8/07/2010 UPDATE: The discussion in this post is continued at Death by Cruise Ship, Lithium, and Suicide.
Adding trace amounts of lithium to the drinking water could limit suicides. Two studies, a recent one in Japan and an older one in Texas, have shown that this naturally occurring substance, used as a psychotropic drug to combat bipolar disorder, could have beneficial effects for society: Communities with higher than average amounts of lithium in their drinking water had significantly lower suicide rates than communities with lower levels. Regions of Texas with lower lithium concentrations had an average suicide rate of 14.2 per 100,000 people, whereas those areas with naturally higher lithium levels had a dramatically lower suicide rate of 8.7 per 100,000.
The highest levels in Texas (150 micrograms of lithium per liter of water) are only a thousandth of the minimum pharmaceutical dose, and have no known deleterious effects. If further studies continue to uncover no harmful side effects, bioethicist Jacob Appel believes that Washington should fortify all of our drinking water with lithium.
This wouldn't be the first time that the US government has spiked our drinking water. The government began adding fluoride to our water in the 1940s to fight tooth decay, and it has been hailed as a great public health achievement (saving more than $38 in dental bills for every $1 spent on fluoridation). Lithium, a psychotropic drug used to level out the manic and depressive swings associated with bipolar disorder, could do for suicide what fluoride did for cavities.
"We are not talking about adding therapeutic levels of lithium to the drinking water," Appel tells Big Think. "If you wanted to get a therapeutic level from the trace amounts that currently exist in the areas where there is already lithium, you would have to drink several Olympic size swimming pools. So the reality is, these are very low levels, and there’s no reason to think they are not safe in the areas they already exist, so why not give everybody that benefit?"
And if people don't want to take part, Appel argues, they can always opt out by drinking bottled water: "If the vast majority of people gain health benefits from fortifying the public water, and particularly if these benefits are life-saving, then there is nothing unreasonable about placing the burden not to drink upon the resistant minority," Appel wrote in The Huffington Post. "One person's right to drink lithium-free water is no greater than another's right to drink lithium-enhanced water. As long as the negative consequences or inconveniences are relatively minor, water fortification seems to be one of those cases where the majority's preference and interest should prevail."
Over 34,000 people in the US commit suicide each year, making it the fourth leading cause of death among Americans aged 18 to 65. If lithium were added to all US drinking water—and the effect were the same as in Texas's highest-lithium regions—the national suicide rate would drop to 20,831, saving over 13,000 lives.
Why We Should Reject This
Lithium is a much more powerful substance than fluoride, with far greater potential side effects. Critics say that drugging the water is a massive infringement and equate this use of pharmaceuticals to something out of Aldous Huxley’s dystopic classic “Brave New World.”
Robert Carton, a former senior scientist for the EPA, argues that the government's fortifying drinking water with any substance, even fluoride, violates people's fundamental right—codified in the Nuremburg Code—to give informed consent to any medical intervention. “All ethical codes for the protection of individuals who are subject to medical procedures," Carton wrote in the International Journal of Occupational and Environmental Health, "whether research or routine medical treatment, endorse the basic requirement for voluntary informed consent.”
—2009 Japanese study, published in the British Journal of Psychiatry.
—1990 Texas study, published in Biological Trace Elements Research Journal.
—2003 article [PDF] from the International Journal of Occupational and Environmental Health, co-authored by Robert Carton, arguing against fluoridation.
Part II of out discussion about drugging the drinking water can be found at Death by Cruise Ship, Lithium, and Suicide.