Editorial: There have been some high profile cases recently that may reflect the effects of drugs.
On March 17th L’Wren Scott hung herself in her Manhattan apartment. She hung herself from a door handle. Hanging with your feet or body on the ground is a classic antidepressant MO when it comes to suicide.
Hanging in this way led Pfizer to claim that Matt Miller, a 13 year old boy, hadn’t committed suicide but had died from auto-erotic asphyxiation gone wrong. It has led people in Bridgend and Wales to speculateon the influence of Satanic cults to explain the rash of bizarre suicides there.
What happens is this. Antidepressants trigger thoughts of self-harm. These thoughts can vary from the mild to the malignant. The drugs can trigger thoughts like this in perfectly normal people, who have rarely if ever thought of harming themselves. Partly because these are such unfamiliar thoughts, someone like Matt Miller, Yvonne Woodley or L’Wren Scott can play with them by attaching a noose around their neck and leaning forward to see what it would be like. But leaning forward like this can put pressure on the carotid bodies, cause a person to lose consciousness, slip forward and asphyxiate.
The New York Post may have had things exactly wrong when they reported it as follows:
“Mick Jagger’s longtime lover didn’t take any chances when she hanged herself, law-enforcement sources told The Post on Tuesday. L’Wren Scott — whose death prompted the Rolling Stones to postpone a nearly sold-out tour of Australia and New Zealand — wrapped a tie around her neck before using a black satin scarf to hang herself from a door handle in her swanky Manhattan apartment on Monday morning, sources said. “The necktie would apply more pressure,” a source said. “She must have figured that if the scarf wasn’t long enough or something, then the necktie would choke her out.” “She clearly wanted to do the job right,” the source added.
It looks highly likely L’Wren was on antidepressants. If she had recently stopped, withdrawal effects can also trigger suicide. We don’t know what Mick Jagger feels about L’Wren or the possibility that her death might be linked to medication.
We do know about lots of other lovers, parents or children left behind after a suicide, heart attack or other drug induced injury. There are several mantras repeated time and again:
The answer is that it’s a cultural issue. And here is where Mick Jagger could make a big difference.
In the 1960s when the song Mother’s Little Helper came out we were on the verge of an historic transformation. The chemicals that we use as medicines that had up till then been viewed as poisons were about to become fertilizers. But this has not been a transformation of Ugly Sisters into Princesses; it has close to destroyed medicine.
Up to the mid-1960s the art of medicine lay in using poisons to bring about cures, thereby saving our lives, marriages and jobs in miraculous fashion. Since the 1960s, good marketing has made pills seem miraculous bringers of benefits and company marketing is now geared to help patients get around doctors who may be slow to prescribe.
When we used poisons to achieve miracles, both we and our doctors knew there was a very real risk that things could go wrong. When things did go wrong, the person was not as shocked and isolated as we are now – we didn’t live then in communities where others were unaware that things might go wrong. We could smell the coffee – we weren’t asleep.
But now when treated with Miracle-Gro, we are profoundly shocked when someone loses a job, a marriage or a life because of the effects of the chemical they have taken.
Mother’s Little Helper marks a point where attitudes were changing. Miracle Gro is on the horizon but there is still a hint that Little Helpers don’t necessarily lead to good outcomes. What has produced this transformation? It’s not that the chemicals have become safer – they haven’t. They have got riskier and riskier as companies have realized they can get away with more.
The black magic dust that has turned poisons into fertilizers lies in randomized controlled trials (RCTs). These came into being as a means to test whether fertilizers worked. It’s far from clear that they can be safely applied to medicines but no-one wants to hear this message.
You cannot run an RCT without hypnotizing doctors to ignore everything except what the company testing a drug wants them to see. As a result the doctors running trials miss any number of elephants in the room. The trials launder risks and generate ignorance. And to compound the problem, when afterwards experts like those in the Cochrane Centre say that RCTs offer us gold standard evidence about drugs, we become ignorant about our ignorance.
Medicines can do no wrong as the shootings last week at Fort Hood show. Lt. General Mark Milley, the post commander, has stated the fundamental underlying causal factor for the shootings was Spc. Lopez’s mental illness. He suffered apparently from an unstable mental or psychological condition – even though he had only just recently had his first mental health treatment contact and only recently started treatment. Nevertheless the media locked onto this and made that its mantra.
Any questions about adverse drug responses by reporters have been discounted by every “expert” brought on board. This is close to psychotic. If Lopez was so ill that his illness was likely to cause the problem, he should not have been in service. If he was able to work, the scientific evidence suggests his drug was more likely to cause the problem.
Mother’s Little Helper was a potent marker of changing times. The growing army of people who are isolated and alienated by drug induced injuries or left behind in the wake of an injury need a new anthem now. If ever we needed a Band to catch the mood of the people, it’s now. Mother’s Little Poisoner. Or perhaps Donovan’s Universal Soldier recreated as Universal Crash Test Dummy.
Illustration: String of Pills, 2014 created by Billiam James