Junkies, the Conclusion

Junkies, the Conclusion

   Finally, you say, the end of this series on prescription painkillers, anxiety drugs, supplements and other such ingestibles.  And again, this series has tried to point out that for many this is a necessary part of their lives, the pain or stress of daily life needing some sort of relief; and while this is recognized, this series was meant more as a caveat to study further and realize exactly what you may or may not be putting into your body, to dig deeper and find the interactions of what you're consuming, for in the end (and in many cases), you may be little more than a guinea pig no matter how strong your beliefs about its efficacy...and don't feel alone in this for my full disclosure is that about twice a year I'll take the occasional echinacea root or valerian root capsule...and yes, I tend to feel better (but then, I don't usually take any sort of prescription drugs or vitamins).  Who knows, I might be consuming a bunch of sawdust since I'm only trusting the bottle's label and the fact that it's being sold in a commercial store and not from some roadside stand...but after reading so many reports, I'm wondering if there's much of a difference?

   Still, getting back to our increasing use of pharmaceutical drugs and such, several people have asked why are we even at this point, a spot where medicine is seeming so necessary in our daily lives.  And further, how did so many lose control and suddenly find themselves addicted, first to controlled medical prescriptions and then later (either because of a doctor cutting them off or finances doing so), heading out to the street to take their chances with what an illegal dealer sold them.  It makes the pain, the thoughts, the nightmares, the voices, go away, that's all that matters.  But to our bodies, the damage might be building to a point of no return.  We hear our own selves crying out for help --in some form, in any form-- and pills must seem a faster, questionably safer, I-can-handle-it-myself way of dealing with a problem we think will be eventually going away...until the next day arrives and we discover that it hasn't gone anywhere.

   One person, Johann Hari, presented a talk on TED asking, is what we know or think we know about addiction wrong?  Here's how he came to study this: One of my earliest memories is of trying to wake up one of my relatives and not being able to.  And I was just a little kid, so I didn't really understand why, but as I got older, I realized we had drug addiction in my family, including later cocaine addiction.  I'd been thinking about it a lot lately, partly because it's now exactly 100 years since drugs were first banned in the United States and Britain, and we then imposed that on the rest of the world.  It's a century since we made this really fateful decision to take addicts and punish them and make them suffer, because we believed that would deter them; it would give them an incentive to stop.   And a few years ago, I was looking at some of the addicts in my life who I love, and trying to figure out if there was some way to help them.  And I realized there were loads of incredibly basic questions I just didn't know the answer to, like, what really causes addiction?  Why do we carry on with this approach that doesn't seem to be working, and is there a better way out there that we could try instead?  (There's a)...professor called Peter Cohen in the Netherlands who said, maybe we shouldn't even call it addiction.  Maybe we should call it bonding.  Human beings have a natural and innate need to bond, and when we're happy and healthy, we'll bond and connect with each other, but if you can't do that, because you're traumatized or isolated or beaten down by life, you will bond with something that will give you some sense of relief.  Now, that might be gambling, that might be pornography, that might be cocaine, that might be cannabis, but you will bond and connect with something because that's our nature.  That's what we want as human beings...it might sound weird to say, I've been talking about how disconnection is a major driver of addiction and weird to say it's growing, because you think we're the most connected society that's ever been, surely.  But I increasingly began to think that the connections we have or think we have, are like a kind of parody of human connection.  If you have a crisis in your life, you'll notice something.  It won't be your Twitter followers who come to sit with you.  It won't be your Facebook friends who help you turn it round.  It'll be your flesh and blood friends who you have deep and nuanced and textured, face-to-face relationships with, and there's a study I learned about from Bill McKibben, the environmental writer, that I think tells us a lot about this.  He looked at the number of close friends the average American believes they can call on in a crisis.  That number has been declining steadily since the 1950s.  The amount of floor space an individual has in their home has been steadily increasing, and I think that's like a metaphor for the choice we've made as a culture.  We've traded floorspace for friends, we've traded stuff for connections, and the result is we are one of the loneliest societies there has ever been.

   The common theme in response seems to be two words, reward and pain, and the drive to either get one (the reward, which is usually a shot of dopamine in our brain) or to get rid of one (the pain).  And as you can see from just these TED Talks, the future looks promising.  Dr. Francis Collins, the Director of the National Institutes of Health, told TED: When you pop a pill, do you know how it works?  Most modern drugs target specific molecules, interacting with disease at the molecular level. But while we know the molecular causes of roughly 4,000 diseases, a very slim 6 percent of those diseases have a safe and effective drug to treat them.  Why?  Because of the incredible difficulty and cost of finding a compound that is perfectly shaped to interact with a molecular cause, and that also happens to be safe.

