Reason Magazine - Contributors > Juliet Samuel

Triumph of the Pill

jsamuel@reason.com (Juliet Samuel) — Tue, 03 Jun 2008 07:00:00 EDT

This past January, the prestigious science journal Nature conducted an online survey asking how many of its readers (who are primarily scientists and academics) had ever used "cognition-enhancing drugs," or brain dope. Perhaps unsurprisingly, the informal survey of 1,400 readers found that "one in five respondents said they had used drugs for non-medical reasons to stimulate their focus, concentration or memory." Moreover, Nature found that "a high four-fifths thought that healthy adults should be able to take the drugs if they want to."

In the absence of any large-scale studies measuring illicit prescription drug use among professionals, these results provide a highly suggestive counterpoint to the increasing hysteria over the abuse of "study drugs" by college students. After all, if some professors are doping up before hitting the books, why shouldn't undergrads do the same?

In fact, over the past decade, prescription stimulants such as Adderall and Ritalin—which are typically used to treat Attention Deficit Disorder (ADD)—have become increasingly available on college campuses. While studies disagree on the prevalence of stimulant "abuse" (that is, non-prescription use) among college students, the numbers suggest that anywhere between five and 15 percent of undergraduates have illicitly used such drugs to improve their academic performance. And while college health officials and various government scolds decry this trend as evidence of "drug abuse" by America's best and brightest, the reality is far from alarming.

Part of the growing concern about stimulants comes from the explosion in legal prescriptions doled out to kids. Between 1993 and 2003 the number of children's doctor's visits resulting in a stimulant prescription jumped from 2.7 million to 6.6 million. Over 10 percent of 10-year-old boys in America are now prescribed some kind of drug to control their unruly behavior, and the average starting age is getting lower. Parents are increasingly told that doping their little ones will make the children happy and successful. In 2000, psychiatrist Peter Breggin testified before Congress that, "Teachers, school psychologists, and administrators commonly make dire threats about their inability to teach children without medicating them." This trend is certainly worrying, not least because the long-term effects of regularly administered stimulants are as yet little understood.

So there are legitimate reasons to be concerned about child doping, particularly given the growing frequency of ADD diagnoses. But what about the strategic use of the same drugs by consenting adults, particularly college students? As usual, the law gets it backwards: While it is perfectly legal to feed—even force feed—Ritalin to a child, unsupervised use by knowledgeable grownups is a crime.

At the same time, it is remarkably easy to score prescription brain drugs at many of America's most prominent universities. A quick survey I conducted of stimulant-using students at Harvard reveals that it's possible to obtain a Ritalin prescription after one 20-minute consultation with a psychiatrist. One student, a sophomore who wishes to remain anonymous, obtained a script for amphetamine salts after just two appointments. He's pretty sure he doesn't have ADD, and he definitely never lied about or exaggerated his symptoms, which featured insomnia more prominently than the ADD hallmark of distractibility. Yet his psychiatrist readily prescribed the drugs. "It's not as if there's some medical authority making this decision for you," he told me afterwards. "Any reasonably capable person could walk out of there with just about whatever [drug]."

Still, there is widespread alarm about the possible health problems arising from unsupervised dosing. "Put the pills in the wrong hands and the results can be dangerous," NBC News warned. Henry Chung, Director of the New York University Student Health Center has warned that, "Students may have some kind of manic reaction or a seizure that could occur from taking these medications." For high doses, Chung is correct. But today's performance-enhancing undergraduates exhibit more responsibility than Chung realizes. One NYU senior I spoke to says it's mainly a case of "every now and again for finals. I don't know anyone who abuses Adderall or Ritalin." Moreover, "because they're prescription you can find out so much about them so you know how you can take it safely."

There is also the claim that student dopers—like testosterone-injecting athletes—are cheating because college is a competitive environment in which participants are obliged to play fair. Of course, this argument ignores the fact that most of the abilities being enhanced by such drugs are already unequally distributed (due to a mixture of biological and socioeconomic factors). Why is doping to achieve "normal" functionality a permissible act for ADD sufferers, but wrong for those seeking better grades or greater knowledge?

