Is Marijuana Still The Gateway Drug?

The Day I Became a Drug User               Drughead

No, I’m not talking about weed.  By a show of hands, how many of you actually like going to the Doctor?  It may be OK for awhile, and your physician might be attractive, funny, compassionate and, maybe, even a good listener.  But, the odds are that at one (or more) visits you’re going to get some information that wrenches your gut. And although it wasn’t a Giant Crisis, my relationship with a prescription maintenance drug began when I was told, for probably the sixth time, that I had ‘familial hypercholesterolemia’.  I had suspected the familial part because my Dad had his first heart attack at the age of 50 and died with ‘congestive heart failure’ at 72. Despite the pharmacopeia of pills he ingested daily, he still ambulanced to the hospital, at least once, during most of his summer stays with us.  And, in spite of my sincere efforts to eat well and exercise much, my total cholesterol refused to stop hovering around 300, with triglycerides hovering a close second.  I felt defeated and I agreed to start taking a statin to pharmacologically lower the cholesterol.  And that, my friends, is a Gateway Drug.  For others it mught be a blood pressure lowering med, which are much more complicated.

Once upon a time, a Disease was determined to be Incurable

Upon receiving the diagnosis of a life-threatening illness, a person may respond with avoidance or denial, suppressing the reality or trying to exclude it from consciousness.  Even with acknowledgment, anger and feelings of vulnerability and dependency may be present….As the illness progresses…      (The Last Dance by Lynne Ann DeSpelder and Albert Lee Strickland)

“Wait a minute”, you say,  “high cholesterol isn’t incurable or life-threatening.”   Actually, if it’s a result of poor diet, excess weight &/or lack of exercise, then it can be reversed.  But something that is hereditary is not usually reversed, not yet anyway. And, those pesky fat globules are going with the flow and just looking for some coronary arteries to block up.   Is high blood pressure life-threatening?  You bet it is.  Go too high and it’ll blow your brain, or your kidneys.  Welcome to the Slippery Slope of a drug dependent life.

“Just Say ‘NO’ to Drugs”

This was the rallying cry of our government’s ‘War on Drugs’ in the 80’s and early 90’s.  First Lady Nancy Reagan is credited with this campaign “to discourage children from engaging in illegal recreational drug use.”   Unfortunately, this overly simplified message was confusing, especially to my 2nd grader.  Alas, it opened the gate for the discussion about how not ALL drugs were bad, and how some things that are legal (like alcohol and prescription drugs) are also to be considered cautiously.  My 2013 Drug Handbook documents about 4500 different medications.  How many different diagnoses do you think our illness care system sustains?   The ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD), a medical classification list by the World Health Organization (WHO). It codes for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases. The code set allows more than 14,400 different codes and permits the tracking of many new diagnoses. The codes can be expanded to over 16,000 codes by using optional sub-classifications.   This is quite the mouth full.

What Drugs Are We Saying ‘Yes’ To?

This is by NO means a scientificly derived list, but I think you’ll get the idea.

  • Acute:  these are the short-term meds; antibiotics may be the most common and we’re facing increasingly antibiotic resistant bacteria. 
  • Occasional:  these are the ‘as needed’ ones – aspirin, Acetominophen, Ibuprofen, Flexeril, opioids, stool softeners, laxatives, antacids, boner pills, etc.  The list is a long one and, too often ‘occasionally’ morphs into ‘maintenance’.
  • Maintenance:  blood sugar management, blood pressure, cholesterol, anti-psychotics, hormones; any drug that is being used to try to maintain or manage a chronic condition, including anti-rejection drugs after organ transplants.
  • Preventive:  primarily vaccines.
  • Palliative: ‘comfort’ meds; to lessen the discomfort of a condition.
  • Vitamins and Minerals and Herbal Supplements: some are preventive and some are maintenance and some are junk.
  • Cancer Treatments:  as many of you may know, these are often highly toxic, very expensive, and require a host of other meds to manage the side effects.
  • Recreational:  fill in the blank.

There were over 2 billion prescriptions written in 2011 and, the reasons we’re taking all these treatments is as complex and varied as the medications themselves.

Antidepressants such as Zoloft and Celexa were the most prescribed class of drugs, with 264 million prescriptions filled.  The cholesterol lowering statin, Lipitor, was the #1 brand-name selling drug, racking up a whopping $7.7 billion in sales in 2011, up from $7.3 billion in 2010. Antidepressants aren’t only used to treat depression, but also a smorgasbord of other disorders such as anxiety, chronic pain, and even menstrual and menopausal symptoms. If [one] looks at anxiety disorders, we find they’re one of the most common disorders in the country.

I think for many people there is an inclination to believe there is a pill for every ill,” Alexander says. Even that tendency has its complexities. “But other treatments may be harder to access, may take more time and effort and may not be covered by insurance. Take obesity as an example. Would you rather have to start eating fruits and vegetables or take a statin every night?”

The Irony

Here we are 30+ years after the inaugeration of the ‘War on Drugs’ and we, as a country and to a person, are taking more drugs than ever before.  This is not to imply that I’m anti-drug; absolutely not.  There is great public health benefit we have garnered from drugs.  Vaccines have essentially eliminated smallpox, polio, and typhus.  We have also, however, created a culture of drug dependence.  Our life spans are increasing but it’s hard to say that the quality of our lives is keeping up when 264 million prescriptions for antidepressants are written each year.  This, and my years of nursing move me to wonder, as I am wont to do, that perhaps our craving for ‘the fix’ of medicine and technology, at great public and private expense, is unwittingly subverting a benevolent natural process.

Death The Benevolent

Now That’s an Idea.                   catacombs

 

 

 

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