May 16, 2007

THE CULT OF PHARMACOLOGY - latest review

"DeGrandpre is master both of his subject and his chosen style. The cult of pharmacology is journalism in the best sense - incisive, meticulous, compelling."

– latest review of The Cult of Pharmacology

The Cult of Pharmacology & Intoxication in Mythology

Richard Barnett | from NthPosition.com

Johnson’s ‘War on Poverty’, Nixon’s ‘War on Drugs’ and ‘War on Cancer’, Bush Jr’s ‘War on Terror’: the self-appointed Leaders of the Free World are fond of declaring war on abstract nouns. Each has proved to be an effective (if temporary) way of distracting public attention from the chronic policy errors at the root of the problem they claim to address, and each has been pursued with all the deluded gusto of Xerxes’ satraps hurling their spears into the Hellespont. As Ziauddin Sardar and Merryl Wyn Davies argue in Why do people hate America? (2002), the just war is a deeply influential topos in American culture. It underpins a wealth of foundation myths, from the Revolution to the Wild West, and pervades the profoundly religious structure of political thought. To wage war in this manner is to invoke the Puritan rhetoric of the Pilgrim Fathers in their redemptive crusade against the world, the flesh and the Devil. It is to declare the conflict eternal, the enemy irredeemable, the conclusion divinely ordained. One hesitates to reach for a stock Orwellian parallel, but this is war in the sense that the residents of Nineteen Eighty-Four’s Oceania understood them - without aim, without mercy, without end.

Nowhere is the yawning gap between rhetoric and reality more apparent than in the ‘War on Drugs’. This is a conflict that, as Chomsky and others have pointed out, many people have an interest in fighting, but very few have an interest in winning. At home, it provides a rationale both for the centralisation of executive and fiscal power in the hands of a profoundly anti-democratic governmental-military complex, and for the extension of official surveillance and disciplinary apparatus such as the Drug Enforcement Agency (DEA). Abroad, it enables the US to extend its military, economic and diplomatic reach, frequently under the aegis of high-profile but low-impact military missions. In 1989, as part of Operation Just Cause, US marines took Manuel Noriega out of power in Panama and into (questionably legal) US custody, all under the celebratory gaze of the world’s media. Meanwhile, cocaine shipments - ostensibly the target of the operation - continued to pour through Panama and into the US.

The result is a growing sense that the rabid attitudes expressed by government bodies and the media towards illegal drugs bear no relationship to the day-to-day realities of their use. As a headline in The Onion some years ago had it, “Drugs Win War On Drugs”. Despite their strikingly different ways of framing the question, both Richard DeGrandpre and Ernest L Abel seem to suggest that much of this confusion arises from the enforcement of a rigid distinction - central to the rhetoric of the ‘War on Drugs’ - between ‘good’, legal therapeutic agents and ‘bad’, illegal drugs of addiction.

In The cult of pharmacology DeGrandpre brings together two genres, one a distinctive product of postmodern disenchantment, the other as old as written culture. The first is the highly successful series of texts critiquing the modern, monolithic pharmacological industry, kicked off by Elizabeth Wurtzel’s Prozac nation (1994) and featuring such highlights as Jackie Laws’ Big pharma (2005) and DeGrandpre’s own Ritalin nation (1999). The second can be broadly if clumsily categorised as studies of the psychoactive effects of particular drugs. This includes both personal narratives, from De Quincey’s Confessions of an English opium eater (1821) to Burroughs’ Junky (1953), and more sober (in every sense) academic texts such as Larry Sloman’s Reefer madness: The history of marijuana (1979) and Abel’s Psychoactive drugs and sex (2003). DeGrandpre is on familiar territory here: in addition to Ritalin nation he holds a PhD in psychopharmacology, and has been a fellow of the US National Institute on Drug Abuse.

DeGrandpre’s theses are firstly, that the distinction between clinical medicines and drugs of addiction - ‘pharmacologicalism’, in his slightly clunky coinage - is a social construct rather than a physiological fact, and secondly, that this construct, rather than the ‘objective’ effects of illegal drugs or a conspiracy of Big Pharma, Big Tobacco and Big Government, is responsible for the Ballardian car-crash of modern attitudes towards drugs. Pharmacologicalism is, in his definition, the claim that drugs can be “classified as having inherent good or evil properties, independent of time, person or place” (p173). The cult of pharmacology is based around a rigorous and highly convincing structural-anthropological critique of pharmacologicalism, founded not on a binary opposition between the raw and the cooked but between inherently ‘good’ and ‘evil’ drugs. His strategy, set out in three sections of three chapters each, is to historicise the status of various drugs, ‘good’ (Ritalin, Prozac) and ‘bad’ (cocaine, heroin, tobacco), showing in each case the shifting social and cultural factors responsible for labelling particular drugs as ‘angels’ or ‘demons’.

