Chemical Reductionism Prospers as the Morgues Fill Up

The United States is in the midst of a frightening opioid crisis. A story in the New York Times this year states that last year more than 59,000 died from drug overdoses. The story has a graph showing drug overdoses skyrocketing, growing from only 20,000 a year around the year 2000 to more than 59,000 last year.

A CDC site says, "We now know that overdoses from prescription opioids are a driving factor in the 15-year increase in opioid overdose deaths."  Why are so many opioids being prescribed?

Let's consider a viewpoint that is popular among many in the mainstream, a viewpoint that we may call chemical reductionism. The idea is that a person is little more than a bag of chemicals. Chemical reductionism is popular among many doctors and psychiatrists. Psychiatrists sometimes push the idea that mental problems are caused by chemical imbalances. The evidence for this claim is weak.

 Thankfully only a minority of doctors think like this

Let's imagine a doctor has been trained to think along the lines of chemical reductionism. What is he going to do when a patient comes in complaining of some pain? His first inclination will be: prescribe some powerful chemicals to treat the pain.

But there are quite a few alternate techniques for treating pain, techniques that do not involve the risks of prescribing opioids. They include the following:

• Surgery. Some types of pain (such as dental pain) can be reduced by permanently dulling nerves.
• Meditation.
• Hypnosis.
• Acupuncture. The World Health Organization says acupuncture can be effective in reducing pain.
• Marijuana. Many states now allow medical marijuana for pain relief. People using it sometimes say they still have the pain, but it doesn't bother them when they use marijuana.
• Chiropractic care. Chiropractic care can be effective in reducing lower back pain.
• Massage. Massage can be effective in reducing muscle pain.
• Exercise.
• Biofeedback.
• Guided imagery.
• Music therapy.
• Yoga.

With so many non-opioid pain techniques, why have so many doctors tended to prescribe addictive opioids as soon as a patient complains of pain?  One reason is that such an approach is convenient from a profit standpoint. A doctor can write a prescription in just a minute, a much shorter time than the many minutes that might be needed to explain some non-drug program of pain treatment.  The more patients handled in a day, the greater the profit for a clinic.  Another reason is that pharmaceutical companies are constantly influencing doctors, to help keep them thinking that pills are the solution to almost any medical problem not requiring surgery  -- largely because the more medicine is chemistry-centered, the higher the profits of pharmaceutical companies.

The enormous influence that pharmaceutical companies have on doctors is documented in the book “White Coat Black Hat” by Carl Elliott. We learn about the enormous number of pharmaceutical sales reps who often arrive at doctor's offices offering free samples or minor gifts like a box of donuts or perhaps a pizza for the staff. Then there are the pharmaceutical companies that pay for doctors to attend conferences or meetings that may have free food and luxury lodging, which often amount to a kind of bribe to the doctor in the form of a paid travel junket.

Then there are the pharmaceutical companies that pay for “ghost-written” research articles. A doctor may put his name on a scientific paper that was conceived and largely written by some “medical ghost-writer” funded by a pharmaceutical company. The benefit for the doctor is that it is an easy way of increasing his number of published papers (the more published papers, the more prestige for the doctor). A 2009 New York Times article guessed that 11% of New England Journal of Medicine articles used medical ghost-writing. The worst abuse occurred when medical ghost-writing was used to help gin up research studies for the pain-killing drug Vioxx. An NPR article says, “Research published in the medical journal Lancet estimates that 88,000 Americans had heart attacks from taking Vioxx, and 38,000 of them died.”

All these bribes and conditioning from the pharmaceutical companies help reinforce in many a doctor's mind the idea that pills are the only non-surgical way to treat pain. The result has been a great excess of prescriptions for opioid medications, which in turn has led to massive cases of addiction, and tens of thousands of overdose deaths per year. 

Given this situation, it would seem sensible for the government to fund additional research into alternative methods of relieving pain, and for doctors to give greater consideration to such non-chemical alternatives when first hearing a patient's complaint of pain. You will hear some people argue the opposite. They will tell us: just because so many thousands are dying of opioid overdoses, that's no reason for us to pay more attention to alternative medicine or integrative medicine. The question we must always ask such people is: are you receiving any money or benefits from the pharmaceutical industry?

