Drug Epidemic Quotes

I felt like a secret agent, relying on my wits and charm to keep me alive amidst an epidemic of violent death

In the United States, people with depression, bipolar, and schizophrenia are losing twelve to twenty years in life expectancy compared to people not in the mental health system.

With psychiatric medications, you solve one problem for a period of time, but the next thing you know you end up with two problems. The treatment turns a period of crisis into a chronic mental illness. - Amy Upham

If you expand the boundaries of mental illness, which is clealry what has happened in this country during the past twenty-five years, and you treat the people so diagnosed with psychiatric medications, do you run the risk of turning an anger-ridden teenager into a lifelong mental patient?

Rather than fix chemical imbalances in the brain, the drugs creat them.

Don't ever think you're better than a drug addict, because your brain works the same as theirs. You have the same circuits. And drugs would affect your brain in the same way it affects theirs. The same thought process that makes them screw up over and over again would make you screw up over and over as well, if you were in their shoes. You probably already are doing it, just not with heroin or crack, but with food or cigarettes, or something else you shouldn't be doing.

When you push someone's head under water for 5 minutes, they will drown. It doesn't matter if the person is a sinner or a saint. It's just a natural process. If their head is under water, the lack of oxygen will make them drown. That rule applies to everyone, good or bad, equally. It doesn't matter if the drowning person has strong moral fiber. And it doesn't matter if you're a good or a bad person, once you become addicted to drugs. What happens next is inevitable. It's a natural process that happens in everyone's brain, once the drugs take over. So don't ever fool yourself into thinking that only weak or bad people get addicted.

2008:  Drug overdoses, mostly from opiates, surpass auto fatalities as leading cause of accidental death in the United States.

It's so exhausting, so mentally and emotionally draining when you care about a drug addict and they never miss an opportunity to disappoint, manipulate or hurt you.

Prior to being medicated, a depressed person has no known chemical imbalance.

...all I could think about was how both sets of parents had needed to make their decision, on whether to medicate their child, in a scientific vacuum. (p. 35)

OxyContin is a simple pill. It contains only one drug: oxycodone, a painkiller that Germans synthesized in 1916 from thebaine, an opium derivative. Molecularly, oxycodone is similar to heroin.

Through all this, patients were getting used to demanding drugs for treatment. They did not, however, have to accept the idea that they might, say, eat better and exercise more, and that this might help them lose weight and feel better. Doctors, of course, couldn’t insist. As the defenestration of the physician’s authority and clinical experience was under way, patients didn’t have to take accountability for their own behavior.

Recovery on the med model requires you to be obedient, like a child," she explains. "You are obedient to your doctors, you are compliant with your therapist, and you take your meds. There's no striving toward greater intellectual concerns.

The front of the brain has to develop through mistakes. But the first reaction of the addicted person is to head back to the family: ‘Will you rescue me?’ Whatever the person’s rescued from, there’s no learning. There’s no experiences, no frontal brain development. They’re doing well and then some idea comes into their head and they’re off a cliff. It may not be a decision to use. Most relapse comes not from the craving for the drug. It comes from this whole other level of unmanageability, putting myself in compromising situations, or being dishonest, being lazy—being a fifteen-year-old.

The number of Ohioans dead from drug overdoses between 2003 and 2008 was 50 percent higher than the number of U.S. soldiers who died in the entire Iraq War.

Drug overdoses passed fatal vehicle accidents nationwide for the first time in 2008.

The “cure,” it seemed, had once again been proven to be “worse than the disease.

And what science had revealed was this: Prior to treatment, patients diagnosed with schizophrenia, depression, and other psychiatric disorders do not suffer from any known "chemical imbalance". However, once a person is put on a psychiatric medication, which, in one manner or another, throws a wrench into the usual mechanics of a neuronal pathway, his or her brain begins to function, as Hyman observed, abnormally.

No,” I start, hesitantly. “Well, we have to end apartheid for one. And slow down the nuclear arms race, stop terrorism and world hunger. Ensure a strong national defense, prevent the spread of communism in Central America, work for a Middle East peace settlement, prevent U.S. military involvement overseas. We have to ensure that America is a respected world power. Now that’s not to belittle our domestic problems, which are equally important, if not more. Better and more affordable long-term care for the elderly, control and find a cure for the AIDS epidemic, clean up environmental damage from toxic waste and pollution, improve the quality of primary and secondary education, strengthen laws to crack down on crime and illegal drugs. We also have to ensure that college education is affordable for the middle class and protect Social Security for senior citizens plus conserve natural resources and wilderness areas and reduce the influence of political action committees.” The table stares at me uncomfortably, even Stash, but I’m on a roll.

These drugs were advertised mostly to primary care physicians, who had little pain-management training and were making their money by churning patients through their offices at a thirteen-minute clip.

Psychosis does not live in the head. It lives in the in-between of family members, and in the in-between of people," Salo explained. "It is in the relationship, and the one who is psychotic makes the bad condition visible. He or she 'wears the symptoms' and has the burden to carry them.

That experience allowed me to see this therapeutic principle in action," Stanton said. "You just can't organize yourself without a connection to another human being, and you can't make that connection if you embalm yourself with drugs.

But across America, thousands of people like Matt Schoonover were dying. Drug overdoses were killing more people every year than car accidents.

This is the way that misery does love company: People are relieved to learn that they are not alone in their suffering, that they are part of something larger, in this case, a societal plague [drugs]--an epidemic of children, an epidemic of families.

Klonopin ruined my lie. It takes away your drive, and in the morning, you don't want to get out of bed, because you feel so groggy. I don't even know what it's like to feel normal. This is my world. Things don't get me as excited as most people because I'm in a constant state of sedation. It should never have been prescribed for long-term use.

