pills symbolize the rational and scientific, though they are offered in a fun-loving variety of receptacles besides the coated and uncoated pills of yesteryear: scored tablets, medications with their famous "tiny time-pills" emanate from the larger mother pill, or slowly dissolving pills (inspired by jawbreaker hard candies) that release their fractions of a dose as each layer dissolves deep inside the body.

    There are the familiar, brightly-colored capsules containing powders in their hard-gelatin shells, and the pastel tints of soft capsules encasing yummy, liquid centers. Some pills are little works of art made to swallow. Although produced at a rate of thousands per minute, pills display a kind of crisp intaglio printing on their flawless surfaces that is technically stunning even if they don't compete with craftsmanship of Faberge eggs or grains of rice inscribed with the Lord's prayer.

    Some pills are made to dissolve under the tongue, the medication passing directly into the capillaries so close to the surface. Others (known a "buccal" tablets) take advantage of the absorption characteristics found in the natural pocket between cheek and gum to best deliver their active ingredients.

    The latest pill engineering feats promise even more exacting and exotic delivery systems. There is the robot pill that carries the medicine in a tiny, motorized vessel that recalls the ever-shrinking injectable submarine from Fantastic Voyage. Either through timing or by watching its course via radar-like equipment, the incorporeal submarine pill releases its cargo at just the right spot to achieve maximum benefit. Other futuristic pills include nearly microscopic bits of protein bound to a few molecules of medication, biologically "trained" to travel directly to the site of injury or disease, depositing exactly enough of the right medicine to do the job and no more.

    Besides the many variations on the pill theme, drugstores' shelves are packed with an array of breathtaking marvels of pharmaceutical engineering: single-dose, disposable syringes, ointments, eye drops, nasal sprays, medicine-impregnated chewing gum and the ever-more-popular transdermal patch!

The Pharmacy in History

The origins of the modern pill stretch back beyond ancient Egypt when various concoctions were mashed up with bread or clay for easier ingestion. The Sumerians compounded medicines from such rustic ingredients as saltpeter and willow bark along the Tigris-Euphrates.

    Greek physicians collected and prescribed the best drugs of older civilizations and passed them on to Rome, where detailed prescriptions first emerged.

    The first apothecary appeared in Baghdad near the ninth century. While the master races of Europe were busy worshipping trees, Arabs were already training, licensing and inspecting pharmacists and pharmacies. Medicinal preparations were manufactured in the great cities of the Middle East and shipped out in caravans as far as sub-Saharan Africa. A hospital in Damascus was built in 1160, remaining in operation for hundreds of years.

    Perhaps the surest sign that Europe had emerged from the Dark Ages was the appearance of the apothecary. Looking to Damian, the patron saint of drugstores, nuns and priests who had saved six centuries' worth of Arabian medical knowledge through Greek translations, abandoned their fear of heathen science and began to make and dispense medicines.

    Even more information streamed into Europe from the Middle East, adding to the existing pharmacopoeia and spawning the codified study of medicine. Encyclopedias of drugs began to appear and by the twelfth century, pharmacies started to appear all over Europe, and the government of Venice started to "supervise" the drug trade—a sure sign that it was profitable.

    Medieval drugstores were not much different than any other type of store at the time. Like other businesses, they were storefront operations that opened up directly onto the streets. Horizontal doors were fastened with hooks and pegs to form both a roof and a counter from which the pharmacist could sell his wares. Behind him, the apprentice was mixing and grinding or doing whatever other work the master decided he should do, including the laundry. Doing double-duty as a doctor, the pharmacist spent some of his time listening to complaints, peering down throats and inspecting a person's urine or feces for tell-tale signs of disease.

    Emperor Federico II of Sicily was the first to recognize a conflict of interest between the two professions and in the 1230s forbade physicians to either own or operate pharmacies. He further ordered druggists to follow doctors instructions explicitly and not play around with the prescription.

