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paranoid theory of the week :: is prescription drug abuse to blame for this week's charleston massacre?

it was inevitable that theories of various sorts would start circulating about dylann roof, the man accused* of killing nine black parishioners as they attended a prayer meeting this week. it's a grotesque, tragic story that reflects the ugly realities of racism in america. a website registered to roof, "the last rhodesian" [link is no longer active, but his already infamous manifesto was reprinted by gawker here], contained a lengthy manifesto about race in america and around the world, familiar to those of us who have read about hate groups before.

despite what some have claimed, this crime is intimately linked with the issues of race, in particular the tension between black and white. and it may be enough to leave it at that: a young man filled with irrational hate acted upon that hate in the worst possible way and now nine innocent people are dead. but for those of us who would like to maintain some hope for the future of the world, there is a desire to dig a little deeper and to examine how dylann roof became the way he was: the manifesto widely attributed to him claims that his family were not racists, but is that true? what was his connection to the council of conservative citizens, the group he mentions as having pushed his beliefs to an extreme form of racism? [the southern poverty law centre lists the council of concerned citizens as one of nineteen hate groups currently active in south carolina.] how many people knew about his plans and did any of them try to alert authorities of the danger he might pose? we ask those questions because we understand that arresting and incarcerating dylann roof doesn't make a whole lot of difference if the system that made him a terrorist remains in place. it's the same reason we should be asking why westerners are identifying with islamic state, even rushing off to fight with them. clearly, there's something wrong with them, but there's also something wrong with us that we keep producing people with this kind of murderous rage.

victims of the charleston massacre
one question that has been raised stems from a previous arrest at a mall in columbia. roof was caught holding strips of suboxone, a painkiller sometimes used as an alternative to methadone in the treatment of heroin addiction. could this drug have played a role in twisting his mind and making him cross the line into violence?

the theory ::

dylann roof's violence was triggered by illegal use of suboxone, in keeping with previously reported side effects of the drug.

the origin ::

hard to pinpoint exactly, but the earliest article on the subject seems to be this piece, by robert harrington.

the believers ::

not a lot of well-known people, but many on social media are giving some credence to the idea that the drug could have contributed to dylann roof's state of mind.

the bad guys ::

big pharma, who have hidden the fact that violent outbursts have previously been linked to suboxone.

the evidence ::

well, to start with, there's the fact that roof was arrested with non-prescription suboxone, which would tend to make one believe that he could have been taking it. a high school classmate claims that roof used drugs, particularly prescription drugs, regularly and heavily. tough to verify, but damning if true. there is no evidence to suggest that roof was on drugs at the time of the massacre, nor anyone who has said that he continued to do drugs in the years since he left high school.

dylann roof
but more important than the question of whether he was taking the drug is the question of whether the drug itself could cause a violent outburst that leaves nine people dead.

well, let's first deal with one part of that allegation: was dylann roof suffering from a violent outburst? no, he wasn't. the fact that he brought his semi-automatic gun with him to the church and that he stayed an hour among the congregation before killing them shows that this was not a "rage killing". he did not suddenly fly off the handle, but carefully planned the massacre, prepared for it, and gave himself the time to think about what it was he was doing in the presence of his imminent victims.

so, what we're really asking about suboxone is if it can be linked to instances of long-term psychological damage, resulting in a shift towards violent behaviour.

harrington claims there are reports of suboxone causing aggressive outbursts, but doesn't actually provide links to any specific cases. instead, the article shows a pie chart of the sorts of violence linked to psychiatric drugs, but that is for the category as a whole and says nothing about whether or not suboxone is even included in the drugs used to come up with the chart. there is also a link to another article on the site, which eventually links back to this study on reports of violence linked to prescription drugs. there are a number of drugs that the study shows have a link to increased violence, however neither suboxone, nor either of its components, are on the list. so if anything, the linked data undermines the theory that suboxone increases violence or hostility.