In recent years, some of the biggest new drug kingpins can't be successfully prosecuted. The Pablo Escobars of today are coming out of China, and they don't have to worry about being imprisoned by their government. They can operate free and in the clear, within the boundaries of their country's own laws. Whenever a deadly new drug is made illegal in China, manufacturers simply tweak its chemical structure and start producing a new drug that is still legal. Many fentanyl analogues and cannabinoids have been made this way.

We have been focusing on the role that psychiatry and its medications may be playing in this epidemic, and the evidence is quite clear. First, by greatly expanding diagnostic boundaries, psychiatry is inviting and ever-greater number of children and adults into the mental illness camp. Second, those so diagnosed are then treated with psychiatric medications that increase the likelihood they will become chronically ill. Many treated with psychotropics end up with new and more severe psychiatric symptoms, physically unwell, and cognitively impaired. This is the tragic story writ large in five decades of scientific literature.

That is where we stand as a nation today. Twenty years ago, our society began regularly prescribing psychiatric drugs to children and adolescents, and now one out of every fifteen Americans enters adulthood with a "serious mental illness." That is proof of the most tragic sort that our drug-based paradigm of care is doing a great deal more harm than good. The medicating of children and youth became commonplace only a short time ago, and already it has put millions onto a path of lifelong illness.

Drug overdose had already taken the lives of 300,000 Americans over the past fifteen years, and experts now predicted that 300,000 more would die in only the next five. It is now the leading cause of death for Americans under the age of fifty, killing more people than guns or car accidents, at a rate higher than the HIV epidemic at its peak.

When it comes to dead bodies in current psychotropic trials, there are a greater number of them in the active treatment groups than in the placebo groups. This is quite different from what happens in penicillin trials or trials of drugs that really work. -David Healy

That’s when they realized that right then and there drug overdose deaths were about to surpass fatal auto crashes as Ohio’s top cause of injury death.

The GAO, in its June 2008 report, concluded that one in every sixteen young adults in the United States is now “seriously mentally ill.

In 1967, one in three American adults filled a prescription for a “psychoactive” medication, with total sales of such drugs reaching $692 million.

Stupid arbitrary shit means the president of the United States can wait six years before even saying the disease’s name. Stupid arbitrary shit means it will take a movie star to die and a hemophiliac teenager to die before ordinary people start to mobilize, start to feel that the disease needs to be stopped. Tens of thousands of people will die before drugs are made and drugs are approved. What a horrible feeling that is, to know that if the disease had primarily affected PTA presidents, or priests, or white teenage girls, the epidemic would have been ended years earlier, and tens of thousands, if not hundreds of thousands, of lives would have been saved. We did not choose our identity, but we were chosen to die by it.

The more we talk about the epidemic as an individual disease phenomenon or a moral failing, the easier it is to obfuscate and ignore the social and economic conditions that predispose certain individuals to addiction. The fix isn't more Suboxone or lectures on morality but rather a reinvigorated democracy that provides a pathway for meaningful work, with a living wage, for everybody.

In Europe, nobody will bleep you, if you want to say a "bad" word on TV. The idea that some self-righteous little old lady at the FCC gets to tell other people which words they may or may not use, seems like a pretty strange concept in the rest of the civilized world. Media censorship is a prohibition of words and pictures. The War on Drugs is a complete failure, and so is the American War on Words. When you forbid a word, you give it power. Self-proclaimed rebels will use words like shit or fuck, simply to shock and sound cool.

We must realize that mental problems are just as real as physical disease, and that anxiety and depression require active therapy as much as appendicitis or pneumonia,” wrote Dr. Howard Rusk, a professor at New York University who penned a weekly column for the New York Times. “They are all medical problems requiring medical care.”12

Every patient who was prescribed the drug stood a chance of soon needing it every day. These people were willing to pay cash. They never missed an appointment. If diagnosis wasn’t your concern, a clinic was a low-overhead operation: a rented building, a few waiting rooms, some office staff. And bouncers. These clinics did require bouncers.

Despite the prominence that "magic bullets" and "wonder drugs" hold in the layman's mind, most of the really decisive battles in the war against infectious disease consisted of measures to eliminate disease organisms from the environment. An example from history concerns the great outbreak of cholera in London more than one hundred years ago. A London physician, John Snow, mapped occurrence of cases and found they originated in one area, all of whose inhabitants drew their water from one pump located on Broad Street. In a swift and decisive practice of preventative medicine, Dr. Snow removed the handle from the pump. The epidemic was thereby brought under control - not by a magic pill that killed the (then unknown) organism of cholera, but by eliminating the organism from the environment.

I have always been told that a person has to accept that the illness is chronic," she says, at the end of our interview. "You can be 'in recovery,' but you can never be 'recovered.' But I don't want to be on disability forever, and I have started to question whether depression is really a chemical thing. What are the origins of my despair? How can I really help myself? I want to honor the other parts of me, other than the sick part that I'm always thinking about. I think that depression is like a weed that I have been watering, and I want to pull up that weed, and I am starting to look to people for solutions. I really don't know what the drugs did for me all these years, but I do know that I am disappointed in how things have turned out." Such is Melissa Sances's story. Today it is a fairly common one. A distressed teenager is diagnosed with depression and put on an antidepressant, and years later he or she is still struggling with the condition. But if we return to the 1950s, we will discover that the depression rarely struck someone as young as Melissa, and it rarely turned into the chronic suffering that she has experienced. Her course of illness is, for the most part, unique to our times.

