Advice Goddess Blog
« Previous | Home | Next »

Keep The Government Out Of Our Bloodstreams
The government, writes AP's Adam Geller, is preparing to use intrusive new ways to find out if employees are using drugs:

Saliva testing, done using a swab that looks much like a toothbrush but with a pad instead of bristles, is best at detecting drug use within the past one or two days.

Hair testing, in which a sample about the thickness of a shoelace is clipped at the root from the back of the head, allows detection of many drugs used as far back as 3 months.

Sweat testing, in which workers are fitted with a patch that is worn for two weeks, is used to screen people who have returned to work after drug treatment.

Oops -- they forgot something. What about employees who are alcoholics? Doesn't that affect job performance? And maybe, like me, you know a high-functioning drug user or two -- like a famous Ph.D. university professor I'm acquainted with, who unwinds after a long day of important discoveries by smoking a thick doob. If it's not ruining his life or demonstrably affecting his work (he seems a tad overproductive, if anything) -- what, please tell me, could possibly be wrong with that?

Posted by aalkon at January 18, 2004 9:35 AM

Comments


I would like to enter the foray on what we refer to as the war on drugs. The aspect of the ongoing farce we euphemistically refer to as the war on drugs I would like to address is the government's, the politicians', and the people's, absolute duplicity regarding our entire societies en masse altering of its collective neurochemistry.

For what are the real problem drugs in our society? Cocaine, heroin, speed, etc.? Oh heavens no, friendly friends. Legal tobacco, alcohol and prescription drugs (uppers, downers, sleeping pills) do a hundred times more damage, more loss of life, disease, cause more loss of productivity, violence, etc. etc. than the aggregate of the other highly publicized illegal drugs.

However, the American people, with their seemingly endless and inexhaustible talents at self-delusion and specious sophistry, refuse to see these rather dolor-inducing truths.
Why, prey tell, you may ask, do they act in these rather curious ways? Simple. Because the majority, the good majority of the entire western world is busy altering their moods and brain chemistry. An entire society in denial about its own drug use.

Perhaps you doubt my premise. Lets examine some facts? Lets look at the United States. Approximately 50 million people currently self-medicate themselves with cigarettes. I have read that 90-100 million drink alcohol to some degree. (Both alcoholics and social drinkers). Tens of millions more, so I have read, take legal prescriptions from their doctors. All perfectly legal. I have seen reports that state that probably in the neighborhood of 70-75% of the American population is currently altering their neurochemistry with these substances alone. This corresponds to my own life as approximately only about 1 person in 4 abstains from these substances. My point is that certainly we have the majority of Americans altering themselves with these brain chemicals. And yet we spend most of our time chasing these craftily constructed canards involving drugs while most of our family is medicating themselves in one way or another.

So what is my prescription? First, lets at least try to be honest about the extent of drug use in this country. I list tobacco as a drug, as the people who smoke it, whether knowing it or not are simply self-medicating themselves with a serotonin and dopamine altering neurochemical that acts similarly to antidepressant and mood elevating agents such as Prozac and Zoloft and to a lesser degree Valium and Xanax. One of the main differences, however is that the cigarette takes only approximately 7 seconds to deliver its properties to the brain.

Secondly, let's acknowledge that this kind of endemic drug use has always been with us, is with us today and will be with us in the future unless we are able to substantially alter our genetic structures through genetic engineering and medicine. The human genome offers us answers in these areas.

But what does this mean? Simply put, human suffering and misery and pain abound in our society, but we seldom talk about such things because we have managed to attach a number of taboos regarding such admissions. So, many of our fellow citizens stoically suffer in silence (Think Max Von Sydow in any Bergman film hes done), while attempting to medicate themselves into happiness. We human beings are really not designed for happiness in any event. When our ancestors roamed the Serengeti desert, only survival and the furthering of our DNA was rewarded. Our perfectly happy, well adjusted ancestors that sat around the barbecue telling jokes, wearing "KISS THE COOK" aprons, were quickly eaten by the tigers and only the edgy, tense, anxiety plagued, clever Woody Allenesque neurotics, who were ever vigilant, were able to escape the tigers sabre teeth. Ours has never been a legacy of happiness. Had it been, we may not have survived. Add to this a people whose brains were formed during the stone age and who are now living in the silicon, sit-commed, superficial cyberage. Both our environment and our genetic hard wiring do not militate toward our achieving anything even remotely approaching Nirvana.

