I skim the news; I read the newspaper; I’m on Twitter (thanks to this class!). I know very little about the Opioid crisis, but I know it’s unique that we are holding more than the addicted accountable. The call to go after pharmaceutical companies and doctors who knowingly overprescribe opioids for their own financial benefit is unprecedented, and likely begs the question many scholars have been asking for a while: to what extent is medication abuse attributable to the doctors, research, pharmaceutical companies, and insurance companies behind its production and prescription? How do societal pressures and trends render themselves as molecules accumulating in bodies, accumulating in water, accumulating in animal and plant cells around us?
I’ll admit that my knowledge on medicine, however, is very slim: The only pill I’ve ever taken was small, reddish dot of Ibuprofen (200mg) that took me at least five tries to ingest. I tried throwing it back with water, hiding it in fizzy soda, and burying it in my mac and cheese before it finally descended down my throat and dissolved in my bloodstream. That day, August 3, 2010, was rough because I had broken my left ulna and radius cleanly in half. What I remember more than the falling-out-of-the-hammock or the commotion of adults or the rushing to the pharmacy was staring in front of the mirror, willing myself to take the damn pill. I’ve not taken one since, not even the pain pills after surgery. I am stubbornly averse to medication.*
But I’m sure that if a doctor told me to take something, I would, despite my deep skepticism or fear. In fact, if I truly believed it would help, I might even ask to.
What has me spinning about Joseph Masco’s “Side Effect” is the notion that the over prescription of antidepressants and antipsychotics points to a larger social epidemic of conditions that foster poor mental health outcomes. Though his primary focus on “side effects” wrestled with how we divorce the negative effects from the positive ones when evaluating medication, among other things, his final conclusion that “increasing drug use is a symptom, not a side effect” drags into light a ton of thorny question about mental health and medication culture (3). When examining medicine biologically, I tend to think of it personally: how a drug might target my receptors, my personal choice to take medication, etc. I think societally we do the same. We rebrand mental health as a chemical imbalance separate from experiential factors that cause it. But we can no longer do so, argues Masco, because the cost of overmedication is too high, specifically the environmental harm of non-metabolized drugs dosing fishes and other creatures without their consent.
I don’t quite know which battle to fight. There is danger in stigmatizing medication because those who need it should get it. But then again, the doctors determining need may or may not be doing so for their own benefit. There is danger in delegitimizing pain to steer people clear of medicine they need, but there is a danger in legitimizing minor pain to medicate people (I acknowledge here that there is a history of delegitimizing certain people’s pain: people of color, women, black women in particular, and that this is something that needs to be addressed here too.) There is a danger of the unknown: Is there a ‘normal’ level of mental illness in a population by natural variety? What if we normalize too high a level or too low?
When I reflect upon my personal aversion to medication, I think of how all my conflicting thoughts and messages about the health/illness industry distill into personal philosophy. In the way that Schacter and Singer’s classic social psychology experiment (1962) describes how we cognitively label our emotions based on our own observations, I’ve come up with a variety of reasons as to why I don’t like to take medication—ranging from sensible to pretty stupid. The most sensible reason is that I don’t know how; it feels like I’m choking and I’m scared of that feeling. But also, I’ve been incredibly fortunate to have experienced relatively good mental and physical health so it’s never been really necessary to take anything. As for the stupid reasons, I’ve always rationalized my way into this: Pain is necessary. No need to dull it. If dulling it in the short-run makes it go away, then in the long-run it will get worse.
On second thought, eh. As a child athlete, the play-through-pain mentality was cemented in my psyche and incentivized taking care of my body. And as soccer player and runner who saw people take Advil until their shins could no longer function, my aversion to medication was a safety net of self-care: Because I was aware of my pain, I would stop when I needed, stretch when I hurt, and quit when I couldn’t take it. Of course, I did none of these things, but that’s another story. What’s important is that I thought medication was a trick—not for the weak, but for the truly injured. That medication was meant to treat the side effects of harm (inflammation, headaches, etc.) but was not the solution to the harm itself.
As a personal philosophy, this is quite stupid, but I think it can do work in a societal sense. If we can say that medication usage in it of itself indicates larger pain-causing forces at play, then we might be able to identify root causes—but we must still acknowledge and legitimize people’s harm. It’s not just the doctors, Big Pharma, and the insurance companies conspiring against us (though they are a large part of it!), it’s how we’ve bought into a society that produces mental harm and implies that one should live free of pain. It’s time we work proactively and not reactively to address drug dependence and take responsibility for the environmental harms of the industry.
* I’m not an anti-vaxxer though! I’ve had all my shots (even Meningitis B), so I just thought I’d be clear about that. Vaccines/some medicine are important!