The enormous pressures on doctors today to prescribe pills, perform procedures, and please patients, all within a disjointed medical bureaucracy and all with an eye on the bottom line, has contributed to the current prescription drug epidemic.

Children of the most privileged group in the wealthiest country in the history of the world were getting hooked and dying in almost epidemic numbers from substances meant to, of all things, numb pain. “What pain?” a South Carolina cop asked rhetorically one afternoon as we toured the fine neighborhoods south of Charlotte where he arrested kids for pills and heroin. Crime was at historic lows, drug overdose deaths at record highs. A happy façade covered a disturbing reality. I grew consumed by this story.

2007:  Purdue and three executives plead guilty to misdemeanor charges of false branding of OxyContin; fined $634 million. 2008:  Drug overdoses, mostly from opiates, surpass auto fatalities as leading cause of accidental death in the United States. 2010:

after the war, historian Marilyn Young warned: The U.S. can destroy Iraq’s highways, but not build its own; create the conditions for epidemic in Iraq, but not offer health care to millions of Americans. It can excoriate Iraqi treatment of the Kurdish minority, but not deal with domestic race relations; create homelessness abroad but not solve it here; keep a half million troops drug free as part of a war, but refuse to fund the treatment of millions of drug addicts at home. . . . We shall lose the war after we have won it.

Stupid arbitrary shit means it will take a movie star to die and a hemophiliac teenager to die before ordinary people start to mobilize, start to feel that the disease needs to be stopped. Tens of thousands of people will die before drugs are made and drugs are approved. What a horrible feeling that is, to know that if the disease had primarily affected PTA presidents, or priests, or white teenage girls, the epidemic would have been ended years earlier, and tens of thousands, if not hundreds of thousands, of lives would have been saved

Cocaine and methamphetamine—the popular drugs through the 1980s and 1990s—are damaging drugs, but people don’t often fatally overdose on them. Heroin, which people do overdose on, hadn’t been a sustained problem since the 1970s. Drug overdoses in Ohio had remained pretty constant for decades.

The number of Ohioans dead from drug overdoses between 2003 and 2008 was 50 percent higher than the number of U.S. soldiers who died in the entire Iraq War. •  Three times as many people died of prescription pill overdoses between 1999 and 2008 as died in the eight peak years of the crack cocaine epidemic.

trick, though. Treatment has always been more effective and cheaper than prison for true drug addicts. What’s changed, Norman said, is that no longer are most of the accused African American inner-city crack users and dealers. Most of the new Tennessee junkies come from the white middle and upper-middle classes, and from the state’s white rural heartland—people who vote for, donate to, live near, do business with, or are related to the majority of Tennessee legislators.

Carthage had a bigger drug epidemic than I ever knew: The cops had been here just yesterday, and already the druggies had resettled, like determined flies. As we made our way through the piles of humans, an obese woman shushed up to us on an electric scooter. Her face was pimply and wet with sweat, her teeth catlike.

The morphine molecule exerts an analogous brainwashing on humans, pushing them to act contrary to their self-interest in pursuit of the molecule. Addicts betray loved ones, steal, live under freeways in harsh weather, and run similarly horrific risks to use the molecule. It became the poster molecule for an age of excess. No amount of it was ever enough. The molecule created ever-higher tolerance. Plus, it had a way of railing on when the body gathered the courage to throw it out. This wasn’t only during withdrawals. Most drugs are easily reduced to water-soluble glucose in the human body, which then expels them. Alone in nature, the morphine molecule rebelled. It resisted being turned into glucose and it stayed in the body. “We still can’t explain why this happens. It just doesn’t follow the rules. Every other drug in the world—thousands of them—follows this rule. Morphine doesn’t,” Coop said. “It really is almost like someone designed it that way—diabolically so.

...and she no longer is having her emotional responses to...stress numbed by medication. "I've been off the drugs for two years, and sometimes I find it very, very difficult to deal with my emotions. I tend to have these rages of anger. Did the drugs bring such a cloud over my mind, make me so comatose, that I never gained skills on how to deal with my emotions? Now I'm finding myself getting angrier than ever and getting happier than ever too. The circle with my emotions is getting wider. And yes, it's easy to deal with when you're happy, but how do you deal with it when you're mad? I'm working on not getting overly defensive, and trying to take things in stride.

The cost savings weren’t what did the trick, though. Treatment has always been more effective and cheaper than prison for true drug addicts. What’s changed, Norman said, is that no longer are most of the accused African American inner-city crack users and dealers. Most of the new Tennessee junkies come from the white middle and upper-middle classes, and from the state’s white rural heartland—people who vote for, donate to, live near, do business with, or are related to the majority of Tennessee legislators.

Yes the fact was that, coincidentally or not, this change of heart was happening among conservatives just as opiate addiction was spreading among both rural and middle-class white kids across the country, though perhaps most notably in the deepest red counties and states. Drug enslavement and death, so close at hand, were touching the lives, and softening the hearts, of many Republican lawmakers and constituents. I’ll count this as a national moment of Christian forgiveness. But I also know that it was a forgiveness that many of these lawmakers didn’t warm to when urban crack users were the defendants. Let’s just say that firsthand exposure to opiate addiction can change a person’s mind about a lot of things. Many of their constituents were no longer so enamored with that “tough on crime” talk now that it was their kids who were involved. So a new euphemism emerged—“smart on crime”—to allow these politicians to support the kind of rehabilitation programs that many of them had used to attack others not so long ago.

African Americans had been spared the full brunt of the opioid epidemic: doctors were less likely to prescribe opioid painkillers to Black patients, either because they did not trust them to take the drugs responsibly or because they were less likely to feel empathy for these patients and want to treat their pain aggressively. As a result, levels of addiction and death were statistically low among African Americans. It appeared to be a rare instance in which systemic racism could be said to have protected the community.

