Debating the epidemic of painkiller abuse.

Debating the epidemic of painkiller abuse.

Debating the epidemic of painkiller abuse.

Science, technology, and life.
Sept. 7 2007 11:01 AM

A Nation of Limbaughs

Debating the epidemic of painkiller abuse.

(For discussions of the latest topics, check out the Human Nature Fray.)

A study shows that anxiety about your pregnancy correlates with subsequent risk of premature delivery. The correlation persists when medical factors that might underlie the anxiety (e.g. early bleeding, previous troubled pregnancies) are canceled out. Theory: The anxiety causes the early delivery. Scientists' conclusion: Let's "educate" women to make them more relaxed about their pregnancies. Human Nature's take: One reason all these women are anxious is that scientists "educated" them about risks to their babies from maternal overweight, vitamin deficiencies, exposure to pesticides and vaccines, consumption of coffee and antidepressants, and practically everything else. (Got a pregnancy scare story? Post it in this thread.)

William Saletan William Saletan

Will Saletan writes about politics, science, technology, and other stuff for Slate. He’s the author of Bearing Right.

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Sales of leading painkillers have increased 90 percent in eight years. By 2005, retail outlets were selling 300 milligrams of codeine, morphine, oxycodone, hydrocodone, and meperidine per American, and trips to the emergency room for painkiller abuse were up 160 percent. Reasons: 1) The populating is aging and suffering more pain. 2) Drug companies nearly tripled their ad spending. 3) We used to think pain was part of healing; now we medicate it. 4) "Pill mills" are supplying the drugs indiscriminately for profit. Reaction: Let's crack down on abusers. Rebuttals: 1) We already have. 2) As a result, sales are leveling off. 3) Increased sales should be expected because of aging. 4) Let's not go back to the bad old days of telling people to suck it up. Question: Which is now a bigger problem: painkiller abuse or untreated pain? Join the discussion.

Scientists identified a gene that controls height. Each copy of the "tall" allele adds one-fifth of an inch, so inheriting two copies makes you nearly half an inch taller than if you inherit two copies of the "short" allele. Studies indicate 90 percent of height is genetic, so researchers expect to find many more height-related genes. Approved reaction: Now parents can rest easy knowing their kid's shortness is genetic, not disease-related. Unapproved reaction: Now parents can seek preimplantation genetic modification to boost their kid's height. False rebuttal: The modification wouldn't work. True rebuttal: It'd work—but you'd be boosting your kid's risk of cancer, too. (Related column: the spread of embryo eugenics.) For Human Nature's short take, click  here.

British regulators approved the creation of human embryos with animal DNA. The embryos are made by substituting a human cell nucleus for an animal cell nucleus in an animal egg. Rationale: Scientists need eggs to clone embryos for stem-cell research, and there's a shortage of human eggs in which to do it. Caveats: 1) The percentage of animal DNA is tiny: 13 genes compared to more than 20,000 human genes. 2) The embryos have to be destroyed within 14 days. 3) Their creation has to serve a "necessary" purpose, such as curing a disease. 4) Regulators are reserving judgment on embryos with higher ratios of animal to human DNA. Objection: We're defying nature's distinction between man and beast. Rebuttal: We're doing it to defy nature's destruction of anyone who gets a degenerative disease. (Related column: why humanized animals are the future of medicine.) For Human Nature's retort, visit the Fray.

Viagra may promote feelings of love. In a rat study, it tripled the release of oxytocin, known as the "love hormone." Researchers suspect it does the same to people. Previous studies showed that "oxytocin-sensitive cells in the brain play a role in the neural control of erectile responses." Old idea: Viagra promotes sex mechanically, by boosting blood flow to the penis. New female idea: Viagra can promote love, not just sex. New male idea: Viagra can promote love, thereby getting me more sex. (Do you have personal experience of Viagra or a similar drug triggering the sensation of love before sex? Discuss it in the Fray.)

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Gynecologists denounced cosmetic vagina surgery. A "committee opinion" by the American College of Obstetricians and Gynecologists says: 1) " 'vaginal rejuvenation,' 'designer vaginoplasty,' 'revirgination,' and 'G-spot amplification' procedures are not medically indicated, nor is there documentation of their safety and effectiveness." 2) Your genitals are probably normal, so you don't need to "fix" them. 3) If you worry about your sexual adequacy, try counseling before surgery. 4) Cosmetic procedures "can cause complications such as infection, altered sensation, pain and scarring." Rebuttal by doctors who do the surgery: It's safe enough, and women ask us for it. Rebuttal by ACOG: They ask for it because you sleazeballs promote it on TV and make women feel inadequate for being less than porn stars. Human Nature's question: If genital surgery is a crime when you don't want it (as in female "circumcision") but a right when you want it (as in changing your sex), is it OK when you want it because a TV show made you think you need it? Post your answer here.

