All of the following were procedures used to treat madness in the 18th century, except ____
A) Trepanning
B) Beatings
C) Counter-spells
D) Psychoanalysis
D
Define psychopharmaceuticals
- medications that are psychoactive (meaning they impact mood, thoughts, or behaviour)
- they are prescribed for psychiatric reasons
When did the use of psychopharmaceuticals grow greatly?
- grown since mid-20th century
What are the 3 different views or roles of medication in recovery processes?
- drugs cured depression and addressed a chemical imbalance
- drugs aided recovery process, allowing progress and breakthroughs to be made in therapy
- potential placebo effect
explain the potential placebo effect
- belief it would help was enough to actually help when combined with therapy and lifestyle changes
define psychoactive drugs
- substances that affect feelings, thoughts, and behaviors
Review:
- have been used throughout human history (a long long history)
- ex. alcohol, caffeine, and cannabis too
What re-shaped our thoughts about these psychoactive drugs?
- emergence of a global consumer culture and the development of the psychopharmaceutical industry
Which country has been instrumental in the development of the psychopharmaceutical industry and a key market for it?
US
define Patent Medicine
- type of branding that’s not regulated
What was alcohol in US
- prescribed as medicine and used informally for therapeutic and recreational purposes
EXTRA
Later concerns about alcohol risks and harms became so intense that it was prohibited and made illegal under an amendment to the US Constitution – health concerns but not solely a medical problem, but a social one (with moral dimensions) focused on harms to families and communities stemming from alcohol
What was morphine sold and marketed for?
- sold and marketed to relieve pain and nervous irritation, quiet restlessness, promote sleep
what was cocaine sold and marketed as?
- sold and marketed as brain tonic and stimulant
Review morphine and cocaine
- Morphine and cocaine were exclusively produced by pharmaceutical industry,
almost always advertised as therapeutic - Some companies were more “ethical”- targeted only physicians, used tested ingredients and noted contents of products
- Also “patent” medicines (think brand name) sector of the market: secret ingredients, trying new substances advertised extensively directly to consumers
What were the unregulated sales of psychoactive substances associated with?
- associated with an epidemic of addiction to opiates and cocaine in the late 19th century
What was the Reform movement?
- to formalize and narrow what was deemed medicine and “therapeutic” to protect consumers
How do we increase medical regulation of substances?
- raise educational and licensing standards for physicians
- create legal monopoly on treatment of illness for physicians
- start regulations for the pharmaceutical industry
How did they regulate psychoactive substances in the public?
- the sale of drugs by non-physicians was criminalized
- legal access to psychoactive drugs was limited to those receiving medical treatment
- even alcohol was subject to legal prohibition in the US and Canada
What are some examples of the introduction of legislation formalized reforms? - acts brought stronger regulations for psychoactive durgs
- US 1906 Food and Drug Act : requirement to disclose substances in labeling
- US 1914 Harrison Anti-Narcotic Act : physician prescription for sale of cocaine and opiates
- Canada Opium and Narcotic Drug Act 1929
- Britain Dangerous Drugs Act 1920
explain immediate impact and implications of the regulation of these drugs
- reduced physician’s prescribing of psychoactive drugs, “non-medical” sales became illegal and criminalized
- access to psychoactive drugs became officially managed by physicians and medical industry (substances were now fully medicalized)
What happened after the consumption of opiates and cocaine as medicine declined?
- new types of drugs became populat
What were the most widely used substanced by the 1950s in the US?
- Barbiturate sedatives (1900s) and Amphetamine stimulants (1930s)
- accounted for 25% of all presriptions
EXTRA
- these drugs were sold for conditions like anxiety, insomnia, depression but were not thought of as “psychiatric drugs” at the time as they were not thought as curing mental illness
What are 5 things that the widespread use of barbiturates and amphetamines revealed?
- High prevalence of emotional and psychological suffering among people not institutionalized
- Appetite for relief using psychopharmaceuticals
- Meeting above appetite can be profitable for manufacturers and professionals involved
- Curative claims are less important than the perception of few side effects (despite high rates of overdose from barbiturates)
- Adverse public health effects of unrestricted psychopharmaceutical use can be considerable (e.g., high barbiturate overdose rates)
What is the most recent pharma-driven epidemic? and what was it prescribed for
- oxycodone
- increasingly prescribed for pain, partially due to aggressive marketing and under-appreciation of risks related to the drug
What are the 2 major reasons why psychoactive drugs began to be described and understood as psychiatric medications following WWII
- psychiatry as a profession began to expand beyond asylums and into the consumer realm (also treating milder conditions)
- this happened gradually as 2/3 psychiatrists still worked in hospitals - a number of new psychoactive medications became available
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