Side Effect

Environmental researchers have recently documented that American rivers and lakes are filled with highly medicated fish – doped on a wide spectrum of antidepressants.  It turns out that Americans are treated for anxiety, depression, and fear at such high rates these days that a huge amount of un-metabolized pharmaceutical-grade chemicals simply flush through their bodies every day, out into sewers, and then the larger environment.  Living in waterways contaminated by the pharmaceutical waste run-off of cities, aquatic creatures are being unintentionally dosed every day by the most highly medicated species in planetary history: Americans.  The use of psycho-pharmaceuticals is up something like 400% in the last twenty years in the United States, with a significant part of the population (over one-in-ten adults) on regular doses of anti-psychotics or anti-depressants [i].  What does this mean for fish?  Laboratory studies have shown that small amounts of Prozac cause striped bass to stop eating and float vertically in their tanks, completely dissociated from their environment [ii].  Swedish researchers have shown that the anti-anxiety medication Oxazepam makes perch less social, more aggressive, and ravenous, even in minute quantities [iii].  American mental health care has literally jumped the species barrier, with potentially profound effects on nervous systems, terrestrial, aquatic, and otherwise.

Now, imagine, just for a second, that you are a fish, tripping.  I don’t mean fantasize that you inhabit a fish-like consciousness, blissfully swimming in fresh water, with gills and fins, cruising with whip-like speed in any dimension at will.  No, imagine that you are a water creature surreptitiously drugged by your aquatic environment – experiencing a new kind of hydro-terrorism.  In any of the major waterways surrounding U.S. cities today, there are fish forced to endure a potentially wide-ranging and unknown cocktail of anti-psychotic and anti-depressive medications. These drugs are engineered to engage the human nervous system, to change affect, thought patterns, and feelings.  They are among the most powerful chemicals known, altering mood, sensation, thinking, perception, and behavior in people.  Doped on psycho-pharmaceuticals, the fish in U.S. waterways are increasingly a node in a broader circuit linking Big Pharma, the U.S. health care system, citizens, urban environments, and watersheds in a new biospheric chemical configuration.  Given that no one intended to create this molecular circuit – this “regime of chemical living,” as Michelle Murphy would put it – such chemically-altered fish become marked as an industrial side effect [iv].

Among humans, one of the most heinous criminal acts is to drug someone without their knowledge or consent. To slip someone a “roofie” is to take advantage of the colorless, odorless, tasteless quality of a drug to immobilize someone against his or her will – a form of assault structured by deception, ruthlessness, and biochemistry.  Yet today, the wholesale medicating of an ecological space is not recognized as a collective matter of concern, let alone a felony.  Slipping the biosphere a roofie is not yet a police matter, even as the cumulative effects of a wide range of social practices are shifting the chemical composition of  the atmosphere, ocean, and climate, and affecting species on a massive scale.  Why?  I’d like to suggest this lack of recognition and urgency has a lot to do with the conceptual nature of the “side effect.”  It is an effect of the side effect, to put it bluntly, to depoliticize inevitable forms of violence by marking them as either unwanted or unforeseen.

A “side effect” is usually defined as the unintended effect of a drug.  The anti-anxiety drug Oxazepam, for example, which gives perch such an aggressive buzz, lists the following side effects in humans:  dizziness, muscle weakness, drowsiness, nausea, hallucinations, mental confusion, slowed heart rate, fainting spells; with extended use, it may be associated with extreme sleepiness, amnesia, confusion, and addiction; and in case of overdose, coma or sudden death.  It might also be a carcinogen.  What benefit could outweigh these awful possible physiological effects? The loss of a generalized anxiety.  The alchemy of the “side effect” concept is to split the effects of a molecule into the desired (treatment) and undesired (side effect).  Thus, the language of the side effect installs a value system as well as a hierarchy within a molecule’s range of biological consequences.

In Drugs for Life, Joe Dumit documents that the average American is now ingesting 9-13 prescribed drugs a year [v].  Many of these medications are to treat the “side effects” of other prescribed drugs, a recursive drug logic that Big Pharma has exploited as a market expansion tool.  As Dumit also reports, the industry goal is to get Americans up to 20 prescribed drugs a year by transforming health into a form of risk management.  The 21st century American body is thus a highly chemically optimized system, but one in which reaching for another pill resolves the difference between the positive acting chemicals and their negative side effects [vi].  Some time ago, Emily Martin contemplated the arrival of a “pharmaceutical person” – the individual who consciously manages their minute-to-minute biological and psychic state through pill taking, trading on experiential knowledge of “side effects” to create an ever more powerful and personalized cocktail of drugs [vii].  At the center of such reasoning is an idea that things marked as “side effects” are lesser phenomena, effects that should be managed via a different chemical brew or eliminated altogether via better bioscience.  But what makes one outcome the benefit of the drug, and another its negative side effect? How is it that this powerful line is drawn, and what forms of value are revealed in its calculus?  Our major collective problems today – finance, war, industry, and health – are all bound up in the explanatory and mystifying logic of the side effect.  We rely on the language of the side effect to maintain support for unregulated markets, permanent war, petrochemicals, and drug economies even as our age is buffeted by boom and bust cycles, blowbacks, climate change, and increasing toxicity.

Or to ask the question differently, perhaps we should examine why so many Americans need mood-altering drugs today – why anxiety and depression are so rampant that the effects have literally spilled out into the rivers and streams to become a problem for other species. Perhaps the issue is not the lack of good drugs but rather the structural violence of neoliberal economics, petrochemicals, or the political commitment to permanent war.  Perhaps overmedication should be read as the consequence of a social order producing multifaceted forms of stress and precarity, rather than merely an accumulation of side effects.  To stay in the language of the side effect today is to mimic the pharmacologically loaded fish, and simply float in one’s tank, zoned out, unable to attend to how the planetary environmental envelope on which we depend is being structurally changed by human activities.  The direct, if unintentional, consequences of the industrial age – the current fight to the death for oil, the rapacious social effects of neoliberal capitalism and a war on terror, not to mention a radically shifting climate – are no longer dismissible as simply the side effects of modernity.

After writing this, I think we need a crimes-against-species act to protect the fish and other creatures from the roofies we keep slipping them. But perhaps the first move is simply to recognize that our increasing drug use is a symptom, not a side effect.


Joseph Masco teaches anthropology and science studies at The University of Chicago. He is the author of The Nuclear Borderlands: The Manhattan Project in Post-Cold War New Mexico and the forthcoming The Theater of Operations: National Security Affect From the Cold War to the War on TerrorHe is currently researching a book on environmental crisis.

[i] Laura Pratt, Debra Brody, and Qiuping Gu. 2011. Antidepressant Use in Persons Aged 12 and Over: United States 2005-2008.  National Center for Health Statistics, Data Brief No. 76. Washington, D.C.: Centers for Disease Control and Prevention.

[ii] Janet Raloff. 2008. Antidepressants Make for Sad Fish. Science News, December 20, 2008, p.15.

[iii] Emily Underwood. 2013. Drugged Fish Lose Their Inhibitions, Get the Munchies. Science Now, February 14.

[iv] Michelle Murphy. 2008. Chemical Regimes of Living. Environmental History 13(4): 695-703.

[v] Joseph Dumit. 2012. Drugs for Life.  Durham: Duke University Press.

[vi] Jonathan Metzl. 2003. Prozac on the Couch: Prescribing Gender in the Era of Wonder Drugs. Durham: Duke University Press.

[vii] Emily Martin. 2006. The Pharmaceutical Person. BioSocieties 1: 273-87.

Image: “Plastic flowers growing well.” material boy, flickr.

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