As the Nature survey suggests, responsible and successful adults dope up for a variety of professional reasons. There is no evidence that student doping is more dangerous or widespread than that done by their professors. Yet many university authorities are nonetheless determined to close Pandora's box. Unlike their Harvard counterparts, for example, students at the University of Michigan typically have to go through $1000 worth of psychometric tests before psychiatrists are willing to prescribe them any neuro-enhancing drugs. And doctors, of course, are loath to relinquish their power over patients.

It's time for such authority figures to admit that performance-enhancing drugs are already part of everyday life for a great many rational, healthy adults and that their use can no longer be dismissed under the title of "abuse" or "cheating."

Juliet Samuel is a writer living in Boston.

Much Ado About Shopping

jsamuel@reason.com (Juliet Samuel) — Thu, 01 Nov 2007 23:40:00 EDT

Speed for Sale

jsamuel@reason.com (Juliet Samuel) — Thu, 01 Nov 2007 12:38:00 EDT

French President Nicolas Sarkozy came to power in May promising “market-based reforms.” Several months later, at least one French market has taken off: the trade in speeding penalties.

A clean French driving license starts with 12 points. Those points can be lost for various driving offenses until, at zero, drivers get a six-month suspension and are required to retake the driving test. Increasingly harsh enforcement of road laws has led to the growth of a black market in license points, which sell on ebay.fr for between $137 and $1,645 each. Those who don’t drive much, or who rarely speed, sell their points to those whose jobs or needs depend on their car; the seller just sends in her name and license number in place of the buyer’s when a ticket is issued.

Participants in the black market have standards, though. One seller told Le Parisien he doesn’t sell his points to just anyone: “I always ask to see a photo of the ticket. I would never sell my points to road hogs.”

The practice began in Spain, but it spread to France after a surge in crackdowns on speeding that started in 2003, while Sarkozy was minister of the interior. Jean Philippe Coin, a motoring lawyer in Paris, says the sheer weight of numbers leaves the government helpless: “There is no checking. There is no control.” He claims that, with the number of penalties imposed rising dramatically—80,000 licenses were confiscated last year, and 200,000 are expected to be revoked this year—the authorities are simply unable to keep up, so the black market takes over.

Fat Pride World Wide

jsamuel@reason.com (Juliet Samuel) — Tue, 23 Oct 2007 16:52:00 EDT

According to fat pride activist Marilyn Waan, the American medical establishment has lost its head over the nationwide "obesity epidemic," and its prejudice is claiming victims. In one case, Waan says, a doctor told a fat woman complaining of shooting lights in her vision that the problem must be her weight. Her next doctor discovered a brain tumor.

Meanwhile, the U.S. Centers for Disease Control and Prevention, along with healthcare consortium Kaiser Permanente have found a great new way to fight childhood obesity: the Amazing Food Detective. The computer game, released last week, features ten "case files" of unhealthy children—click on each prisoner-style mug shot and you proceed to help a fat child make a healthy choice. The solution to chubby 12-year-old Emily's dilemma is to install a security camera to catch and stop her eating at home (After all, "Those large portions were quite suspicious!"); little Cole has to learn that he can only eat raw carrots and bananas because, "Healthy snacks are the way to go!" And the game comes complete with a time-out after 20 minutes: "You should take a break and do something active, like 100 pushups!" Gee whiz-that sounds fun!

And medical professionals are on the same bandwagon. "Our doctors have the same superstitions that everyone else has," Waan says. "They act on them in ways that are not scientific." It's not difficult to find serious grievances from fat patients. On one recently started blog, First, Do No Harm, a woman with Cushing's Syndrome, a muscle-wasting disease that turns muscle to fat, says she was told that she just needed to go on a diet.

In response, fat people are mobilizing. The "fat pride" or "fat acceptance" movement might provoke the scorn of skinnies, but it is growing in number and makes a compelling case. Much of the organizing takes place online, where fat people shares stories of abuse, gripe about prejudicial scientific studies and debate the finer points of weight discrimination. Some groups, like one started by Waan often delve directly into activism, with members urging one another to write complaints about discriminatory food advertisements or boycott insensitive organizations. Other groups are simply about offering mutual support. SeaFATtle, a group started by activist Mary McGhee, began simply as a way for fat women to swim together without fear of catcalls.

