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GENERATION RX How Prescription Drugs Are Altering American Lives, Minds and Bodies By Greg Critser 308 pages. $24.95. Houghton Mifflin Co. Reviewed by Michiko Kakutani
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In his hilarious stand-up routine, Chris Rock talks about the ubiquitous television drug commercials that "keep naming symptoms till they get one that" the viewer has. Sometimes, he says, the ads don't even tell you what the pill does: "You see a lady on a horse or a man in a tub, and they just keep naming symptoms: 'Are you depressed?' 'Are you lonely?' 'Do your teeth hurt?'" He adds that one commercial he saw went, "Do you go to bed at night and wake up in the morning?"
"They got that one!" he says. "I got that. I'm sick. I need that pill!"
Rock's observations are almost too close to the truth to be considered satire, as Greg Critser's provocative new book, "Generation RX," makes clear. Indeed, baby boomers and their offspring have become the most medicated generation ever, devoted consumers from cradle to grave of every manner of pharmaceutical imaginable pills that not only cure real diseases, but that also promise, in Critser's words, to "do everything from guarding us against our excesses of drink, food and tobacco, to increasing our children's performance at school, to jump-starting our own productivity at work, to extending our very time on this mortal coil."
Boomers, who grew up using drugs recreationally, have become a generation that lives almost full time in the Valley of the Dolls: bombarded by direct-to-consumer ads, they are happy to self- medicate. Little wonder, then, that drug use of the legal sort has soared. Americans routinely take pills for high cholesterol and high blood pressure, and they also routinely take pills to sleep, pills to focus, pills to chill and pills to perk up, pills for more sex and pills for less stress. Critser notes that in America, the average number of prescriptions per person in 1993 was seven, but that had risen to 11 by 2000, and 12 in 2004.
"The cost per year?" he writes. "About $180 billion, headed to an estimated $414 billion by 2011."
What Critser has done in these pages is synthesize a lot of information and reserve it to the reader in an accessible, easily digested form much as he did with information about obesity in his 2003 book, "Fat Land." While his prose sometimes buckles from his efforts to be chatty and conversational, he does a lucid job conveying the dramatic ways in which the development and marketing of pharmaceuticals have changed over the last two decades and the equally dramatic and often disturbing consequences of this phenomenon.
Critser traces the big changes in the drug business back to what he calls "newly loosened and speeded-up regulatory processes" that began with the Bayh-Dole Act of 1980.
Needless to say, the pharmaceutical industry has done everything it can to promote its own interests in America: Critser estimates that the business spends "between $8,000 and $15,000 annually per physician to sell its wares."
At the same time, drug companies have employed a host of other strategies to maximize sales and profits: focusing on the development of drugs for chronic conditions and drugs with large patient populations; enlarging the patient base for existing drugs by selling them as cures for related disorders; and promoting drugs like Viagra as "quality of life" products that patients would ask their doctors to prescribe.
Although Critser skims a little too briefly over the stories of specific drugs like Vioxx and Seldane that have been recalled for serious safety reasons, he does an effective job of showing why the speeded-up review process, combined with the pharmaceutical industry's push of its drugs, has led to such tragic cases. He also raises important questions about the possible damage that the long- term use of pharmaceuticals may cause from liver damage to cascading drug interactions to the more intangible psychological effects of young people relying on antidepressants and attention- deficit-disorder drugs to cope with the stresses of life.
"The principal forces that have so deeply pharmaceuticalized American life are hardly likely to abate anytime soon," he writes.
(C) 2005 International Herald Tribune. via ProQuest Information and Learning Company; All Rights Reserved