    Medieval monks added their own folk remedies to the Greek and Roman instructions, equipping their monasteries with a hospital, physician and pharmacy. The growing number of Catholic hospitals continues this link between religion and medicine.

    Renaissance was a time when pharmacies became a common business. Local pharmacopoeias were drawn up to help standardize medicines (no more "special recipes"), beginning with Nuremberg and the Dispensatorium of Valerius Cordus (1546). Pharmacy organizations sprouted. Apprenticeships gave way to academic study and formal training.

    In Britain, apothecary shop owners were members of the Grocer's Company before they formed their own guild, selling medicines in open competition with doctors.

    But things lagged behind in the Masonic frontier of America. People visited apothecary shops for medical advice as often as they went to doctors, and there was little difference between a physician and a druggist. Most doctors bought raw materials from a wholesale druggist and mixed their own compounds. The idea of separating doctor from pharmacist didn't come to the United States until one John Morgan studied medicine in Europe and then returned to the wild colonial territories in 1765.

    Morgan thought overdrugging of patients seemed a big problem, too, but both patients and doctors disliked his idea of separating doc from drugs. Patients didn't want increased expense and inconvenience, and doctors weren't thrilled about handing over part of their livelihood to future pill-counters. Needless to say, Morgan won no popularity contests and died penniless in the gutter.

    The making of medicines finally became pharmacist's domain after the War of 1812. Seduced by medical school, doctors began to illegibly write prescriptions rather than compound drugs. Gregory Higby notes in his essay, "From Compounding to Caring: An Abridged History of the American Pharmacy," "By the turn of the 19th century, the position of the pharmacist in the American health care system was firmly established. Physicians had agreed to dispense medicines only rarely and pharmacists reciprocated by limiting their diagnosing and prescribing to cases of minor ills and emergencies." Finally the merchant was the merchant and the doctor the doctor.

The Pill as Virgin/Whore

Every pill released to the masses goes through a "Therapeutic Life Cycle," a process that tracks the fluctuating level of public acceptance. "The Benzodiazepines," a 1981 article in Pharmacy International, tracks the acceptance level of pills—the line in the graphs starts fairly high, then climbs steeply before experiencing a sharp drop, leveling out somewhere between the initial rate of acceptance and its highest point. And indeed, this is the pattern of most drugs. When first introduced, the new medications are regarded with curiosity. As news spreads, faddism comes into play, and hope springs forth that a "miracle pill" has been discovered.

    Then all possible side effects, most of which were known and announced at the very start, start cropping up in an ever-growing population of new users. Tabloid horror stories begin to appear, demonizing the pill while buck-chasing lawyers start advertising for victims of the satanic tablet. If lucky, an ambulance chaser will find a sensationally freakish victim to parade around in lurid videotapes shown on tabloid news programs, encouraging the FDA to pressure pharmaceutical firms into discontinuing the pill's manufacture. Or else laws are passed to make the newly demonic drug illegal, ensuring further growth of the prison industry by providing even more victims of the so-called Drug War, an unconstitutional, classist and racist program so unconscionably evil that even such cop and prison-loving, right-wing leaders like George Schultz and William F. Buckley, Jr. have voiced their opposition to it.

    It should be pointed out, however, that most demonized pills are not withdrawn or made illegal when clinical use of the drug becomes more firmly established, and drawbacks are measured against the drug's therapeutic value. Following the initial controversy and government retests, the drug is transformed from being an imminent threat to a crashing media bore.

    Prozac offers a perfect example of the process most pills undergo—glorification, demonization and normalization. Introduced as a "miracle drug," then skewered soon after as a "devil drug," Prozac finally became accepted as just another pill. Its demonizing period created so much press that Prozac finally became such a dull media cliché that the multitude of immediately published Prozac books can now be found in the Ed Hamilton remaindered book catalogue.