Admittedly, agitating through a fat women's swimming club might not be the best way to attract serious attention. But the claims fat pride puts forward aren't so unreasonable: The movement holds that the nation's "public health crisis" isn't really about health at all. It's about bad science and intolerance.

Listen to any public health official and you'd think obesity was a scientific slam dunk, but studies on the exact causes and effects of weight gain are highly ambiguous. One study of 25,000 men by The Cooper Institute for Aerobics Research, for example, found that a fit fatso is actually healthier than a sedentary skinny: over an eight year period even those technically classified as "obese" (a BMI of over 30) were less likely to die from heart attacks, strokes and cancer than inactive people of normal weight. And many of the studies released as "proof" of America's impending death by gristle fail to take into account confounding variables, like yo-yo dieting, a sedentary lifestyle and fat distribution on the body.

But even if the science were sound, public officials and anti-fat crusaders still confuse bad health with moral depravity. Paul Campos, a law professor at Colorado University and author of The Obesity Myth, claims that this "moral panic" sticks because it finds an "ideological resonance." On the right it appeals to an ascetic attitude; on the left it taps into anxieties about capitalist over-consumption and manipulative force-feeding by corporations.

Unfortunately, the "obesity crisis" has real victims. At 500 pounds, Gary Sticklaufer was judged too fat to make a good adoptive father to his own cousin—despite having adopted and raised several other children without problems. His cousin was forcibly taken from his care. Meanwhile, fat women are regularly told by their doctors that to become pregnant would be irresponsible, despite a lack of medical evidence demonstrating a higher risk for overweight women. And in the UK it's now commonplace to raise concerns over fat children with a view to placing them in foster care. In short, cutting a slim figure is now a moral imperative for responsible parenting, and those who refuse the "cure" to this aesthetic "disease" are summarily punished.

The anti-obesity campaign is waging war against the very people it purports to help and, in doing so, undermines the very medical authorities it relies on to perpetuate the crisis. Fat people are tired of being patronized by politicians, mistreated by doctors and barraged by crises and "cures." Many, like Big Fat Blog writer Paul Macaleer have simply concluded that, "A lot of people don't like fat people." And hard as it may be to accept, many fat people don't want to be "helped" by quack dieticians, misguided doctors, and opportunist politicians. Most, in fact, just want to be left alone.

Juliet Samuel was reason's 2007 Burton Gray memorial intern.

Much Ado About Shopping

jsamuel@reason.com (Juliet Samuel) — Fri, 17 Aug 2007 15:40:00 EDT

Last year, a group of conservatives in Saudi Arabia filed a lawsuit against a book they declared to be "an outrage to the norms of Saudi society." The book was too controversial to be published in Arabia itself, but pirated copies were smuggled over the border from Lebanon or sold for hundreds of dollars online. The book's author received death threats and a petition circulated to strip her of her state scholarship to study in Chicago.

It's probably not a situation you'd associate with Bridget Jones, but the book in question is self-proclaimed "chick lit"—albeit with a very political bent. Rajaa Alsanea's first novel, Girls of Riyadh, was only released this month in English, but its 2005 debut in the Middle East sparked both a storm of controversy and a flurry of new literature in Arabia. For months after its publication, conservative Muslims condemned the novel as contravening Shariah law, calling for a government crackdown on its distribution. But the book's popularity continued to spread, even while some critics tried to dismiss its success as a product of Alsanea's feminine wiles: "Rajaa has the looks, and so even when the product, i.e. the novel, is bad it sells and is selling like hot cakes," one disgruntled man told Arab News.

Alsanea's looks don't explain the flurry of debate, news and editorializing it has provoked (reportedly over 250 articles): The Iranian organization Homan claimed that "al-Sanie's frank and sometimes shocking insight into the closed world of Saudi women is making waves," while London's Independent newspaper called it "revealing, hilarious and chilling in turn." It has even become the subject of litmus-test questions in job interviews, and Alsanea herself received a supportive call from the Saudi royal family.