   Already large drug companies are cautiously admitting to work with big data gatherers such as Google and Yahoo to see if their web search data is proving to be a faster and possibly more effective way to discover a drug's side effects, as reported in Bloomberg.  A search from 176 million Yahoo queries was already done in 2010, showing that people are concerned about not only what they're taking but how it might (or did) react in their bodies.  Another article in the magazine reported on emerging companies such as Treato which scans "online patient forums" and sells that information to pharmaceutical companies.  Said the company's CEO, Ido Hadari, "The way we are taking care of patient safety once it's out there --once products are out there in the real world-- belongs in the 70s.  We can do much better." 

   And that seems to be the attitude of some of the major pharmaceutical companies as well.  People with unusual conditions are being sought for their genetic markers.  With a scary title of "The Mutant Path to Powerful Drugs," Bloomberg Businessweek told of a new drug developed (and scheduled for release): ...based on the rare gene mutation of an aerobics instructor with astoundingly low cholesterol levels...the drugs can lower cholesterol when statins alone don't work.  They are estimated to cost as much as $12,000 per patient per  year and bring in more than $1 billion annually.  Another company turned to the giant Genentech after discovering a pain-blocking pathway in the body called the Nav 1.7 sodium ion channel:  The promise of the Nav 1.7 channel is to create an entirely new class of painkiller.  Options on the market are all problematic.  Opioids, such as morphine, are addictive, while nonsteroidal anti-inflammatory drugs, such as ibuprofen, are ineffective with severe pain and can cause gastrointestinal side effects including bleeding.  Genentech is still in the earliest stage of clinical trials, and it could take more than five years before a drug is released.  But as with anything bringing in the promise of such financial gains, the reality is that many diseases will continue to go unresearched, as the article concludes..."While outliers may hold the secret to curing the ills of the rest of humanity, there is no profit motive to find treatments for their aberrant sufferings.  The market is too small, even though their suffering is real"

   So the ingredients for our pharmaceuticals (about 80% currently) will continue to come from such far away nations as India and China, although the average consumer won't see the cost savings (in 2005, Congress passed a bill to prevent Medicare from negotiating for lower prices on pharmaceutical drugs).  Yes, companies are creating medical pills with 3-D printers (which may or may not bode well for the consumer in the future), says Smithsonian.  And in an even more promising bit of innovation, here comes the Wize mirror to give you a diagnosis just by looking at it, possibly in your home.  Says the Smithsonian piece by Heather Hannsman: The mirror uses a visible light monitoring system to study a user's blood vessels.  Different wavelengths of light get absorbed depending on a person's levels of blood oxygenation, which the mirror can determine based on the backscattered light.  Then the mirror scans the face with ultraviolet light to measure concentration of fatty tissues and glycated proteins, which can indicate high blood glucose levels.  A change in cholesterol deposits can indicate heart problems, and high blood glucose levels point to increased risk of Type 2 diabetes.  Changes in blood volume and in a person's pallor and weight can also be signs of cardio-metabolic diseases.  Then, users can breathe into the so-called "Wize Sniffer."  The gas sensors analyze their breath for high concentrations of sugars—an indicator of diabetes—and evidence of smoking and drinking...The mirror builds a 3-D reconstruction of the face, to assess any changes since the last time the person looked in the mirror.  Then, it spits out a score to indicate a user's overall health, and if it's changed.  The device can tell users if they're approaching unhealthy or dangerous territory.

   Exciting changes ahead.  But perhaps the biggest change would be one of simple connection and dignity.  Certainly, real problems exist, and real abuse of the system occurs, and not everyone can be reached or rescued.  But perhaps a good start would be to simply change the negative wording, to drop the word "junkie" and "addict" from our lexicon.  And admittedly, perhaps reaching out isn't enough, but it would be a beginning.  It's a complicated problem, certainly, and likely, there are no real simple answers to why we search for and use ever more drugs, legal or not.  But if Congress won't listen or see the problem (the lobbying power of the pharmaceutical and vitamin industry is too large), then perhaps it is up to the individual to make the decision...to reach out, to comfort, to touch, to provide contact, to connect.  Overnight successes are rare, yes, and it might be a long-term journey; but for someone crying out in pain, the road there and back seems to be one without end; and perhaps, like a hitchhiker on a desert highway, all he or she is looking for is for someone to stop, someone to care enough (even if a stranger), someone to lower the window down on a blistering hot day, lean out, and say, "Need a lift?"