The Cult of Pharmacology: How America Became the World's Most Troubled Drug Culture [Hardcover]

Richard DeGrandpre might be familiar to you as the author of Ritalin Nation. Ritalin comes in for much attention by detailed comparison with cocaine. Both are said to produce the same mental effects to the point where Ritalin is called "synthetic cocaine". A main theme of this book is that Ritalin is considered and "ethical" drug and an angel in dealing with ADHD, while cocaine is considered a "street" drug and a demon; this artifical difference had nothing to do with the pharmacology of the two drugs, but to the conditions of use and the dogma on each, called "placebo text". Both are dopamine reuptake inhibitors in the brain.

Methamphetamine as "meth" or "speed" has been called by a federal "drug czar" "the worst drug ever to hit America", and The New York Times wrote that it was "feeding an epidemic of addiction that...rivals that of heroin and cocaine over the past few decades". The same drug has been available as Methedrine or Desoxyn for decades and is said to have "all the qualities you could possibly want in an ADHD med -- it doesn't cause anxiety, it barely raises heart rate or blood pressure, it totally wipes out depression and fatigue, and it lasts a full twelve hours..." (p32). Angel or demon?

DeGrandpre also notes that "demon" heroin, introduced by Bayer of Leverkusen around 1885 as a non-addictive form of morphine, was available without a prescription for about 25 years, and is not nearly as addictive as US government officials have propagandized. Doubters should be warned that loose claims are not found in this book, and fully 52 pages are devoted to citations, mostly to medical journals, appendices, and index. Provision of maintenance doses of heroin and other street drugs in the UK and the Netherlands paid by their national health services was noted as a far better solution to a violent underground drug supply economy, which is the result of the prohibition in the USA.

Quite a good history of "mind-altering" drugs from Big Pharma is given, including amphetamines, tranquillizers, etc. Prozac from Eli Lilly came in for much attention. Not the first nor the last SSRI, Prozac was at first considered as an antihypertensive drug. "After the drug succeeded in not killing laboratory animals in initial exploratory studies--although it turned cats from friendly to growling and hissing..." Lilly responded to competition by launching Prozac as an antidepressant (p53). DeGrandpre left little doubt that that Prozac occasionally led to self-mutilation, suicide and murder (p62). Prozac was used as an example of overpromotion of a drug and drug class that lasted as long as the patents, then a "newer, better" drug under a new patent would be promoted. Of course, many other recent books with this theme exist; but The Cult is not primarily a jeremiad against Big Pharma, but a window into how much the pharmacology of a given drug, including nicotine, is combined with the myths and prohibitions of a drug to confuse its supposed benefits and risks.

The lack of effect of nicotine levels on the addiction to cigaret smoking, and the failure of alternate nicotine supply treatments to curb addiction more than slightly was quite a shocker. The special status of tobacco and alcohol because they were common farm products in the USA was brought out. Prohibition of alcohol was a failure partly because it was and is an excellent tranquilizer when not overdosed, and only addictive in a small minority of users.

Gradually the war on street drugs is shown to be similar to the current war on supplements in that Big Pharma wants its most expensive stuff used, and has gone to great lengths with both overt attacks, indirect attacks by entities not identifiable as B. P., and control of government and non-government agencies (Abramson, 2004; Cohen, 2001; Kauffman, 2006). "The cult of pharmacology must therefore have served a different purpose than the elimination of dangerous drugs and the sanctioning of psychiatric medications. ...during the twentieth century. The competitiveness of the drug market and the fact that one or two successfully approved and marketed compounds could raise a company from rags to riches almost overnight made for an increasingly aggressive and reckless industry. The medicopharmaceutical industrial complex that... emerged benefited directly from differential prohibition, moreover, in that the demonization of certain natural substances--marijuana, cocaine and opiates--helped set them apart from the "ethical" pharmaceutical compounds, even if the latter had equal or greater toxicity" (p241).

Very highly recommended with the sole complaint that there was not a single graph, chart, table or photo.

Abramson, J. (2004). Overdo$ed America: The Broken Promise of American Medicine, New York, NY: HarperCollins.

Cohen, J. S. (2001). Overdose: The Case Against the Drug Companies, New York, NY: Tarcher/Putnam.

Kauffman, J. M. (2006). Malignant Medical Myths, Infinity Publ., West Conshohocken, PA, 2006.

It seems pretty hard to read "The Cult of Pharmacology" by Richard DeGrandpre and still believe we have to keep throwing money at the war on drugs. But knowledge in and of itself does not make a culture's demons disappear. Not only do we have complex individual psychologies that seem to follow each its own rules and development but also shared cultural psychology, which cannot be changed on demand, or merely by the facts.

This is a book about how the very nature of the study of chemicals (pharmacology) for human use has lead to huge distortions and wrong beliefs to the extent of a "cult" -like following over and over again.

DeGrandpre does not try to run a campaign to change things. He writes about what is revealed if one studies the scientific and cultural literature through and through.

He strikes the right balance of presenting what "hard" science can say about human relationship to drugs and yet values reflection (social science?) on the facts of history and observations of complex human behavior. In my view, those who only say what a scientific laboratory would allow about human beings too often arrive at very odd conclusions or at obvious common sense conclusions, after spending much money and time.

This is not exactly a book about how Big Pharma is driven to make ever-increasing profits at the cost of human values, though that awareness informs it.

This is about the how the model used by pharmacology (in particular psycho-pharmacology) is driven by an ideology of reductive "science" -- that chemicals act on specific brain centers to "cause" either heath or addiction, hence very similar drugs are arbitrarily treated as either angel or devil. In contrast, the book opens doors to thinking about the vast variety and complexity of human reality.

I couldn't help but think as I read there must have been a great deal of politics involved in what experiments were done over the last century, what questions asked. How can scientists completely escape their own culture and history? That is not DeGrandpre's primary interest.

DeGrandpre instead showed many scientists not following the cultural nor the capitalist interests but challenging the culture's assumptions, a necessary and appropriate role, which need not undermine the usual ideal of "disinterested science." Rarely did the interpretation of scientific results make it to the populous however.

In my view, DeGrandpre's linking of science with humanism in its most generic sense is the right balance for any policy discussion or even any true scientific understanding. That is, science should approach humans as humans, not as machines or chemistry alone, or any other reduction. Of course scientist should be always asking questions about what it means to be human, and not resort to cutting off whole parts of the human as they enter their sacred labs.

DeGrandpre is clearly against isolating the study of chemistry (what he calls pharmacology)from studying human behavior directly in the real world, both the outer social and the inner psychological world. But this is also true of any particular "field" of scientific study. Scientist must always return to the larger human "field" or they have failed to reach an interpretive understanding of their subject.

There have been too few scholars like DeGrandpre over the years to fill this need of (hard) scientists for an interpreter, or we perhaps would not have to reflect back on such a fraught and confused relationship to drugs.

After reading the "Cult of Pharmacology" my conclusion is just a beginning: Drugs are tools but we often develop relationships with them, with all the complexity that a relationship implies. Furthermore, an "addictive" relationship is only one possible relationship and is highly contextual psychologically and socially--which is the meaningful and most important part--not to be trivialized by mono-focus on brain chemistry.

This book opened my eyes and was a pleasure to read. Richard DeGrandpre's writing style and depth of thought makes this a HIGHLY RECOMMENDED experience for anyone interested in the fascinating world of human reality.