So, if what I have stated is correct then what might some suggestions be to improve this situation? Let me offer the following proposals. Lets realize that illegal drug use is simply a game that has been created by society. We have deemed certain drugs legal and certain other ones illegal causing this situation. While a few million people are actually addicted to hard drugs like cocaine, heroin and meth, some 120-150 million American adults and minors are feverishly altering their brain chemistries by employing alcohol, tobacco and prescription uppers and downers. Reports vary, but the consensus of the reports I have read would suggest that something on the order of about 2,000 hard drug addicts die each year. Approximately 500,000 to 600,000 die annually from alcohol, tobacco and legal drugs. In terms of violence, lost productivity, countless billions spent on rehabs, lost days of work, treatment of related health problems, etc. etc. there is simply no comparison.

Until we are able to alter our essential genetic code through genetic engineering, probably a couple of centuries into the future, lets realize that human beings, for the reasons elucidated above, and a myriad of other complex reasons, will be using drugs, period. Like so many other issues before us, we can either live in the dream world of what should be or simply face the reality that surrounds us.

If an agent could be found that could supplant these deadly toxic drugs that the good majority of our citizenry are currently taking, wouldnt that be just a peachy situation? Well, lo and behold, we do have such agents. They are the class of drug we have given the unfortunate name of antidepressants, mood elevators etc. Prozac, Paxil, Zoloft. These agents have been shown to be effective in a wide range of conditions that have stalked man in perpetuity. Using an analogy, these chemicals have the ability to maintain the proper amounts of chemicals in our brains, sort of like keeping enough oil in our cars engine to keep it running smoothly. If your car runs low on oil, bad things happen. Well, so it is with our brains. These neurochemicals have the ability let us retain more of the dopamine, serotonin and noradrenaline that our brains need to produce feelings of wellbeing and felicity.

The only problem with these medicines is that they are only available by prescription. Now, let the pontificating commence. Look at the ludicrous situation we have regarding this aspect of drug policy. On the one hand we have mood altering substances like alcohol, tobacco, addictive legal uppers and downers, heroin, cocaine etc. and all the rest being feverishly consumed by large amounts of the population. These drugs cause untold havoc, death, disease, addiction, misery and suffering. The costs in human lives and disease and monetary loss are really beyond comprehension. The tobacco and alcohol are readily available at the 7-11. The illegal drugs are easy to find and plentiful, just watch an episode of Cops if you doubt this. Legal uppers and downers can be obtained through a doctor, but are addictive. Addictive not good.

Now on the other side of this equation we have the so-called antidepressants. First off and most importantly, they are not addictive. This good. They act essentially to keep our vital oils properly lubricating our brains. By boosting the reuptake of familiar neurotransmitters like serotonin and norepinephrine they act to mitigate our unpleasant feelings like sadness and anxiety. Also, they happen to work, as a plethora of double blind studies and clinical experience bears out. I can tell you what they dont do as well. As far as is known they are not associated with lung cancer, emphysema, diabetes, pancreatitis, a variety of liver diseases, wet brain, delirium tremens, driving into school buses, paranoia, insanity, and stays at the Betty Ford clinic, just to name a few. The one problem with antidepressants, depending on your point of view, is that they do not get you high. They do not cross the blood brain barrier. So the people seeking chemical oblivion may be less inclined toward these substances than your typical user. But the important question seems to me to be, how many millions, perhaps tens of millions of people currently using these potentially deadly substances, could benefit and benefit greatly by switching to these types of effective but relatively benign agents? And what would the financial cost difference be?

Now a few brief caveats. No, antidepressants are not cures for nicotine and alcohol addiction but they can help. One study showed that 40% of smokers were able to quit when using Selective Serotonin Reuptake Inhibitors (SSRIs). Some studies have shown a cessation or, more commonly, a reduction in the consumption of alcohol by alcoholics. Perhaps the gentleman drinking 20 beers a day will now be drinking 6 a day. Not perfect but none-the-less progress. While they are not cure-alls they certainly represent a significant step in the right direction.

