Still in a pre-pandemic coronavirus scenario, the American journalist Thomas Hager In the United States’ bestseller list, an in-depth journalistic study of ten drugs that changed the direction of humanity, trying to deviate from clichés, but keeping an eye on the big trends. Ten Drugs – Plants, Powders and Pills That Changed the History of Medicine, published in Brazil by publisher However, outlines “biographical profiles” of ten different substances, with an emphasis on opium and its derivatives (opiates) and synthetic drugs created to solve opiate addiction, with an even greater addictive power: opioids.
The book was born from the realization that the United States is home to 5% of the world population, but is responsible for about 50% of the pharmaceutical industry’s revenues. “Perhaps we should rename our species as Homo pharmacum, the species that makes and takes drugs. We are the People of the Pill,” writes Hager. The book, then, aims to show how mankind reached this point.
With accessible language, the work is not intended for scientists, but for the general public, who is interested in the subject. “If there is an important lesson that I hope to leave you with, it is this: no drugs are good, no drugs are bad. All are both,” explains the author, in the preface.
Hager leaves aside some “stars” from the pharmacy, such as aspirin and penicillin, in favor of interesting stories about, for example, CPZ, the first antipsychotic that, as the author demonstrates, emptied hospices in America and Europe.
Particularly interesting is the chapter on vaccines, such as the discovery and scientifically disseminated as a preventive against smallpox, a disease that killed one in four people it infected in the early 18th century, and was even responsible for a large part of the genocides of natives in the Americas. .
In the book, he profiles Lady Mary Montagu, an Englishwoman who traveled with her ambassador husband to Constantinople (now Istanbul), in the 18th century. There, she learned from her new Ottoman friends a technique called “grafting”: they applied a variant weak skin disease of children, who contracted a milder smallpox, recovered and were thus protected forever.
With courage and taking advantage of her connections in the nobility, Lady Mary managed to apply the “vaccine” to her own son and then paved the way for the spread of the technique in the West.
But the main subject of Ten Drugs turns out to be opioids in all their forms, “from the prehistoric harvest of the poppy sap to today’s synthetic, deadly powerful products.”
About the book and the current pandemic, Hager, professor of journalism and author of books on the history of medicine and science, answered some questions from the state.
In a crisis like the one we are facing, due to the coronavirus, how do you describe the role of drugs?
Drugs from two categories will be important in the fight against covid-19. The first are antivirals, medicines to help treat the disease after it started, and here the current options are not very good. With all the money now being redirected to the search for antivirals against covid-19, we can see something new and useful. But until then, we are stuck with existing substances, such as antimalarial chloroquine and its derivatives, which have no proven efficacy, or antivirals made for other types of infections. This is a very difficult area of research, and I hope that interest in a “cure” for covid-19 will make some important advances possible, but there is no guarantee of any discovery. The second category is vaccines, which prevent people from getting the disease. More than 50 groups around the world are rushing to develop an effective vaccine, and we are very likely to see one in the next year or the next. When that happens, I hope, the covid-19 will become a relic of the past, just as it was with smallpox.
Based on your research, what other epidemics would you say are close to the current one, in terms of impacts on people’s lives?
In terms of infectious diseases (it’s not like talking about an “epidemic” of obesity, cancer or diabetes), malaria is still very widespread, the common flu is still very deadly, as are several types of pneumonia, and tuberculosis is always dangerous. Antibiotic resistance is an imminent problem for bacterial diseases; as mentioned, we still need effective antivirals; and parasitic diseases, such as malaria, are still very widespread. And there is always a chance that something new will appear, as happened with the covid-19. The only answers to these problems are ongoing, well-funded and well-directed public health programs and scientific research.
In your opinion, what is the biggest culprit about the current opioid crisis in the USA: science, money or politics?
It is not one or the other, but they are all. The political climate in the United States, with its focus on criminalizing drugs (instead of treating them as a medical problem), has created an atmosphere in which addictive drugs, such as opioids, find their users illegally through the black market, the that makes it harder to find and treat addiction effectively. Criminals make a lot of money from this trade. And some drug makers, by influencing widespread sales for their products, including highly addictive painkillers, can help create a bigger market for addiction. The medical community can also affect this, prescribing opioids for pain control more or less widely.
Do you see the opioid epidemic growing on an international scale? Can it be “exported” from the United States to other countries?
The United States is the largest opioid user in the world by far, but many other nations also have problems with these drugs. For this to become an “epidemic” in these countries is in the hands of their doctors, pharmacists, political leaders and criminal organizations.
You say in the book that “we have barely started the long journey to understand consciousness”. Is this due to lack of technology? How do you see the medical field evolving in this direction?
Human beings still do not have an understanding of how to define “consciousness”, let alone how it operates, in scientific terms. It is an interesting area of research, covering biology, neurology, philosophy, linguistics, biochemistry, biophysics, pharmacology, an extensive number of areas. The problem is partly technological – we need better tools to study more effectively how the brain creates consciousness at the molecular level – but partly rooted in a lack of communication and cooperation between the various scientific disciplines I mentioned.
Could cannabis research be useful to combat the rampant use of opioids?
There is a debate about this among researchers. A considerable number of cannabis activists feel it could be useful, but the evidence is fragile.
In the chapter on the vaccine book, you say that Lady Montagu’s efforts were ignored at the time, as well as the efforts of many other women in science. In the book, you chose to talk about her, and not so much about the Turkish ladies who, it seems, actually invented vaccines.
Turkish ladies took from shamans and healers from Africa and Asia; various approaches have been tried for centuries. But my book focuses on scientific efforts, and true medical science as we know it today did not begin until Lady Montagu’s time.
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