health/medicine: drugs

Originally posted in 2012; re-posted because tomorrow is the 145th Belmont Stakes, the 3rd and final leg of the Triple Crown in thoroughbred horse racing. This is the dark side of the sport.

In humans you never see someone snap their leg off running in the Olympics. But you see it in horse racing.

These words, spoken by the equine medical director for the California Racing Board, summarize the truly terrifying absurdity that is horse racing today.  A team of investigative reporters at the New York Times has found that over 1,200 horses die at race tracks every year in the U.S.  Many of them die immediately after a race, euthanized after their bodies literally crumble underneath them.  Their legs break, unable to withstand the forces that the horses exert upon their bodies.  People in the industry call it, euphemistically, a “break down.” It occurs 1 out of every 200 times a horse starts a race.

All of these horses are being ridden by a jockey who is pitched off when the horse falls.  Moving at upwards of 50 miles an hour, and in the midst of many other horses running at top speed, jockeys are often seriously injured and sometimes killed. Currently there are over 50 permanently disabled jockeys receiving financial assistance from their professional trade association. Jacky Johnson, for example, was paralyzed from the neck down after his horse, Phire Power, broke its leg during a race. He will need a respirator for the rest of his life; Phire Power was euthanized on the track.

Why is this happening? Because we are making it so.

First, race horses are bred in order to run as fast as possible.  Short legs and thick bones slow a horse down, while longer, more delicate legs give them longer strides.  Breeders, then, have an incentive to build horses who are both faster and more fragile.

Second, owners may be putting these horses on the track too young.  Horses typically start getting raced at 2 to 3 years old, very young for an animal with a lifespan of 30 years.  Some argue that the bodies of young horses are not ready to handle the physical demands of racing.  For instance, the 2-year-old horse Teller All Gone broke its leg during a race; it had to be euthanized.

The owners dumped his body at a junkyard.

Third, there is the drug problem.  Many trainers illegally give their horses performance-enhancing drugs.  Many of them are experimental and are not yet or cannot be tested for.  These include “chemicals that bulk up pigs and cattle before slaughter, cobra venom, Viagra, blood doping agents, stimulants and cancer drugs.”

Built for speed and not safety, on the track too young, and amped up on steroids and other performance-enhancers, these horses are pushed to their limits.  Just this week Doug O’Neill, the trainer of I’ll Have Another, the horse set to win this year’s Triple Crown, was fined after his horse tested positive for performance enhancing drugs.

Even more problematic than the doping is the legal practice of giving horses pain-relieving drugs, including cocaine.  These mask the pain signals that would otherwise tell a horse to slow down or be careful on the track and also increase that chances that the track veterinarian will miss an injury when clearing the horse to race. The NYT reports that “[a]s many as 90 percent of horses that break down had pre-existing injuries” and they argue pain-masking drugs “pose the greatest risk to horse and rider.” The Louisiana Racing Commission call it “a recipe for disaster.”

The drugs detailed below are what were given to Coronado Heights in the week before he collapsed and was euthanized on the track:

Horse racing is subject to regulation, but these vary by state and are typically very poorly enforced, bringing us to the fourth reason why we see so much tragedy on race tracks. The punishment for violations is insignificant, sometimes only a warning:

Trainers in New Mexico who overmedicate horses with Flunixin get a free pass on their first violation, a $200 fine on the second and a $400 fine on the third, records show… [the state also] wipes away Flunixin violations every 12 months… To varying degrees, the picture is similar nationwide. Trainers often face little punishment for drug violations, and on the rare occasions when they are suspended, they are allowed to turn their stables over to an assistant.

When it comes down to it, many owners and trainers are willing to risk a horse’s life for the chance at the prize money and the less likely a horse is to win, the less they’re worth to the owner, so the harder they’re willing to push it.

The economic incentive to run horses till they die may seem to apply to the highest stakes racing but, in fact, it’s at the lowest end that we see the most disregard for the safety of horses and their jockeys. In the backyards of those casinos where racetracks are now part of the attraction (often referred to as “racinos”), horses and jockeys are a dime a dozen, and the money gives people a reason to break the rules. Meanwhile, the casino tracks are low profile, so they receive even less regulatory attention.

The use of the phrase “break down” to describe a horse who has snapped its own bones in the process of entertaining and enriching human beings is an indication of how nonchalantly industry figures approach this problem.  It suggests that these animals, and perhaps their jockeys as well, have been thoroughly objectified: cars break down, air conditioners break down, we break down boxes.  The language entirely fails to capture what is happening to these horses.  It may very well, however, describe what has happened to the industry and to the basic humanity of its most culpable beneficiaries.

