Pill-popping on an empty stomach: what Michael Jackson tells us about ourselves

http://blogs.telegraph.co.uk/news/damianthompson/100117108/pill-popping-on-an-empty-stomach-what-michael-jackson-tells-us-about-ourselves/

William Pitt the Younger is supposed to have expired with the immortal line: “I think I could eat one of Bellamy’s meat pies.” Michael Jackson’s last words, we learned this week, were: “Please, please, let me have some milk.” That’s much creepier, because the pitifully deranged man-child was speaking in code. His “milk” was propofol, a white-coloured hospital anaesthetic. Dr Conrad Murray, Jackson’s doctor, was convicted on Monday of involuntary manslaughter by injecting his patient with the drug.

It’s tempting to dismiss this as just another instance of a celebrity falling into the hands of a quack with a prescription pad for hire – think of Marilyn Monroe, Judy Garland and Elvis Presley. Tempting, but wrong. What happened to Jacko is happening, in less dramatic form, to millions of people who treat doctors as suppliers of their own personal “milk”.

Obviously, people aren’t queuing up at the surgery asking to be knocked senseless with anaesthetic. But 11 million prescriptions for benzodiazepine tranquillisers such as Valium are written in the UK every year. More significantly, prescriptions for antidepressants have doubled over the past decade, to 40 million.

Antidepressants have a better image than tranquillisers. They are thought of as “good” drugs that lift the spirits of depressed people. The reality is more complicated. Some antidepressants don’t just make patients feel “better than well”, as Prozac was supposed to: they make them feel high and unnaturally sharp-witted. That can tip into paranoia.

Meanwhile, increasing use of opiate painkillers is introducing people to the floaty feeling of calm associated with those drugs, some of them available over the counter. You can walk into any British pharmacy and buy pills that, taken on an empty stomach, will chill you out – and put you on a path to heroin-like dependence.

You can’t buy these codeine drugs in a US pharmacy. If you could, the demand would be huge. Vicodin – the mega-strong painkiller that Hugh Laurie’s character gobbles in House – is the most prescribed drug in America: 130 million scripts were handed out in 2010, plus 114 million for other narcotic analgesics. That’s an awful lot of “pain”.

In the course of researching a book about addiction, I’ve watched Americans go “doctor shopping” for GPs who don’t ask too many questions. Some were looking for painkillers; others were after the even more desirable amphetamine drugs handed out for Attention Deficit Hyperactivity Disorder. In theory, if you’ve got ADHD, the medicine will just correct it. But “attention deficit” is a slippery concept, and if you don’t suffer from it then you’ll be able to concentrate and get high – as college students all over America are discovering. A mellow form of speed that helps you pass exams? Try just saying no to that if your grades are slipping in law school.

Michael Jackson took his prescription drug habit to grotesque lengths, but his encyclopaedic knowledge of pills was typical of Hollywood celebs. That obsession is shared by countless Americans, for whom pharmacies are basically candy stores for troubled adults. Organised crime is having a field day, as the explosion in dodgy online pharmacies demonstrates.

In short, the old dividing line between therapeutic and recreational drugs is just so 20th century. How are we going to navigate through the new pharmaceutical playground? That’s a tricky question; we need to put in a lot of mental effort if we’re going to answer it. Perhaps the doctor could give us a little something to help us concentrate…