NOTEBOOKS Esteve Foundation 42 Television fiction viewed from the perspective Medicine in Television Series of medical professionals House and Medical Diagnosis. Lisa Sanders Editor: Toni de la Torre The Knick and Surgical Techniques. Leire Losa The Sopranos and Psychoanalysis. Oriol Estrada Rangil The Big Bang Theory and Asperger’s Syndrome. Ramon Cererols Breaking Bad and Methamphetamine Addiction. Patricia Robledo Mad Men and Tobacco Addiction. Joan R. Villalbí The Walking Dead and Epidemics in the Collective Imagination. Josep M. Comelles and Enrique Perdiguero Gil Angels in America, The Normal Heart and Positius: HIV and AIDS in Television Series. Aina Clotet and Marc Clotet, under the supervision of Bonaventura Clotet Nip/Tuck, Grey’s Anatomy and Plastic Surgery. María del Mar Vaquero Pérez Masters of Sex and Sexology. Helena Boadas CSI and Forensic Medicine. Adriana Farré, Marta Torrens, Josep-Eladi Baños and Magí Farré Homeland and the Emotional Sphere. Liana Vehil and Luis Lalucat Series Medicine in Television Olive Kitteridge and Depression. Oriol Estrada Rangil True Detective and the Attraction of Evil. Luis Lalucat and Liana Vehil Polseres vermelles and Cancer. Pere Gascón i Vilaplana ISBN: 978-84-945061-9-2 9 788494 506192 42 NOTEBOOKS OF THE ESTEVE Foundation Nº 42 Breaking Bad and Methamphetamine Addiction Patricia Robledo If any series has garnered close to unanimous approval among both critics and viewers, it is without a doubt the story told over five seasons about a common chemistry teacher’s descent into hell, a man who becomes the largest methamphetamine distributor in New Mexico. Thanks to Bryan Cranston’s outstand- ing acting, the character of Walter White has become a TV icon. Having won sixteen Emmys, the series, along with Mad Men, has turned cable channel AMC into a serious competitor with the all-powerful HBO. After the show’s 2013 finale, its creator Vince Gilligan presented Better Call Saul, based on a secondary character from the original series. The main theme of the series Breaking Bad is accidents, convulsions, agitation and hyperther- synthesis and distribution of methamphetamine mia, and they are mostly the cause of abuse and in a small US town on the border with Mexico. addiction to this substance as well.1 The subject In a highly realistic way, the series depicts how of addiction presented in the series agrees with the methamphetamine market can be a lucrative scientific evidence and clearly shows the addict- business, since there is huge demand for this ive process. So, according to one of the most product and because its synthesis is inexpensive, influential theories, addiction to abusive drugs is its chemical precursors being relatively cheap established by the interaction of a vulnerable indi- and easy to purchase legally. Meanwhile, the vidual with the neurobiological changes the drug series deals with two crucial problems linked to causes, which depend on the amount of expos- methamphetamine trafficking. The first is the vio- ure. Addiction is a recurring illness that consists lence associated with the war for absolute market of different phases, including the intensification of control, and the second, abusive consumption of consumption or escalation, increase in the need this substance and its negative consequences. to consume, loss of control and relapse into us- On the latter point, the series faithfully shows how ing even after prolonged abstinence.2 methamphetamine is a highly addictive abusive drug which is mainly consumed for its long-lasting The three faces of methamphetamine euphoria-inducing properties. It produces its psy- synthesis and distribution chostimulant effects by increasing monoamine extracellular concentrations in the brain. The fast, Jesse Pinkman is a young high school dropout constant increase of noradrenaline is the cause with substance abuse problems, who is rejected of its known “toxic syndrome”, characterized by by his family because he cannot get off drugs tachycardia, hypertension, mydriasis, diaphoresis and back into society. and psychomotor agitation. Prolonged release of Though he failed chemistry at high school, he central monoamines and activation of the sym- has the formula for preparing methamphetamine pathetic nervous system produce most of the –or crystal meth as it is called on the streets– acute neurological complications associated with which he prepares in a secret lab in his garage. methamphetamine use, such as cerebrovascular Jesse’s formula, which is based on chemically re- -49- Breaking Bad and Methamphetamine Addiction ducing pseudoephedrine, is the method used in This method of methamphetamine synthesis is real life. Jesse’s friends, Badger and Skinny Pete, shown in episode “Seven Thirty-Seven” of the se- are also drug addicts and undertake to source ries, the first in the second season. Walter’s broth- the raw material by buying the nasal deconges- er-in-law, who works for the US Drug Enforcement