Death at the Track:

Visit the New York Times to watch “The Rise of the Racinos” and “A Jockey’s Story.”

Lisa Wade and Gwen Sharp are professors of sociology. You can follow Gwen on Twitter and Lisa on Twitter and Facebook.  They have also written about the abuse of Tennessee Walking Horses.

A guiding principle driving the sociological understanding and analysis of deviance is the recognition that behaviors themselves are not inherently deviant; rather it is the social perceptions and reactions to a behavior that makes a particular behavior deviant.  This explains why opinions and attitudes towards different forms of supposedly deviant behaviors regularly change.  A notable change in one type of deviance, using marijuana, is revealed in a report compiled by the Pew Research Center.

According to David F. Musto, a century ago marijuana was an obscure drug used almost exclusively by Hispanics in the Southwest.  Its limited association with this ethnic group is largely why marijuana initially became illegal.  With the onset of the Great Depression, both federal and state governments sought ways to expel nonwhites from the country as their cheap labor was no longer necessary.  Making one of this group’s pastimes illegal was a way to stigmatize Hispanics and rally public support for a population transfer.  With a populace stirred into a moral panic by racism, nativism and propaganda movies like Reefer Madness, there was little resistance to the 1937 Marijuana Tax Act which effectively made cannibas illegal.

In the 1960s marijuana experienced a cultural comeback when it became the drug of choice for baby-boomers who saw the drug as a safer alternative to the alcohol and methamphetamine that plagued their parents’ generation.  Marijuana was even legal for a brief period after the Supreme Court found the 1937 marijuana act unconstitutional.  However, because of widespread concern that drugs were corrupting the moral fabric of America’s youth, in 1970 marijuana was one of many drugs outlawed by President Nixon’s Comprehensive Drug Abuse Prevention and Control Act.  Interestingly, marijuana was the only drug targeted by this act that did not include a medical exception.  In the 1980s, President Reagan increased penalties for breaking drug laws, and subsequently the prison population in the United States swelled to a size seemingly unimaginable in a wealthy democracy.

The graph below from PEW’s report captures how federal action came during times of heightened public support to make marijuana illegal.

Yet, the graph also captures how in the early 1990s, support for the legalization of marijuana started to increase.  According to the PEW report, around this time California pioneered using the drug for medicinal purposes; seventeen other states (including D.C.) have since followed California’s lead while six other states decriminalized possession of small amounts.  In 2012, citizens in Colorado and Oregon voted to completely legalize marijuana despite federal law.  This relaxing and even elimination of marijuana laws mirrors favorable opinions of marijuana and growing support for its legalization.

It is difficult to tell if legalization, medical or otherwise, drives public opinion or vice-versa.  Regardless, an especially noteworthy finding of the PEW report is that right now, more than half of the United States’ citizens think marijuana should be legal.  Sociologists always take interest when trend lines cross in public opinion polls because the threshold is especially important in a majority-rule democracy; and the PEW report finds for the first time in the history of the poll, a majority of U.S. citizens support marijuana legalization.

This historical research data on opinions about marijuana reveals how definitions of deviance, and in many cases the ways those definitions are incorporated into the legal system, grow out of shared social perceptions.  Although there have been some notable genetic and cultivation advances, marijuana has changed relatively little in the last forty years; yet our perceptions of this drug (and therefore its definitions of use as deviant) regularly evolve and we can expect opinions, and therefore our laws, to further change in the future.

Jason Eastman is an Assistant Professor of Sociology at Coastal Carolina University who researches how culture and identity influence social inequalities.

The Institute of Medicine and the National Research Council released some damaging numbers this month: Americans ranks startlingly low in life expectancy, compared to 16 other similarly developed countries.  This is especially true for younger Americans. Indeed, among people 55 and under, we rank dead last.  Among those 50-80 years old, our life expectancy is 3rd or 2nd to last.

Sabrina Tavernise at the New York Times reports that the “major contributors” to low life expectancy among younger Americans are high rates of death from guns, car accidents, and drug overdoses.  We also have the highest rate of diabetes and the second-highest death rate from lung and heart disease.

Americans had “the lowest probability over all of surviving to the age of 50.”  The numbers for American men were slightly worse than those for women. Overall, life expectancy for men was 17 out of 17; women came in 16th.  Education and poverty made a difference too, as did the more generous social services provided by the other countries in the study.

What isn’t making a difference?  Apparently our incredible rate of health care spending.

Via Citings and Sightings.

Lisa Wade, PhD is an Associate Professor at Tulane University. She is the author of American Hookup, a book about college sexual culture; a textbook about gender; and a forthcoming introductory text: Terrible Magnificent Sociology. You can follow her on Twitter and Instagram.