For the first time, we could calculate the six-year total for the entire state. There were two ways to do it. Simply add up all the pills the pharmacies bought. Or add up each distributor’s deliveries to every county. Both methods produced the same number—780 million. That was just hydrocodone and oxycodone—in a state with fewer than 1.8 million people.

Meth users include men and women of every class, race, and background. Though the current epidemic has its roots in motorcycle gangs and lower-class rural and suburban neighborhoods, meth, as Newsweek reported in a 2005 cover story, has “marched across the country and up the socioeconomic ladder.” Now, “the most likely people and the most unlikely people take methamphetamine,” according to Frank Vocci, director of the Division of Pharmacotherapies and Medical Consequences of Drug Abuse at the National Institute on Drug Abuse (NIDA).

The Xalisco traffickers’ innovation was literally a delivery mechanism as well. Guys from Xalisco had figured out that what white people—especially middle-class white kids—want most is service, convenience. They didn’t want to go to skid row or some seedy dope house to buy their drugs. Now they didn’t need to. The guys from Xalisco would deliver it to them.

But none of these drugs had been developed after scientists had identified any disease process or brain abnormality that might have been causing these symptoms.

Because there is no love you can throw on them, no hug big enough that will change the power of that drug; it is just beyond imagination how controlling and destructive it is.

There was a little of nineteenth-century patent medicine in Valium’s DNA. It didn’t treat any root cause of stress. Instead, it treated vague symptoms and thus allowed doctors to avoid the complicated work of understanding the causes of that stress. Like patent medicines, Valium was a name-brand drug, promoted together with the idea that a pill could solve any ailment.

For the past twenty-five years, the psychiatric establishment has told us a false story. It told us that schizophrenia, depression, and bipolar illness are known to be brain diseases, even though—as the MindFreedom hunger strike revealed—it can’t direct us to any scientific studies that document this claim. It told us that psychiatric medications fix chemical imbalances in the brain, even though decades of research failed to find this to be so. It told us that Prozac and the other second-generation psychotropics were much better and safer than the first-generation drugs, even though the clinical studies had shown no such thing. Most important of all, the psychiatric establishment failed to tell us that the drugs worsen long-term outcomes.

Wallace Laboratories hired Salvador Dalí to help stoke Miltown fever, paying the great artist $35,000 to create an exhibit at an AMA convention that was meant to capture the magic of this new drug.

The cocktail she took usually included a mood stabilizer, an antidepressant, and a benzodiazepine for anxiety, although the exact combination was always changing. One drug would make her sleepy, another would give her tremors, and none of the cocktails seemed to bring her emotional tranquility. Then, in 2001, she was put on an anti-psychotic, Zyprexa, which, in a sense, worked like a charm. "You know what?" she says today, amazed by what she is about to confess. "I loved the stuff. I felt like I finally found the answer. Because what do you know. I have no emotions. It was great. I wasn't crying anymore.

But the idea of a peace dividend could not be stifled so long as Americans were in need. Shortly after the war, historian Marilyn Young warned: The U.S. can destroy Iraq's highways, but not build its own; create the conditions for epidemic in Iraq, but not offer health care to millions of Americans. It can excoriate Iraqi treatment of the Kurdish minority, but not deal with domestic race relations; create homelessness abroad but not solve it here; keep a half million troops drug free as part of a war, but refuse to fund the treatment of millions of drug addicts at home. . . . . We shall lose the war after we have won it.

When the moral history of the 1990s is written, it might be titled Desperately Seeking Satan. With peace and harmony ascendant, Americans seemed to be searching for substitute villains. We tried drug dealers (but then the crack epidemic waned) and child abductors (who are usually one of the parents). The cultural right vilified homosexuals; the left vilified racists and homophobes. As I thought about these various villains, including the older villains of communism and Satan himself, I realized that most of them share three properties: They are invisible (you can’t identify the evil one from appearance alone); their evil spreads by contagion, making it vital to protect impressionable young people from infection (for example from communist ideas, homosexual teachers, or stereotypes on television); and the villains can be defeated only if we all pull together as a team. It became clear to me that people want to believe they are on a mission from God, or that they are fighting for some more secular good (animals, fetuses, women’s rights), and you can’t have much of a mission without good allies and a good enemy.

Meanwhile, though supplies of heroin were unrelenting and addicts were everywhere, Jaime saw no outrage in Charlotte. He spoke to the parents of one junkie after another. As soon as he said the word “heroin,” their minds crashed to a halt. They couldn’t conceive of their children on heroin. For every symptom, the parents had an answer. Did they see burned aluminum foil around the house? We thought he was burning incense. Was he slurring his speech? He was getting over the flu. Were his grades falling? He was going through a phase. Jaime spoke to the city’s Drug Free Coalition, which was focused on alcohol and marijuana. “No,” he told them. “Heroin is the real problem.” He

The off-drug patients also suffered less from depression, blunted emotions, and retarded movements. Indeed, they told Carpenter and McGlashan that they had found it "gratifying and informative" to have gone through their psychotic episodes without having their feelings numbed by the drugs. Medicated patients didn't have that same learning experience, and as a result Carpenter and McGlashan concluded, over the long term they "are less able to cope with subsequent life stresses.

