I’m back living in the US, courtesy of five months researching with the Latin American studies folks at Tulane U in New Orleans.

After the banal surveillance and corporate vocabulary of English higher education, it’s an incredible tonic to be in a genuinely intellectual and largely progressive environment.

Tulane is a research-1 university but has the feel of a little liberal-arts college—an amazing combination, and remarkably different from the daily infantilisation and mistrust of scholarly life in the UK, with its incipient institutional vulgarity waiting to leap onto your shoulder at any moment, wagging its disciplinary finger in just the way that la perfide Albion’s amour propre has adored since, you know, that Empire thing.

Along with Mauro Porto, I’ve organized a seminar at Tulane for post-docs, doctoral students, and faculty called “Trump and the Americas.” We are attempting to understand what Tiberius’ reign may mean for the region, in terms of everything from completing the Bush-Obama project of building a wall on the border with Mexico to relations with Nicaragua and Venezuela. We’re also supporting the student-led initiative to create a sanctuary campus that will provide shelter to the undocumented, the refugees, and people who dare to come from Muslim-majority countries.

At our first meeting, there was an interesting generational divide.

Grayer-headed folks wanted to talk about the paranoid style in American politics and Gramscian notions of pessimism of the intelligence but optimism of the will. Grad students, by contrast, led with discussion of Twitter and Tiberius’ use of anti-social media.

Meanwhile, the knowledge that Tiberius’ diurnal agenda is largely set by cable news suggests that this is really a complex feedback loop, rather than one in which his Twitter rants simply tell the bourgeois news media’s cravenly lazy journalists what to write about. Though that applies, too.

Being back in the land of the Great Satan, I am watching lots of cable TV—just like the great-orange-crested-leader-who-must-be-obeyed. I’m especially enjoying the seemingly constant promotions for pharmaceutical treatments that counter constipation brought about by opioid addiction.

The 2016 Super Bowl debuted a confronting commercial on this happy topic that has a besuited chap eying a man emerging from a rest room and a dog squatting on the ground with an uncontrolled envy. It alienated viewers, but similar promotions are now in heavy rotation. Qv. a smiling middle-aged white guy in a hard hat discussing construction plans with his blue-collar workforce, and his opioid addiction and subsequent blockage with us. Aw gee, shucks. Take Movantik.

He is not alone. The flawed body that has been over-treated, causing new problems iatrogenetically, has been the very stuff of US advertising since its beginnings. People smell, are weak, lose desirable hair, grow unwanted hair, bleed, collapse, and die. Then they take tonics and really fall ill.

In the American imaginary, all maladies can be countered, or at least treated, by magic pills and other interventions that bring with them dates, money, and happiness—in short, fulfilment. All this despite the fact that you are an animal, your body is always-already falling apart, and these marvelous medications cause their own problems.

The anti-opioid constipation commercials are extremely controversial—the Obama administration opposed them as offering the wrong message: ‘Hey, become addicted to a crazy drug; get bad side-effects; take another drug. Party on, dude!,’ as it were. Governors, too, got involved, denouncing the commercials.

With under five percent of the world’s population, we consume 80 percent of its opioids in this country. And most folks who love to do so grow constipated.

So what is Movantik?

Its active ingredient is naloxegol, which treats overdoses. Naloxegol is effective in blocking receptors that otherwise welcome drug users; but it generates its own side-effects: nausea, diarrhea, abdominal pain, and other results from withdrawal (which it basically forces the body to endure) such as sweats, chills, anxiety, and irritability. The other side-effect is profit: by 2019, Movantik is expected to bring in US$500 million a year. Nice work if you can get it.

HBO comedy and talk-show host Bill Maher said this following the Super Bowl commercial: ‘Was that really an ad for junkies who can’t shit? America, I luv ya but I just can’t keep up.’ The US Pain Foundation was outraged by this wee outburst. Unlike Maher, the Foundation highlights the work of ‘pain warriors and care champions.’

Three-time Olympic gold-medal athlete Jackie Joyner-Kersee has leant her name to popularise drug treatment for opioid-induced constipation. Thanks for the video to Hollywood Health Report. Though if you read the small print, the interview with her is courtesy of the makers of Movantik. I think that means they paid her and others involved in the ‘program.’

Oh, and the American College of Physicians just updated its guidelines on treating lower-back pain. The news? Don’t take opioids. Go for a stroll, go for a run, wait it out.


Toby Miller is Emeritus Distinguished Professor at the University of California, Riverside, the Sir Walter Murdoch Professor of Cultural Policy Studies at Murdoch University, Profesor Invitado at the Universidad del Norte, Professor of Journalism, Media and Cultural Studies at Cardiff University/Prifysgol Caerdydd and Director of the Institute for Media & Creative Industries at Loughborough University in London. He can be contacted at tobym69@icloud.com and his adventures scrutinized at www.tobymiller.org.