32. Picking and Mixing with the Mules.

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It’s not cool and it’s not clever.

Aren’t we funny about taking tablets? Some people just refuse to admit they are biological machines run by small computers made of gloop. We are quite happy to have additives in petrol, but not in food, unless you call butter, sugar and salt additives, which you would if they were called by their chemical names.

Nevertheless, when Pain is the issue, most people are fairly quick to give up grinning and bearing it. Suddenly alien molecules are allowed into the body. And in the case of opiates, not just allowed in, but given the full red carpet treatment.

I’ve been speculating a lot about pain this week, thanks to my foolish attempt to test the limits of the sacral disc mechanism. (Is that quite a good name for a progressive rock band?) God was clearly having an off day when he drew this part on the celestial white- board. Perhaps he was going through an ‘organic’ phase, knowing deep down he should be using neoprene and titanium for load bearing surfaces, and proper grommets instead of cartilage.

We can’t change our spinal parts, but we can get painkillers from Wilko.

It’s interesting what pharmaceutical products you can find in a hardware store. All the inconsistencies of the so called war on drugs present themselves along aisles 5 and 6.You can buy two packets of aspirin or paracetamol, but no more, in case you take an overdose. The rule does not seem to apply to Ibuprofen though, and certainly not to other tablets which are not painkillers.Just across the shop you can buy any amount of Evo – Stik, Meths or nail varnish remover, not to mention turpentine. Possessing and inhaling solvents is not illegal and never has been.

Similarly not illegal, some of our patients take what are called ‘legal highs’. The current favourite seems to be ‘Clockwork Orange’ which I am told costs £10.95 a sachet and can be added to tobacco.Most people who tried it seem to have become violently sick, much like the effects of tobacco itself, only exaggerated.I looked at the wording on the packet- poor quality graphic design by the way – which says not to consume it at all, it is a ‘research chemical’. This obviously appeals to a sizable minority of drug users who like to experiment, usually without getting permission from the ethical committee and seldom sticking to robust methodology

.I think I can trust most of our patients not to take it, but what concerned me most was that many of them did not know Clockwork Orange was a book and a film. That’s why we need psychiatrists from my age group, so we can explain the cultural background properly, including how Stanley Kubrick had the film taken off the market for a long period for fear of copy cat violence. Probably the drug will go the same way. Maybe one day it will turn out to be a useful remedy for migraine or piles and stage a comeback

.Meanwhile, for only 36p, thirty times less than Clockwork Orange, you can get 16 Ibuprofen tablets. They are foil wrapped, mint coated and come in a nice carton with tasteful graphic design and a better instruction leaflet than you get with a Sony TV. I’m tempted to photograph the packet lovingly and put it on ebay. Would that make me a drug dealer?

Supposing opiate painkillers like Tramadol or Morphine were on sale in Wilko for a similar modest price – what would happen? Would everyone become an opiate addict within a few weeks? To some extent this is the question that needs to be answered by those who seek to legalise drugs.

One of Thomas Szasz’s better works was: ‘Ceremonial Chemistry: The Ritual Persecution of Drugs, Addicts and Pushers’. One of his arguments was that certain cultures had learned to deal with opiates and used them medicinally and recreationally while still holding down jobs and families.This has probably not happened yet in Rotherham, so we could expect a learning curve if Wilko suddenly turned into a Head Shop. And by learning curve I mean spates of car accidents, marital breakdowns and people getting fired.

What would happen to the NHS if Opiates were freely available? Would we even need the NHS at all if we could get Tramadol from Poundshop, instead of behind Poundshop? Which section would Wilko have to delete to make room for extra tablets? Already it’s quite a nuisance that the gardening section disappears in September to make room for an aisle of Christmas tat.

We could easily lose the pick and mix selection. Light-bulb moment! What about a pick and mix section for drugs? Like we have in the NHS. You read it here first

.All drugs are just molecules, whatever the effects they might have on the human body. Some are poisonous, some are illegal, some are helpful, some are  more or less inert. Some are called over the counter, some are called prescription, some are called controlled. Some are called research chemicals and some are called plant food. Some are just called glue. If the molecule gets a hold over us, it’s a power we have bestowed on it.

There is a kind of market for drugs, artificial to an extent, and distorted by the way compounds are treated by the authorities and tradition, but the likely premier league would consist of the old favourites – opiates like heroin and psycho-stimulants like cocaine.

As far as Depression goes, all these are off limits, being gigantic holes to fall down.Life is a battle against adversity and these substances – unlike Chateauneuf du Pape and Theakston’s Old Peculiar –  are classed as chemical weapons.If Wilko seriously try putting these on sale they can expect a surgical strike from the US air force, or at least a visit from Kofi Annan.

I think he’s more of a Waitrose man to be honest.

 

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