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HAGER
Canada $33.00
U.K. £18.99
TEN
TEN DRUGS
“A thorough and thoroughly satisfying biography of a genius.” A CENTURY-SPANNING HISTORY OF
—The New Yorker MEDICINE TOLD THROUGH THE STORY
OF TEN DRUGS, FROM OPIUM TO THE
“Monumental and authoritative.”
FIRST DIGITAL PILL
—Nature
Photo by Philippe Vermès
B
THE DEMON UNDER THE MICROSCOPE ehind every landmark drug is a story. It
DRUGS
“Thomas Hager tells the sulfa saga in vivid and compelling detail. . . . could be an oddball researcher’s genius
Reading Hager’s fascinating book not only makes us grateful for this boon to insight, a catalyzing moment in geopoliti-
mankind and all it engendered but even leads the optimist to wonder what cal history, a new breakthrough technology, or
role it might still play in our future.” an unexpected but welcome side effect discov-
THOMAS HAGER’s award-winning books on —Los Angeles Times ered during clinical trials. For example, the first
the history of science and medicine include The “Surprisingly entertaining. . . . [Hager’s] enthusiasm for the search for tranquilizer was discovered by accident when a
Demon Under the Microscope and The Alchemy a ‘magic bullet’ drug in the early twentieth century is infectious.” chemist was looking for a preservative for pen-
of Air. He is a courtesy associate professor of —Entertainment Weekly icillin. Launched in 1955 as Miltown, it quickly
journalism and communication at the Univer- became a Hollywood fad, a “martini in a pill”
“Hager does a remarkable job of transforming material fit for a graduate biology
sity of Oregon. Visit his website at thomashager. seminar into highly entertaining reading. He knows that lay readers need plenty that changed public attitudes toward mood-
net. of personality and local color, and his story is rich with both.” altering drugs. Piece together these stories, as
50,000 PILLS
take an average of ten pills per person per day. Add in nonprescrip-
tion drugs—over-the-counter vitamins, cold and f lu remedies,
aspirin, and other supplements— and run the numbers: Let’s say
a low-ball estimate of two pills per day per American over an aver-
age seventy- eight-plus years of life. The total comes to somewhere
more than 50,000 pills, on average, in the average American’s
lifetime. And there’s a good chance it’s a lot more. America con-
sumes more pharmaceuticals than any other nation on earth, and
we spend a lot more to get them: more than $34 billion each year
on over-the-counter drugs, and $270 billion on prescription drugs.
That’s way beyond what any other nation spends, because our drug
prices are a lot higher than any other nation’s. Americans constitute
less than 5 percent of the world population but spend more than 50
percent of the money that flows into the world’s drug companies.
And that’s not even counting illegal drugs.
No nation in human history has taken as many drugs or spent
as much money to get them as the United States does today. And
the drugs have had profound effects. They have added decades
to our average life spans, playing a central role in the graying of
America. Drugs have changed the social and professional options of
women. Drugs have altered the ways we view our minds, changed
our attitudes toward the law, shifted international relations, and
triggered wars.
By these measures, perhaps we should rename our species
Homo pharmacum, the species that makes and takes drugs. We are
the People of the Pill.
This book will introduce you to how we got here, with a
focus on medical (that is, legal, non-recreational, mostly prescrip-
tion) drugs. It is written as a series of brief, vivid sketches, sort of
mini-biographies of ten drugs that changed medical history, linked
by common themes, with each story leading into the next.
One of those common themes is the evolution of drugs. The
word drug itself comes from old French and Dutch terms for the bar-
rels once used to keep herbs dry. Pharmacists 150 years ago were in
many ways like today’s herbalists, extracting and compounding their
medicines for the most part from jars of dried plants. That gave doc-
tors in the 1800s a couple-dozen somewhat effective natural medi-
cines to help their patients (along with hundreds of useless, often
alcohol-rich elixirs, poultices, and pills made and ballyhooed by local
pharmacists). Today we have ten-thousand-plus, ever-more-targeted,
increasingly powerful high-tech medicines that can treat and often
cure conditions that have confounded healers for thousands of years.
Wrapped in this evolution and guiding its trajectory is human-
ity’s search for magic bullets, medicines that can unerringly seek out
and destroy diseases in our bodies without doing any harm to our
health along the way. The goal has always been to find medicines
that are all-powerful, but without any risk. That is likely an impos-
sible goal. We haven’t yet found a perfect magic bullet. But we keep
inching closer.
Another thread that runs through these chapters tells a bit about
the growth of the industry that makes drugs— the trillion- dollar
behemoth that critics have dubbed “Big Pharma”—and changes in
the ways we regulate that industry. For instance, in the 1880s you
could get just about any drug you wanted without a prescription,
over the counter, including mixtures laced with opium, cocaine,
and cannabis. Now you need a prescription for almost any powerful
medicinal drug, and even with a prescription you can’t buy narcot-
ics like heroin (well, at least not in the United States). Drugmakers
before 1938 could put just about anything they wanted on the mar-
ket as long as it didn’t kill you, and they didn’t try to fool you with
false advertising. Today, prescription drugs have to be proven both
safe and effective before they can be sold. These laws governing
our drugs evolved, in sometimes surprising ways, along with the
drugs themselves.
Our attitudes have changed, too. In the 1880s, most people con-
sidered the right to self-medicate as something close to inalienable.
It didn’t matter if a drug was good for you or not, deciding whether
to take it was your choice, not your doctor’s. If you wanted to buy one
of the many patent medicine horrors available from local drugstores,
anything from radioactive water for cancer to opium-spiked syrups
for insomnia, well, it was your body. Nobody had the right to tell
you otherwise.
Today that’s been turned on its head. Now physicians hold the
keys (in the form of their prescription pads) to getting most drugs.
Today, when it comes to taking our medicine, we pretty much do as
we’re told.
Drugs changed the practice of medicine, too. In the 1880s, doc-
tors were family counselors good at diagnosing ailments and provid-
ing solace and advice to relatives, but almost powerless to alter the
course of killer diseases. Today, physicians are able to work miracles
of lifesaving that their brethren a century ago could only dream of.
They are also all too often overscheduled, data-stuffed technocrats
more comfortable reading lab reports than holding a patient’s hand.
During the past sixty years, the average life expectancy for
Americans has lengthened by two months each year— mostly
because of drugs. Vaccines have allowed us to completely conquer
age-old enemies like smallpox (and we’re closing in on polio). Pre-
scription drugs, along with public health efforts, have made our lives
much longer and, in general, healthier.
Not that there aren’t also great risks. Drug overdoses, from both
legal and illegal sources, are killing around 64,000 people each year,
an annual death toll that exceeds all U.S. military deaths in all the
years of the Vietnam War.
Here’s what drugs have done for us: In the bad old days, say two
hundred years ago, men lived twice as long, on average, as women
(mostly because of the dangers of childbearing and -birth). And
and calm, destroy and protect, alter your consciousness, restore your
health. They can jack you up or chill you out. They can addict you,
and they can save your life.
What gives them this power? Are they animal, vegetable, or
mineral? All of the above. Are they good for you? Often. Are they
dangerous? Always. Can they perform miracles? They can. Can they
enslave us? Some do.