Editors’ Note: We’re delighted to bring Points readers another installment (number sixteen) in the “Points Interview” series. Today, we’re getting happy with David Herzberg, author of Happy Pills in America: From Miltown to Prozac (The Johns Hopkins University Press, 2009). David Herzberg has been a Contributing Editor here at Points, and is also an Associate Professor in the Department of History at SUNY-Buffalo (where he also hosted the recent conference of the Alcohol and Drugs History Society).
Describe your book in terms your mother (or the average mother-in-the-street) could understand.
Happy Pills is a cultural history of Miltown, Valium, and Prozac—three of the best known, most widely used, and controversial medicines in the postwar era. It tells their medical and commercial stories, but also asks why they became so faddish and contentious, and how their fame (and infamy) influenced medical and popular ideas about consciousness and identity.
The book begins in the 1950s, when Miltown became the first “blockbuster” tranquilizer and an early icon of biological psychiatry. The drug’s celebrity was the product of several developments: intensified popular marketing of prescription drugs; increased medical and public attention to anxiety as an illness, led in part by Freudian psychiatry; and a burgeoning consumer culture primed to deliver technological wonders in the name of comfort and convenience for the middle classes.
But Miltown’s popularity didn’t sit well with everyone; in fact the prospect of eradicating anxiety made some people quite nervous. The tranquilizer and its successors quickly became embroiled in postwar gender battles and the explosive politics of the “war against drugs,” and Happy Pills traces these stories to their combined conclusion in a feminist campaign against Valium addiction in the 1970s. This was a most unusual anti-drug campaign, targeting sexism in drug companies and the medical system rather than stoking fear of addicts. It capped off a decade of challenges to the pharmaceutical industry, and was part of a broader effort by reformers to rethink the boundaries between “drugs” and “medicines.”
Happy Pills ends with a look at the emergence of Prozac and other antidepressants in the late 1980s and 1990s, and the accompanying revival of popular belief in wonder drugs. Why was this resurgence so successful when the drugs themselves turned out to be far from revolutionary? Prozac’s boosters, I argue, took new findings in brain science and used them to create a story that was as much political as it was scientific: miraculous new consumer goods now made it possible to pick and choose personalities—identities—in a utopian free market of accessorizable selfhood. However exaggerated such promises may have been, they proved a powerful cultural vehicle for pushback against feminist-era drug critics, and a fitting vision of identity and personal change for an increasingly conservative era.
What do you think a bunch of drug and alcohol historians might find particularly interesting about your book?
One way to look at Happy Pills is that it does the opposite of “drug war” literature: it explores the economic, political, and cultural dynamics that encouraged mass drug use during the era of narcotics control, and tries to understand the impact and significance of pro-drug cultures in postwar America. It is possible to look at this story as pharmaceutical history, i.e., concerned with the FDA, doctors, drug companies, and health activists. But it can and should also be seen as part of drug history. Sometimes the two histories intersect directly, as in the 1970 law that established the Schedule of Controlled Substances, or when panics flared up over prescription drug addiction. The histories are also connected when they seem farthest apart: when tranquilizers’ rise in the 1950s was aided by cultural distinctions between “drugs” and “medicines,” for example, or when antidepressants’ successfully replaced tranquilizers in the 1990s in part because they were seen as non-addictive.
Counterculture youth in the 60s and 70s loved to criticize their parents for using an endless stream of mind-altering substances while waging a war against drugs. Without sharing their contempt for pill-takers, I do think they were onto something: if you want to understand the history of drugs in America, you can’t ignore pharmaceuticals. At multiple levels—policy, culture, commerce, and lived experiences—the history of drugs and alcohol is richer, more complete, and, I would argue, makes more sense when they are included.
Now that the hard part is over, what is the thing YOU find most interesting about your book?
I hate to admit it, but one part that’s really stuck with me is the drug marketing. It’s an embarrassing confession both because it’s sort of a cliché and because advertisements are very limited as a historical source—they tell us what one influential set of actors were saying, but not much more. They say nothing about how and why drugs were actually used, or even how drug advertisements themselves were used.
One of my favorite stories in the book is the way one strand of “second wave” feminists, starting with Betty Friedan, re-deployed drug ads—sometimes even reproducing them in their entirety—to show the sexism of the medical system, and also to “steal” the idea that housewives were anxious and unhappy in their constrained roles. Drug companies, in other words, were not puppet-masters controlling an innocent and credulous public; once advertisers placed medicines in the public eye, they could be put to all sorts of unexpected uses, personal and political. That said, drug marketers were wonderfully inventive, and their campaigns to doctors and the general public were fascinating even when they were terrible and/or embarrassing flops—maybe even especially then.
Every research project leaves some stones unturned. What stone from Happy Pills in America are you most curious to see turned over soon?
I guess the most appealing unturned stone was the one that motivated my next book project: the history of prescription drug abuse. At first I thought I was seeing something remarkable and new in the Valium addiction scare. Then I saw that prescription drug scares—and abuse of prescribed medicines—had been rampant earlier in the 1960s, then also in the 1950s, and then back to the 1930s and even earlier. And it wasn’t just tranquilizers and stimulants (amphetamines): there were also prescription narcotics like Demerol and all the hydrocodone, oxycodone, etc. drugs. These had a commercial history, a cultural history, a legal history, and a social history, all relevant to the history of drug use and addiction. Valium, in other words, turned out to be just one tiny chapter in a much longer story that raises all sorts of fascinating questions about drugs, medicines, and drug policy.
Also, on a different note, I do hope someone will pursue a transnational history of prescription meds for the mind. It’s clearly not just an American story, and there are loads of unexplored questions on this front.
BONUS QUESTION: In a Ken Burns film version of this book, who should provide the narration?
Probably someone who does voice-overs for prescription drug ads—maybe the speeded-up sotto voce they use for side effects?
Joe Spillane is Professor of History at the University of Florida. He has authored Cocaine: From Medical Marvel to Modern Menace in the United States (Johns Hopkins Press, 2000) and co-edited Federal Drug Control: The Evolution of Policy and Practice (Haworth Press, 2004). More recently, he authored Coxsackie: The Life and Death of Prison Reform (Johns Hopkins Press, 2014). His current drug-related research agenda includes: the history and development of drug abuse liability assessment; reflections on the nature of drug epidemics; and examinations of drug war “harms” in historical context.
2 thoughts on “The Points Interview: David Herzberg”
Interesting book. After reading just the section on Miltown, I’m learning how much I did not know. Apparently meprobamate, as Miltown and Equigesic, did not just gradually drop in popularity vs. the newer benzodiazepines. It was actively demonized. How to explain the fact that essentially the same compound, in the form of carisoprodol (United States brand name, Soma) which is partially metabolized to meprobamate, is to this day widely prescribed and abused? There is no evidence that being a pro-drug makes carisoprodol any safer than meprobamate itself, to my knowledge. Soma was positioned as a skeletal muscle relaxant although with the admission, in small print, that the muscle relaxation was a result of its effect on the central nervous system. Slippery language? Efforts are now being made to schedule carisoprodol as a class IV narcotic, but no one has worried much about it in the 40 years since Miltown was displaced by Valium.
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