the prescribing information sheet given to doctors and pharmacists does list depression, nervousness and agitation as possible side effects, occurring in 5% or more of the test group for the drug. another study cited by drugs.com lists hostility as an "uncommon" side effect, meaning that it presented in between 0.1% and 1% of subjects. while others may have cited anecdotal evidence from around the internet, we're going to stick with what's been proven: suboxone has been shown to increase hostility in up to 1% of patients.

of course, studies don't take into account what happens when you take more than the prescribed dosage of a drug, which recreational users often do. in the case of suboxone, however, that might not matter. one of the things that makes suboxone an interesting alternative to methadone is that it has a "ceiling" effect. rather than producing the opioid euphoria that addicts get from drugs like heroin, suboxone gives a lift and then stops. one of its components actually blocks the brain from getting access to more euphoria-inducing opioid goodness and blocks the channels through which it flows. so a person could shoot heroin after taking suboxone and, assuming they didn't experience respiratory failure, they wouldn't get any higher. [there's a more detailed discussion of how the drug works here.]

ultimately, though, hostility does not mean violence. there is no scientifically tested record of people committing acts of rage after taking suboxone, let alone one that was so carefully planned and executed. [nor is hostility the same thing as paranoia, which is an important distinction in this case.] whatever stories might float around the drug, it is important to remember that even though the people who report them might believe that the drug caused them to become violent, it doesn't mean that they're qualified to give a medical diagnosis and until the results can be reproduced in a controlled experiment, it's always best to take a skeptical view.

the likelihood :: 0.001/10

i was prepared to give this one a "0", but i figured since there was just the slightest possibility it isn't complete bullshit, i'd acknowledge that with a nominal score. but let's look at how qualified we need to make this:

if dylann roof was on suboxone in the months leading up to the massacre [because we only know he was in possession of it in february of this year] and if he was one of the 1% or less of people who become hostile and angry as a result of taking it and if that hostility manifested as a growing and lasting rage rather than as sudden outbursts, then it is possible that suboxone was a contributing factor to his state of mind.

"contributing" rather than "key" or "important" because it's pretty clear from what appear to be his own words that his hostility and anger was directed almost entirely towards one group: blacks. [you could make an argument that jews, who he accuses of agitating blacks and who he describes as "an enigma", would come second.] there is a very slim possibility that the drug might have made him more aggressive, but it did not make him a racist. it did not make him develop theories of racial superiority/ inferiority. it did not make him believe the misleading and false stories from hate sites like the council of conservative citizens. it didn't make him take up the cause of apartheid south africa or white rhodesia. everything that he has said and the deliberate nature with which he carried out his crime speaks of racism and abiding hatred.

it bears mentioning as well, that the idea that there is a conspiracy within the pharmaceutical industry to deny the violent side effects of suboxone is clearly false. after all, the only meaningful information on those side effects comes from the pharmaceutical industry. i feel weird defending them, because i know full well that they've been implicated in some pretty awful things, but i do think that it's important that we weed out what big pahrma does right versus what it does very wrong and acknowledge that one of the difficulties in dealing with such corporations is that they do both.

ultimately, the suboxone conspiracy is one more "false flag" [to use a term popular among conspiracy theorists] that distracts from the issues that are clearly behind the massacre in charleston. it might provide some sense of comfort- conspiracies usually do- in reassuring the rest of us that a regular person couldn't do such a thing, that our culture couldn't produce a specimen capable of perpetrating something so awful. but it's a false comfort. and it's the worst kind of conspiracy theory: one that allows us to shift blame away from a long-standing pattern of well-documented bad actions. we choose to believe the outlandish conspiracy rather than the wall of evidence assembled around us.

*i use "accused" since roof remains legally that until he is convicted. there is currently no other suspect in the crime, and several news outlets have reported that he has confessed.

note:: an earlier version of this post identified the council for conservative citizens as the council for concerned citizens. we apologize for the error

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