Katrin sent in a set of signs and advertisements, collected at Buzzfeed, urging young people to refrain from doing methamphetamine, or “meth.”

What I found interesting was how many home made signs in rural areas were included.  It suggests that many people in small towns feel that their children are under attack.  Meanwhile, there’s no big money in drug addiction prevention.  Hence the town-specific, home made signs that contrast so starkly to the generic, glossy, high-production value advertising we are so used to seeing.

Many examples at Buzzfeed.

Lisa Wade, PhD is an Associate Professor at Tulane University. She is the author of American Hookup, a book about college sexual culture; a textbook about gender; and a forthcoming introductory text: Terrible Magnificent Sociology. You can follow her on Twitter and Instagram.

In Wayward Puritans: A Study in the Sociology of Deviance, Kai Erikson states,

 …the agencies built by society for preventing deviance are often so poorly equipped for the task that we might well ask why this is regarded as their “real” function in the first place. (p. 14)

He notes that the amount of deviance and crime found in a society is largely related to how many resources we commit to looking for it. And once we’ve created institutions and industries to deal with particular types of deviance, we tend to continuously find enough deviance to continue to justify the system’s existence. If we’ve built a large criminal justice system, that system takes on a self-sustaining life of its own. Even if we eradicated all major crime as we know it, Erikson suggests, the agencies would turn their attention to behaviors we’ve previously ignored or treated as relatively unimportant, finding a new reason for the system’s existence and access to resources.

In the past several decades, fighting the War on Drugs has become an important role of the U.S. criminal justice system. Drug infractions are a major cause of the growth in imprisonment rates and, especially, the racial gap in incarceration.

I thought of Erikson’s insights when I recently saw the trailer for The House I Live In, an upcoming documentary about the impact of the War on Drugs. The trailer highlights the way that low-level drug dealers and addicts are fed as raw material into the criminal justice system. Law enforcement agencies often benefit directly from seizures of cash or property during drug busts, which then becomes property of the agency; additionally, agencies that design programs to target drug use/sales often get access to federal funds for training and equipment that they’d have no way to purchase otherwise:

The War on Drugs is an industry, one with vested interests with a powerful motivation to ensure its continued existence and expansion, regardless of any objective cost-benefit analysis of the consequences of incarcerating such a large proportion of the population or even of the effectiveness of our policies for actually decreasing drug use.

The first drug court started in Miami in 1989 as an effort to stop the cycle of drug addiction and crime.  The program brought together judges, prosecuting and defense attorneys, addiction counselors, and social workers to collaboratively build an individualized treatment program.  Rather than sending people to jail, the drug court program was designed to treat addiction while participants lived in the community.  Drug courts have become an increasingly common way for communities to engage with low-level drug offenders.

Seeking to raise awareness and support for drug courts, the National Association of Drug Court Professionals has released a series of PSAs entitled, “All Rise.”  Using a mix of celebrities and drug court judges, these commercials assert that 75% of drug court participants are never arrested again.

The promise is clear.  Drug courts not only treat addiction, they also treat a number of social problems (“no more families torn apart… no more neglect… no more overdoses”).

Are drug courts really this successful?

The truth is, we still don’t know.  The 75% success statistic comes from a study published in 2003.  The authors report that only 27.5% of drug court participants had been re-arrested and charged with a serious crime within two years.  So, we don’t know what re-arrest rates look like after that two-year period and the data doesn’t include arrests for minor crimes or arrests for serious crimes that did not result in a charge.  This is a far cry from the claim made in the video: that 75% of drug court participants are never arrested again.

The claims asserted in the “All Rise” campaign, then, should be treated with caution.  That said, drug courts are a significant move away from punitiveness for addicted offenders. Increasing the time to reoffending is a very positive step for the offender, for the community, and for the criminal justice system.  Additionally, most recidivism occurs within three years of release, so if the drug court program is helping participants to make it past this milestone it may indeed lead to some graduates leaving criminality altogether.

But before we turn to drug courts as “the” solution, we need more research on the effectiveness of drug courts.  Women and Caucasians fare better in the program than men and people of color.  And large courts tend to be more effective than small courts. Nevertheless, since the 1990s drug courts have spread across the nation to all major cities and many medium and small-sized cities, some of which have limited resources and less dedication.  All Rise’s enthusiasm should be tempered with a critical eye aimed at making these programs work well, and for as many people as possible.

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Kimberly Baker is an assistant professor of Sociology and Women’s Studies at Ithaca College.  She teaches classes in crime, deviance, and law.  Her research is on drugs, addiction, and U.S. drug policy, including drug courts.

