The Cult of Pharmacology will encourage even the most fervent anti-drug campaigner to reconsider the pharmaceutical industry and the war against drugs. Though seemingly anticlimactic and disorganized in spots, Richard DeGrandpre's book challenges the hard-liners, the hippies, and the on-the-fence folk. According to the myth of pharmacology, 'pharmacologicalism', the chemical structure of a drug wholly and exclusively creates drug effects. Approved medicinal drugs are assigned angel status, whereas illicit drugs are assigned demon status [27]. Before pharmacologicalism took hold, drugs were explained in terms of magical properties and powers. Despite advances in our understanding of drugs' structures and effects, most scientists and officials proliferated the overly simplistic story about drugs' unique ability to access the brain's key areas directly. The resultant pseudoscience led to differential prohibition of good drugs and bad drugs [104]. He offers numerous case studies, experiment data, and historical evidence to argue against the angel-demon drug dichotomy. This highly toxic ideology has made America the world's most troubled drug culture.

DeGrandpre attacks the angel-demon distinction by showing how, depending on environmental factors and the individual, demons can become angels and vice versa. Ritalin and cocaine, the quintessential angel and demon, similarly affect dopamine levels in the brain. Andean tribes chewed the coca plant for religious and health reasons and did not experience negative effects supposedly inherent to cocaine. When snorted or taken intravenously, Ritalin would create intense highs similar to pure cocaine, which led to Ritalin's widespread abuse [7-19]. A massive 1992-1994 WHO/UNICRI study found that the majority of cocaine users did so casually without many ill effects. The report saw no definite angel or demon status for cocaine; the drug affected different people in different ways. The U.S. responded to the findings by dismissing them [22-26]. The demonization of angels continues with the serotonin reuptake inhibitors. The SSRIs inspired mutilation, suicide, and homicide for a number of patients shortly after they began the medication [49-50]. Despite tens of thousands of Prozac-related suicides, SSRIs continue to dominate the pharmaceutical market. (I should mention that Eli Lilly recently chose to target women for Prozac, now calling it Sarafem and recommending it for premenstrual moodiness).

American culture demands high energy and productivity during the day and worriless sleep at night. To fulfill these robotic commands, people turned to uppers and downers and "white collar pill parties" [161]. DeGrandpre argues that environmental factors, not merely pharmacological or physiological, contribute to drug effects. The myth of withdrawal's pharmacological and physiological inevitability will actually produce drug dependence. DeGrandpre calls this type of self-fulfilling prophecy 'placebo text' [120]. He contends that cigarette habituation, not addiction, prevents many people from quitting. The act of smoking becomes an integral part of people's daily routine, so quitting immediately and directly diminishes smokers' quality of life [84-88]. In a study designed to prove the importance of environment, researchers administered cocaine to two animal groups, with only one of the groups choosing to self-administer. The self-administering group had no deaths, whereas almost half of the involuntary injection group died [185]. Robert Nozick would be proud: Animals receive more pleasure and experience fewer ill-effects when they have an active role in their pleasure. Other studies reveal that the availability of other pleasures and the cost of drug use dramatically affected rates of drug use [200-207]. DeGrandpre argues that exteroceptive stimuli (stimuli that originate outside the body) can affect brain and behavior far more efficiently and dramatically than drugs due to sensory transduction [222].

Following his rejection of pharmacologicalism's reductionistic and damaging ideology, DeGrandpre vehemently admonishes the war on drugs: "In a kind of Apollonian war on the Dionysian spirit, drug use in America was a straightjacketed by the AMA into a Calvinist doctrine toward making a healthier, more moral citizen" [173]. He suggests motivations for pharmacologicalism. Drugs create a table rasa in the brain to a certain degree, and individuals need cognitive suggestion to interpret their stimuli [234]. Our society tries its best to control these cognitive suggestions, so people will inadvertently reinforce the angel-demon, patient-drug user dichotomy. Pharmacologicalism financially benefits pharmaceutical industries and gives governments the power of social control [240-241].

DeGrandpre's book provides a multifaceted argument against pharmacologicalism, and he paints a shocking portrait of governmental and institutional myths. I especially appreciated his multidisciplinary approach to the same issue, providing readers with scientific, philosophical, and legal evidence. He was keen to point out implications for different genders, races, and classes. His radical conclusions will certainly cause more than one raised eyebrow, but he justifies his stance empirically and philosophically. At a few points he assures readers that no compelling evidence can be found on the other side of the debate, but he unfortunately does not summarize the other side's bulk of evidence very often. As a result, readers are more often than not forced to take his word for it.

DeGrandpre does not clearly articulate a thesis until page 104, making reading somewhat aimless until that point. He stresses the falsehood of the angel-demon dichotomy repeatedly, but he neglects some of his other themes. In the last chapter he brings up an ideology of otherness, normally reserved for racism. This message is lost in the preceding pages. During the cigarette chapter, one does not know how to interpret the lengthy description of nicotine addiction and manipulation given previous arguments against the angel-demon dichotomy. DeGrandpre finally reveals that smoking, like so many other drugs, is situational in its effects. Considering the lop-sidedness of the evidence presented, one would have to be rather astute to guess where DeGrandpre was going in this section.

DeGrandpre fails to offer clear advice on how to ameliorate our troubled drug culture. DeGrandpre walks readers up to the gates, but then walks away without giving us a key. Especially considering his impassioned desire to end the war on drugs, one would hope that he had some policy suggestions. The SSRI chapter might make us terrified of monstrous pharmaceutical companies, but we apparently have no method for combating them outside of not taking SSRIs.

The Cult of Pharmacology is not exceedingly technical, and the author does an adequate job of clarifying scientific terminology and discoveries. His arguments will resonate for the political scientist, philosopher, scientist, or average Joe or Jane.

© 2007 Laura Guidry-Grimes

Laura Guidry-Grimes (lkg04@fsu.edu) is currently pursuing a dual degree in Philosophy and Religion at Florida State University. Her main interests include philosophy of psychology, bioethics, feminism, environmental ethics, and disability studies.

Categories: Medications, General