Space the Nation: Drugs and addiction in genre

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Jun 5, 2018, 3:00 PM EDT

The headlines:
Ambien maker Sanofi: 'Racism is not a known side effect'
Ketamine ingredient improves severe depression in large trial
Trump signs ‘Right to Try’ bill giving terminally ill people access to experimental drugs

Roseanne Barr took heat from the makers of sleep aid Ambien for attributing her dehumanizing “joke” about former Obama official Valerie Jarrett to having taken the drug. “Racism is not a known side effect,” Sanofi tweeted, and the internet had a good laugh. But while Ambien probably can’t change your inherent personality, it does have a host of documented, bizarre side effects, most of which were only discovered after doctors began prescribing it, including sleep-eating, sleep-cooking, and, terrifyingly, sleep-driving. (I took Ambien on-and-off for awhile and once prepared for my husband — he told me later — a meal consisting entirely of various hot sauces. This is also proof that whatever Ambien does, it does not actually change us all that much.) Side effects for widely-available drugs can include compulsive gambling (Mirapex), ultra-sensitivity to sunlight (ibuprofen), and tinting everything you see blue (Viagra). The “interferon” class of drugs — and even run-of-the-mill antibiotics — can cause you to lose your sense of smell. The cancer drug capecitabine can cause patients to lose their fingerprints.

The truth is drugs are often out in the public long before doctors and scientists always have full command of their effects — sometimes it can take years, or even decades, to puzzle out what, exactly, a drug does to a person, and it’s a separate riddle entirely as to how the drug does it. Researchers still can’t explain why acetaminophen relieves pain, or lithium stabilizes bipolar disorder. Ketamine, originally marketed as a tranquilizer, then adopted for recreational use, is now being used to alleviate depression — though scientists still don’t quite understand exactly how it does that. Studies have found that up to 20 percent of all prescriptions are based on “off-label” treatments; that is, doctors prescribe a drug for what is officially merely a side-effect of an approved use: an antipsychotic that happens to improve sleep quality or an Alzheimer medication that also soothes obsessive-compulsive tendencies. Technically, I suppose snorting Xanax is also merely an “off-label” use.

As consumers, we have some idea that drugs are capable of more than doctors tell us, and that’s the appeal of “right-to-try” bills, allowing patients to obtain experimental treatments directly from manufacturers. But all that legislation really does is allow patients to present themselves as uncompensated test subjects who will have to foot the bill for any complications that occur and who are statistically more likely to receive a new compound that doesn’t do much rather than one of the rare true advances. Perhaps we’re drawn to the untold, unearned promise of medications because there is something inherently magical about even the idea of ingesting some substance that can change you. Substances can alter our bodies, our perceptions, our personalities, and can do so invisibly. No wonder imaginary drugs have been a presence in genre literature since literature began.

Now, one has to parse out what are merely intoxicants or hallucinogenics by any other name from the truly inventive cocktails. For instance, The Odyssey’s lotus eaters are getting high, but those who take nepenthe, well, they’ve been given a specific gift: freedom from grief.

No one who drank it deeply, mulled in wine,
could let a tear roll down his cheeks that day,
not even if his mother should die, his father die,
not even if right before his eyes some enemy brought down
a brother or darling son with a sharp bronze blade.

Specificity of effect itself might be science-fictional, given that real science is so bad at predicting (and limiting) what drugs can do. And most creators build into their invented drugs some kind of unintended consequence, whether that’s addiction or anti-social behavior. Science fiction and genre, for all their libertarian tendencies, seem to rarely depict serious drug use as a cost-free indulgence. Generally, the bigger the bang, the bigger the risk — a lesson that seems less in tune with an imagined future than our Puritan past. It is, on the other hand, pretty easy to find analogs of pot smoking and social drinking: Smash in the Wayfarers series, the herbs of Robin Hobb’s worlds, and the numerous brews of Star Trek universe (and maybe even Harry Potter's butterbeer?).

(Stoner Tolkien fans — are there any other kind? — will be disappointed to know that the preponderance of evidence is against “pipe-weed” being code for weed-weed.)

Perhaps inventing new kinds of experiences is less difficult than exaggerating the ones we already know about. For instance, while the effects of Robert Louis Stephenson's trope-defining elixir in Dr. Jekyll and Mr. Hyde are fantastical, critics generally agree that Stephenson was using the split-personality title character as a commentary on plain old alcoholism. Likewise, as trippy as A Scanner Darkly’s “Substance D” may sound — it supposedly separates the left and right hemispheres of the brain — Phillip K. Dick insisted it was based on his experiences in California drug culture: “Everything in A Scanner Darkly I actually saw.”

Perhaps the most frequent function of drug use in imaginative fiction isn’t about chemicals at all. Rather, creators embroider on two truisms of modern times: the multitude of ways that a population can be lulled into compliance (aka “opiates of the masses”), and the addictive nature of control over those masses. The “soma” of Brave New World is perhaps the most famous, if least subtle, of the former trope. Hobb's world has elfbark, which is a stimulant that also induces feelings of despair — and is used by slave masters to keep their charges busy and downtrodden (capitalism much?). In the Firefly universe, the attempt to pacify the populace boomerangs, as a chemical meant to weed out aggression and anger winds up paralyzing 99.9 percent and driving the rest of the people insane. Magic and magic-making are used compulsively in fictional worlds old and new, from Willow’s dalliance with wizardry in Buffy the Vampire Slayer to Bran’s obsessive warging in Game of Thrones to the soul-sucking power of The One True Ring to Rule Them All. The Magicians TV adaptation series tagline is, literally, “Magic is a drug.”

Others have suggested there’s a trend toward genre fiction exploring performance-enhancing drugs, as our society fetishizes success even as social mobility is almost static. Think Limitless or even Inception. How else are we to climb the economic ladder except if we obtain some modern form of magic beans? Or perhaps we’ve so internalized the ability to level-up our characters in video games, we’re willing to believe that real-world herbal supplements and nootropics do something other than create really expensive pee.

You might think that real-life unpredictability and apparently boundless capacities of known pharmaceuticals means that genre creators have to really stretch their imaginations to posit substances that do things beyond what we already know (or think) is possible. Yet coming up with fictional drugs has often been more about familiar problems than unfamiliar solutions. An imaginary drug is only as compelling as the need it fulfills.

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