I love chemistry.  It was my favourite subject in high school and university.  Which is a good thing, because when you go through med school, you have to know a lot of it.

Several reports in the media which have brought the darker side of chemistry into focus.  My beloved science is now seeming like a Jekyll and Hyde monster as issues like the over-medication of children, turning conditions into diseases to justify pharmacological treatment and the impact of non-renewable fuels on food security come to the fore.

Chemistry as a science went through a growth spurt in the post-war era of the 1950s when giants like DuPont and Dow were promising man-made chemical solutions to problems many people didn’t even know they had.

Since then, chemistry has made ever larger inroads into our daily life: from the food that we eat, to the clothes that we wear, to the hygiene and grooming products we use and our forms of transportation.  All of these innovations have been developed with the intentions of improving life in some way, and generating profits.  To a large degree, both of those objectives have been met.

But they’ve been met with unintended consequences as well.  Our dependence upon a non-renewable resource, petroleum, has grown enormously.  In fact, this dependence is a factor in almost every facet of modern life.

This fact was driven home to me while watching a program on TVO called Rebecca’s Wild Farm.  Rebecca Hosking makes a credible case for concern regarding the way agribusiness has become petroleum-dependent, and the impact that this has and will have on food production.

I had never previously thought in detail about the “carbon footprint” of agriculture, which is strange since many of my relatives are farmers or come from farming families.

No mater what is being farmed, the dependence on oil and petrochemicals is intense.  Oil and gas for farm equipment and the transportation of the harvest, fertilizers, pesticides, herbicides…the consumption is substantial.  And this is where the Jekyll-Hyde nature of chemistry is illustrated.

The chemical companies that support agribusiness have focused on how to improve yields, disease and pest resistance and the esthetics of crops through chemical applications, hybridization and genetic modification.  All of this is well-intended but the problem is we don’t fully understand what we’re tinkering with.

The petrochemical-driven changes in agricultural practices have led to huge increases in food production but have also resulted in mono-culture farming that, over time, depletes the soil of nutrients, with extended implications for the biosphere through its impact on the populations of other plants, insects, birds and animals.  In Rebecca’s Wild Farm,  the program focuses on the agricultural issues impacting Great Britain, but what has happened there could happen in North America, and has to some degree.

Ms. Hosking also presents several brilliantly innovative alternatives that support sustainable, eco-sensitive food production. It’s also not clear to me whether or not the alternatives would be viable throughout the world, but if the 10-fold increase in crop productivity is representative, the implementation of these alternatives could mark a major turning point for humanity.  And no, I don’t think that’s an overstatement.

Apart from the obvious issue of food security, there are other health implications for our existing farming practices.  People who farm are being exposed to chemicals on a regular basis that may be neurotoxic, DNA and/or hormone disrupting.  Exposures also occur to a lesser extent to the people who consume what is farmed because of chemical residues on food.

Just as we don’t fully understand the reach of the consequences of tinkering with crops, we also don’t fully understand the consequences of medication use.

The introduction of thalidomide as a nausea-relieving drug in pregnancy from 1957 to 1962 provides a graphic example.  Drug testing before release of the drug for use by pregnant women did not reveal its teratogenic effects.

One could argue that this was a case of an “unknown unknown”.  No doubt that’s true, but isn’t it always true when it comes to drug development?  Isn’t that why the urge to relieve suffering must also be tempered by the principle: Do No Harm?

A recently released study, Do Stimulant Medications Improve Educational and Behavioral Outcomes for Children with ADHD?, neither supports nor condemns the use of stimulant medications such as Ritalin in cases of ADHD but raises concern about the extent to which it is being used on a population basis.

The study showed that long term use of Ritalin with Quebec children diagnosed with ADHD has been accompanied by increased emotional problems for girls and lower academic performance for boys.  Stimulants, such as Ritalin, are prescribed in cases of ADHD with the intention of reducing emotional problems and increasing academic performance.

One has to wonder based on these findings: do all these kids truly meet the requirements for ADHD diagnosis, and if they do, is Ritalin the best treatment for them?  Or are we “pathologizing” a spectrum of normal human experience (childhood boisterousness) and treating it because quiet, pliable children are more easily managed and more convenient?

Other examples to consider:

• Prozac and other SSRI anti-depressants being prescribed for non-depressed people with “social anxiety”, otherwise known as shyness;
• Normal, hormone-related declines in libido in men, and now women, being treated with medications (Viagra, Cialis, Lybrido).

Apparently, personality and passion can now be bottled.  But should they?

Earlier this week, the American Medical Association deemed obesity to be a disease, rather than a condition and the Canadian Medical Association is currently debating whether or not to follow suit.

While this change in classification probably won’t much alter the way a doctor advises a patient with a weight problem, it will pave the way for weight to become an even bigger target for “medicalization”, along the lines of shy or rambunctious behaviour and declining libido.

Interestingly, even within the AMA, this decision has been viewed as controversial.  A group of Association members, impaneled to advise on this issue, had recommended not labeling obesity as a disease out of concern that healthy people with a BMI greater than 30 will be inappropriately targeted for treatment, and people who are in fact obese will be more likely to be presented with medication and surgery as treatment options than dietary and lifestyle changes.  In line with this latter concern, others are worried that pathologizing non-morbid obesity will relieve people of their accountability for the controllable factors that influence their condition.

I suspect there will be beneficial fall-out from this decision as well as negative.  Time will tell.  But one thing I am sure of: pharmaceutical companies will be investing more in developing anti-obesity drugs.  As pharmaceutical treatments become more available, are we going to see a change in the definition of obesity?  In other words, will we lose our acceptance of a variety of body types, just as we have lost some acceptance for introverted personalities and seniors who don’t act like randy teenagers?  We seem to be making the parameters that define “normal” more and more narrow and may be over-treating as a result.

Chemistry may have morphed into Mr. Hyde, but I’m still hopeful Dr. Jekyll will re-emerge.  Perhaps the best way to encourage that re-emergence is for each of us to insist that the products we use are sustainably produced, ecologically sensitive, and directed towards problems, whether they be health concerns or otherwise, that are real, not just extensions of some chemical or pharmaceutical company’s profit goal.