I do wonder what might have happened if [at age sixteen] I could have just talked to someone, and they could have helped me learn about what I could do on my own to be a healthy person. I never had a role model for that. They could have helped me with my eating problems, and my diet and exercise, and helped me learn how to take care of myself. Instead, it was you have this problem with your neurotransmitters, and so here, take this pill Zoloft, and when that didn’t work, it was take this pill Prozac, and when that didn’t work, it was take this pill Effexor, and then when I started having trouble sleeping, it was take this sleeping pill,” she says, her voice sounding more wistful than ever. “I am so tired of the pills.

the Times says there's a heroin epidemic, Malone thinks, which is only an epidemic of course because now white people are dying. Whites started to get opium-based pills from their physicians: oxycodone, vicodin... But, it was expensive and doctors were reluctant to prescribe too much for exactly the fear of addiction. So the white folks went to the open market and the pills became a street drug. It was all very nice and civilized until the Sinoloa cartel down in Mexico made a corporate decision that it could undersell the big American pharmaceutical companies by raising production of its heroin thereby reducing price. As an incentive, they also increased its potency. The addicted white Americans found that Mexican ... heroin was cheaper and stronger than the pills, and started shooting it into their veins and overdosing. Malone literally saw it happening. He and his team busted more bridge-and-tunnel junkies, suburban housewives and upper Eastside madonnas than they could count....

They demanded legal clarity. So, beginning with California, states passed laws exempting doctors from prosecution if they prescribed opiates for pain within the practice of responsible health care. Numerous states approved so-called intractable pain regulations: Ohio, Oregon, Washington, and others. Soon what can only be described as a revolution in medical thought and practice was under way. Doctors were urged to begin attending to the country’s pain epidemic by prescribing these drugs. Interns and residents were taught that these drugs were now not addictive, that doctors thus had a mission, a duty, to use them. In some hospitals, doctors were told they could be sued if they did not treat pain aggressively, which meant with opiates. Russell

I don’t fundamentally understand why people give a shit about what other people put up their noses or what other people put in their veins or what other people breathe into their lungs. I mean I sort of care like if somebodies an addict it’s very destructive to people around that addict. It’s destructive to themselves. I’d like to get them help. I certainly support that which is to get that person help but, I don’t understand how people wake up and say I have to eradicate drug use across the land. “I gotta stick my nose into the business of what other people stick up their nose.” I just find that incomprehensible. I mean, is your life so vacant and so hysterical, so empty, so void of love, care and affection? I can go play with my daughter or I can go and obsessively try and get politicians to throw people in jail for doing things I don’t like. I can’t imagine why people would be choosing option “B” but, only because they don’t have anyone who loves them or, anyone they care about. They don’t have any rich, significant, important, hobbies, relationships, artistic pursuits or anything rich enough to keep them from obsessing about what other people do or bossing and bulling what other people do. This “stick your nose in other people’s business” Is so compulsive and epidemic to human society.

Death by drugs is now a national problem, but the crisis began as an epidemic of overprescribed painkillers in the distressed communities that were least likely to muster the resources to fight back. It erupted in rural fishing villages, coal communities, and mill towns—because Purdue’s sales strategy was to convince doctors that the nation’s injured miners and factory workers were better and more safely served by OxyContin than its weaker competitors. The company even maneuvered to convince the FDA to back this bogus claim.

The human parallels are important here, because the legend of the urban pit bull would become a literal companion piece to America’s failed war on drugs. When a dog scare collides with a drug scare—especially one as racialized as the crack “epidemic”—the effects are multiplicative.

Jaime figured that among the Xalisco Boys’ greatest innovations was figuring out that a mother lode of heroin demand was now waiting to be mined in these neighborhoods if they’d only offer convenience. The Happy Meal of dope, he called it. Marketed like fast food—to young people. “‘We want what we want when we want it and thus we are entitled to get it,’” he said. “This drug is following the same marketing [strategy] of every other product out there. ‘I’ll give you good heroin at a great price. You don’t have to go to the bad neighborhoods. I’ll deliver it for you.

Our nation now affirms, through its legislative bodies and courts, a distinctively anti-Christian agenda. Anything singularly Christian has been virtually swept away under the aegis of equal rights and moral freedom. The divine standards and biblical morality that our nation once embraced are assaulted constantly. Moral freedom now reigns. Materialism and the breakdown of the family are epidemic. Abortions, sexual evils, drugs, and crime are rampant. And our leaders are at a loss to know what to do because there are no standards left to provide controls for these problems.

One thing should be clear, but apparently it is not: if this were indeed our nature, we would be living in paradise. If pain, humiliation, and physical injury made us happy, we would be ecstatic. If being sold on street corners were a good time, women would jam street corners the way men jam football matches. If forced sex were what we craved, even we would be satisfied already. If being dominated by men made us happy, we would smile all the time. Women resist male domination because we do not like it. Political women resist male domination through overt, rude, unmistakable rebellion. They are called unnatural, because they do not have a nature that delights in being debased. Apolitical women resist male domination through a host of bitter subversions, ranging from the famous headache to the clinical depression epidemic among women to suicide to prescription-drug tranquilization to taking it out on the children; sometimes a battered wife kills her husband. Apolitical women are also called unnatural, the charge hurled at them as nasty or sullen or embittered individuals, since that is how they fight back. They too are not made happy by being hurt or dominated. In fact, a natural woman is hard to find. We are domesticated, tamed, made compliant on the surface, through male force, not through nature. We sometimes do what men say we are, either because we believe them or because we hope to placate them. We sometimes try to become what men say we should be, because men have power over our lives.

In the sixteenth century, Swiss chemist Paracelsus coined the adage “the dose makes the poison.” It’s a fundamental principle of toxicology: High concentrations of any substance can kill. In this case, prescription opioids were particularly deadly. The coal barons no longer ruled Appalachia. Now it was the painkiller profiteers.