When I learned of Whitney Houston’s untimely death, I was in the process of re-reading James Baldwin’s short story “Sonny’s Blues.” Sonny, like so many entertainers struggled with addiction and the rigors of being an artist. I couldn’t help but think of Whitney. The tragedy of her death has resonated throughout our culture in both artistic and social contexts. It also ripped the curtain off the destructive underbelly of celebrity and its trappings.

We engage in the public consumption of images of the rich and famous as a way of life now. They live under an intensely bright and hot spotlight. Baldwin relates this quite eloquently.  In the process of Sonny’s recovery from heroin addiction, he returns to doing what he loves best –playing jazz piano. Sonny’s older brother agrees to accompany him to one of his performances. The brother, seated in a dark corner of the club, watches Sonny and his band mates prepare to perform. While sitting there he contemplates just how many of them have struggled with addiction like Sonny and how they would negotiate Sonny’s homecoming performance. The narration reads:

Then I watched… while they horsed around, standing just below the bandstand. The light from the bandstand spilled just a little short of them and, watching them laughing and gesturing and moving about, I had the feeling that they, nevertheless, were being most careful not to step into that circle of light too suddenly; that if they moved into the light too suddenly, without thinking, they would perish in flame.

Baldwin provides a powerful metaphor for the dangers of the spotlight and stepping into it too soon. When I read that passage, I thought of this image of Whitney from her 2009 American Music Awards performance. She sang “I Didn’t Know my Own Strength.” It was a “comeback” performance in which Whitney was trying to reclaim her image. She is wearing white, which looks absolutely beautiful against her cinnamon caramel skin. The stage is black and Whitney is lit from the back with a piercingly bright spotlight. In that moment we can see her balancing darkness with light, hope with pain, insularity with exposure.

We loved her voice. We rooted for her comeback. But perhaps she moved into the spotlight too suddenly. Perhaps the flame from the light burned her in places no one could see. As I write this, there have been no rulings on the cause of her death. So I do not want to speculate what contributed to her untimely passing. But I love this image because it is how I would like to remember Whitney. Regal, angelic, light and dark, embodying the very essence of humanity and its many contradictions.

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Stacie McCormick, PhD, is a literature scholar whose work focuses primarily on African Diaspora and Women’s literature. Presently she is working on a project exploring the black female body and how it is represented in print and visual culture (photographs, artist renderings, the theatrical stage, etc.).

Lisa Wade, PhD is an Associate Professor at Tulane University. She is the author of American Hookup, a book about college sexual culture; a textbook about gender; and a forthcoming introductory text: Terrible Magnificent Sociology. You can follow her on Twitter and Instagram.

The mysterious SocProf, who writes The Global Sociology Blog, offered a nice review of Richard Wilkinson and Kate Pickett‘s book, The Spirit Level: Why More Equal Societies Almost Always Do Better.  Wilkinson and Pickett offer transnational research showing how, exactly, income inequality is related to bad outcomes on average.  In other words, as SocProf puts it, “…egalitarianism is not a bleeding heart’s wet dream but rather the only rational course of action in terms of public policy.”  The 11 graphs, available at the Equality Trust website, speak for themselves.

Societies with more income inequality have higher infant death rates than other societies:

Societies with more income inequality have higher rates of mental illness than other societies:

Societies with more income inequality have a higher incidence of drug use than other societies:

Societies with more income inequality have a higher high school drop out rate than other societies:

Societies with more income inequality imprison a larger proportion of their population than other societies:

Societies with more income inequality have a higher rate of obesity than other societies:

Individuals in societies with more income inequality are less likely to be in a different class than their parents compared to other societies:

Individuals in societies trust others less than people in other societies:

Societies with more income inequality have higher rates of homicide than other societies:

Societies with more income inequality give less in foreign aid than other societies:

Children in societies with more income inequality do less well than children in other societies:

The authors sum it up pretty simply: : “Th[e] dissatisfaction [measured in this data is] a cost which the rich impose on the rest of society.”

And they have a clear policy proposal relevant to the current economic crisis.

[This is] a clear warning for those who might want to place low public expenditure and taxation at the top of their priorities. If you fail to avoid high inequality, you will need more prison and more police. You will have to deal with higher rates of mental illness, drug abuse and every other kind of problems. If keeping taxes and benefits down leads to wider income differences, the need to deal with ensuing social ills may  force you to raise public expenditure to cope.

Readers Ana and Dmitriy T.M. sent in a TED talk of Richard Wilkinson discussing the relationship between income inequality and social problems:

Lisa Wade, PhD is an Associate Professor at Tulane University. She is the author of American Hookup, a book about college sexual culture; a textbook about gender; and a forthcoming introductory text: Terrible Magnificent Sociology. You can follow her on Twitter and Instagram.