Future Technology for Analyzing Near-Death Experiences

There was an interesting story in the news recently about a man who claims to have had a near-death experience after his heart stopped for 45 minutes. Such cases have been reported since at least the 1970's, and more than a thousand cases are described at this site. But during the past 40 years the debate on this particular topic has not changed very much. Many people continue to say that the phenomenon of near-death experiences is an indication of some afterlife. But many skeptics continue to say that such experiences are just hallucinations caused by drugs, some surge of brain electricity, or some surge of chemicals in a dying brain.

Those who argue for a paranormal interpretation of near-death experiences argue that the experiences tend to have common characteristics, not the random characteristics one might expect to see in hallucinations. Some of these common characteristics are said to be a sense of floating above the body, travel through a tunnel, a life review, an encounter with dead relatives, and an encounter with a being of light. But skeptics argue that such narrative elements have been widely publicized, so perhaps some kind of wish-fulfillment mechanism of the brain sometimes kicks in near death, using elements stored in the memory.

This argument has been going back and forth for decades, but perhaps within a few decades new technology will throw new light on the phenomenon of near-death experiences. I can imagine such a technology.

Consider the operation of a commercial web site. A typical large web site has a thing called an audit trail. An audit trail is a set of logs that record exactly what was happening with the web site during any time period. There are typically two main parts of such an audit trail: a web server log that records each and every time some external user accessed a page of the web site, and a database log listing each and every database operation that occurred during a particular time period.

With this audit trail, it is then possible to analyze exactly what happened if the web site ever crashes. The support team can then track down the cause of the crash, and try to fix it.

Now we can imagine, with sufficiently advanced technology, a kind of audit trail for the human body. This would be a series of chronological records showing over a time period many different states of the human body. This audit trail would be a record of heart rate and brain waves, but it would also have more much more detailed information. It would show the ebb and flow of particular chemicals in the brain. It would show which parts of the brain were becoming active during particular moments of time. This more detailed information would require some technological breakthroughs, perhaps some technology for sniffing remote traces of chemicals (a Star Trek fan might call this “tricorder” technology).

Modern jetliners all have a “black box” (also called a flight recorder) that records all states of the different parts of the plane. (The boxes are actually orange-colored, to make them easier to find.) To find out what happened when a plane crashes, it is merely necessary to retrieve this black box. We can imagine a similar type of device for the human body – a little black box that precisely records all changes in vital signals, brain electricity, body chemistry, and so forth.

An aircraft "black box"

Such a “body black box” would be mainly useful for analyzing the effectiveness and safety of different medical techniques. Today doctors may give a drug to a dying patient, who then may die some time later. The doctors are left to guess whether it was wise to give the patient that particular drug – maybe the drug gave the patient some extra time, or maybe it quickened his death. But with this “body black box” it would be much easier to find out if the drug did any good. Once the patient died, a doctor could remove the “body black box,” and plug it into a machine that would analyze the audit trail stored in the box. The doctor might then get a report giving a probability estimate on whether the drug was helpful or hurtful. The report might say: “Based on this patient's audit trail, there is a 40% chance that the calcium disulphate injection hastened his death.”

This type of “body black box” would also be useful in helping to resolve the question of whether near-death experiences are mere hallucinations. If a patient claimed to have had a near-death experience, his “body black box” could be analyzed. Looking at the chemical, biological, and electrical audit trail, scientists might look for some unusual trace that might give clues as to a natural explanation for near-death experiences – perhaps a surge of electricity in a particular brain area, or a surge of some particular chemical. If no such clue was ever found, it might lend credence to the theory of a paranormal explanation for near-death experiences.

The ultimate tool for analyzing near-death experiences might be a consciousness recorder. This would be a device that would somehow kind of videotape every single thought, sensation, and emotion that was passing through the brain. If such a consciousness recorder were turned on for a person near death, it might somehow be able to record exactly what the person experienced in a near-death experience. But such a recording would not necessarily silence skeptics. They might review the tape from the consciousness recorder, compare some parts of it to old photographs, and then make skeptical comments such as: “Aha! That wasn't really your dead grandma you saw in that vision – your grandma's nose was shorter than that woman's nose.”