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Happy Pills in AmericaReview - Happy Pills in America
From Miltown to Prozac
by David Herzberg
Johns Hopkins University Press, 2008
Review by Marnina Norys
Aug 11th 2009 (Volume 13, Issue 33)

If it had emerged that Michael Jackson was addicted to heroin rather than a commercial anesthetic, it is worth asking whether many would have seriously considered charging his dealer with murder. As David Herzberg argues there is dichotomy between our conceptions of street addicts and the abusers of prescription medication, and in his book Herzberg describes the historical context that has given rise to this distinction. What emerges is that 'drug crazed junkies' have typically been vilified through history, meanwhile middle-to-upper class users who abuse pharmaceuticals tend to garner more sympathy. Street addicts conversely, many of whom belong to lower classes, are typically held to be responsible for their state and few onlookers appear to look at life circumstances to explain addiction among the poor.

And while Herzberg concludes his book by raising concerns about the economic and political circumstances faced by users of illicit substances, he gets there by way of studying the cultural impact the anti-anxiety drugs and anti-depressants that hit markets following WW II. Herzberg starts his story with Miltown, an aggressively marketed anti-anxiety blockbuster drug that was introduced in the 1950's, then turns his attention to Valium, feminist's responses to the drug, and the alarms raised over the drug's addictiveness in the 1970's. Finally, Herzberg discusses Prozac, the next drug to provoke a tremendous level of commentary across the US. In telling his story of the rise of these drugs Herzberg draws a rich variety of sources including psychiatric journal articles, popular magazines such as Ms. and Cosmopolitan, newspaper stories. Several advertisements are also reproduced in the book, which add much to Herzberg's account.

As a cultural historian, Herzberg is mostly concerned with manner in which such drugs were portrayed and received by Americans and he is decidedly neutral about the efficacy or dangerousness of the substances he discusses. Hence, Herzberg's work lies at the periphery of heated debates between advocates of psychotropic medication such as Peter Kramer and vocal critics such as Peter Breggin and David Healy. Instead, Herzberg shows us how the meanings attached to such drugs evolved from a complex interplay of shifting interests, including those of marketers, patients and doctors. Although the story is a complicated one, it is highly readable and Herzberg tells it using plain, non-technical language.

While Herzberg writes of the shift in consumer culture that added doctor's offices and pharmacies to the list of places in which to shop for happiness or the good life he also discusses the impact of feminism on attitudes towards both legal and illegal drug users. While Herzberg does appear to be a supporter of the feminist project he also notes that early feminists mainly addressed conditions of white middle-class women. According to the historian, Feminist thinkers such as Betty Friedan helped to reinforce an image of illicit drug users as inherently depraved. By contrasting seemingly innocent housewives from hardcore addicts, Herzberg argues, feminists hoped to garner sympathy for oppressed women using drugs to cope with their lot. As such, while the inequality of women came under intense scrutiny, the economic and political conditions of street addicts remained unexamined. This persisting image of a drug user as dangerous and depraved also seems to have underwritten much of the fervor in anti-drug campaigns that have sprung up over the years.

Throughout the book, and in his conclusion, Herzberg questions the dichotomy between the users of street drugs and medication. It's true that distinguishing Valium from heroin is necessary to bolster sales of the pharmaceutical, but Herzberg's point is that we need to look at the impact of this on abusers of illegal substances. By reinforcing negative stereotypes associated with street addicts, these largely poor and marginal users become further disenfranchised, given that, argues Herzberg, the war on drugs is cashed out in practice as a war on drug users. The upshot then is that Americans ought to be addressing the economic and political conditions that give rise to addiction to street drugs.

However, in focusing exclusively on the cultural impact of the drugs associated with the middle to upper classes, this book reiterates the very logic Herzberg aims to critique. As Herzberg notes, the producers and marketers of pharmaceuticals have historically catered to the needs of the wealthier classes, or those who could afford the drugs being produced. This book, meanwhile, in recounting the impact of these same drugs is apt to appeal to the reader who, for example, recalls her mother taking Valium, or the person interested in the ubiquitous use of Prozac among her colleagues at work. Namely, the book would tend to interest middle to upper class readers. This may, in fact, partly account for the publication of a book with this particular subject matter, as it's not clear that a book recounting cultural impact of heroin use and crack cocaine would hold similar appeal for more affluent consumers. Nevertheless, if at least some readers are left supposing that the external circumstances surrounding the heroin addict's overdose warrants as much scrutiny as those surrounding Michael Jackson's death, then perhaps this book will represent something of a start in addressing the root causes of addiction among the poor.


© 2009 Marnina Norys


Marnina Norys is a PhD student in Social and Political Thought at York University in Toronto, Ontario, Canada. Her work is in philosophy of psychiatry and psychiatric ethics.


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