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With its foreboding talk of an impending epidemic that will overwhelm
services and its eye grabbing before and after photos of a woman following
two and a half years of taking crystal meth, Coombes article (Coombes,
2007) reminded us of an article published 80 years earlier (Ruddock,
1927), warning of yet another contemporary psychiatric epidemic. As in the
BMJ article, a first photo shows a relaxed and dignified man before the
“habits of the secret vice began to show”, while the second photo shows
the same man, now haggard and furtive, “three years later, when he had
become an inveterate victim of the vice”. What was this vice that
threatened to overwhelm the asylums of the day? “Self-pollution, the
unnatural and degrading vice of producing venereal excitement by the
hand.”
A recent nationwide electronic survey of psychiatrists by the
National Director for Mental Health found no significant evidence of an
increased prevalence of psychiatric disorder related to methylamphetamine
(personal communication, Louis Appleby). Whilst the prevalence of the
methylamphetamine use may be increasing (but probably remains less than
the prevalence of masturbation), the argument for vigilance to its adverse
effects does seem reasonable. However, there is a common theme running
through both of these stories. Despite knowledge that mental health
problems are almost always caused by a complex interplay of biological,
psychological and social factors, a simple culprit, and a simple solution,
will always be attractive to the public, the media and to policy makers
(Goldacre, 2007). Driving home this message of bogus simplicity with
before and after photos provides compelling visual evidence that
implicitly supports the simple culprit. Public health measures, such as
banning nasal decongestants, legitimise the concept of a simple solution
and give the false impression that something useful is being done. Such
measures misdirect attention and free all of us from the moral and
rational obligation to address more ubiquitous social problems that
adversely effect the mental health of our communities. They encourage us
to withdraw from uncertainty and seek a safe haven in false truth, as in
the words of Bertrand Russell, “what men really want is not knowledge but
certainty.”
Coombes, R. (2007) Cold Turkey BMJ 334 1190-1192
Goldacre, B. (2007) Given the choice, I’d rather have the miracle
pill story The Observer, May 6, 2007.
Ruddock, E. (1927) Vitalogy: An Encyclopaedia of Health and Home
(1927) Vitalogy Press, Chicago
Russell, B. (1979) History of Western Philosophy Allen & Unwin,
London
Crystal meth: before and afterphotos as a time honoured way of oversimplifying complex problems
With its foreboding talk of an impending epidemic that will overwhelm
services and its eye grabbing before and after photos of a woman following
two and a half years of taking crystal meth, Coombes article (Coombes,
2007) reminded us of an article published 80 years earlier (Ruddock,
1927), warning of yet another contemporary psychiatric epidemic. As in the
BMJ article, a first photo shows a relaxed and dignified man before the
“habits of the secret vice began to show”, while the second photo shows
the same man, now haggard and furtive, “three years later, when he had
become an inveterate victim of the vice”. What was this vice that
threatened to overwhelm the asylums of the day? “Self-pollution, the
unnatural and degrading vice of producing venereal excitement by the
hand.”
A recent nationwide electronic survey of psychiatrists by the
National Director for Mental Health found no significant evidence of an
increased prevalence of psychiatric disorder related to methylamphetamine
(personal communication, Louis Appleby). Whilst the prevalence of the
methylamphetamine use may be increasing (but probably remains less than
the prevalence of masturbation), the argument for vigilance to its adverse
effects does seem reasonable. However, there is a common theme running
through both of these stories. Despite knowledge that mental health
problems are almost always caused by a complex interplay of biological,
psychological and social factors, a simple culprit, and a simple solution,
will always be attractive to the public, the media and to policy makers
(Goldacre, 2007). Driving home this message of bogus simplicity with
before and after photos provides compelling visual evidence that
implicitly supports the simple culprit. Public health measures, such as
banning nasal decongestants, legitimise the concept of a simple solution
and give the false impression that something useful is being done. Such
measures misdirect attention and free all of us from the moral and
rational obligation to address more ubiquitous social problems that
adversely effect the mental health of our communities. They encourage us
to withdraw from uncertainty and seek a safe haven in false truth, as in
the words of Bertrand Russell, “what men really want is not knowledge but
certainty.”
Coombes, R. (2007) Cold Turkey BMJ 334 1190-1192
Goldacre, B. (2007) Given the choice, I’d rather have the miracle
pill story The Observer, May 6, 2007.
Ruddock, E. (1927) Vitalogy: An Encyclopaedia of Health and Home
(1927) Vitalogy Press, Chicago
Russell, B. (1979) History of Western Philosophy Allen & Unwin,
London
Competing interests:
None declared
Competing interests: No competing interests