Much ado about a book on the love lives, sex and shopping habits of four rich Saudi girls. A modern epistolary novel, it's written as a series of emails sent to a Yahoo! group list serve by a mysterious, lipstick-wearing Saudi woman. In another world, it would be a trivial lip gloss narrative of life as a desirable young woman in Riyadh. But such a story can't avoid being political—and it turns out that chick lit is a convenient vantage point from which to critique Saudi society. Alsanea explores Saudi values in all their mundane invasiveness; this is a world where possessing The Nutty Professor on DVD is a political act, inviting social disgrace. And beyond the picayune restrictions lies blatant hypocrisy: the Saudi elites enforce dressing conventions at home and happily change into chic Western attire on the plane out of Riyadh.

Details form the basis of Alsanea's careful criticism: In an atmosphere where every action is politicized, and where convention always trumps personal preference, human relations are reduced to envy and power play-which makes chick lit the ideal genre in which to discuss such problems. A friend's wedding is not just a celebration, but a political battleground. While one character, Sadeem, garners praise for her help in planning the party (a suitable wifely quality), the more liberal Michelle draws "sharp looks" for refusing to cover up when the men enter. In short, this feminine world is a one straight out of Mean Girls-backbiting gossip, jealousy and personal politics-only the stakes in Riyadh are higher. It's not a question of high school popularity, but marriage and lifelong prosperity. Yet the basic tools-handbags and husbands-are the same.

The prose stays mostly light, even gratingly so at times. Hushed-up nose jobs in Lebanon, makeup tips, modest robes tailored to show off curves and designer-label hijabs are all part of the bitchy game that decides a girl's future. And even once the thumbprint is on the marriage contract (women aren't allowed to sign), the woes aren't over: How long, for example, is it appropriate to make one's husband wait for sex? One night after the wedding? Seven? Which unspoken code of behavior might be governing his actions, and will he punish you if you're wrong? Navigating this maze of requirements could mean the different between divorce—and thereafter possible confinement to the house—and a tolerable lifestyle.

It's hardly surprising, then, that courtship often manifests as a materialist status race. Alsanea expects a lot of her guys: money, height, prestige, culture, Barry Manilow-singing teddy bears, diamonds on Valentines Day, affectionate notes stuck on the fridge, and so on. And from the weak-minded puppets of familial authority, to abusive cheaters and pathologically suspicious control-freaks, the guys always disappoint. Flirting, officially forbidden, struggles through a variety of tortured avenues-instant messaging, "numbering" girls through tinted windows (that is, publicly displaying one's cell number in the hopes of getting a call), and the occasional covert café meet-up.

Despite her criticisms, Alsanea is cautious, which is probably why her book has received much support as well as censure. None of the book's main characters ever truly defy their families; most instead find livable compromises. And Alsanea is a moderate when it comes to method; she says that change is unachievable without a degree of respect for tradition: "There are a lot of people who want change in Saudi Arabia but they're not succeeding," she told Newsweek, "because they're not going through the right channels, or they're not doing it gradually. They're just screaming, ‘We went this change and we want it now.'"

In that sense, Girls of Riyadh can seem disappointingly un-revolutionary. But it's a useful exposé of a social malaise—a community stranglehold so tight that it poisons individual relations and imbues personal decisions with intense social meaning. Which, to any Clueless fans, ("Why should I listen to you, anyway? You're a virgin who can't drive") makes chick lit a fitting place to start the discussion.

Juliet Samuel is reason's 2007 Burton Gray memorial intern.

Easter Island Fights Prosperity

jsamuel@reason.com (Juliet Samuel) — Fri, 13 Jul 2007 14:40:00 EDT

“My people are changing due to development,” explains Pedro Edmunds, the democratically elected mayor of Chile’s Easter Island. “The people are getting more and more individual-thinking—and it’s not good.”

