An intersection on the outskirts of the town where I live features national chain drugstores on three of the four corners. Near my office in the city where I work are two CVS pharmacies not more than 300 yards apart. I’ve often wondered about the economics of this proliferation, concluding that the reasons must be complex and probably have to do with how many members of Congress the drug companies own. But our cover story by Philip Alcabes suggests that drugstore ubiquity is a simple matter of supply and demand: we Americans love our drugs.
Okay, we fill lots of prescriptions and buy lots of probably unneeded drugs over the counter. If we can afford it, and apparently we can, what’s the problem? Well, yes, we do buy a lot of drugs elsewhere, too. A friend of mine in his 80s recently walked out of the Tattered Cover bookstore in Denver and into a newer establishment called Rocky Mountain High. There he scored some magic brownies for a friend of his across state lines suffering from a botched knee replacement. And then there are the illegal drugs we buy—the heroin, the methamphetamines, the cocaine, the crack, the synthetic marijuana and the harvested sort. An increasing share of all of these drugs, legal and not, are available online. Presumably the CVS lobbyists are working on this problem, but as Alcabes suggests, darknet sales of illegal drugs could be preferable to young men shooting each other over urban turf. Alcabes, a professor of public health, points out that the line between legal and illegal drugs tends to move. Did you know, for instance, that heroin was first introduced by the Bayer company as a cough medicine?
It’s a little unsettling to read an article about drug use written by a writer whose hair is not on fire. Alcabes accepts that people are going to have their drugs. His concern is with a larger question implied by their widespread use: Why is there so much pain of the spirit as well as of the body?
Several days before the writer Paul West died in October, we sent him proofs for the remarkable memoir in this issue, and we learned from his assistant, Liz Butler, that she had read it to him as he sat in his wheelchair in the sun during one of his last lucid moments. If you admire this piece as much as we do, read another memoir of his we published in 2007, a few years after he had suffered a devastating stroke. With the encouragement of Diane Ackerman, his beloved wife, Paul had fought to regain his extraordinary linguistic abilities, keeping a diary of his struggle to recover. That’s the piece we published, calling it “Mem, Mem, Mem”—the first words he spoke after the stroke. His recovery was so successful that he went on to write five more novels and a collection of essays.
