PSYCHOATIVE DRUGS have always been mainstays of medicine because they make people feel different. They work. But today, widespread ignorance of basic pharmacology among doctors, along with high-pressure advertising by pharmaceutical companies that clearly hold their own profit-making above the public interest, have made the drugging of patients' minds a serious problem.
In the late 1800s, the most widely prescribed drug in the world was Vin Mariani, a tonic of red wine infused with coca leaves which comforted millions of people and drew extravagant testimonials from celebrities. The most widely prescribed drug today is Valium, a depressant billed as a "minor tranquilizer." It has made a fortune for its manufacturer, Hoffmann-LaRoche, a Swiss-based firm that also markets Librium, a similar drug. Valium is essentially whiskey in a pill, but it has been represented as an anti-anxiety drug and even recommended for treating alcoholics. Despite the claims of its manufacturer, it can produce stubborn dependence and dangerous toxicity.
Authors Hughes and Brewin make a stron case here against the growing addiction to legal drugs in America. They indict not only Valium, Librium and their relatives but also painkillers like Darvon, the major tranquilizers like Thorazine, antidepressants, amphetamines as treatment for hyperactivity in children, and a variety of over-the-counter products.
The two authors are journalists and their style is classical muckraking. The book is filled with horror stories of addiction and toxic effects, excerpts from outrageous pharmaceutical ads and waffling quotes from goverment officials. Occasionally, the substance seems thin, but, generally, the book is well-documented and, I hope, will bring the problem of legal drug absue to wider attention. I have long maintained that illegal "drugs of abuse" do not approach legal drugs in potential for harm. This book supports that contention.
Feminists will be pleased with the chapter on "Women as Victims," because women suffer disproportionately from the prescribing of mood-altering chemicals. They take tranquilizers at a two-to-one ratio over men and take 71 percent of all antidepressants. Male doctors commonly get rid of female patients by giving them tranquilizers for vague complaints. (They also used to give them stimulants to make them do their housework better until that practice was outlawed.) The pharmaceutical companies encourage this kind of medicine with blatant "before" and "after" pictures in their ads showing how "bitchy" women are easily transformed into docile helpmates by the likes of Valium. The authors also discuss the dangers of current medicating practices in obstetrical, pediatric and geriatric medicine.
There are enlightening chapters on the pharmaceutical indutray and the inability of the Food and Drug Administration to regulate it properly. Brewin and Hughes show how companies like Hoffmann-LaRoche through clever marketing transformed the stressful situations of ordinary life into disease states treatable by their products. For example: "Valium was recommended for the over-educated woman who got married, had children, and grew bored, finding her master's degree in fine arts going to waste in volunteer work . . .
"Librium was suggested for the college girl whose 'newly stimulated intellectual curiosity may make her more sensitive and apprehensive about unstable national and world conditions.' Ritalin (a stimulant marketed by CIBA) was recommended as a pick-me-up for 'environmental depression,' such as when an air conditioner is 'turned down or off.'
My only complaint with this book is its tendency to place blame on the drugs themselves. There are no good drugs or bad drugs, only good and bad uses to which people put drugs. All of the compounds discussed here have their place and can be used intelligently. The problem is that doctors misuse them most of the time patients do not understand what they are taking, the pharmaceutical companies push them shamelessly, and government agencies do a poor job of regulating the companies. I see no hope for improving our situation with these chemicals except through education of everyone involved, beginning with physicians, who now rely on the companies for their information. This book is a good start. I would like to see it made required reading for all medical students.