Review by New York Times Review
synthetic opioids - drugs far more potent than anything that's come before - are flooding America's streets. New users start up daily, while old users fall deeper into cycles of despair. And as officials bicker about whether addiction is a medical problem or a criminal one, thousands upon thousands of people are dying. That may sound like a contemporary account, but as Thomas Hager, a historian of medicine and science, explains in his absorbing new book, "Ten Drugs," it also describes America's first, forgotten opioid epidemic a century ago. The culprit back then was morphine, a compound isolated from poppy sap. And as Hager makes clear, we're just as helpless treating addicts today as we were in the early 1900s. The 10 titular drugs aren't necessarily the most important ones ever; neither penicillin nor aspirin makes the cut. Instead, Hager writes, he picked each for its "historical importance plus its entertainment value." (The first public demonstration of a treatment for erectile dysfunction - onstage at a medical conference - is especially memorable.) But above all, Hager explores the fraught human relationship with drugs: "Are they good for you? Often. Are they dangerous? Always. Can they perform miracles? They can. Can they enslave us? Some do." One chapter covers chlorpromazine, which awakened thousands of catatonic mental patients in the 1950s. Many were able to leave their asylums for the first time in decades - only to find an alien world, with their careers obsolete and their spouses remarried. Other drugs were selected less for their medicinal value than for the groundbreaking way they were discovered: through high-tech, systematic screening rather than blind groping. Hager also dissects how the rise of giant drug companies has changed medicine. His critique is no screed: He acknowledges, rightly, what they do well. As late as the 1930s, doctors had just a dozen drugs in their armory to fight diseases; today, they have thousands. He even admits a grudging admiration for drug marketing, which is extraordinarily effective. At the same time, he recognizes the bad. Companies scare patients into taking drugs with marginal benefits, or conjure up wholly new ailments (e.g., social anxiety), which then require pricey drugs to "cure." He also highlights the chicanery of companies that trumpet flattering research while burying negative studies. But the core of "Ten Drugs," the subject of three separate chapters, is opioids. Human beings have been cultivating opium for more than 10,000 years - "before towns," Hager writes, "before agriculture, before science, before history." And opioids do kill pain, no question. The problem is, they're frighteningly addictive, and chemists since the 1800s have had no luck creating new opioids that dull pain without creating dependency. This work has not only failed, it's also backfired spectacularly. Like the monster in a horror-movie franchise, each sequel - morphine, heroin, OxyContin, fentanyl - grows more terrifying. Fentanyl, which killed Tom Petty and Prince, is 50 times stronger than heroin, which itself is roughly twice as potent as morphine. Still more powerful drugs await government approval. For various reasons - wealth, a broken health care system, a determination to self-medicate - the United States has suffered more from opioids than other nations. Although just 4.4 percent of the world's population, Americans consume a staggering 80 percent of all opioids. "Opioid overdoses," Hager notes, "kill more Americans than car accidents and gun homicides put together." Time and again throughout history, our mastery of new pharmaceuticals gave us a feeling of omnipotence at first, until we realized just how little control we had over them. But maybe that ambiguity is an intrinsic part of their nature. As Hager aptly sums up: "No drug is good. No drug is bad. Every drug is both." SAM KEAN'S newest book, "The Bastard Brigade," will be published in July.
Copyright (c) The New York Times Company [July 11, 2019]
Review by Booklist Review
Throughout history, physicians, chemists, and observant mothers have discovered drugs serendipitously. Looking to cure specific diseases, they found treatments for different diseases or chronic conditions. Often, the medical community then resisted these new drugs, continuing with bleeding, doses of mercury, or other traditional treatments. In recent decades, research and testing have kept new drugs in development for years. Ironically, once the Food and Drug Administration approves drugs, pharmaceutical companies and physicians find uses other than those for which they were approved. In the wake of DNA mapping, the pharmaceutical industry is changing again. Biochemists are designing drugs, such as monoclonal antibodies, for very specific diseases. In profiling 10 drugs, Hager (The Alchemy of Air, 2008) shows that drug development generally benefits human health and longevity, but there are often side effects for patients and society. Especially troubling is the influence of profit-driven corporations and the inequality of health care. Written for general readers, Hager's book is entertaining, insightful, and recommended for all public libraries.--Rick Roche Copyright 2010 Booklist
From Booklist, Copyright (c) American Library Association. Used with permission.
Review by Publisher's Weekly Review
In this lucidly informative and compulsively readable work, science writer Hager (The Demon Under the Microscope) explores the intertwined histories of drug discoveries and medical practice. He begins with a sweeping, 10,000 year-spanning account of opium usage, covering its multiple applications as painkiller, party drug, and means of suicide, and its many derivatives, including codeine and morphine. The latter was such a staple on Civil War battlefields-and so addictive-that it led in the 1880s to the U.S.'s first opiate crisis. Other drugs discussed include the first synthetic medicine, chloral hydrate (knockout drops); the first antibiotics (sulfa drugs); and the "mind drugs" of the 1950s, such as chlorpromazine, that revolutionized psychiatric practice. Readers will also meet the people responsible for these discoveries, such as Paracelsus, a 16th-century Swiss alchemist who tracked the effects of opium; Lady Mary Wortley Montagu, who introduced the smallpox vaccine to Britain; and CAcsar Milstein and Georges Kohler, who didn't patent their monumental discovery of monoclonal antibodies-natural drugs that target specific cells-out of a desire to share it with humanity. Hager's thoughtful and captivating survey leaves readers with the insights that finding "magic bullets"-all-powerful drugs with no risk-is unlikely, and that no drug is all good or all bad. (Mar.) © Copyright PWxyz, LLC. All rights reserved.
(c) Copyright PWxyz, LLC. All rights reserved
Review by Kirkus Book Review
A history of significant drugs and their evolutions.Despite the title, the book contains 10 isolated chapters recounting the history of a score of important drugs. Readers will not miss the absence of an overarching theme because the stories are skillfully told and entirely entertaining. An award-winning writer on science and medicine, Hager (The Alchemy of Air: A Jewish Genius, a Doomed Tycoon, and the Scientific Discovery that Fed the World but Fueled the Rise of Hitler, 2008, etc.) devotes significant space to "the most important drug humans have ever found": opium. "Dried and eaten or smoked," writes the author, "it was early man's strongest, most soothing medicine. Today it is among the most controversial." Discovered in prehistoric times, it spread across the world. Its addictive property was no secret but considered only a modest drawback because, unlike alcohol, users of opium were rarely violent. By the end of the 19th century, its refined versionsmorphine and, later, heroinproduced an addiction epidemic, the beginning of moral disapproval, and increasingly aggressive but ineffectual government efforts to suppress opiate misuse. The history of vaccines, mostly the story of smallpox eradication, is so satisfying that it deserves its chapter. Hager follows with exciting stories of discovery with an international reachantibiotics in Germany, antipsychotics in France, cholesterol-lowering drugs in Japanand plenty of unknown geniuses. Though not a muckraker, the author is no fan of drug companies, and he admits that new drugs are greeted with too much enthusiasm, unpleasant side effects invariably appear, and the juiciest pharmaceutical "low-hanging fruit" was plucked during a golden age that ended 50 years ago. New antibiotics cost at least 1,000 times more than old ones. Nowadays, lifesaving drugs attract less attention than those that improve the quality of lifee.g., Viagra, Botox, contraceptives, and tranquilizers.An expert, mostly feel-good book about modern medicine. Copyright Kirkus Reviews, used with permission.
Copyright (c) Kirkus Reviews, used with permission.