In the first section DeGrandpre examines the history and current status of three iconic modern drugs: cocaine, tobacco and the selective serotonin reuptake inhibitor (SSRI) anti-depressants such as Prozac. In the second he takes a long view of US drugs policy over the twentieth century, tracing the parallel emergence of a legally sanctioned ‘white market’ and an equally lucrative ‘black market’. In the final section he reviews the evidence from pharmacological and sociological studies in this field. In the hands of a lesser author this subject might have been rendered dry and vague, overburdened with detail and finger-wagging in tone. Fortunately, DeGrandpre is master both of his subject and his chosen style. The cult of pharmacology is journalism in the best sense - incisive, meticulous, compelling. The text is not without faults: he has a slight tendency to repeat himself, and attributes ‘soma’ to Nineteen Eighty-Four rather than Brave New World (p 163). The structure of the book is at times confusing, and might have gained in impact if presented in simple chronological order. But these are mere quibbles. His prose is a model of clarity and elegance, his examples well-chosen and finely limned, his arguments lucid and enlightening.

Take cocaine, for example. Cocaine - particularly in the form of crack - is widely portrayed as the very model of an inherently addictive, socially corrosive, physically debilitating drug. On this basis, the US government has put intense diplomatic and economic pressure on South American states, linking financial aid programmes to the eradication of coca plant cultivation and the native habit of coca leaf chewing. But as DeGrandpre points out, if cocaine is an inherently addictive and destructive drug, how is it that rural Andean communities have been chewing coca leaves for centuries with no signs of addiction or dependence, no breakdown in traditional social structures, and no apparent ill health? (Ironically, the arrival of cheap imported American spirits has brought illness and deprivation to many of these communities). How can regular cocaine users mistake caffeine and even sugar pills for the hard stuff in clinical trials? How did an entire generation of Americans survive the 1920s while consuming prodigious quantities of coca extract in tonics, unguents, pep pills and the most successful product of a world-famous but highly litigious soft drinks manufacturer? How did Ritalin - a drug whose psychoactive effects are generally indistinguishable from those of cocaine in clinical trials, and which is rapidly acquiring high status as a party drug - become one of the most feted and widely prescribed pharmaceuticals of the twenty-first century?

DeGrandpre’s answer is that the pharmacological action of a particular drug cannot be considered in isolation from the context in which it is taken. “Drugs are animated by the ecology of the human settings they enter - psychosocial, cultural and historical - and it is in these powerful and complex settings that drug discourse and so-called drug effects emerge” (p174). These discourses - the “placebo text”, as he calls them - give form to the apparently objective clinical aspects of drug use. He cites a wealth of experimental evidence to demonstrate that neither addiction nor dependence nor the ‘high’ can be identified as consistent physiological phenomena. All are, he argues, functions of “the ritual of drug use, used in combination with a certain attitude and a certain placebo text” (p124). Even opiate withdrawal - one of the most emotionally loaded tropes in drug literature from De Quincey via Burroughs to Irvine Welsh - seems to be largely a matter of expectation and acculturation. (One further quibble: after this thoroughgoing critique of withdrawal as an objective phenomenon, it is slightly disheartening to find DeGrandpre using the term unproblematically in subsequent chapters).

But hold on. If the effects of drugs are socially constructed, subjective, all in the mind of the user, where’s the beef? Why can’t addicts just pull themselves together? To take this line is to miss the powerful sense of social responsibility at the heart of DeGrandpre’s project. As Jacques Derrida never tired of pointing out, to show that something is socially constructed is not to make it any less real or powerful. Rather, it is to expose its foundations to the most radical and searching of critiques. DeGrandpre has the intelligence and compassion to take the placebo text seriously, to trace the sources and structures of its power, and to look for ways in which this power can be redacted. The cult of pharmacology will expand the consciousness of anyone who cares to read it. It is a surprising, questing, questioning book, but most of all it is full of hope and humanity. DeGrandpre offers us the chance not to replace myth with truth (and who could honestly offer such a thing?) but to restore agency to individuals and cultures in their mythmaking.

Which brings us to Ernest Abel’s Intoxication in mythology. Abel, a Distinguished Professor (though of what he does not say) at Wayne State University in North Carolina, dedicates the book to his “personal intoxicants” - his parents, wife and children. Fortunately, this touching display of familial affection is not sentimentalised by Flanders-esque animadversions on the intoxicating power of love, life or homemade lemonade. Like DeGrandpre, Abel is scrupulous, sharp, and very good company. Intoxication in mythology marks his 30th year of publishing, both as Ernest L Abel and E Lawrence Abel, on a truly bewildering range of subjects. These include the sociology and psychology of graffiti; cultural histories of marijuana and alcohol; the aforementioned study of psychoactive drugs and sex; a collection of Confederate sheet music; and, with an admirable sense of geopolitical correctness, laymen’s guides to both Arab and Jewish genetic disorders.