Edmunds has presided over the Island, known locally as Rapa Nui, for 15 years, and his proclamations about ‘his people’ have the air of a tin-pot dictator growing increasingly detached. The Island, totaling just 63 square miles, lies 2,200 miles west of Chile in the middle of Pacific Ocean, but modern technology has dispensed with its former isolation, and Edmunds is concerned. “There’s something we need to keep, to protect—that is, the magic of this island… the people being lovable and friendly,” he told me, leaning back under a painting of a mighty Rapa Nui tribesman. “I grew up on an island where selfishness didn’t exist.”

This would-be kinglet boasts that he can trace his own ancestry back to one of the centuries-old stone heads, or moai, on the island, and he’s determined that any changes to come will happen only under the auspices of “a master plan.” Asked if he thinks such a plan can possibly please everyone, he laughs: “My dear, we can never satisfy people.”

Yet change, unplanned and unregulated, has come to Easter Island. Tourism has skyrocketed over the last decade, and an island of 3,800 inhabitants now hosts 50,000 visitors a year. Souvenir shops, tour companies, and guesthouses have popped up, and where there were two taxis ten years ago, there are now 150. The Island’s only town, Hanga Roa, has been transformed.

Edmunds is not alone in his nostalgia for economic isolation. Francisco Hochstetter, Director of the local Archeological Museum, feels that tourism and an influx of Chilean immigrants have left Rapa Nui’s culture less “authentic” than it was decades back. “They are confusing [the culture],” he says of Rapa Nui’s younger inhabitants.

Outsiders too are troubled by development on Rapa Nui. Last year, when local businessman Petero Riraroko announced a plan to build a casino on the Island, The New York Times called the plan the “latest in a long series of calamities”—thus equating the casino with the slave trade and various epidemics that cut the Island’s population down to only 111 people in 1877. Longwinded travelogues, like one published in The Condé Nast Traveler, exoticize the Island and its inhabitants as an “archaeological trove, object lesson in eco-disaster, remoteness incarnate.” The Boston Globe worries that Rapa Nui’s language is being lost as the Island modernizes.

But all this hand-wringing mistakes culture for some kind of communal public good to be molded and preserved for later use. The people of Rapa Nui seem to have chosen a different future: Every day, contra to Edmunds’ apparent desires, they select engagement and profit over tradition. Young people I spoke to on the Island grow restless with its isolation, welcome tourist cash and relish their growing communication with different societies.

As outsiders fret about their cultural heritage, Easter Islanders are opening guest houses and tourism centers. Hanga Roa now offers visitors horse-riding, scuba diving, jeep and bike rentals, souvenirs and a range of restaurants and guesthouses. And with the expansion of The Explora luxury hotel chain onto the Island, and substantial refurbishments in the Hanga Roa Hotel, businesses are looking to attract guests with more spending power than the cheapskate backpacking crowd. Hucke Gerardo Radolfo, who mans a fruit stall in the local market, puts it simply: “Tourists are good for the Island because they bring cash.”

More than New York Times editorializing stands between Rapa Nui’s people and economic success. Riraroko, the businessman who tried to bring a casino to the island, was thwarted by Chilean gambling regulation. Yet even before the plan was rejected, a counter-casino movement was being roused by globalization skeptics, who didn’t want to hear about its potential benefits for islanders. Riraroko says the project would have created 500 jobs and $2 million in tax revenue for Chile, which already allocates that amount to the Island annually. “So the Island lost $2 million,” he concludes, with a shrug.

Paradoxically, the island needs this kind of money to protect its culture and invest in its future. Rapa Nui’s tourism industry relies entirely on the allure of the hundreds of maoi that dot the Island, relics of an ancient tribal culture. The moai are currently owned by Chile, and administrated by the Chilean National Forestry Corporation (CONAF), but CONAF’s local Acting Provincial Chief, Ignacio Espina, claims that he simply does not have enough government money or manpower to look after the sites. The very heritage sites some say are threatened by development need upkeep, and upkeep costs money.

As Rapa Nui develops, Mayor Edmunds is likely to grow even more dissatisfied with the island’s forward tilt. But if Rapa Nui’s entrepreneurs are permitted to trade and engage, they’re sure to reject his “master plan”—and they may even find the cash to save a bit of the culture Edmunds is nostalgic for.

Juliet Samuel is the 2007 Burton Gray memorial intern for reason.

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