The Age of Sedatives
The 21 years between 1918 and 1939 have been called the Aspirin Age. They were the years of jazz and the flappers’ new morality, of sensation and unemployment, when society first pressed down in earnest upon the accelerator. The years when a world in crises and turmoil turned for comfort to—the little white tablet. A future historian may likewise seek to describe the period since 1945 in terms of the problems and panaceas of the day. He might well consider calling our times the Pheno-barbitone Phase.
“This 20th Century,” said the Medical World of May, 1953, “ is an age of sedation therapy.” About one-tenth of all our prescriptions for drugs are for barbiturates; in addition 10 million aspirin tablets, commonly used as sedatives, are taken in Britain every day. These mountains of drugs are consumed largely in combat with insomnia, which is becoming one of our commonest complaints and as such cannot be disregarded by to-day’s medical investigator. Even the august British Medical Association spent much time at a recent meeting discussing it as a major recognised illness. The day may yet come when a certificate will be signed which gives insomnia as the cause of death. The widely used sedatives have many disadvantages, such as the possibility of raising an annoying skin rash. A more sinister complication is the fatal effect of an overdose, which is sometimes taken whilst the mind is dulled by the drug. We are all familiar with the story of suicide by aspirin, now the Registrar-General reports that barbiturates are responsible for more suicides than any other substance or group of substances. The number of cases of accidental poisoning by these drugs is also increasing.
Sleep is vital
The nature of the apparently elusive thing which we call sleep is uncertain. A popular view sees it as the replacement of expended energy, like the re-charging of a battery. Another opinion, which is gaining support, is that it is a state of inhibition of the senses caused by their over-stimulation during wakefulness. A fair parallel is the donkey which is beaten excessively and so becomes indifferent to the touch of the whip. However, it is a complicated business and best left alone in this article. It is indisputable that sleep is vital to the human being, since it provides the necessary protection from the dangers of exhaustion. Sound sleep is best achieved in the presence of emotional and physical relaxation—any disturbance of it can cause great distress. ,
There are many reasons for sleeplessness, from cold feet to indigestible suppers. But the growth of chronic insomnia and the increase in barbiturate consumption are not to be explained by larger sales of bedtime fish and chips. A Middlesex doctor wrote to the Manchester Guardian of August 5th, 1953 . . . “The root of the trouble which creates the enormous present demand for sleeping draughts . . . is found in men in the increasing strain of their business worries and activities, in their fear of competition, in their apprehension of losing their jobs, in the friction among those working together under high pressure in small offices day after day after arriving there in trains overcrowded to suffocation. I have in 30 years of practice had more than enough occasion to see such cases. . . . The increasing demand for sedation is a result of the high pressure of modern life and the inability of many people to adapt themselves to it.” That is plain enough, and is a fairly representative opinion.
The Advertisers’ Remedies
The cure of sleeplessness presents no problem to the wordy advertiser. “This customer said she suffered from insomnia,” says one advertisement, showing a lady in blissful slumber upon a sharply identifiable mattress. Certain pillows, blankets and bedtime drinks, we are told, have the same desirable effect. Everyone has read the strip cartoon advertisements which suggest that a particular beverage can give us”. . . real, relaxed ” sleep which can “reach down to our subconscious mind” and open the door to success in many a field, from travel-agent to trapeze-artist. (One strip which was rather nearer the mark dealt with the problems of a harassed housewife and mother—her success was managing the kids without flying off the handle.) A subtler approach is offered in America. New York City has the “World’s Only Sleep Shop,” a retail establishment which provides for a bottleful of bedtime difficulties. There are firm mattresses and soft mattresses, and some half-firm and half-soft. Dust-free pillows, musical alarm-clocks, anti-snore ear plugs, window silencers and so on. The very latest books about sleep are also on sale, if you should still think that you need them. (In America, incidentally, the yearly consumption of barbiturates reaches the shocking average of 24 tablets for every man, woman and child.) There is one thing which the sleep salesmen never mention. About half of the world’s population sleep—quite soundly—on the earth or a hard mat, with no pillow or one of wood or china and with little or no covering.
The Road to Suicide
This is a world of war and destruction, noise and competition, hydrogen bombs and helicopters, speed and smog, and to live in it we must make unnatural “stop and start” demands on our bodies and nervous systems. These demands are responsible for the rising incidence of nervous disease; each man between the ages of 35 and 65 has to-day as much chance of going at least once into the overcrowded and understaffed mental hospitals as of contracting cancer of the lung, or of being knocked down on the road. And for every patient in the mental hospitals there are thousands outside who are suffering from emotional disorders and who go to their doctor asking for something to calm their nerves or to give them a good night’s rest. The doctor, often himself a victim of modem strain, and with a waiting room probably already overfull, has little time to try to unravel the causes of his patient’s trouble. The cure in most cases—a long and thorough rest—is out of the question, for both patient and doctor have a living to earn. So an attempt is made to outwit the symptoms of the illness and the patient leaves the surgery gratefully clutching a prescription for a sleeping draught. Thus a nervous person may start on the road to barbiturate addiction—by far the commonest type of drug addiction—and possibly eventual suicide. For a lengthy use of barbiturates can in itself foster the very conditions—insomnia, depression, anxiety—which it is originally prescribed to cure. For this reason, many doctors try to get away with prescribing a “placebo” which is a “sugar and spice” pill designed to calm the patient in the belief that he is taking an effective drug.
An old, wise man, once said that we always proceed from the simple to the complex and ignore the obvious. The expanding use of sedatives is an example of this. It is an elaborate attempt to shelve a problem which in its bones is quite straightforward. If the tensions of modem capitalism do not relax, the human nervous system will suffer deepening harm. That is the harsh simplicity of the matter. It is worth a little cogitation. Even if it means losing a little more sleep.