"Through all this, patients were getting used to demanding drugs for treatment. They did not, however, have to accept the idea that they might, say, eat better and exercise more, and that this might help them lose weight and feel better. Doctors, of course, couldn't insist. As the defenestration of the physician's authority and clinical experience was under way, patients didn't have to take accountability for their own behavior."
In his research around the prescription drug craze of America in the 1990s, Quinones learns that the prescriptions gained popularity through successful marketing to the public. Patients, in charge of their own medical decisions, began asking for the drugs despite being warned of their addictive qualities. The American public leapt at the chance to feel better without changing their lifestyles.
"OxyContin is a simple pill. It contains only one drug: oxycodone, a painkiller that Germans synthesized in 1916 from thebaine, an opium derivative. Molecularly, oxycodone is similar to heroin."
Quinones outlines the effectiveness of OxyContin on the market. As a painkiller, it was relatively innocuous for its strength, presenting few side-effects. The historical issue of its abuse comes to a head because OxyCotin's molecular composition closely resembles that of heroin. When patients could no longer receive the first, they began to seek out the second because of their addiction.
"If a child was sick, maybe her mother was tense. Valium was marketed above all to women, pitched as way of bearing the stress of lives as wives and mothers. Before the feminist movement, women were presumed to need that kind of help for the rest of their lives, thus there was no worry then about its addictiveness."
In this excerpt Quinones explains that the exploitation of patients through the marketing of addictive drugs for profit was not a new phenomenon in the U.S. In fact, it was a common practice during the mid twentieth century among the doctors of female patients. Upholding different expectations for how a woman may be a well functioning member of society, the pharma companies could make a neat profit. Compare this situation with the rise of big pharma in the 1990s due to the overprescription of opiates.
"In heroin addicts, I had seen the debasement that comes from the loss of free will and enslavement to what amounts to an idea: permanent pleasure, numbness, and the avoidance of pain. But man's decay has always begun as soon as he has it all, and is free of friction, pain, and the deprivation that temper his behavior."
Quinones notes the negative effects of heroin on an addict's character. Reflecting a general feeling of dissatisfaction in the American public, the increasing number of opiate addicts preferred the escape of total satisfaction to pretty much every responsibility of normal life. The temptation for escape was too irresistible.