So, what is the current state of affairs? On the one hand perhaps 70-75% of the adult population is currently self-medicating themselves with substances that can kill them, destroy them, make them sick, get them incarcerated, get them addicted, leave them bankrupt, and on and on. These substances are readily available and implicitly sanctioned and approved by our society. On the other hand we have safe, non-addicting, doctor prescribed medicines that can also alter the brain chemistry of people and help to mollify and assuage their negative feelings. These substances, however, are not sanctioned by our society. Taboos and ignorance are attached to them. And finally, only doctors can prescribe them. Making the doctors the gate keepers as to who can benefit from these agents and who may not. Alcohol, tobacco, heroin, cocaine, all relatively easy to get. Antidepressant medicine, comparatively harder to get. Does this make sense to you?

Personally, I do not even use caffeine, and do not advocate anybody using drugs of any kind. However, as long as people are going to continue to self-medicate themselves in massive numbers, for reasons that are largely out of their control, wouldnt we be better off if the tables were turned and truly helpful medicines were at least as easy to get as the deadly, destructive, potentially addictive ones that so many of us pick up at the nearby 7-11 on the way home?

Posted by: Chris Volkay at January 18, 2004 9:12 AM

Amy --

Great post, and I think your concern about civil liberties is justified. Just a couple of things to add:

A new drug testing technology doesn't mean that alcohol users are going to be let off the hook by employers after, say, a work-related accident. They'll be tested for all substances, just like before. But now they'll know whether someone who tests positive for drugs used them in the 1-2 days before the accident. This might benefit the employee! Someone who tests positive by the hair test but not the new swab test can say "Okay, I use drugs, but not within a time frame that would've caused this accident."

From a research standpoint, being able to detect drug use within the previous 1-2 days is amazing. Hair and urine testing are pricey, and probably feel invasive to study participants. The swab test will make it a lot easier to do epidemiological studies of drug use.

Posted by: Go Ask Lena at January 18, 2004 12:52 PM

Hi Chris --

A couple of responses to your comments about anti-depressants:

"I can tell you what they dont do as well. As far as is known they are not associated with lung cancer, emphysema, diabetes, pancreatitis," etc.

Those are diseases that can take decades to develop. The SSRIs have not been around long enough to know what they might or might not cause.

"They do not cross the blood brain barrier."

Are you sure about that? Clinical depression is something that happens in the central nervous system (ie, the brain and spinal cord) not the peripheral nervous system (ie, smooth and striated muscle, other connective tissue).

"Some studies have shown a cessation or, more commonly, a reduction in the consumption of alcohol by alcoholics. Perhaps the gentleman drinking 20 beers a day will now be drinking 6 a day."

I would love to see those studies! Send references if you have them. I've noticed that I have a lot more control around booze when my depression is treated adequately.


Happy-faced Lena :)

Posted by: Lena Zoloft at January 18, 2004 1:05 PM

http://www.nap.edu/books/0309064015/html/80.html
second paragraph
they mention about three abstracts
in second paragraph, I've also read others.

Posted by: chris volkay at January 18, 2004 2:52 PM

I'm all for finding ways to get people to reduce their consumption of the legal drugs of tobacco and alcohol (I consume neither). But as Chris points out, antidepressants are prescriptions. And prescription medications are paid for by your insurance. So who do you think will be lobbying against these ideas?

As stupid as that is, they prefer to skip the up-front cost of the antidepressant prescription to the back-end costs of treating heart disease, cancer, etc. Until, of course, the government forces them to cover it. But isn't government control what we were bitching about in the first place?

Posted by: Peggy C at January 18, 2004 6:08 PM

Antidepressants also make you impotent. But I guess lots of alcohol kinda does too.

20 beers a day is impressive. Even on those rare occasions that I drink all day, I don't think I've ever gone that high.

Posted by: LYT at January 18, 2004 7:09 PM

I've been on antidepressants since 1995 and have never had impotence or loss of desire. I don't know if that's been the case for drinking though. I guess that's the nice thing about blacking out.

Posted by: Lena's Lush Life at January 18, 2004 7:49 PM