The painkiller known as methadone was synthesized by German scientists in the effort to make Nazi Germany medicinally self-reliant as it prepared for war. The Allies took the patent after the war, and Eli Lilly Company introduced the drug in the United States in 1947. U.S. doctors identified it as a potential aide to heroin addicts.

The three books were The Emperor’s New Drugs: Exploding the Antidepressant Myth by Irving Kirsch; Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America by Robert Whitaker; and Unhinged: The Trouble with Psychiatry—A Doctor’s Revelations About a Profession in Crisis by Daniel Carlat.

A severe recession in 1980 had inaugurated the era of rising homelessness. But the problem was driven and sustained by many long-brewing problems: the shabby treatment of Vietnam veterans; the grossly inadequate provisions that had been made for mentally ill people since the nation began to close its psychiatric hospitals; the decline in jobs and wages for unskilled workers; the continuation of racist housing policies such as redlining and racially disproportionate evictions; the AIDS epidemic and the drug epidemics that fed it. Also the arcana of applying for Social Security disability—a process so complex that anyone who could figure out how to get assistance probably didn’t need it.

Twenty-four percent of the patients treated with Saint-John’s-wort had a “full response,” 25 percent of the Zoloft patients, and 32 percent of the placebo group. “This study fails to support the efficacy of H perforatum in moderately severe depression,” the investigators concluded, glossing over the fact that their drug had failed this test too.29

The UK needs a post Brexit US trade deal like a hole in the head. Given America's out-of-control opioid crisis, fuelled by prescription drug addiction, along with an obesity epidemic like the world has never seen, why on earth would the UK want to open its doors to US healthcare companies ? So that they can wreak untold havoc and destroy our National Health Service ? No thanks !

Today, according to the NIMH, bipolar illness affects one in every forty adults in the United States, and so, before we review the outcomes literature for this disorder, we need to try to understand this astonishing increase in its prevalence.9 Although the quick-and-easy explanation is that psychiatry has greatly expanded the diagnostic boundaries, that is only part of the story. Psychotropic drugs—both legal and illegal—have helped fuel the bipolar boom.

Wolf was taken aback. This was the 1950s, years before the advent of cholesterol-lowering drugs and aggressive measures to prevent heart disease. Heart attacks were an epidemic in the United States. They were the leading cause of death in men under the age of sixty-five. It was impossible to be a doctor, common sense said, and not see heart disease. Wolf decided to investigate. He enlisted the support of some of his students and colleagues from Oklahoma. They gathered together the death certificates from residents of the

The history of psychiatry and its treatments can be a contentious issue in our society, so much so that when you write about it, as I did in an earlier book, Mad in America, people regularly ask about how you became interested in the subject. The assumption is that you must have a personal reason for being curious about this topic, as otherwise you would want to stay away from what can be such a political minefield. In addition, the person asking the question is often trying to determine if you have any personal bias that colors your writing.

Some people, most particularly the guy who came up with the concept, will tell you that 'The Grim Reaper' was a work of genius, a revolutionary approach to television advertising. But I’m here to tell you that was, and remains, a total and utter shit stain of an idea. And you don’t need to go any further than the first line of the ad to understand why: 'At first, it was only gays and drug users being killed by AIDS.' It is the word 'only' that pisses me off. 'Only gays and IV drug users.' that is to say: 'Only' people who don’t matter. 'Only' people whose suffering should be of no concern to you. Like I said. A total and utter shit stain of an idea. Defenders of the ad might argue that the 'only' was simply about identifying those whom the AIDS epidemic was affecting, and not a statement of this demographic’s value to the community. To which I would say: If you’re such a genius at mass messaging then you should be aware of how the word 'only' would work in the minds of those who are already looking for ways to subjugate the humanity of the people who are listed after the world 'only'.

Cutting. Starving. Compulsive exercising. Drinking. Drugs. Hair pulling. Skin picking. These are not attention-grabbing strategies, or else why would we, who employ them, work so very hard to keep our behaviors secret? They are evidence of poor coping skills. Of terrible anxiety. Of invalidation and loneliness—and shame. Manifestations of anxiety and cognitive rigidity to the point of epidemic levels. Why? It’s all about relief. About trying to escape from your own feelings and experiences of the world that those of us on the spectrum are constantly told are wrong.

The most notorious story is the Trovan antibiotic study conducted by Pfizer in Kano, Nigeria, during a meningitis epidemic. An experimental new antibiotic was compared, in a randomised trial, with a low dose of a competing antibiotic that was known to be effective. Eleven children died, roughly the same number from each group. Crucially, the participants were apparently not informed about the experimental nature of the treatments, and moreover, they were not informed that a treatment known to be effective was available, immediately, from Médecins sans Frontières next door at the very same facility. Pfizer argued in court – successfully – that there was no international norm requiring it to get informed consent for a trial involving experimental drugs in Africa, so the cases relating to the trial should be heard in Nigeria only. That’s a chilling thing to hear a company claim about experimental drug trials, and it was knocked back in 2006 when the Nigerian Ministry of Health released its report on the trial. This stated that Pfizer had violated Nigerian law, the UN Convention on the Rights of the Child and the Declaration of Helsinki.

The number of episodes, and it’s a very rich literature [documenting this], is associated with more cognitive deficits,” he said. “We are building more episodes, more treatment resistance, more cognitive dysfunction, and there is data showing that if you have four depressive episodes, unipolar or bipolar, it doubles your late-life risk of dementia. And guess what? That isn’t even the half of it…. In the United States, people with depression, bipolar, and schizophrenia are losing twelve to twenty years in life expectancy compared to people not in the mental health system.