    To see how pills lend themselves to quick and dirty "feature" articles we only need glance at weekly news magazines or "investigative" television news programs for the typical evil pill lead story. In its September 7, 1992 issue, the leftist weekly, The Nation, ran an exposé purporting to examine the dangers of Xanax. Little did the reader know that most of its anti-Xanax information came from a public relations agency whose client produced a competitor pill that had a lot to gain by Xanax's troubles. Mass market magazines and television news shows reveal their deficient investigations when they depend almost solely upon press releases to either tout or denounce any pill.

    As a measure of how implicitly the American masses trust their news sources, consider the kinds of lawsuits filed against pills. While in the devil pill stage, both Prozac and Halcion were involved in some ludicrous claims by people who sought to blame their own stupidity or criminal actions on a pill. Between 1992 and 1993 these two pills were named in more than a hundred lawsuits alleging they had transformed an otherwise mellow Dr. Jekyll into a raging Mr. Hyde.

    None of these claims turned out to be true, but the stories created such a fear of these pills that its detractors in the mainstream media no longer had to prove anything. Soon, anybody could be an expert.

    The Nation once once again sneered at pills in William Styron's April 11, 1993 article entitled "Prozac Days, Halcion Nights," in which the author made a good case for himself as someone quite fearful of pills. Styron's bestselling autobiography, Darkness Visible, recounted a bout with depression, for which he made good money discussing on the lecture circuit. Even though Styron's speeches were often paid for by pharmaceutical firms marketing competitors to the drugs he was dissing, Styron claims his missionary zeal was motivated out of the "charitable impulse to tell others similarly afflicted not to give up hope." He thought his very presence as a survivor and his kind words of encouragement could be "life-saving" to audience members paying a high tariff.

    Unlike his memoir, Styron's article in The Nation didn't discuss his depression, and instead took up anti-Prozac zeal, a drug he had never taken and ignorantly describes as "merely an improvement on an old formula." At least several paragraphs admit that he's seen evidence of Prozac helping the depressed, but alternately warns of its dangers, as told him by other depressed individuals who popped the drug.

    Styron informs the depressed that they should never take tranquilizers. Even if plagued by sleeplessness and anxiety, tranks "should be shunned like cyanide." And that's it. Like cyanide. As for Halcion, Styron writes that it made his depression worse. That's because for a time he was taking the pill to get to sleep. And during that time, he was depressed. Then he frankly admits Halcion couldn't have either caused his depression or suicidal thoughts.

    Still, he calls Upjohn (Halcion's makers) the "crazy Eddie of the [pharmaceutical] industry." To provide an example of just how bad Halcion could make a person feel, he cites a character in a Philip Roth novel. The article proves that Styron is obviously prone to depression as well as hysteria. He recalls being so fraught with anxiety over an operation he visited a doctor to treat insomnia. The doc prescribed Halcion. Here's the kicker—while chewing his nails in sunny California, he says he thought of suicide.

    While recovering in the hospital Styron complained to a doctor that he suffered from lack of sleep but was still taking Halcion. When the doctor switched him to another sleeping pill, he took that as a special sign that Halcion was evil.

Prozac and the Death of Tragedy

One of the best examples of a love/hate relationship with pills is Elizabeth Wurtzel's book, Prozac Nation. This tiresome, 300-plus page whine says Prozac saved her from a life of debilitating depression—unfortunately it failed to save her from yammering at the drop of a hat.

    One of Wurtzel's biggets complaints about Prozac seems to be that other people take it, too. How would anyone know how special she is, if everybody's taking Prozac! Especially people didn't earn it like she did. Her comments are perfect examples of medical Calvinism—the belief that feeling bad is good and feeling good is bad, the belief that taking medication to improve mental state is cheating. She takes her attitude a step further when she exalts the pill to holy status she feels the drug is being profaned.

    Consider the following excerpts:

    "Maybe you find out that the guy who fixes your plumbing is on Prozac, that your gynecologist is on Prozac, that your boss is on Prozac, that your mother is on Prozac, maybe your grandmother too ..."

