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Reinforcing Networks: The Medical, Pharmaceutical, Mass Media and Paraphernalia Establishments

Large scale shifts in psychoactive drug use have occurred in the US in the past several decades. While cigarette use declined briefly in response to the Surgeon General's Report and anti-smoking TV commercials, use of alcoholic beverages per capita has increased in the US in the past fifty years. Over $300 million was spent in 1974 for advertising of alcoholic beverages, although the effect of such advertising on demand for alcohol is unclear. Use of alcohol in T.V. and film production is very frequent, often in a glamorized fashion. The pharmaceutical industry has a large investment in promoting prescribing of psychoactive medications, with 1982 retail sales of $16 billion and advertising and promotion at a cost of $2 billion in 1982. Medical journals are heavily dependent on advertising revenues from the pharmaceutical industry. The drug paraphernalia industry is very large, with estimates of its income being in the multi-million dollar range, but being difficult to detail in exact figures. Overall, the patterns of psychoactive drug use in the US are linked to a complex array of cultural factors, mass media factors, pharmaceutical advertising factors, and physician prescribing behaviors.