This new marketplace for drugs proved profitable for all involved. Drug industry revenues topped $1 billion in 1957, the pharmaceutical companies enjoying earnings that made them “the darlings of Wall Street,” one writer observed.19 Now that physicians controlled access to antibiotics and all other prescription drugs, their incomes began to climb rapidly, doubling from 1950 to 1970 (after adjusting for inflation). The AMA’s revenues from drug advertisements in its journals rose from $2.5 million in 1950 to $10 million in 1960, and not surprisingly, these advertisements painted a rosy picture. A 1959 review of drugs in six major medical journals found that 89 percent of the ads provided no information about the drugs’ side effects.20

And meanwhile we decayed. When I was born, when I grew up in the fifties, we believed our country was the land of opportunity, where nobody was doomed to remain poor, where every person of goodwill had a chance to rise. By the time my child was born in the nineties, beggars were crowding the streets of every city, accosting shoppers in the malls. There were camps of homeless in the parks and empty lots, young people going to war with each other for drugs and booze and a few bucks. Our compassion eroded faster than the topsoil, and when we began to notice the earth changes, the droughts and the warming and the die-offs of the animals, the hole in the ozone layer and the epidemics of strange diseases that showed our own immune systems faltering, when we still had a chance to save so much and avert the worst of what followed, we continued to distract ourselves with war.

Understanding the narcissism epidemic is important because its long-term consequences are destructive to society. American culture’s focus on self-admiration has caused a flight from reality to the land of grandiose fantasy. We have phony rich people (with interest-only mortgages and piles of debt), phony beauty (with plastic surgery and cosmetic procedures), phony athletes (with performance-enhancing drugs), phony celebrities (via reality TV and YouTube), phony genius students (with grade inflation), a phony national economy (with $11 trillion of government debt), phony feelings of being special among children (with parenting and education focused on self-esteem), and phony friends (with the social networking explosion). All this fantasy might feel good, but unfortunately, reality always wins. The mortgage meltdown and the resulting financial crisis are just one demonstration of how inflated desires eventually crash to earth.

Over the course of the 1970s conservatives made the endangered child into a kind of political and rhetorical abstraction, a way of thinking about the country and its citizens that could help advance a wide range of policy initiatives. They opposed the counterculture on the grounds that rock and roll caused adolescents to lose respect for family life. They promoted the War on Drugs with racially tinged morality tales about addicted inner-city mothers and, crucially, the “superpredator” “crack babies” to whom those mothers supposedly gave birth. (That particular epidemic was later shown to be a myth.)40 And when Anita Bryant led a campaign to allow Dade County to discriminate against homosexuals in hiring teachers for public schools, she named the effort “Save Our Children.” The fear that tied all of these campaigns together was of the ease with which children could be victimized or else corrupted and turned against the society that was supposed to nurture them.

Out on the northwest side of Nashville, Tennessee, Judge Seth Norman has come to expect phone calls to start pouring in around late January every year. “The legislature comes back in session in January,” Norman said. The calls come from state legislators, each with the same problem: an addicted son, a daughter, a brother-in-law. “‘Um, uh, my nephew down in Camden, you think maybe you might be able to help?’ I get those kinds of calls,” he told me while we sat in the office adjacent to his courtroom. Most of the country’s twenty-eight hundred drug courts are set up to divert drug abusers away from jail and prison and into treatment somewhere. Seth Norman runs the only drug court in America that is physically attached to a long-term residential treatment center. He takes addicts accused of drug-related nonviolent felonies—theft, burglary, possession of stolen property, drug possession—and puts them in treatment for as long as two years as an alternative to prison. Down the hall from his court are dorms with beds for a hundred people—sixty men and forty women. I

In studies of first-episode bipolar patients, investigators at McLean Hospital, the University of Pittsburgh, and the University of Cincinnati Hospital found that at least one-third had used marijuana or some other illegal drug prior to their first manic or psychotic episode.10 This substance abuse, the University of Cincinnati investigators concluded, may “initiate progressively more severe affective responses, culminating in manic or depressive episodes, that then become self-perpetuating.”11 Even the one-third figure may be low; in 2008, researchers at Mt. Sinai Medical School reported that nearly two-thirds of the bipolar patients hospitalized at Silver Hill Hospital in Connecticut in 2005 and 2006 experienced their first bout of “mood instability” after they had abused illicit drugs.12 Stimulants, cocaine, marijuana, and hallucinogens were common culprits. In 2007, Dutch investigators reported that marijuana use “is associated with a fivefold increase in the risk of a first diagnosis of bipolar disorder” and that one-third of new bipolar cases in the Netherlands resulted from it.13

If you look back in the 1930s, Leon Trotsky said that fascism was the inability of the socialist parties to come forth with an alternative,” Hudson said. “If the socialist parties and media don’t come forth with an alternative to this neofeudalism, you’re going to have a rollback to feudalism. But instead of the military taking over the land, as occurred with the Norman Conquest, you take over the land financially. Finance has become the new mode of warfare. “You can achieve the takeover of land and the takeover of companies by corporate raids,” he said. “The Wall Street vocabulary is one of conquest and wiping out. You’re having a replay in the financial sphere of what feudalism was in the military sphere.” The debauched ethics of all casino magnates, including Trump, define the dark, petulant heart of America. Our schools and libraries lack funding, our infrastructure is a wreck, drug addiction and suicide are an epidemic, and we flee toward the promise of magic, unchecked hedonism, and perpetual stimulation. There is a pathological need in America to escape the dreary and the depressing.