As its title suggests, Intoxication in mythology is laid out as a dictionary, though Abel might have been nearer the mark had he called it an encyclopaedia. Entries are between a sentence and several pages in length, and a typical entry provides a brief description of an intoxicant or mythological figure, an outline of the rites and stories associated with it, and an account of its action in terms of current Western botanical and pharmacological thought. From this (English) reviewer’s perspective, the entries encompass both the well known - opium, alcohol, Trickster, Anansi, the denizens of the Classical pantheon - and the completely unfamiliar. The Chinese Peaches of Immortality? Pass. Kezer-Tshingis-Kaira-Khan, the Siberian counterpart to Noah? Well I never. Welsh brewing lore? Erm…

Fortunately, the text is accompanied by two appendices, covering subject categories and the geography of mythologies, a detailed bibliography and a brief but illuminating introductory essay. Abel has based his selection on two criteria: “to be included, an intoxicant had to have been mentioned in a myth… [and] had to have a connection with the supernatural; either it is considered a gift from the gods, contains their spirits, or liberates the soul so that it can communicate with the supernatural” (p3). This is reflected in Abel’s broad and permeable distinction between ‘intoxicants’ and ‘entheogens’ (a term coined in 1979 to replace the increasingly pejorative ‘hallucinogen’. Both intoxicants and entheogens produce altered mental states, but entheogens are capable of producing “not only mystical states, but also prophetic seizures, erotic passion, and artistic inspiration” (p69). Abel follows DeGrandpre in arguing that psychoactive effects are context-dependent. Alcohol, for example, may be an intoxicant or an entheogen when used in different circumstances: consider the pub and the bacchanal.

Faced with so many parallels between the cultural practices associated with, say, tobacco or opium, it is difficult to resist a spot of Golden Bough-style armchair anthropology. Like DeGrandpre, Abel addresses this point in his introduction: “There is in fact no society in the world where some kind of consciousness altering substance hasn’t been used” (p2). Both cite Andrew T Weil and Mary Bernard as suggesting a role for intoxicants in the genesis (pun intended) of mythological and religious categories of thought. Intoxicants have, Abel argues, provided the “common human experience” (p2) from which widely employed concepts such as the soul and the spirit world emerged. “Who discovered you could get milk from a cow”, Billy Connolly used to ask, “and what did he think he was doing at the time?” Abel’s point about “common human experience” raises a similar question. Who discovered that if you scraped out the soft inner bark of the Amazonian Virola vine, roasted the scrapings, ground them, sifted them, and finally hoofed the result, you could achieve a brief but consistent entheogenic experience, albeit at the cost of a very runny nose? The answer seems to lie in an inversion of the question. The exhaustive (not to say exhausting) lengths to which cultures have gone to secure these experiences reflect the powerful sense of place and meaning they provide, and the strength of the social bonds they forge.

In terms of a potential readership, the only major drawback to Intoxication in mythology is its layout. One problem with setting out this sort of information in the form of a dictionary is that the “gods, rites, intoxicants and places” associated with a particular culture are necessarily split up and scattered throughout the text. So, to return to my earlier example, references to intoxication in Mayan mythology are spread across 15 or so entries, admittedly with a rigorous system of cross-referencing and the very useful appendices and bibliography. This is fine for those who already possess a good knowledge of the subject, and for these readers - Mike Jay springs to mind here - Intoxication in mythology will surely become a standard reference work. But if, like me, your acquaintance with the subject is limited to hazy adolescent memories of the Metamorphoses and the Bacchae, hacked into prep-sized chunks, you may find yourself flicking back and forth like a schoolboy chasing dirty words in a Latin primer.

Both the peril and the charm of a book like this is its tendency to rouse the reader’s latent, lurking EL Wisty. I found myself, in an ecstasy of sorts, having to hold back from pressing (ahem) “interesting facts” on unsuspecting friends, colleagues and strangers. Did you know that the Mayans measured intoxication on a scale of rabbits - the rabbit being the least sensible creature they could think of - so that ‘15 rabbits’ denoted pleasant social tipsiness and ‘400 rabbits’ signified a state of utter oblivion? Or that the decline of mead drinking in early modern England was a consequence of the fall in demand for beeswax church candles following the Reformation? Or that… you get the picture. As any fule kno, the highest praise a bibliophile can bestow on a book is to put it on the shelf in the lavatory, alongside a broken-backed copy of Molesworth and a collected edition of MR James. Intoxication in mythology is, amongst other things, a splendid lavatory book. Armed with this, and with a paperback copy of Westwood and Simpson’s masterful The lore of the land: a guide to England’s legends (2005), you may be in there for days.

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