Conservatism Consumer Choice And The Food And Drug Administration During The Reagan Era

In the last quarter of the 20th century, politicians in Washington, as well as interest groups, regulatory policy makers, and drug industry leaders were forced to confront the hot-button issue of pharmaceutical regulation. The struggle always centered on product innovation, consumer protection, and choice in the free market. As the American economy stuttered in the late 1970s, the stakes were extremely high for the powerful drug industry and the American public. At the center of this drama was the Food and Drug Administration, which was censured from both the left and right of the political spectrum for being too strict and too lenient in the application of its regulatory powers. Lucas Richert explores the FDA, drugs, and politics in the context of the watershed Reagan era, a period when the rhetoric of limited government, reduced regulation, and enhanced cooperation between businesses and U.S. regulatory agencies was on the ascent. As he investigates the controversies surrounding Laetrile, Reye’s Syndrome, Oraflex, patient package inserts, diet pills, and HIV/AIDS drugs, Richert argues that the practical application of conservative economic principles to the American drug industry was A Prescription for Scandal.

“Antipsychiatry,” Esalen, psychedelics, and DSM III: Radical challenges to psychiatry and the conventional treatment of mental health in the 1970s. The upheavals of the 1960s gave way to a decade of disruptions in the 1970s, and among the rattled fixtures of American society was mainstream psychiatry. A “Radical Caucus” formed within the psychiatric profession and the “antipsychiatry” movement arose. Critics charged that the mental health establishment was complicit with the military-industrial complex, patients were released from mental institutions, and powerful antipsychotic drugs became available. Meanwhile, practitioners and patients experimented with new approaches to mental health, from primal screaming and the therapeutic use of psychedelics to a new reliance on quantification. In Break on Through, Lucas Richert investigates the radical challenges to psychiatry and to the conventional treatment of mental health that emerged in the 1970s and the lessons they offer for current debates. Drawing on archives and government documents, medical journals, and interviews, and interweaving references to pop (counter)culture into his account, Richert offers fascinating stories of the decade's radical mental health practices. He discusses anti–Vietnam War activism and the new diagnosis of post–traumatic stress disorder given to some veterans; the radical psychiatrists who fought the system (and each other); the entry of New Age–style therapies, including Esalen's Human Potential Movement, into the laissez-faire therapeutic marketplace of the 1970s; the development of DSM III; and the use of LSD, cannabis, and MDMA. Many of these issues have resonance today. Debates over medical marijuana and microdoses of psychedelics echo debates of the 1970s. With rising rates of such disorders as anxiety and depression, practitioners and patients continue to search for therapeutic breakthroughs.

The contemporary opioid crisis is widely seen as new and unprecedented. Not so. It is merely the latest in a long series of drug crises stretching back over a century. In White Market Drugs, David Herzberg explores these crises and the drugs that fueled them, from Bayer’s Heroin to Purdue’s OxyContin and all the drugs in between: barbiturate “goof balls,” amphetamine “thrill pills,” the “love drug” Quaalude, and more. As Herzberg argues, the vast majority of American experiences with drugs and addiction have taken place within what he calls “white markets,” where legal drugs called medicines are sold to a largely white clientele. These markets are widely acknowledged but no one has explained how they became so central to the medical system in a nation famous for its “drug wars”—until now. Drawing from federal, state, industry, and medical archives alongside a wealth of published sources, Herzberg re-connects America’s divided drug history, telling the whole story for the first time. He reveals that the driving question for policymakers has never been how to prohibit the use of addictive drugs, but how to ensure their availability in medical contexts, where profitability often outweighs public safety. Access to white markets was thus a double-edged sword for socially privileged consumers, even as communities of color faced exclusion and punitive drug prohibition. To counter this no-win setup, Herzberg advocates for a consumer protection approach that robustly regulates all drug markets to minimize risks while maintaining safe, reliable access (and treatment) for people with addiction. Accomplishing this requires rethinking a drug/medicine divide born a century ago that, unlike most policies of that racially segregated era, has somehow survived relatively unscathed into the twenty-first century. By showing how the twenty-first-century opioid crisis is only the most recent in a long history of similar crises of addiction to pharmaceuticals, Herzberg forces us to rethink our most basic ideas about drug policy and addiction itself—ideas that have been failing us catastrophically for over a century.

Winner of the 2021 Joan Thirsk Memorial Prize from the British Agricultural History Society​ 2020 Choice​ Outstanding Academic Title​ Winner of the 2020 Turriano Prize from ICOHTEC Short-listed and highly commended for the Antibiotic Guardian Award from Public Health England​ Long-listed for the Michel Déon Prize from the Royal Irish Academy​ Pyrrhic Progress analyses over half a century of antibiotic use, regulation, and resistance in US and British food production. Mass-introduced after 1945, antibiotics helped revolutionize post-war agriculture. Food producers used antibiotics to prevent and treat disease, protect plants, preserve food, and promote animals’ growth. Many soon became dependent on routine antibiotic use to sustain and increase production. The resulting growth of antibiotic infrastructures came at a price. Critics blamed antibiotics for leaving dangerous residues in food, enabling bad animal welfare, and selecting for antimicrobial resistance (AMR) in bacteria, which could no longer be treated with antibiotics. Pyrrhic Progress reconstructs the complicated negotiations that accompanied this process of risk prioritization between consumers, farmers, and regulators on both sides of the Atlantic. Unsurprisingly, solutions differed: while Europeans implemented precautionary antibiotic restrictions to curb AMR, consumer concerns and cost-benefit assessments made US regulators focus on curbing drug residues in food. The result was a growing divergence of antibiotic stewardship and a rise of AMR. Kirchhelle’s comprehensive analysis of evolving non-human antibiotic use and the historical complexities of antibiotic stewardship provides important insights for current debates on the global burden of AMR. This Open Access ebook is available under a CC-BY-NC-ND license, and is supported by a generous grant from Wellcome Trust.

