To paraphrase Dorothy’s line in The Wizard of Oz, “Acid and reefer and coke, oh, my!” (Well, Dorothy knew something about drugs – think of what happened to her in the poppy field.) I doubt if too many Americans of my generation got through the 1960s and early ‘70s without fooling around with various forms of illegal pharmaceuticals, from marijuana through hashish, opium, speed, cocaine, LSD, peyote, psylocibin, and heroin. I tried them all, and grew particularly fond of weed and hash, which I smoked whenever I could get them. I still have a little hash pipe that I bought in 1972 at a convenience store near my New York apartment, which also sold newspapers, magazines, cigarettes, and pipe tobacco. Speed and coke got me too wired, though, and after a very bad trip I stopped dropping acid (the LSD turned out to have been cut with crank, crystal methamphetamine). Peyote and magic mushrooms didn’t come my way often, and although I loved their highs, I didn’t care for the vomiting that preceded the visions. I never injected heroin (I hate needles), but I snorted it in powdered form once. Spent the next hour mindlessly drooling on my shoes, and decided that it was a waste of time.
But all in all, I made a sincere and heartfelt effort to sample all the illegal drugs which the counter-culture had to offer, and I’m glad I did. I’m also glad I quit while I was ahead. One friend of mine became psychotic from doing too much acid, and another fell into the heroin trap, and eventually overdosed and died
My hippie days are long gone, and nowadays, though I still smoke cigarettes and drink a bit (beer and wine), I don’t use the serious shit, and only get high on reefer if someone else offers me a toke or two. Mary Jane’s a sweet high, especially its current form, all buds, no headaches, and I’d start smoking it again if I could afford it, which I can’t. I won’t get into the debate over “medical” marijuana and whether or not it should be legalized, except to say that its negative aspects are far outweighed by its positive ones, especially for cancer patients and others suffering from painful, incurable diseases. And even its down sides, which include some cases of temporary short-term memory impairment among teenage users, aren’t a patch on the lethal side effects of cigarettes and booze. The liquor and tobacco companies should downplay their usual products, and develop side-lines in marijuana while they can still dominate the market for uppers and downers. I can see the ad: dapper Johnnie Walker in his topper and the rough-hewn Marlboro Man in his Stetson, sharing a joint, with big goofy grins on their faces.
However, today I’m certainly not drug-free. Far from it. According to a weekly schedule which is getting hard to remember as I get older, I take Doxazosin, Atenolol, Triamterine, Crestor, and Aspirin. These medications were prescribed for me when I first began seeing my current doctor, ten or twelve years ago, to offset the effects of my unhealthy life style. They are turning out to be too much of a presumably good thing.
She was – and is – most concerned about my smoking addiction, which I have yet to kick. Smoking causes lung cancer, but it’s also a major factor in heart disease, hypertension, and several other horrible conditions. Hence, she put me on Doxazosin, which treats high blood pressure. But so do Atenolol and Triamterine. Crestor is one of the statins, used to lower “bad” cholesterol. I used to take another one, Lipitor, but the side effects, which include leg cramps, were harsh; Crestor causes the same pain, but it’s somewhat milder, and I don’t have to take it as often. Some years back I began to suffer attacks of gout, mostly in my toes, and when it flares up, I take Colchisine for it. Finally, every day I take an 81 milligram Aspirin pill, to keep my heart happy.
All well and good, but the sensible reader, if there is one out there, probably wonders why I don’t just quit smoking, drinking, and overeating, thereby obviating the need for all the pills. In fact, I’ve cut way back on my drinking; I’m watching my diet, and the only thing I don’t have under control is the cigarette habit, though I don’t smoke as much as I used to, thanks to restrictions such as a no-smoking rule in the car during what amount to eight-and-a-half-hour round-trips from New York to New Hampshire every other weekend. And of course on airplane flights, smoking is forbidden.
