I came across this Forbes article discussing efforts in New York to curb the over-prescription of drugs. The Attorney General’s I-STOP bill, proposing the institution of a computer system that would track the medical history of patients to prevent against drug abuse, is facing backlash from some members of the medical community. As the article notes, New York “ranks 11th in the nation for admissions to chemical dependence programs for abuse of opioids other than heroin”.

This made me think of our discussion on Thursday regarding the prevalence of self-medication – through prescription drugs, alcohol and caffeine – in order to disassociate from the ‘soul splitting’ involved in the legal profession and to cope with those times “when you’re working on some deal that, if you were to think it through, you’d realize that it was going to ruin the lives of thousands of people and their families”. I think part of the problem may be that dependency on these substances to cope with moral compromise and cognitive dissonance is not viewed as an addiction or a crutch, but is normalized and accepted by those engaged in the same profession and society at large. The article’s discussion of the dangers inherent in over-prescription retains a focus on “crooked doctors, street-level drug dealers, and doctor-shopping addicts”. This perpetuates stereotypes associated with serious drugs - primarily that these drug problems are confined to a particular subset of society that doesn’t include ‘us’. There is significantly less attention paid to the prevalence of addiction within the employed upper-middle class.

While not as serious as prescription drugs, the routine use of caffeine and alcohol for coping with work and social situations is normalized even in the law school context. I’m not knocking a good cup of joe and rum and coke, but it is interesting to think about why we have come to believe in the necessity of these substances for proper functioning in day-to-day life. Are we attempting to subvert true consciousness and remain in denial of our moral ‘split’ through over-medication and consumption of performance enhancing drugs? I think this explanation, while perhaps true in certain cases, may be overreaching and an improper generalization to make. It seems less likely that my morning cup of coffee or evening cocktail is a manifestation of my subconscious attempt to cope with the splitting of my soul, and more likely that I have just been socially conditioned to use these devices. Perhaps we are brought up to believe that if we “time when it hits” just right, our “consciousness is heightened and everything glows” – but regardless, does this really matter? As Eben said, if all you’re selling is time not judgment, who cares? And even if we were to choose to dismiss the econodwarf, and start measuring our worth not by time spent but by judgment proffered, would anyone care then? Or have these processes of making it through the day and engaging socially with others become so entrenched and so normalized in society that no one would take notice of our dependence?

-- MeaganBurrows - 03 Mar 2012

Yeah you better not be knocking a good cup of joe and a rum and coke.

I'm joking, but I think that your light-humored qualification actually proves your point. In order to not come off as a radical, you had to at least in some sense come across as ok with self-medication.

Also I totally agree with your point about the relationship between the econodwarf, cognitive dissonance and drug use in the economic upper-middle class. It reminds me of the scene in the film American Psycho where Patrick Bateman and Timothy Bryce do cocaine together in a bathroom stall of a nightclub after work:

"It's definitely weak. But I have a feeling that if we do enough of it, we'll be ok."

-- PrashantRai - 06 Mar 2012

I apologize if I run off course of the conversation that Meagan started. But from what I've read about the bill in the article, it seems to be missing some important issues - one of which is that many psychiatrists and physicians prescribe drugs based on ties with pharmaceutical companies. I personally have experience with a doctor prescribing me a drug while writing on a clipboard that bore the name of that drug. It's a little unsettling to say the least. Also, the bill adds an additional, heavy burden to pharmacists who are often already overworked and overburdened, by forcing a responsibility on them which is not supposed to be theirs. But it is crucial to have a better system of keeping psychiatrists and physicians in check. I honestly don't see a good reason why prescription for OxyContin? should have gone up 82% in the span of 3 years, especially when that drug is infamous for being abused, and according to the article, "contributed to more deaths than any other prescription opioid there since 2006". I think reform has to come from something fundamental about pharmaceutical companies, specifically their marketing and patenting practices.

In terms of self-medication or use of prescribed medication bordering on abuse, I think one problem is that there is a lack of resources to get to the heart of the issue of soul-splitting for people who want them. Try looking for a psychologist/therapist who is not a psychiatrist on insurance that is not school insurance - you will have a hard time. Even schools, they want students to be able to go on with their lives, so they will often refer you to psychiatrists. Of course, going on with your life is important, but not at the expense of harboring unresolved issues that will continue to manifest themselves in the person's activities for their lifetime. I guess Wiley did attempt to do this with a sort of classic psychologist, but unfortunately, that psychologist was inept and had daddy issues.

I also think that muscling through those kinds of issues is glorified in many countries/cultures, especially the U.S. There is a stigma that you're a weakling if you can't function due to internal strife, and it's your own fault not to be able to deal with those issues. And that leads to what Meagan said, that self-medication is normalized. After all, our society wouldn't function with lawyers and other professionals being unable or unwilling to do their job due to internal conflicts or strife. And I think what Meagan said is also true, that nobody takes note of "our" dependence because it is necessary for our society to function efficiently. Who cares is, or who should care is, each and every one of us for our own well-being.

-- AgnesPetrucione - 07 Mar 2012