We have a crisis in this nation, and it has nothing to do with regulatory reform or marginal tax rates. This book is not going to be about politics. (Sorry to disappoint.) It’s about something deeper and more meaningful. Something a little harder to quantify but a lot more personal. Despite the astonishing medical advances and technological leaps of recent years, average life span is in decline in America for the third year in a row. This is the first time our nation has had even a two-year drop in life expectancy since 1962—when the cause was an influenza epidemic. Normally, declines in life expectancy are due to something big like that—a war, or the return of a dormant disease. But what’s the “big thing” going on in America now? What’s killing all these people? The 2016 data point to three culprits: Alzheimer’s, suicides, and unintentional injuries—a category that includes drug and alcohol–related deaths. Two years ago, 63,632 people died of overdoses. That’s 11,000 more than the previous year, and it’s more than the number of Americans killed during the entire twenty-year Vietnam War. It’s almost twice the number killed in automobile accidents annually, which had been the leading American killer for decades. In 2016, there were 45,000 suicides, a thirty-year high—and the sobering climb shows no signs of abating: the percentage of young people hospitalized for suicidal thoughts and actions has doubled over the past decade.1 We’re killing ourselves, both on purpose and accidentally. These aren’t deaths from famine, or poverty, or war. We’re literally dying of despair.

Weaknesses in claims about self-esteem have been evident for a long time. In California in the late 1980s, the state governor set up a special taskforce to examine politician John Vasconcellos’s claim that boosting young people’s self-esteem would prevent a range of societal problems (see chapter 1). One of its briefs was to review the relevant literature and assess whether there was support for this new approach. An author of the resulting report wrote in the introduction that ‘one of the disappointing aspects of every chapter in this volume … is how low the associations between self-esteem and its [presumed] consequences are in research to date.’1 Unfortunately, this early expression of concern was largely ignored. Carol Craig reviews more recent warnings about the self-esteem movement in an online article ‘A short history of self-esteem’, citing the research of five professors of psychology. Craig’s article and related documents are worth reading if you are interested in exploring this issue in depth.2 The following is my summary of her key conclusions about self-esteem:        •   There is no evidence that self-image enhancing techniques, aimed at boosting self-esteem directly, foster improvements in objectively measured ‘performance’.        •   Many people who consider themselves to have high self-esteem tend to grossly overestimate their own abilities, as assessed by objective tests of their performance, and may be insulted and threatened whenever anyone asserts otherwise.        •   Low self-esteem is not a risk factor for educational problems, or problems such as violence, bullying, delinquency, racism, drug-taking or alcohol abuse.        •   Obsession with self-esteem has contributed to an ‘epidemic of depression’ and is undermining the life skills and resilience of young people.        •   Attempts to boost self-esteem are encouraging narcissism and a sense of entitlement.        •   The pursuit of self-esteem has considerable costs and may undermine the wellbeing of both individuals and societies. Some of these findings were brought to wider public attention in an article entitled ‘The trouble with self-esteem’, written by psychologist Lauren Slater, which appeared in The New York Times in 2002.3 Related articles, far too many to mention individually in this book, have emerged, alongside many books in which authors express their concerns about various aspects of the myth of self-esteem.4 There is particular concern about what we are doing to our children.

Kaffman (2009) described childhood victimization as a "silent epidemic", and Finkelhor, Turner, Ormrod, and Hamby (2010) reported that children are the most traumatized class of humans around the globe. The findings of these researchers are at odds with the view that children have protected status in most families, societies, and cultures. Instead, Finkelhor reports that children are prime targets and highly vulnerable, due principally to their small size, their physical and emotional immaturity with its associated lack of control, power and resources; and their related dependency on caregivers. They are subjected to many forms of exploitation on an ongoing basis, imposed on them by individuals with greater power, strength, knowledge, and resources, many of whom are, paradoxically and tragically, responsible for their care and welfare. These traumas are interpersonal in nature and involve personal transgression, violation and exploitation of the child by those who rely on the child's lesser physical abilities, innocence, and immaturity to intimidate, bully, confuse, blackmail, exploit, or otherwise coerce. In the worst-case scenario, a parent or other significant caregiver directly and repeatedly abuses a child or does not respond to or protect a child or other vulnerable individual who is being abused and mistreated and isolates the child from others through threats or with direct violence. Consequently, such an abusive, nonprotective, or malevolently exploitative circumstance (Chefetz has coined the term "attack-ment" to describe these dynamics) has a profound impact on victim's ability to trust others. It also affects the victim's identity and self-concept, usually in negative ways that include self-hatred, low self-worth, and lack of self-confidence. As a result, both relationships, and the individual's sense of self and internal states (feelings, thoughts, and perceptions) can become sources of fear, despair, rage, or other extreme dysphoria or numbed and dissociated reactions. This state of alienation from self and others is further exacerbated when the occurrence of abuse or other victimization involves betrayal and is repeated and becomes chronic, in the process leading the victim to remain in a state of either hyperarousal/anticipation/hypervigilance or hypoarousal/numbing (or to alternate between these two states) and to develop strong protective mechanisms, such as dissociation, in order to endure recurrences. When these additional victimizations recur, they unfortunately tend to escalate in severity and intrusiveness over time, causing additional traumatization (Duckworth & Follette, 2011). In many cases of child maltreatment, emotional or psychological coercion and the use of the adult's authority and dominant power rather than physical force or violence is the fulcrum and weapon used against the child; however, force and violence are common in some settings and in some forms of abuse (sometimes in conjunction with extreme isolation and drugging of the child), as they are used to further control or terrorize the victim into submission. The use of force and violence is more commonplace and prevalent in some families, communities, religions, cultural/ethnic groups, and societies based on the views and values about adult prerogatives with children that are espoused. They may also be based on the sociopathy of the perpetrators.