First they took away the booze and now pills
As a nation we don’t drink like we used to but tablets are now the quiet props of the coping classes, writes Donal Lynch
‘THEY have already taken our booze,” I couldn’t help thinking as I digested the crusading moralism of Dr Eva Orsmond’s documentary Medication Nation, “and now they want our pills.”
Not that I’m rattling around popping Ritalin like a hyper teenager or getting off my box on Oxycontin, like a rapper. Not that I really fitted into the documentary’s demographics of an old person being kept alive on blood thinners and heart pills or a depressive trying to feel normal.
But which Irish adult couldn’t use a sleeping tablet every now and again? I can’t nod off without one before an early flight.
Who wouldn’t ‘accept’ the proffered Valium of a good friend during a time of high stress, as I did a number of years ago, or pop a couple of Solpadeine when in the throes of a nasty hangover? And who hasn’t been deeply grateful for the lifeline of a painkiller when in actual physical pain?
The question seems to be, when are these types of drugs a reprieve, and when are they a crutch? There’s ongoing debate about which chemical supports are currently okay for the coping classes — alcohol is out, weed is in vogue — but the contents of our medicine cabinet occupy a strange middle ground.
Valium, sleeping tablets, painkillers — they are the quiet props of carers and of copers.
They are passed through families, as needed, often around funerals, much like a hot whiskey might have been given to a person with shock in the old days.
Dr Eva enthusiastically visited dry-out centres and heard about the “epidemic” of medication use here (something that has, in fact, been seen to a similar degree all across Europe).
But it felt ironic to have her, of all our ‘celebrity’ doctors, presenting a programme about such a nuanced subject.
Dr Eva is a weight-loss expert and medical doctor. Beyond that, her Operation Transformation incarnation might be a fair approximation of what it is about other humans that would drive you to anti-anxiety medication.
She first appeared on our screens at a time in television history when hectoring, sighing women were all the rage. Kirsty from Location, Location, Location, Trinny and Susannah, the How Clean Is Your House? duo — it went on and on.
We wanted these women to know it all. We wanted to be bossed into shape by them. But just occasionally we turned on one of them.
Trinny and Susannah were sent up to their faces by Jo Brand, which seemed to finish them. And, in 2013, RTE was “inundated” with calls after one particularly berating, semi-pantomime performance by Dr Eva on Operation Transformation.
She was giving out to some poor girl for not trying hard enough and didn’t realise that the reality trope of “being rude to a fat person” has to be softened for Irish audiences.
Instead of just stating that — and pointing out that it was obviously up to RTE to decide where the line was — she defended herself by saying: “I hope I wasn’t shouting. I think I was just using a very loud voice.”
Dr Eva’s previously hectoring persona seems no more, but there are glimmers of her previous self in her new caring visage. Her central problem always seemed to be that she didn’t appear to understand how Irish people really live.
Medication Nation took its time with the excesses of Ireland’s pill use, but mostly ignored the wider context of a country which has just struggled to the end of nearly a decade of austerity.
We learned that the highest per capita prescription drug use is in Cork’s north inner city (have you been to Cork’s north inner city? You’d need Valium if you lived there, too).
We have an ageing, overworked population and poor structures for people to access talk therapy (for example, long waits for psychiatrists and little regulation for counsellors).
It really is not all that baffling that a variety of pills have been deployed to fill the locus and help people make it through.
Still the characterisation of GPs as sops for the pharmaceutical industry or as eager to prescribe these medications wouldn’t ring true for a lot of people.
Most GPs are highly aware of the addictive properties of certain medicines and quite properly dole out sleeping tablets as though they were precious jewels.
The contributors to Dr Eva’s documentary tried to set the addictiveness of Valium and its ilk in the context of harder ‘street’ drugs like heroin and cocaine.
Pills are just as addictive, destructive and sinister was the message, and who could doubt the testimony of the brave young men who spoke. But part of the whole debate around legalisation in the country and elsewhere looks at the wider societal effects of drugs.
One of the strongest arguments for legalising marijuana is that it doesn’t cause ‘antisocial’ behaviour which impinges on others, and that we should therefore, broadly speaking, leave it up to the individual how they want to manage their use.
The same might be said of sedatives and painkillers. They are addictive and they can lead to a private hell, but, beyond the illicit trade in them they really don’t drive crime figures in quite the same way that alcohol does, for instance.
That’s also doubtlessly part of the reason that what Dr Eva calls an epidemic has sailed under the radar for so long. A housewife might be sinking into a Valium vortex and that’s tragic, but it’s also unlikely to cause problems outside of her own family.
When people refer to the spurious “respectability” around prescription medication, this is also what they mean: misuse looks very different than it does for cocaine or alcohol.
For about 10 months in my early 30s, I took pain medication on a daily basis to help me deal with knifing sciatica from a back injury.
My theory about the tablets was that they did little for actual pain but put you in a slightly better mood so that you could more easily cope with it.
Like anything, however, this effect quickly wore off and as my back improved I was faced with a daily choice: was the pain bad enough that I actually needed a tablet? Pain is, of course, very subjective, and it’s hard to give precise advice about what the threshold for taking a pill should be, but I was relieved that I was given the freedom to decide the threshold myself, on an as-needed basis. Just as I am relieved not to be badgered by the pharmacist if I need a Solpadeine (Dr Eva wants over-the-counter codeine to be banned). We might want to be somewhat careful about how much we position the laws in this area around the few hard cases that present themselves. There is still a stigma about getting the right help. The Boston Globe recently reported that in the US chronic pain patients, for instance, are now often seen as “potential drug users first and suffering human beings second”. We are possibly in the process, as a nation, of changing the kind of chemical expedients we resort to. Studies show that young people in Ireland drink less than their parents but also take more illegal drugs. As they age and grow into the copers and carers of tomorrow, we may well have to take a much closer look at our national habits and how they impinge on our health. We may well find better, non-chemical ways of dealing with the vicissitudes of life. And perhaps, by then, there will even be a cure for reality TV doctors.