In lieu of an abstract, here is a brief excerpt of the content:

• The Problem of Pain
• Sophie Pinkham (bio)

White Market Drugs: Big Pharma and the Hidden History of Addiction in America
by David Herzberg
University of Chicago Press, 2020, 400 pp.
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A worker removes the Sackler name from a building at Tufts University in 2019. (David L. Ryan/The Boston Globe via Getty Images)

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Reams have been written about the misdeeds of Purdue Pharma, the manufacturer of OxyContin, and Purdue’s majority owners, the Sackler family. After years of litigation prompted by spiking overdose rates, in November 2020 Purdue pleaded guilty to conspiracy to aid and abet doctors in dispensing OxyContin without a legitimate medical purpose. The company was ordered to pay $8.3 billion in penalties, damage, and forfeiture. This sum is less impressive than it looked in headlines: Purdue’s bankruptcy in 2019 means that the money is unlikely to be collected. Though they were branded as villains in the eyes of the public, the Sacklers escaped criminal charges and had to pay only $225 million of their family money—small potatoes for a family that took some $10 billion out of Purdue between 2007 and 2017.

Mostly overlooked was the fact that OxyContin was only the latest in America’s long history of pharmaceutical disasters. David Herzberg’s White Market Drugs: Big Pharma and the Hidden History of Addiction in America seeks to correct this “radical act of forgetting” by examining the troubled history of psychoactive drugs in America. He considers licit and illicit drugs together, arguing that the marketing of medicine relies on the stigmatization and criminalization of those who consume drugs outside the medical system; the development of America’s gargantuan pharmaceutical markets must be understood alongside the growth of the illicit drug market. His choice of the phrase “white market” to describe pharmaceuticals reflects the racial bias that has been baked into this system from the start.

The distinction between licit and illicit drugs hinges on binaries: healing versus harm, relief of suffering versus desire for pleasure, medication versus recreation, obedience versus rebellion. These oppositions crumble under the slightest pressure. There are countless examples of harm caused by medical interventions. In the case of psychoactive medications, the most severe unwanted effects include addiction, psychosis, overdose, and suicide. Illicit psychoactive drugs, meanwhile, can heal. Ibogaine can help those addicted to heroin; psychedelics and MDMA can help relieve PTSD, depression, and anxiety in some people; opiates, stimulants, and sedatives can help people survive the aftermath of trauma or the suffering of unhappy everyday life. Relief is a kind of pleasure, engendering desire. Recreation relieves pain, and obedience can be a form of self-harm.

Drugs often move from one category to the other. Cocaine was first marketed to Americans as a pharmaceutical. Bayer’s Heroin (diacetylmorphine), named for its [End Page 131] heroic powers, was introduced in 1898. Today, cannabis, MDMA, psilocybin, and ketamine are all in the process of moving from the illicit to the white market. They’re the same as they ever were; we’re the ones who have changed. A bottle of Adderall prescribed for a student struggling with term papers or a banker exhausted by long working hours can have a new existence at an all-night party. A drug becomes illicit when it’s used for fun.

Medical diagnoses legitimize the need for relief in the eyes of the law, but diagnosis is subjective, shaped by a doctor’s preconceptions about a patient on the basis of race, class, gender, age, sexual orientation, and self-presentation. A diagnosis and prescription can be a reward for conformity or a blunt instrument used to enforce it. In the 1970s, feminists protested the widespread prescription of Valium, which they viewed as a tool to suppress female rebellion. If, on the other hand, you’re looking to be prescribed a particular drug, be sure to dress neatly—imagine you’re going to court—and tell the doctor you need the pills for your office job.

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The story of America’s love affair with pharmaceuticals starts in the late nineteenth century, during a period of rapid industrialization and rising consumerism. Among the cornucopia of new...

中文翻译：

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疼痛问题

代替摘要，这里是内容的简要摘录：

• 疼痛问题
• 索菲·平克汉（Sophie Pinkham）（生物）

《白市毒品：美国的大制药业和隐藏的成瘾史》
，戴维·赫兹伯格
，芝加哥大学出版社，2020年，400页。
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一名工人于2019年从塔夫茨大学的一栋建筑物中删除了萨克勒的名字。（戴维·莱恩（David L. Ryan）/《波士顿环球报》通过Getty Images）

[完第130页]

关于OxyContin制造商Purdue Pharma和Purdue的大股东Sackler家族的不当行为的书面记录。经过数年不期而至的高剂量诉讼之后，普渡大学于2020年11月承认共谋协助和教doctor医生在没有正当医疗目的的情况下分发OxyContin的罪名成立。该公司被勒令支付83亿美元的罚款，损害赔偿和没收罚金。这笔款项没有像头条新闻那样令人印象深刻：普渡大学在2019年破产意味着这笔钱不太可能被收取。尽管萨凯勒人在公众眼中被冠以恶棍的烙印，但他们逃脱了刑事指控，只需要支付家庭财富的2.25亿美元，这对于一个在2007年至2017年间从普渡大学拿走了约100亿美元的家庭来说是小菜一碟。

最容易被忽视的事实是OxyContin只是美国漫长的药物灾难历史中的最新事件。戴维·赫兹伯格（David Herzberg）的《白市药品：美国的大型制药公司和隐藏的成瘾史》试图通过研究美国精神药物的困扰历史来纠正这种“遗忘的激进行为”。他认为合法药物和非法药物一并考虑，认为药物的销售取决于对医疗体系以外消费药物的人的污名化和定罪；必须与非法药物市场的增长一起了解美国庞大的制药市场的发展。他选择用“白色市场”来形容药品，这反映了种族偏见从一开始就已经渗入该系统。

合法药物与非法药物之间的区别取决于二进制：治愈与伤害，缓解与愉悦，药物与娱乐，服从与叛逆。这些反对派在最小的压力下崩溃了。医疗干预造成伤害的例子不胜枚举。就精神活性药物而言，最严重的不良影响包括成瘾，精神病，药物过量和自杀。同时，非法的精神活性药物可以治愈。伊博加因可以帮助沉迷于海洛因的人。迷幻药和摇头丸可以帮助减轻某些人的PTSD，抑郁和焦虑。阿片，兴奋剂和镇静剂可以帮助人们度过创伤或不快乐的日常生活。救济是一种乐趣，产生了欲望。娱乐可以减轻疼痛，

毒品经常从一种类别转移到另一种类别。可卡因最初是作为药物销售给美国人的。拜耳的海洛因（二乙酰吗啡）以其[End Page 131]英勇的力量而命名，于1898年问世。如今，大麻，摇头丸，psilocybin和氯胺酮都在从非法市场转向白色市场。他们和以前一样。我们就是那些改变了的人。一瓶为忙于学期论文而努力工作的学生或长时间工作疲惫的银行家开的Adderall可以在通宵通宵聚会上重新出现。毒品用于娱乐时会变得非法。

医学诊断将法律上的救济需求合法化，但诊断是主观的，取决于医生基于种族，阶级，性别，年龄，性取向和自我表现对患者的先入之见。诊断和处方可以是对合规性的奖励，也可以是用于实施合规性的钝器。在1970年代，女权主义者抗议Valium的广泛处方，他们将其视为镇压女性叛乱的工具。另一方面，如果您要开处方特定药物，请确保穿着整齐-想象您要去法庭上去-告诉医生您需要药片才能上班。

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美国与制药业的热恋故事始于19世纪后期，当时工业化迅速发展，消费主义抬头。在新的聚宝盆中...