Drugs take strange journeys from the black market to the doctor's black bag. Changing marijuana laws in the United States and Canada, the opioid crisis, and the rising costs of pharmaceuticals have sharpened the public's awareness of drugs and their regulation. Government, industry, and the medical profession, however, have a mixed record when it comes to framing policies and generating knowledge to address drug use and misuse. In Strange Trips Lucas Richert investigates the myths, meanings, and boundaries of recreational drugs, palliative care drugs, and pharmaceuticals as well as struggles over product innovation, consumer protection, and freedom of choice in the medical marketplace. Scrutinizing how we have conceptualized and regulated drugs amid the pressing and competing interests of state regulatory bodies, pharmaceutical and for-profit companies, scientific researchers, and medical professionals, Richert asks how perceptions of a product shift – from dangerous substance to medical breakthrough, or vice versa. Through close examination of archival materials, accounts, and records, he brings substances into conversation with each other and demonstrates the contentious relationship between scientific knowledge, cultural assumptions, and social concerns. Weaving together stories of consumer resistance and government control, Strange Trips offers timely recommendations for the future of drug regulation.

Cannabis consumption, commerce, and control in global history, from the nineteenth century to the present day. This book gathers together authors from the new wave of cannabis histories that has emerged in recent decades. It offers case studies from Africa, Asia, the Americas, Europe, and the Middle East. It does so to trace a global history of the plant and its preparations, arguing that Western colonialism shaped and disseminated ideas in the nineteenth century that came to drive the international control regimes of the twentieth. More recently, the emergence of commercial interests in cannabis has been central to the challenges that have undermined that cannabis consensus. Throughout, the determination of people around the world to consume substances made from the plant has defied efforts to stamp them out and often transformed the politics and cultures of using them. These texts also suggest that globalization might have a cannabis history. The migration of consumers, the clandestine networks established to supply them, and international cooperation on control may have driven much of the interconnectedness that is a key feature of the contemporary world.

How should we weigh the costs and benefits of scientific research on humans? Is it right that a small group of people should suffer in order that a larger number can live better, healthier lives? Or is an individual truly sovereign, unable to be plotted as part of such a calculation? These are questions that have bedeviled scientists, doctors, and ethicists for decades, and in Pain, Pleasure, and the Greater Good, Cathy Gere presents the gripping story of how we have addressed them over time. Today, we are horrified at the idea that a medical experiment could be performed on someone without consent. But, as Gere shows, that represents a relatively recent shift: for more than two centuries, from the birth of utilitarianism in the eighteenth century, the doctrine of the greater good held sway. If a researcher believed his work would benefit humanity, then inflicting pain, or even death, on unwitting or captive subjects was considered ethically acceptable. It was only in the wake of World War II, and the revelations of Nazi medical atrocities, that public and medical opinion began to change, culminating in the National Research Act of 1974, which mandated informed consent. Showing that utilitarianism is based in the idea that humans are motivated only by pain and pleasure, Gere cautions that that greater good thinking is on the upswing again today and that the lesson of history is in imminent danger of being lost. Rooted in the experiences of real people, and with major consequences for how we think about ourselves and our rights, Pain, Pleasure, and the Greater Good is a dazzling, ambitious history.

When does epidemic disease disrupt society to the point where it becomes a political crisis? In the early 1980s, almost unnoticed in the larger drama that was AIDS, over half of hemophiliacs and a large number of blood transfusion recipients were infected with toxic blood contaminated with HIV. The French public's "discovery" of this catastrophe in the early 1990s created a transformative political crisis; this same discovery in the United States went largely unnoticed. In The Social Production of Crisis, Constance A. Nathanson and Henri Bergeron focus on a profoundly troubling story to present a detailed case comparative analysis not only of the catastrophe itself and its multiple retrospective interpretations but also of its intimate connection to the history and organization of blood as a consumer product in each country. They draw on secondary sources, archival research, and interviews with key players to provide a historical, political, and social reconstruction of the HIV contamination of the blood supply to answer the question of how and why disease morphed into crisis in France and not in the United States. They also raise questions about the curious immunity to human suffering as a policy engine in the United States, about the often reiterated weakness of civil society in France, and about theorizing alternative epidemic trajectories. Investigating a series of morally shocking events, this book develops a sociological theory of how political crises are socially produced and raises questions about disease policy and politics in the US and France.