    "I never thought that this antidote to a disease as serious as depression—a malady that easily could have ended my life—would become a national joke."

    Wurtzel is peeved. Prozac may have relieved she was suffering but it made the mushy dark swamp of her worst despair mundane. I mean, the cab driver takes it. She has no choice but to put these people, the Wurtzel wannabes, in their places.

    "Every so often I find myself with the urge to make sure people know that I am not just on Prozac but on lithium too, that I am a real sicko, a depressive of a much higher order than all these happy-pill poppers with their low-level sorrow.

    What can she do except moralize on the sheer wrongness of others taking Prozac to escape depression?

    "But it seems to me that there's something wrong with a world where all these pills are circulating ... I have no way to be certain of this, but my guess is that most of the people on Prozac haven't taken the circuitous path to this drug that I did. Many general practitioners give Prozac to patients without much thought ..."

    Unlike you, she paid her dues!

    "Sometimes I find myself resenting the ease with which doctors now perform this bit of pharmacological prestidigitation. By the time I was put on Prozac they'd tried everything else possible, I'd had my brain fried and blunted with so many other drugs, I'd spent over a decade in a prolonged state of clinical despair. Nowadays, Prozac seems to be a panacea available for the asking."

Prozac as Some Kinda Nazi Drug

Of course Prozac has been implicated in sinister scenarios. It was once accused as being a part of a plot to sedate black youth. This theory mainly came from Dr. Peter Breggin, of Rockville, Maryland, who has devoted his career to fighting any and all psychotropic pills—especially anti-depressants. In his book, Talking Back to Prozac, he suggests that "giving anti-aggression drugs to inner city kids would be an excuse for continued neglect. "Indeed he says the mass-drugging of "inner-city kids" (code phrase) is the hidden agenda of a group called the Violence Initiative. Like others before him, he romanticizes mental illness as the only sane reaction to an insane world, maybe even a sign of genius. In his 1991 book, Toxic Psychiatry, he asks "How is it that some spiritually passionate people find themselves being treated as mental patients?" Instead of seeing mental illness for the anguished condition it is, he wants disturbed people to stay that way, at least without pharmaceutical treatment.

    Thus the horror of "Soma," Huxley's Brave New World, is upon us. Relief from psychic pain is indeed an abomination.

The Pill as Holy Eucharist

The unrealistic view of pills is possible because of what we could call the "holy pill" syndrome. Pills are viewed by society as something holy, sort of a Eucharist.

    In this analogy the pill—or host—is capable of miraculous things but only if it is treated in a certain ritualistic way. Thus, a high priest (your doctor) must first authorize its use in accordance with proper canon. It must be further consecrated by another level of priest (your pharmacist) who will place it into your outstretched hands from a counter three feet above your head.

    You must not vary from the bottle's holy procedures. You must not transfer any of the pills in the bottle to another person or else something unspeakable may happen.

    When pills are handled by lay people, they can become hideous things, instruments of death, sowers of discord. Drugs routinely used by psychiatrists in the U.S.A. to treat schizophrenics were the very ones used by the evil Soviets to "torture" patients in its mental hospitals. Mom's Darvon is good for mom only. If anyone else takes the pill consecrated for mother's use, they are abusing it. To give anyone else one of your sleeping pills is a heretical act. To act on your need for an antibiotic without prescription is also heretical. It is also irreligious, not to mention illegal, to manufacture your own medicine without proper license—tantamount to permission from the Bishop.

    As long as a pill keeps its prescription status, it stays holy. Once it goes over-the-counter it is never viewed in quite the same light. That's why Benedryl was such a "powerful" pill before. Now its OTC competitors make fun of it. Once a pill passes into the land of the profane, it cannot go back. The only exception to this might be when an OTC remedy is banned outright by the government—thus achieving a low-grade "devil status."

    But there is always hope for a banned pill.

