Compulsive Shopping

The irony could hardly be more profound.

The most recent issue of the Journal of Clinical Psychiatry reports that use of the anti-anxiety drug citalopram, the generic name for Parke-Davis’s Celexa, can significantly reduce the impulse to shop in individuals diagnosed with Compulsive Shopping Disorder. As the Reuter’s story reports:

“The patients who remained on citalopram for 16 weeks also reported they could stop browsing for items on the Internet or television shopping channels, as well as the ability to enter stores without making impulsive purchases.”

Celexa, a $100/month consumable “treatment” for over-consumption, is just the latest installment in a serial tragedy. Only weeks ago the headlines were filled with debate over Medicare reform. The GOP wants to make drugs more accessible by allowing the market to work its magic. The Democrats responded with a plan to subsidize the cost of drugs for the elderly by bringing prescription coverage under the umbrella of the traditional Medicare program. A compromise will happen, but in the end one thing is guaranteed: more seniors will get more drugs cheaper.

Unchallenged and seemingly unnoticed is the assumption that we care for the health of our elderly – or any of us – by making pharmaceuticals more readily available. There has been a meteoric rise in the use of prescription medications over the past 4 decades. However, there has been no concurrent meteoric fall in the incidence of disease, or any dramatic enhancement in the quality of life. At best, a handful of months have been added to the average lifespan of those who live to the age of 50, and even those months are disproportionately allotted to the higher socioeconomic classes. Further, this increase has never been linked to the increased use of medications over the same time period.

How did it happen that increased consumption of medications got equated with enhanced health? How did consumption of medication become so accepted as “health care” that it is actually a focus of “health care reform”? Certainly there is a mountain of studies showing that drug X reduces some risk, or decreases some discomfort, or lowers some lab value in a percent of those taking it. But clinically there is a vast gulf between the benefits of drug X on a condition, and the debilitating effects of one or many medications used to treat multiple health complaints, many of which are brought on by the medications themselves.

Currently, seniors account for about 34% of all medications dispensed in the United States and 42% of prescription drug expenditures, but make up only 13% of the population. Eighty percent of retirees take at least one prescription drug every day, and many take as many as 8 medications daily. When an Ohio State University pharmacist spoke with 187 seniors about their medication usage, he found an average of 5.7 medications being taken per individual.

This, while 20% to 40% (depending on the study) of seniors admitted to a hospital are malnourished in some way. How does the malnutrition contribute to the symptoms or disease they may be experiencing? In what way do the nutrient-depleting medications seniors take directly contribute to their malnutrition and thus their symptoms? Answers to these questions are unknown, with no apparent interest in finding answers. But under both the GOP and Democrat plan, they will more easily get medications.

It is a perpetual double standard of our times: we rage against the dehumanizing and debilitating effects of relentless consumption. We are appalled by the exorbitant cost of health care, and the vast profits being generated on the back of our miseries. We clamor for social and economic and environmental justice, partly because we witness the biological toll that market-driven capitalism extracts from the bodies of those oppressed by its institutions. We progressives spend some or most of our days imagining a better way.

Yet at the same time, we nary blink an eye about- and more often strongly support – making consumable chemicals (aka pharmaceuticals) more accessible to everyone (“Free health care for all!”) under the untested assumption that our health is served through that consumption. Where is the evidence that the growing societal pharmaceutical binge of the past 4 decades correlates to a population feeling more vibrant, succumbing less and less to disease, feeling healthier?

A corporate sleight of hand, accomplished in part through an uncontested monopoly on “facts” as they relate to bodies, health, disease and treatment, allows industrial medicine to transform care for health into the dispensing of products. It is undeniably a brilliant marketing strategy. Universal health care tinkers with the financing for the products, but the assumptions behind their use are impervious to challenge.

Our bodies and minds – and for some of us, our spirits – respond in unpleasant ways to the insults they receive every day in the form of industrialized food, air, and water. They respond negatively to the insults received through chemicals that saturate our clothes, our homes, and our workspaces. Our bodies make a stand against the abuses that come in the form of a myriad of injections that start at birth and continue for life.

Bodies do their level best to rid themselves of non-nutrients that constantly flood in as over-the-counter remedies, as daily incidental exposures, as colorings and flavorings and texturizers and a mountain of other designer molecules that are even added to the industrial strength vitamins we buy to keep ourselves healthy.

Our capitalist world abuses our bodies in many ways, but bodies are amazingly well equipped to repair themselves. And so they try, by kicking into elimination mode and cranking up the break down/build up cycles (aka inflammation), by producing and overproducing fluids in an attempt to flush the membranes exposed to irritants, by churning out antibodies in response to exposures, and many other clever mechanisms.

In short, by exhibiting what we call “symptoms.” Symptoms and disease are not evolutionary flukes, but names we’ve given to the body’s attempt to reestablish some internal balance. When the insult is short-term, the symptoms resolve as biological order is restored. When insults are unending because they are embedded within daily existence, the symptoms devolve from short-term to long-term, acute to chronic and, ultimately, to degenerative.

Lo and behold, the rising tide of chronic disease in the industrialized world is now spilling over into the developing world, and is being capped with a return of “emerging” infectious disease. Abuses to the body and mind of the human animal have shifted from acute to chronic as they’ve become embedded in our lives, and every day we export those abuses as a matter of policy. Industrialized insults to our bodies are going global, right along with the economic system whose coattails they ride.

Industrial medicine is there to capture a guaranteed market: define and quantify, in microscopic terms, the inevitable biological breakdown that follows development, then monopolize all discussion on what constitutes “treatment” for the disease. If the courts will mandate that treatment and activists will demand it – as both are increasingly inclined to do – all the better.

The history of Western medicine over the past century is, in part, the history of explaining the human experience of an increasingly toxic world in microscopic terms, thereby turning that experience into a source of profit. Perhaps soon we will be able to cheaply export Celexa to Africa and India to treat compulsive shopping in those needy places. But first, we’ll have to build lots of shopping malls that the drugs can help them resist.


Greg Nigh is a naturopathic physician and licensed acupuncturist practicing in Portland, Oregon. He can be reached at

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