Scientists published the first virtually complete genome of an individual. Subject: Craig Venter. Lead author: Craig Venter. Funder: the Craig Venter Institute. Details: Some of Venter's genes "increase his risk of … antisocial behavior and conduct disorder." Unlike the previously published "human genome," this one is more complete and is a real person, not a composite. Cost: Tens of millions of dollars—but that's a huge drop from the billions that went into the composite genome project, and today's cost would be $100,000, heading toward $1,000. Main finding: People differ genetically more than we had thought. Reactions: 1) Can you believe Venter's egomania—all that money to decode his own genome? 2) "Can I get my genome done, too?" 3) Don't touch my genome—if my employer finds out my health risks, I'm screwed. (Question: We can all advance medicine by putting our genomes and medical records on the Web so computers can search them for correlations. Would you do it? Post your answer here.)

Diagnoses of bipolar disorder in kids and teens increased 40-fold in eight years. The latest data were for 2003; experts think the trend has continued upward. More than 90 percent of these kids "received a psychotropicmedication"; half got antipsychotics. Theories: 1) Thank God we discovered the juvenile bipolar epidemic. 2) The juvenile bipolar epidemic is a fraud perpetrated by drug companies to make money by stoning our kids. 3) They're preying on parents who will latch onto any diagnosis that relieves them of responsibility. 4) It's an insurance ruse. 5) Most "bipolar" kids don't get the same symptoms as adults. 6) Juvenile bipolar wasn't invented until the 1990s. 7) Ah, for the good old days, when we called these kids brats, bullies, and truants. 8) The bipolar epidemic may be bogus, but the old days were worse. (To chime in, spend your manic phase here.)

Dermatologists are offering faster access to Botox than to medical services. Evidence: Phone surveys of dermatologists in 12 cities to determine median waiting times for 1) Botox or 2) "urgent consultation" about a changing (possibly cancerous) mole. Results: 8 days for Botox, 26 for moles. Fine print: The mole survey preceded the Botox survey. Theories: 1) Demand for mole exams is outstripping dermatologist supply due to rising public fear of melanoma and other skin diseases. 2) Dermatologists are less eager to do mole exams because insurance payments are low and slow. 3) They're eager to do Botox because it's more expensive and is paid by the patient up front. Socialist solution: Force them to spend less time on Botox and more on mole exams. Libertarian solution: Stop insuring mole exams. Human Nature's theory: Longer waits are the price of cheaper services, and probably worth the trade. But if you're more outraged, speak up here.

Scientists are drug-testing whole cities through their sewage systems. Concept: "community urinalysis." Sample required: 1 teaspoon of wastewater. Drugs targeted: cocaine, meth, pot, oxycodone, and 11 others. Ten cities have been tested so far; more are in the works. In addition, "The U.S. Office of National Drug Control Policy has obtained samples from a dozen different waterways." Official purpose: Tracking drug use collectively so we don't have to target people individually. Unofficial purpose: Tracking drug use collectively so we can choose where to target people individually. Human Nature's view: Data-guided privacy invasions may be bad, but broader, unguided privacy invasions are worse. To disagree, add your teaspoon of wisdom here.

Surgery to repair female genital mutilation is spreading. It involves clitoral reconstruction and/or reopening the vagina. It started in France; roughly 100 women have now had it in Burkina Faso. Rosy spin: It's a feminist breakthrough. Complaints: 1) It doesn't restore wholeness or normal sensation. 2) It's no substitute for eradicating FGM. 3) It's dangerous for now, because few doctors have learned to do it right. 4) If the family that forced the woman into FGM finds out she's been repaired, they'll put her through it again. 5) If they think FGM is reversible, they'll be less hesitant to do it in the first place. (Related column: male vs. female circumcision.) To comment, enter the Fray.

Brazil will pay for sex-change surgery under its national health system. Fine print: Before the surgery, you have to get a psychological evaluation and approval from a committee of doctors. The policy was prompted by a court ruling that the surgery is a constitutional right. Government's objection: We don't have enough money to pay for all these operations. Court's conclusion: If we don't subsidize and supervise the surgery, people will do it themselves, and they'll butcher it. (Related columns: Transsexuality, transhumanism, and self-mutilation.) Question: Is genital mutilation a crime if you don't want it but a right if you do? Post your answer here.

Latest Human Nature columns:  1) Larry Craig's anti-gay hypocrisy. 2) The jihad against tobacco. 3)  Fat lies and fat lies revisited. 4)  Liberals and bioethics. 5) The case for turning food into fuel. 6) Recombining  man and beast. 7) The spread of virgin births. 8) Abolishing menstruation.