    The Grand Ju-Ju men of the FDA and DEA can rehabilitate an excommunicated pill. Thalidomide, once reviled as the archetypal satanic pill, has been quietly and very successfully used to treat leprosy and lupus for the last couple of decades, and has shown promise as an AIDS drug as well. In the public's mind, however, it remains locked in a world of untouchability.

Drugs as the Devil

In Ceremonial Chemistry: The Ritual Persecution of Drugs, Addicts, and Pushers, the brilliant social analyst and medical doctor, Thomas Szasz, may have been the first to notice the similarities between pill culture and religious culture. In his book he makes this view of a "medical theocracy" quite clear.

    First, he points out that the separation of Church and State may have looked good on paper, but man's need for organized religion will not go unsatisfied. Taking the Church out of politics is impossible—the two are so hopelessly entwined. Both organized religion and politics depend on shared illusions and ego-tripping—two psychic needs of all human beings. Any attempt to remove the pomp and magic from political life is doomed. People seem to need it.

    Szasz also points out that individual autonomy is intolerable to a ruler. Authority cannot abide by any "subject" entity that considers itself a "non-subject," and will discipline the offending subjects until they behave. As Szasz puts it: "There is only one political sin: independence; and only one political virtue: obedience."

    At the same time, the rulers provide an unassailable explanation for such deviant behavior: evil. During the late middle ages and well into the Renaissance, the Roman Catholic Church tirelessly sought out and punished the "heretics" who questioned authority or tried to reason for themselves. Such behavior was called "blasphemy." Its cause was always the same: Satan. No action was too extreme in the face of such manifest evil. No punishment could be too excessive, let alone wrong.

    The War against Satan was a constant in the hundreds of years of Inquisitional battle. Like the War on Drugs, this religious oppression sprang from seemingly innocent, well-intentioned plans. What began as a mere inquiry soon became a huge state-run enterprise of torture and fear. The harder the rulers sought to extinguish satanic thoughts, the more insidious they became. New heresies were being discovered all the time, some so subtle even the Church didn't recognize them right away. It wasn't long before the Inquisition discovered heresy in anything.

    With this in mind it becomes clearer why we treat drugs the irrational way we do. Drug War rhetoric seems identical to the Inquisition. The use, possession, and, at times, even thought of them (and explanations how to procure them) are considered illegal. It follows that no reaction is too extreme to rid society of such an evil. Life in a hell behind bars is considered just punishment for anyone who comes into contact with the evil. Even from a public health point of view, sequestering contaminated people is a rational way to deal with a fearsome and contagious disease. Commitment to a mental institution because of heretical drug use is called "treatment," and considered compassionate even though it is compulsory.

    This, according to Szasz, is part of the politics of scapegoating. With a scapegoat, all of a society's ills can be blamed on the witch, the foreigner, the social (or political) outcast, the schismatic, the "criminal." "Good" (obedient) citizens are weak and need guidance and control by the authorities. In return for recognizing this, good citizens are allowed to participate in the ritual persecution of scapegoating.

    Earlier in human history the "scapegoat" was a real goat, symbolically loaded with a community's sins and chased into the desert. As time went on, things became considerably crueler. The Greeks used human beings instead of goats and began killing, instead of chasing, the "scapegoat."

    Szasz gives us an eerie lesson in etymology when he traces the word pharmakos back to its earliest meaning of "scapegoat." Only after 600 B.C. did pharmakos come to mean "poison" or "drug," whence we take our word "pharmacy."

How Low We've Sunk

The War on Drugs reached and surpassed the limits of mere hysteria and superstition many years ago. It has now come to the point that a microscopic bit of cocaine (or heroin or whatever illegal thing) on a piece of paper currency can ritually (that is legally) "contaminate" its owner. It contaminates him so much that all the owner's property can be taken from him and his own body becomes subject to forfeiture and confinement (jail) and purification (physical punishment, incarceration, "treatment").