I get by with Nicorette gum and nicotine patches in the car and when aboard planes. At home I puff on V2 Cigs, which deliver a blast of nicotine with every inhalation, and leave nothing but steam in the air on the exhale. But I’m still not shut of tobacco. The only recommended way to quit, short of a solo cold-turkey effort which is beyond my willpower, is to join a support group similar to AA. I’ve looked into such smokers’ groups, and I’ve found that their success rates are even worse than AA’s, which is dismal news indeed. There’s another way out, but it involves a stay in a hospital, and– you guessed it – powerful prescription drugs from Big Pharma. Wanna quit smoking? We got a pill for that. Just don’t ask about its side effects.
I’m due to see my doctor soon, and I intend to ask her about eliminating some of the drugs I take. I haven’t had a gout flareup in a long time, and in researching my medications, I learned that Doxazocin, Atenolol, and Triamterine are all blood thinners that treat high blood pressure. Since my B.P. has been fine during my last two annual physicals, perhaps she’ll let me drop a couple of them, because hypotension can be almost as serious a problem as hypertension.
I speak from recent experience. Less than two weeks ago, as I write, my wife and I were having an early supper with friends at an outdoor restaurant here in New Hampshire that features ice cream and lobster rolls. I sat down, took a couple of bites of my lobster, and blacked out. General alarm at the table, but I recovered very quickly, and got up, reseating myself. It happened again, and this time an ambulance was called. I wound up in the Emergency Room of Monadnock Community Hospital, and was put to bed. I didn’t lose consciousness again, and responded well to a saline drip, answering the ER doctor’s questions clearly and cogently, as he checked me over. An EKG showed my heart to be functioning properly; my blood pressure had risen to a normal level; and an X-Ray (done right in the bed, with a machine on rollers – ah, the miracles of modern medicine!) showed nothing amiss with my lungs, heart, or gut.
The doctor finally told me that in his considered opinion, the fainting episode hadn’t been serious. Sometimes, he said, the vagus nerve which regulates blood flow in the body is triggered by food, if the patient hasn’t eaten in several hours, and directs too much blood from the brain to the stomach. Of course a nurse had grilled me about my medications, and the doctor looked at the list and suggested that the “blood thinners” – my three hypertension pills – might already have sent my brain on the way to shut-down mode. It was he who suggested I have a serious talk with my primary physician about eliminating one or even two of them, because I probably didn’t need all three. Oh, and of course he also told me to quit smoking, since in addition to its other awful effects, it constricts capillaries in the brain (that’s why nicotine provides a momentary high).
I’m OK, now, no new episodes of swooning like a Victorian maiden whose corset is too tight. The hospital solution to my cigarette habit is looking more attractive, but as I said above, God knows what sort of new pills and potions I’ll have to swallow. Contemporary medicine does indeed work wonders, but any honest doctor will admit that the pressures involved in maintaining a practice while trying to keep up with advances in the literature of his or her specialty, all the while being bombarded by freshly FDA-approved new drugs touted by reps from Big Pharma, can be overwhelming. Add the HMOs trying to limit the length of routine patient visits to less than half an hour, and it’s no wonder overprescription has become common. It’s no longer, “Take two Aspirins and call me in the morning.” It’s “Take three or four of these pills, whatever the hell they are, and see what happens.”
We all have to die sooner or later, and the Hippocratic Oath enjoins physicians to keep sick or injured people alive for as long as possible. So doctors in the Ancient World and during the Middle Ages and Renaissance tried all sorts of outlandish and utterly ineffectual cure-alls, many of which wound up killing their patients. I submit that things haven’t changed all that much today. The corridor to the morgue is tiled with good intentions, and patients should research their own maladies, at least to the extent the Internet makes possible, and alert their doctors to possible problems with the medications they prescribe. Traditionally, the High Priesthood of Aesculapius has sneered at suggestions from lowly laymen, but that may be changing, now that doctors are finally realizing that an informed patient can work in partnership with his or her physician, for mutual benefit. And if your doctor still resists your input, change doctors. The new one may turn out to be as deep in thrall to Big Pharma as the old one, but if she or he at least pays attention when you describe your previous experience with Magic Pills, you might wind up on a medication regimen that actually helps you. It’s certainly worth a try.
– this essay is updated from published in Black Lamb in 2011