tant Sudafed, which contains pseudoephedrine, Administration (DEA), is surprised to see the video from different pharmacies. Once the pseudo- of a theft of methylamine and comments: “P2P ephedrine is extracted, it is reduced using iodine –they’re cooking old school biker meth”. His com- and red phosphorus to form methamphetamine ment refers to the fact that during the 1970s and or N-methylamphetamine. Jesse’s methamphet- early 1980s, methamphetamine was produced amine distribution is small-scale, using his drug- by this method and distributed by the Hell’s An- addict friends as pushers, who mainly sell the gels motorcycle club in northern California, until drug locally. According to the Spanish National it stopped being used due to the classification of Plan on Drugs, in Spain, methamphetamine is P2P on the list of controlled substances.3 By the known by the names speed, meth, chalk, ice or mid-1990s, most P2P labs had been substitut- crystal, and is consumed by smoking. It can also ed by pseudoephedrine/ephedrine-based labs.3 be taken orally, inhaled or injected, which deter- However, the law relating to methamphetamine mines the type and magnitude of the effects it precursors in the years 1993, 1995 and 2005 in produces. the US meant that both ephedrine and pseudo- Walter White is a highly intelligent man whose ephedrine also became controlled substances.4 creative aspirations in the chemistry field are This fact contributed to a decrease in the market foiled, so he ends up as a high school chemis- and the recovery of the old P2P method of synthe- try teacher. The situation makes him deeply bitter sizing the drug. So, in late 2010, 69% of American because of the lack of incentive and his financial and Mexican samples examined showed that they problems. Moreover, he has serious health prob- were produced using the P2P method.4 lems involving costly treatment. By chance, Wal- Some discrepancies between the TV fiction ter finds out that Jesse, a former student of his, and reality have to do with the incredible purity is synthesizing methamphetamine under danger- that the methamphetamine prepared by Walter ous conditions. He decides to suggest a more seems to have. So one feature of Walter’s meth- efficient manner of synthesizing a large quantity amphetamine is its blue color, which in strict of extremely pure methamphetamine. His idea chemical terms does not agree with its claim to is to earn a lot of money so that his family can be 99% pure, given that this color is a sign of im- live comfortably after his death from lung cancer. purity. Another discrepancy with real life is related Walter is a disciplined, well-organized man, with to the fact that the ultra-pure methamphetamine an astonishing ability in chemistry, traits which that Walter prepares is found on the streets in will serve him well to improve the purity of the equal purity, which does not normally happen meth and set up a lab in a van that can travel because distributors tend to adulterate the drug out to desert regions to effectively elude the city’s with other compounds to increase its volume and police controls. In the series, Walter stops using earn more profit. the pseudoephedrine-based method because of Walter also changes the means of metham- the difficulty of acquiring large quantities of this phetamine distribution to make the business more precursor. Instead, he suggests using a meth- lucrative, associating with an extremely danger- amphetamine preparation method known as ous Latin distribution network. These two means “reductive animation” or “2P2 method”, which of methamphetamine distribution are faithfully re- consists of reducing phenyl-2-propanone (P2P) flected in the series. The first, on a small scale, using phenylacetone and methylamine. Methyl- carried out locally by drug addicts, and the other amine is used in industry, but it is a substance on a large scale, controlled by mafia. that is tightly controlled by the anti-drug law en- Gustavo Fring is a Latin drug trafficker who forcement agencies. controls the business in the American west in an -50- NOTEBOOKS OF THE ESTEVE Foundation Nº 42 MEDICINE IN TELEVISION SERIES organized way. He passes completely under the by dysphoria, restlessness and anxiety. Further- radar because he has an infallible money laun- more, he displays bruxism (clenching or grinding dering system. Walter and Jesse are associated his teeth for no reason) and the shakes. In the with him to synthesize big amounts of meth in a series, Jesse is the typical meth addict who little large secret lab that Fring sets up for them in the by little loses control of his life and the support of city where they live. This fact is similar to the real- his parents due to his addiction. So, in “Down”, ity of the so-called super-labs, that are known in the fourth episode in the second season, we see Mexico and which probably also existed in the US how Jesse becomes homeless because his par- at some point.