    It has been almost ten years since Ronald Reagan officially and repeatedly declared drugs the nation's number one foe, even greater than the Soviet Union. These have been the very words used by Presidents, Attorney Generals, Customs Directors and nearly every other politician since then. Maniacs like former "Drug Czar" Bill Bennett have unashamedly called for the beheading of anyone who sells drugs. LAPD chief Daryl Gates declared that all drug users should be summarily executed ("taken out and shot"). One has to wonder why a call to mass murder by a city's police chief wasn't immediately denounced and Gates run out of town on a rail. But if people really believe in the diabolical nature of drugs ... then murder doesn't seem so bad.

    It should be recalled that one explanation for the beating of Rodney King was the possibility of his use of PCP, the magical substance that makes an ordinary human immune to pain and as strong as five or ten men. Yeah, that was it! There was PCP. Drugs!

    As Szasz recounts it, all of our country's anti-drug laws have been concocted as responses to political problems, seeking to vilify and punish feared elements of society. The relentless hunting of communists, anarchists, Bolsheviks, drug pushers, kingpins, aliens, spies and plain old colored people is a theme that has been played out countless times in American history. And each time, drugs have been there to provide the evil talisman that justifies it all. The steady output of propaganda has created children so terrified by the mere sight of white powder that they call the police on their parents. I have seen a little kid become unnerved as we drove past what he must have considered the incarnation of his most terrifying nightmare—a DRUGstore!

The Latest from the Front

Drugs have proven themselves political tools more powerful than communism. Cocaine was the reason given the American public to justify the invasion of Panama, the kidnapping of its leader, and the killing of thousands and thousands of Central American citizens. Cocaine was ample justification to arrest a foreign citizen, on foreign soil, for a crime alleged to have been committed outside the United States. Cocaine has proven to be more heinous in the eyes of the U.S. government than Nazi war crimes.

    That's outside the borders of the United States. Inside the country, the demonization of drugs has provided enemies of the Constitution their best weapon to undermine our rights. The U.S. army could not have been legally called in to help attack the Branch Davidians at Waco until Texas governor, Ann Richards, lied that there was a methamphetamine lab on the premises. That assertion was the magic phrase that made it all right to do what is otherwise considered reprehensible. Muttering the word "drug" is enough to allow a conviction for "conspiracy" even if the person is alone and does nothing more than talk about planning a drug crime.

    More bizarre thinking is evident in the outlawing of imaginary things. A federal law known as the "Analogue Substances Act" prohibits the legal possession of chemicals that do not even currently exist, and never have. But if they are created sometime in future, their possession will require 20 years in prison. Maybe life.

    It is possible to be prosecuted for simply planning to, or inventing, a brand new substance that has the ability to get people high.

    On the flip side, the establishment sanctions some drugs as sacraments, their consumption being a symbol of acceptance and obedience. The same customs official who will gladly coerce, threaten and bribe people to inform on each other about heroin, knows he's made it to the top of his organization when his superior takes him out drinking.

    This celebratory drink as totem recalls an incident involving then Vice-President George Bush, returning from a drug war stump speech in Miami Florida. Relaxing aboard Air Force Two with a few DEA agents, he invited them all for a drink. At least one agent declined, giving as his excuse that (among other things) he was on duty. Bush continued insisting, but the agent continued to just say "no." Finally, Bush told the agent, "Don't be such an asshole."

    By not drinking, this agent had incurred the substantial wrath of the executive office. In effect, he was rejecting not just the drink, but a class of people—and apparently Bush himself.

State-Approved Religion

For Szasz, theocratic religion banned by the state was replaced by a Therapeutic Religion that currently holds sway. The medical government neatly replaces the traditional Church, in which the citizen is seen as a patient instead of a wayward soul in need of guidance. The therapeutic state views antisocial behavior as an illness that requires "treatment." The social illness is diagnosed to have grown so verifiably large that practically everyone is told they need "treatment". Nazi concentration camps are now explained as being the result of nationwide psychosis.

