Most of us would probably agree that what have sometimes been called ‘street drugs’ (heroin, for instance) are dangerous and just as well illegal. Certainly, they’ve wreaked havoc on innumerable families. And, of course, crime fiction is full of references to those sorts of drugs and the trade in them.
It’s sometimes not as clear-cut with other sorts of drugs, though. For instance, people with certain mental and emotional illnesses benefit greatly from certain drugs. There are other people, too, such as people with certain learning and attention disabilities, who can benefit from certain medications. It’s not always an easy question what role those drugs should play, and people have very different opinions on the topic.
That question comes up in crime fiction, and it’s interesting to see how the answer to it has changed over time as public and professional views on the topic change. And even today, there isn’t consensus. There rarely is with complex issues that don’t have easy answers.
Fans of Arthur Conan Doyle’s Sherlock Holmes will know that he is a user of both morphine and cocaine. He doesn’t use drugs for fun, and he doesn’t deal in them. Rather, his drug use reflects the views of his generation. More than one easily-available medication of that time contained cocaine or heroin, and people saw those drugs as perfectly legitimate. Dr. Watson disapproves of Holmes’ use of those drugs, but he doesn’t make much headway in getting his friend to stop.
There’s an interesting discussion of barbiturate use in Agatha Christie’s Lord Edgware Dies. In one plot thread, we are introduced to American actress Carlotta Adams. She’s quite the sensation of the day, with a one-person impersonation show. She’s quite gifted, too, and popular. One night, she apparently takes an overdose of Veronal and is found dead the next morning. At first, it’s put down to a tragic accident. At the time, plenty of people take sleeping medicine (it’s actually mentioned in more than one of Christie’s stories). So, no-one thinks much of it. And yet, the dead woman’s maid swears she wasn’t a regular drug user. And it turns out that this overdose was far from accidental. Hercule Poirot connects this murder to the stabbing murder of wealthy, unpleasant Lord Edgware, and finds the surprising link between them. On the one hand, a local doctor expresses his strong disapproval of drug use:
‘‘Why these girls must have drugs, I can’t think.’’
On the other hand, it’s not an unusual thing to use powerful barbiturates.
In Barbara Vine’s (AKA Ruth Rendell) The Minotaur, we meet Kerstin Kvist, a Swedish nurse who’d decided to move to England to be closer to her lover, Mark Douglas. She accepts a job with the Cosway family, where her duty will be to look after thirty-nine-year-old John Cosway, who’s been diagnosed with schizophrenia. On the surface, the job looks like exactly the right choice for Kerstin. But all too soon, she begins to suspect that all is not what it seems. For one thing, the family still seems to be living in the Victorian Era, which is odd in itself. Also, family matriarch Mrs. Cosway has given strict instructions that her son is to be kept heavily medicated. Kerstin doesn’t think he needs that much medication; so, bit by bit, she reduces his dosages without telling anyone. Her decision has tragic consequences, which she documents in a diary that she keeps.
One of the ongoing debates in the world of education, especially special education, is how much (if any) medication children should be given when they are diagnosed with attention and other learning disorders. It’s not an easy question. It’s addressed a bit in Jonathan Kellerman’s When the Bough Breaks, in which we first meet child psychologist Alex Delaware. One day, he gets a visit from his friend, LAPD detective Milo Sturgis. It seems that a psychiatrist named Morton Handler and his lover, Elena Gutierrez, have been brutally murdered. The only witness is seven-year-old Melody Quinn. Getting any information from her is going to be difficult, though. For one thing, she’s a child, with a child’s perspective. For another, she’s on heavy medication for ADHD and other learning issues. Sturgis is hoping that Delaware will be able to communicate with the child and find out whatever information she has. Delaware is reluctant to take on this task, but he agrees. He soon finds, though, that it’s all but impossible to have any meaningful conversation with Melody. The child’s doctor, Dr. Lionel Towle, refuses to reduce her medication, so Delaware convinces her mother to let him reduce it. At first, it seems that Melody might open up and trust Delaware. Very soon, though, she begins to have severe nightmares. That’s enough for her mother and doctor to bar Delaware from seeing her again. By this time, though, Delaware is curious about the case, so he works with Sturgis to find out the truth.
Several medical thrillers, such as those by Robin Cook, also explore questions around the ethics of medication. In Acceptable Risk, for instance, a new line of psychotropic drugs is being developed, and the result turns out to be disastrous. One of the issues Cook raises is how much pressure pharmaceutical companies should put on researchers to develop new medications. Another is what the limits of such research should be, especially if the result could potentially be helpful to millions of people.
These aren’t easy questions. Nor are other questions about pharmaceuticals and medications. Attitudes towards them have changed as time has gone by, and we see both that complexity and those changes in crime fiction. These are just a few examples. Over to you.
*NOTE: The title of this post is a line from the Rolling Stones’ Mother’s Little Helper.