A Brief History of OD’ing in America

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The conviction of Dr. Conrad Murray in Michael Jackson’s death highlighted a worrying drug trend in the U.S. Less than a week before a jury found Murray guilty of involuntary manslaughter for improperly using an anesthetic to help Jackson sleep, the Centers for Disease Control and Prevention reported that the number of overdose deaths from opioid pain relievers had tripled between 1999 and 2008, the most recent year for which data were available.

Today more people are dying from painkillers than from cocaine and heroin combined. Which raises a question: why are narcotics the drug of the moment? Why are so many of us anesthetizing ourselves to death?

The answer surely has something to do with deep anxiety about a global economic decline that, by most accounts, isn’t expected to turn around for years. I’m not saying Michael Jackson died because of the great recession — although he was hundreds of millions of dollars in debt when he was allegedly begging Murray for more and more propofol so he could sleep enough to plan his comeback. What I am arguing is that each cultural moment seems to choose its particular intoxicant. Consider this timeline:

1955 to the mid-’60s. The drug of the moment is a sedative called meprobamate that is first marketed in 1955 under the name Miltown. These years are marked by extreme social anxiety — Soviet spies, McCarthyism, the Kennedy assassination — not to mention the constant threat of nuclear annihilation. Who doesn’t want to be sedated?

Colloquially known as “Mother’s Little Helpers,” drugs such as Miltown are also widely used by pre-feminist women who are expected to keep tidy houses and unlined pantyhose even as the world tilts toward obliteration. According to the New York Times, Miltown becomes the best-selling drug ever marketed in the U.S.

By the 1960s, reports of Miltown dependence and overdose lead to declining demand. But it remains such a potent drug that as recently as 1997, the journal Forensic Science International reports that meprobamate was involved in more than 15% of all overdose deaths.

The mid-’60s through the mid-’70s. The reaction against ’50s rectitude helps lead to what is likely the biggest recreational-drug experiment in human history: the widespread use of psychedelics such as lysergic acid diethylamide, which becomes known as acid or LSD. Psychedelics alter consciousness but don’t usually dull the central nervous system, as meprobamate does. For that reason, they are safer than sedatives but also more likely to be abused recreationally.

Also, LSD plays a role in many accidental deaths, some of them tragically famous. As Robert Greenfield documents in his exhaustive 600-page biography of Timothy Leary, one of Leary’s (many) arrests comes one day in 1969 after a teenage girl who had taken LSD dies in a pond near Leary’s ranch. A few weeks later, a heavy drug user and incipient guru named John Griggs also dies at the ranch, and on Oct. 4 of the same year, the daughter of entertainer Art Linkletter jumps (or possibly falls) to her death from the sixth floor of her West Hollywood, Calif., apartment. For the rest of his life, her father blames her death on LSD even though her autopsy finds no sign of the drug. His crusade against acid coincides with — and almost certainly contributes to — a drop in its usage.

The late ’70s through the ’80s. They were quaintly called the “me” generation at first. But many people who enter their 20s and 30s during this period become victim to one of two overlapping drug crises: the abuse of pre-powdered cocaine or, a bit later, the abuse of less-processed cocaine nuggets that are — chemically speaking — indistinguishable from powdered cocaine but acquire the name “crack.”

During this period, cocaine becomes the leading cause of unintentional drug deaths — a position it holds until deaths from opioid drugs eventually grow to their current levels. Miltown had deadened the central nervous system, but cocaine revs it by flooding the brain with the neurotransmitter dopamine, which fuels the pleasure and reward centers. More and more cocaine is required to elicit more and more reward — an apt congruence with the wild grab for wealth associated with the period.

The 1990s. Powered by Internet stocks and ever-rising housing prices, the U.S. economy reaches a giddy apogee. Designer clothes, interior design and foodie experimentation become fads in which even the middle class can dabble. And so the drugs of the moment become designer drugs: ecstasy, ketamine and gamma-hydroxybutyric acid (GHB). In 1995, the office of the White House drug czar, Barry McCaffrey, says ketamine — a lightly controlled anesthetic — is “all over” the country; by the late ’90s, Congress adds the drug to its list of controlled substances. In 1999, TIME prints a cover story on ecstasy (which I am partly embarrassed and partly proud to say that I wrote) reporting that the drug is being used from Michigan to Arkansas and from New York City to L.A.

And then we settle into the 2000s. True, methamphetamine use rises briefly, but by last week, it has become clear that we have returned to sedatives and narcotics as our self-remedies of choice. We have entered a dire period that we are trying to dull with drugs. Instead, many users create only more cataclysm for their families. Each cultural moment picks its own intoxicant, but the consequences can be highly personal

John Cloud is a senior writer at TIME. Find him on Twitter @JohnAshleyCloud. You can also continue the discussion on TIME’s Facebook page and on Twitter at @TIME.