    Pill Worship and pillfiend hatred can be viewed as the contemporary version of medieval Catholicism. But the anxiety-ridden public perception of pills also comes from a decidedly Protestant point of view.

    The term for the Elizabeth Wurtzel scorn of pills, "Medical Calvinism," we derived from the phrase "pharmacological Calvinism," coined in 1970 by G. Klerman to explain resistance to the use of tranquilizers. Medical Calvinism simply widens the scope to all pills. It is a doctrine that sneers at too much dependence on the host for help.

    This is why Princess Di attacked British doctors in a 1994 speech for prescribing "too many pills" to women. She didn't say which pills, but hinted at anti-depressants. Her message is one often repeated in America, too, where maintenance treatment of any mild mental disorder is frowned upon as encouraging weak behavior.

    Anti-depressants are often dismissed as a panacea for a fake disease. Could Di have gotten away with saying the docs were handing out too many antibiotics? Maybe. How about too many diuretics or—hormones? Possibly. She could have taken issue with these drugs, but her audience wouldn't have taken her seriously. Her arguments were emotional, not medical.

    Totally in character with the suffering Calvinist, Di's speech is all the more astonishing having been made after she recovered from a well-documented depression that saw her roaming about the castle making crank phone calls, barfing in a bulimic frenzy, bursting into tears and considering suicide. If she pulled through with pills, her hypocrisy is almost commendable in an English Protestant sort of way. If she recovered from the depression spontaneously, her pride in suffering is just as understandable. It's obvious "Di" didn't simply stand for "diazepam!"

    Small Comfort : A History of the Minor Tranquilizers (1985) a fascinating social history by Dr. Mickey Smith devotes a chapter to the glorification and demonization of tranks, from its beginnings as "Wonder Drug of 1954" to a thing of criminal terror, more dangerous than heroin.

    Using the drug Miltown as a benchmark, Dr. Smith, a professor at the University of Mississippi, exhaustively and entertainingly depicts the emperor's clothing worn by the lawgivers and "expert" writers.

Small Comfort

"Miltown" (meprobamate) introduced the era of the tranquilizer, a term that first appeared to describe the drug in 1957. Then came Librium, Valium and a cavalcade of "happy pills," including one with the unlikely name of "Darvo-Tran" marketed for a short time by Eli Lilly. Smith discusses the impact of these so-called minor tranquilizers on doctors, society, and medicine itself. Along the way, he launches into topics like the "medicalization" of social problems—something that hadn't been clearly examined since it was decided to restrict the use of opium in the early part of this century. Smith quotes arguments that say today's benzodiazepines serve the same function as opium for the stir-crazy housewife or benumbed factory worker. Others describe tranquilizers as "the psychiatrist's morphine" that helps deal with pain while the psychic fracture is set.

    Smith also explains how medical Calvinism affects the use of tranquilizers. At first, "happy pills," "aspirin for the soul," and "don't give a damn pills." were widely seen a societal boon New Yorker cartoons confirmed their acceptance in the highest echelons of society. Farmers even began to add them to feed to produce mellower, fatter pigs!

    The pills were seen as a cop-out. Emotional distress could be dealt with by moral fortitude and simply getting back to work.

    Today, tranks are seen as just another type of medication, although their use is still freighted with social and quasi-moral ramifications. Small Comfort muses on the role of tranquilizers in society, from the doctor's office to everyday situations. Does the use of tranquilizers by a single person affect the people he associates with?

    One of the best chapters deals with media coverage of the pills, with charts demonstrating the rise, decline, and leveling out of the minor tranquilizers.

    Other chapters reveal the marketing strategies used by the various drug companies, aimed primarily at doctors. Smith painstakingly describes how doctors prescribed the pills over the years, and why. In the chapter called "Doctor's Dilemmas," Smith explores the degree to which physicians and patients play ridiculous cat-and-mouse games with these pills. Fear of "addiction" overcoming therapeutic value is something Smith refers to as "cultural lag"—that is, technology's ability to outpace society's ability to cope with tranks.


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