Looking beyond the spin of Big Pharma PR. But encouraging gossip. Come in and confide, you know you want to! “I’ll publish right or wrong. Fools are my theme, let satire be my song.”
Sunday, May 05, 2013
Happy Fiftieth Birthday Valium - by Will Nicholl
A recent report published by the charity MIND – which paints a troubling, and important portrait of Britons driven to alcohol, cigarettes and prescription medication to differing extents by the stress of working-life – makes it a prescient moment to cast the mind back to a series of very strange goings-on.
The time was the late 1950s, the place a hospital canteen in the North of England. Perhaps pickings in that week’s British Medical Journal had been lean – or patients that day exasperating – because the topic of conversation was a newspaper article about a Swiss circus-master who had found a drug to calm his tigers.
A series of regrettable decisions – which still piece together to make faint sense, like fragments of an argument remembered after a long lunch – prompted one young doctor to phone the drug’s manufacturer. His offer was to test the compound, and its predecessor, on the then unwitting inhabitants of Sheffield. After he, and others, relayed the positive results to Hoffman La Roche, Valium – a drug which might otherwise have remained the preserve of big cats – was marketed in the UK in 1963.
Few decisions have proved more detrimental to the reputation of young doctors – or damaging to popular culture – than this show of youthful over-enthusiasm.
Still known as Mother’s Little Helper – but more likely to be given to nervous air passengers, than the anxious housewives who The Rolling Stones describe in their song – Valium has been eschewed, for the most part, by modern society. The drug peaked in popularity in the late 1970s, before tumbling from grace in the largest ever class-action lawsuit attempted against drug manufacturers in British history.
Anyone who asks a doctor for the drug is likely to be brow-beaten – while any prescription will be issued with a whispered caution – or at worst a mild ticking-off. On account of the tranquilizer’s ‘pleasant side-effects’ – which led its inventor’s wife to forbid him from taking it – Valium is now widely abused. Yet it is remembered as the first blockbuster drug – a wonder pill, sold aggressively using gender stereotypes usually confined to cave-art.
One advert, entitled ’35, single and Psychoneurotic’ describes ‘Jan’ – a frail, wholesome lady, resembling Betty Crocker – who has ‘never found a man to match up to her father’. Jan’s big problem is that she ‘realises that she’s in a losing pattern – and may never marry’.
Considerably fewer adverts seem aimed at men – but one, ‘Women dominate his universe – psychic tension can rule his life’, shows, using a series of stern matriarchs – complete with crimped care and pantomime pouts – how nagging wives and mothers-in-law might drive the modern man to Valium.
If Roche’s adverts seem more concerned with bumblingly undoing every victory in the drive for gender-equality since female suffrage, then its legacy – in the way we use medication – remains wide-reaching and troubling. Valium may be waning – but its sales, which exceeded one billion dollars, reveal a link between over-medication and over-consumption, which lingers to this day.
Commenting in its inventor’s obituary for The New York Times, Dr. Jeffrey A. Lieberman describes how Valium constituted a milestone in psychopharmacology, by helping to create generations of drugs which were more precise and selective in their activity. These drugs now exist, but the way we use them – writing 46.7 million prescriptions in 2011 – represents an approach to depression in Britain, which, 35 years after Valium’s heyday, is no less glum or scattergun.
The new antidepressants – or Selective Serotonin Re-uptake Inhibitors – work differently to tranquilizers like Valium, but have replaced them as the weapons of choice for treating anxiety. Prozac, which recently celebrated its 25th birthday, is the most distinguished – and arguably as notorious. Troubled journalist Elizabeth Wurtzel wrote about it. American psychiatrist Peter D. Kramer listened to it. British politician Nick Clegg complained about it, in a speech to The Guardian Public Services Summit in 2008.
In the speech, Clegg made some excellent points about Britain’s overreliance on medication, and how it features too prominently in our treatment of mental-health problems, when for many therapy would be more effective. Yet Clegg – like many others – misses the point. The rate at which we prescribe these drugs does not necessarily mean that we are lacking psychological services – though we certainly are – but that we are over using drugs which don’t work.
Professor Malcolm Lader, Emeritus Professor of Clinical Psychopharmacology at King’s College London – who was first to warn of Valium’s dangers – was keen to place the problem of the tranquilizers, and the SSRIs, within the same curve.
‘This is not one problem,’ Professor Lader said. ‘It’s part of a general over-reliance on psychotropic medication, particularly for people who are less ill, or who may, in fact, be within normal limits. They are unhappy, haven’t got help with things or haven’t got social support, and they don’t have access to psychological treatments, which are usually very effective for them.’
It’s critical to point out that the SSRI antidepressants are indispensable to those suffering from serious anxiety disorders, but the evidence that they work for others – who may fall within normal ranges of emotion – is at very best, scant. In short, if like most, you lead a busier life – involving more debt, less fun, demanding children, and a house which is depreciating in value at the same pace as a Greek time-share – an antidepressant is unlikely to help.
Like Valium – which first gave lie to the belief that drugs could comfortably ameliorate all worry without serious consequences – there is also an increasingly robust body of evidence against the SSRIs. Many of their problems relate to their ability to cause, or worsen, suicidal feelings, particularly in the young. Each drug has been implicated in scandal – most notably Paroxetine, or Seroxat.
Though cheap, a large number of the 46.7 million prescriptions written in 2011 may not have actually helped anyone – which means our use of them to treat those experiencing life’s ups-and-downs equates to behaviour which is baffling and recalcitrant. The saddest thing, though, is that we are giving false hope to those who are suffering – when it may actually be kinder, if harder – to tell them that antidepressants won’t help.
Mother’s Little Helper is synonymous with mass-medication – but on its 50th‘birthday’ we prescribe antidepressants at a far higher rate than we ever did at the height of its popularity. By convincing us that happiness can be bought safely and easily with a pill, the drug constitutes a work of nefarious genius.