Mal Fletcher
Bad For Our Health: A Culture Of Over-Prescribing Drugs

'Reality is just a crutch for people who can't handle drugs.' So said American author Robin P. Williams.

Her remark was made with her tongue firmly filling out her cheek, but it may carry an important message for a culture that has become overly dependent on prescribed drugs. The message is this: reality and drugs are unnatural bedfellows.

Improving one's reality is not best served by a reliance on drugs.

A few years ago, I was speaking at an event in Sydney, Australia. Just a few miles away, a global conference of psychiatrists had just adjourned.

In its press release, this convention declared this to be the 'Age of Paranoia'. It raised concerns about the rapid increase in the number of people suffering from anxiety, depression and various phobias.

In light of this, some developed nations are seeing alarming growth in the number of prescriptions issued for quite powerful drugs.

According to a report in the Sunday Times yesterday, the number of British deaths involving tranquilisers and strong painkillers has risen by 16 percent over the past five years.

In the last decade, the number of such prescriptions per year has jumped by more than 60 percent. This growth has featured drugs prescribed for anxiety and depression as well as those used to deal with pain.

Meanwhile, 11,000 women were hospitalised in 2011-12 with antidepressant poisoning. Apparently this is now a bigger problem in the UK than heroin addiction.

Where does this prescription culture come from? What is feeding our apparent hunger for pharmaceuticals?

I Got The Blues

At least two major factors play into this. The first is the growing number of cases in which physical ailments relate directly or indirectly to increased anxiety and mild depression.

More than one in five people in the UK live with very high levels of anxiety, according to The Office for National Statistics’ Personal Well-being in the UK report for 2012/13.

Dr Andrew McCulloch, Chief Executive of the Mental Health Foundation, noted that: 'Symptoms of anxiety can amount to mental illness or predispose towards it and may lead to more serious problems such as depression, phobias, and obsessive compulsive disorder if they are not tackled early on.'

Not surprisingly, recent surveys reveal that anxiety levels have been impacted by the state of the economy and by government efforts to improve it.

Not long ago, a survey by the Anxiety UK charity found that almost 60 percent of people feel 'much' more anxious than they did before, especially in the wake of changes to welfare and housing benefits. Almost 25 percent reported feeling 'a little more' or 'quite a lot more' anxious or stressed as a result of their economic circumstances. 

Much of the anxiety problem relates to what experts call 'anticipatory anxiety', which sees many people making very negative projections into the future, about specific events or situations.

Anxiety is a challenge because it often builds up under the surface, over time. It can remain hidden until a person suddenly faces debilitating psychological or physical symptoms, such as those associated with anxiety or 'panic' attacks.

Drug use is not an adequate solution to the most commonly experienced forms of anxiety. Whilst the harsher edges of anxiety can, to some degree, be softened by treatment with drugs, the real problem is usually one of unhealthy habits of thought.

Negative responses to external stimuli are the product of wrong or unhelpful conditioning. Drugs may help with the physical symptoms of anxiety, but the root problem most often requires other forms of treatment.

These may include professional counselling and/or self-help using the principles of Cognitive Behavioural Therapy, for example.

High anxiety levels in our society are also a product of vastly weakened support mechanisms, which traditionally helped people to deal with high levels of stress.

Families, neighbourhoods, community clubs and religious groups have all suffered as a result of changes to the social fabric.

Some of these changes have been 'forced' - such as the systemic spread of multiculturalism as a policy of previous governments. Others have flowed naturally from changing cultural ethics - as with approaches to family life, for example.

Whatever their origin, these and other pressures - including digitisation, which has people retreating from the physical environment - have contributed to a loss of communal identity.

With that has come a perceived loss of emotional support. Where once we may have turned to a trusted family member or close neighbour to share a problem, many of us now have to go it alone.

Until, that is, the resulting anxiety begins to manifest itself in ways that are clearly damaging to our health.

When that happens, we're often forced to rely upon arms-length care of the type offered by medicos and other professionals. We simply haven't developed relationships of sufficient depth or strength within our immediate living environment to provide us with more hands-on solace and encouragement.

With all the goodwill in the world, medical professionals can't offer this kind of intimacy - and they shouldn't be expected to. Drugs are offered as a way to help us to function, at least at a very basic level.

This brings me to the second factor that feeds the modern beast of over-prescribing drugs.

Science Rules, OK?

It is, simply put, our tendency as a culture to believe that medical science - and science in general - holds the key to overcoming almost every human affliction. 

Some social commentators have long warned that we are over-reliant on the NHS and on the medical profession generally.

People will call for a doctor's appointment when they or their children have little more than a sniffle. In part, this is driven by economic and social factors; sickness costs money, reduces productivity and places strains on relationships.

