Drugs: What do you know about the rising sea in which we swim?

Are you among the many people who will use a drug this month? When you answer, you may first think about what prescriptions you are taking. But include “self-medicating” with alcohol and marijuana — and maybe some other stuff.

You may also be experimenting with “psychedelics.” I am acquainted with people who have had profound experiences with two of the increasingly popular array of mind-altering drugs being offered to people seeking mental health (whether health means eradication or remission to them). Ketamine, psilocybin, and MDMA are high on the list of researchers as they look for new solutions to age-old problems.

In the consumer-driven U.S., buying whatever products are offered almost seems like an obligation, whether we need them or not. We have a lot of what we need, here, and a lot we probably don’t. Drugs are a well-advertised product, so you are more likely to be using them than not. I am with you. I will keep using the prescription drug I have been taking every day until the treatment is over. On our walk yesterday, I thanked God for a pain-killer that was so helpful to my wife, not long ago. According to SAMHSA, about half the people in the United States used a prescription drug in the last month. 24% used two or more. 13% used five or more (13% of the U.S. is 43 million people).

According to the CDC, when people went to see their doctor in 2018, 860+ million of them were given or prescribed drugs. 68.7% of visits included drug therapy. The drugs frequently prescribed were analgesics (pain), antihyperlipidemics (blood), and antidepressants (mental health).

In the same year, people who went to the emergency room were given or prescribed drugs 336 million times. 79.5% of the visits involved drug therapy. The drugs most frequently prescribed were analgesics, minerals and electrolytes (hydration), and antiemetics (nausea) or antivertigo agents (dizziness, nausea).

drugs: top ten drug companies 2022
The FDA approved 50 new drugs in 2021

Last year, the pharmaceutical giant, Pfizer (42nd St. NYC), netted $21.98 billion. Johnson and Johnson (New Brunswick, NJ) netted $20.88 billion. Two Swiss companies, Novartis and Roche were #1 and #4 in the top five profit-makers. Local favorite, Merck (Kenilworth, NJ), netted $12.35 billion to be #5. If you watch commercial TV for five minutes, you are likely to hear from one of these worldwide mega-corporations selling their latest wonder.

The medical/pharmaceutical industry is designed to sell products for consumers, like everything else in consumer economies. It is no wonder, with huge corporations needing to sell so shareholders profit and a huge distribution system dispensing drugs as a primary means of healing, there is a lot of encouragement, even pressure, to use drugs of all kinds, legal and illegal.

Suspicious drugs

Like so many products people want, certain drugs that used to be illegal are creeping into mainstream acceptance. People will kill the planet to inject fossil fuels into their environment, so we have companies too big to die who extract and refine those products for them to buy. It is not the same, but similar, with drugs. People do not think they should suffer and die (ever) and will buy whatever promises to stop that.

Drugs that were formerly illegal (or still are) are creeping into mainstream use. People appear to be more desperate for them every year. Legal opioids famously addict and kill thousands of people every year. Prescription opioids (natural and semi-synthetic opioids and methadone), along with heroin and synthetic opioids other than methadone (primarily fentanyl) caused 21,000 overdoses in 2010. People were aghast when that number rose to 69,000 in 2020. In 2021 the number shot up to 107,622.  2022 is expected to see further increase.

The sea of drugs we live in is full of wonders, but there are a lot of predators in it, too. So the experts are doing studies and the news people are reporting on what they are finding. I am writing because I think the researchers and reporters could be a bit more suspicious.

drugs: psilocybin capsule
A psilocybin capsule Credit…John Karsten Moran/NYU Langone Health, via Associated Press

For instance, the NYTimes published a story last week about how psilocybin (‘shrooms) curbed excessive drinking. The researchers suggested it might be a new treatment in the making. AA suspects it is more likely a new way to lose one’s sobriety. MDMA (ecstasy) is being tested as a treatment for PTSD.

In general, psychedelics are moving into mainstream mental health treatment. Forbes recently published a helpful article about the trend, focusing on treating autism. In it, the author noted the increasing use of ketamine for mental health purposes:

While the drug’s usage carries serious risks if used recreationally, there is a reliable protocol for doctor-controlled use that has a steadily increasing track record of success for treatment-resistant depression. There’s even an FDA-approved spray called Spravato that is helping to make ketamine more and more mainstream, and improve more lives each day.

I think it is easy to notice that most drugs which provide out-of-control experiences are rarely effectively controlled. The Spravato website is worth a look to see, again, how salesmanship leads the way when it comes to introducing treatments.

Generosity about drug use needs limits

With the legalization of marijuana and mainstreaming of hallucinogens, it is no surprise that the use of those substances among young adults rose to an all time high in 2021, according to the NIH.

When the NIH, CDC, DHHS, etc. talk about drugs, they are even-handed. They try to stick to the facts — even though they track illegal uses and deaths, which implies disapproval. I think I might have a similar generosity. I have clients who use cannabis for more than recreation. Other clients have had life-altering experiences with ketamine and mushrooms. In their cases, the impact was not long-lasting. But I don’t know about everyone else. I generally reserve judgment.

Even though our minds are open, our discernment needs to be sharp when we introduce drug technology into our bodies. About seven years ago, the church in which I served offered a time for our theologians to think about drugs together. I wrote about our findings and I think they still provide helpful discernment. What do God and the Church think about drugs? What are some practical ways to approach life in the midst of constant wooing into and opportunity for drug use?

Colombian drugs smugglers shipwrecked
Shipwrecked cocaine smugglers on rising seas in 2019

I’m still pondering and applying what I learned then and have learned over the past few years. Each year, as overdose deaths rise (significantly in my own hometown!), the need to think and act becomes more urgent. I can’t help but notice that as the oceans have risen due to climate change, the sea of drugs has been rising with them. Do the powers-that-be extravagantly use them to pacify the most vulnerable? Regardless, like the Covid-19 vaccines did not solve all the problems of the pandemic, most drugs over-promise and under-perform until the general population feels it is normal to have 100-year floods and 100+ thousand opioid deaths in a year.

I repeatedly encouraged drug use for my clients and loved ones last year. Some wonders were worked. But I suspect I am being too generous about the new normal, in which we use drugs as the first act of healing. I think of giant drug companies as part of the powerful forces who brought the world to the present disasters we face. Now they want us to rely on them to solve the problems with their latest products.

While I don’t think the blanket mistrust rampant these days is the answer, Psalm 146 comes to mind. Discernment begins with trusting God, not just assessing the data and making endless, experimental choices.

Do not put your trust in princes,
in mortals, in whom there is no help.
When their breath departs, they return to the earth;
on that very day their plans perish. (Whole psalm)

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