Sometimes it is also sometimes driven by fear. If I don't receive professional care for this relatively minor ailment, will I face a far worse predicament further down the line?

In the end, our almost blind faith in doctors is a problem, because it prevents us from learning to stand on our own feet, at least in terms of lesser ailments. But it also reflects a wider issue - our almost unquestioning admiration for all things scientific.

For millennia, societies have reserved a place of special favour and status for healers. In many modern societies, doctors still regularly top the list of professionals whom people admire and trust.

In post-Enlightenment times, medicine may be the most admired of the sciences, but it is not the only one that benefits from high levels of public esteem. Arguably, our faith not just in medicine but in science generally has never been stronger than it is today.

Medicine, the most humane of all the sciences, is now linked more closely than ever to other branches of science, such as chemistry. Overworked medicos rely heavily upon products and online guidance provided by chemists and others within the pharmaceutical industry.

Science is treated with a respect bordering on reverence. We treat the prognostications of eminent scientists such as Stephen Hawking as almost being inviolable. It is as if the scientific method is the only one capable of discovering what is true in this world - and what is best for us.

How often do we find ourselves accepting something simply because it is prefaced with the phrase 'scientific studies have shown...'?

In the process, we fail to recognise the fact that science is as much about questions as it is about certainties, and often more so. The scientific method is at its best when someone is questioning the received wisdom and challenging the status quo, in the hunt for better explanations and paradigms.

We also overlook the fact that science is a pursuit undertaken by human beings, with all the frailties they bring to any process. Scientists are just as prone to obsess over status or material gain as the rest of us and to use their skills for essentially self-centred ends.

Without proper accountability - not only to other scientists but to politicians, the law and a cautious wider community - science becomes a form of secular religion.

When that happens, scientists scoff at the subjectivity of other forms of belief - a la Richard Dawkins - while expecting that they will be shown a kind of priestly deference.

This reflects, in fact, what some of them are today: postmodern high priests in a religion that venerates rationalism.

In a sense, our culture encourages us to place our 'faith' in drugs in a quasi-religious way.

Ubiquitous advertising by drug companies offers us near instant cures for even the most mundane aches and pains. In the process it oversimplifies our physical shortcomings, passes over our innermost pain and promises shortcuts to 'salvation'.

Some drug suppliers present narratives and images which suggest that our lives will improve on a wide variety of fronts, if we will use their products. They play on human aspiration in much the same cynical way as cigarette advertisers once did (and would still do, if they were allowed).

The commercial power of the drug companies is considerable. It is set to increase as we become more reliant on emerging biotechnologies, nanorobotics and the like.

This power lies partly, of course, in the huge profits these companies generate.

The influence of drug companies, however, is also based upon a heady sense of utopian idealism. More than a few scientists hold to the idea that we will soon live in a world where disease is a thing of the past and even death is on its way out.

The Transhumanist school of philosophy - a serious academic study in some universities - insists that we are rapidly approaching the next stage of human evolutionary development.

Its advocates promise that advanced bio-mechanical prosthetics, microchip implants and medical advances will extend human lifetimes beyond anything we can envisage now. Within a few generations, they say, we may even be able to live indefinitely.

This sounds exhilarating. The fact is, though, that diseases have a habit of pushing back and fighting for their own survival. Diseases we thought we had eradicated have a tendency to reappear in new forms, having developed immunities to current treatments.

There is also the challenge of the so-called 'law of unintended consequences'. In futurism, there is only one certainty: nobody can definitively predict the future. By definition, the future is unknowable. If it we could be certain about what it holds, it would not be the future, but the past or the present.

New technologies and techniques for disease eradication may bring about unforeseen negative side effects.

This is not to say that we shouldn't invest in those techniques - far from it. We must take advantage of every reasonable possibility to end human suffering. But we must do so in an ethical way, keeping on eye on the difference between progress and progressivism.

The latter idolises pragmatism; it says, 'If a thing can be done it should be done.' It has little time for ethical debate or considered deliberation on what progress really means, in any holistic sense.

For progressivism, achieving pragmatic results in isolated, individual processes is the only measure of success. Their consequences in other areas of life are not considered.

A culture of over-proscribing drugs, particularly for problems arising from anxiety and depression, will continue as long as we place the expedient of the immediate fix above long-term healing.

In the end, psychological and emotional wellbeing are not primarily found within the purview of the medical profession. They are not achieved with the help of science alone.

The sooner we can wean ourselves off an overwhelming reliance on pure science, the sooner we might be able to see our way clear to other important solutions for the psyche and the soul.

Mal Fletcher (@MalFletcher) is the founder and chairman of 2030Plus. He is a respected keynote speaker, social commentator and social futurist, author and broadcaster based in London.

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