Efficacy

Efficacy (pronounced ef-i-kuh-see)

(1) A capacity for producing a desired result or effect; effectiveness; an ability to produce a desired effect under ideal testing conditions.

(2) The quality of being successful in producing an intended result; effectiveness; a measure of the degree of ability to produce a desired effect.

1520-1530: From the Old French efficace (quality of being effectual, producing the desired effect), from the Late Latin efficācia (efficacy), from efficāx (powerful, effectual, efficient), genitive efficacis (powerful, effective), from stem of efficere (work out, accomplish).  In eleventh century English, in much the same sense was efficace from the Old French eficace from the same Latin root efficācia; there was also the early fifteenth century efficacite from the Latin efficacitatem.  The sixteenth century adjective efficacious (certain to have the desired effect) was often used of medicines (presumably a favorite of apothecaries), the construct being the Latin efficaci-, stem of efficax from the stem of efficere (work out, accomplish)  + -ous.  The –ous suffix was from the Middle English -ous, from the Old French –ous & -eux, from the Latin -ōsus (full, full of); a doublet of -ose in an unstressed position.  It was used to form adjectives from nouns, to denote possession or presence of a quality in any degree, commonly in abundance.  In chemistry, it has a specific technical application, used in the nomenclature to name chemical compounds in which a specified chemical element has a lower oxidation number than in the equivalent compound whose name ends in the suffix -ic.  For example, sulphuric acid (H₂SO₄) has more oxygen atoms per molecule than sulphurous acid (H₂SO₃).  The noun inefficacy (want of force or virtue to produce the desired effect) dates from the 1610s, from the Late Latin inefficacia, from inefficacem (nominative inefficax), the construct being in- (not, opposite of) + efficax.

The most familiar related form in modern use is efficacious but in general use this is often used in a more nuanced way than the pass/fail dichotomy of "efficacy" familiar in medical trials.  In general use, efficacious is a "spectrum word" which describes degrees of the ameliorative effects of treatments although while the comparative is "more efficacious", a more common form is "quite efficacious"; the superlative "most efficacious" appears to be popular among the small subset of the population who use efficacious at all.  Efficacy, efficacity & efficaciousness are nouns, effectuate is a verb, effectual & efficacious are adjectives and efficaciously is an adverb; the noun plural is efficacies.

Clinical trials in the pharmaceutical industry

In the development of vaccines (and medicinal drugs in general), efficacy trials (sometimes called phase III or explanatory trials) determine the percentage reduction of disease in a vaccinated group of people compared to an unvaccinated group, under the most favorable conditions, which is with the subjects housed in a hospital equipped to handle intensive care patients.  Conducted on human subjects if tests on animals proved satisfactory, it’s a purely clinical exercise, practiced since 1915 and can be done as a double-blind, randomized study if no safety concerns exist.  One potentially distorting aspect of both efficacy and (particularly) safety trials is a historic bias towards healthy young males as the subjects.  The antonym of the adjective efficacious is inefficacious but the word is rarely used when drug trials produce unsatisfactory results: the punchier "failed" is almost always used.  Under normal circumstances, the testing process can take many years, the industry usually referring to trials as phases:

Phase I: Safety Trial

Phase I trials are done to test a new biomedical intervention for the first time in a small group of people (typically 20-100) to evaluate safety.  Essentially, this determines the safe dosage range and identifies side effects.

Phase II: Efficacy Trial

Phase II trials are done to study an intervention in a larger group of people (several hundred or more depending on the product) to determine efficacy (ie whether it works as intended) and further to evaluate safety.

Phase III: Clinical Study

Phase III studies are done to study the efficacy of an intervention in large groups of trial participants (often thousands) by comparing the intervention to other standard or experimental interventions (or to non-interventional standard care).  Phase III studies are also used to monitor adverse effects and to collect information that will allow the intervention to be used safely.

Phase IV: Efficiency Study

Phase IV studies are done after the drug has been released and is being prescribed.  These studies are designed to monitor the effectiveness of the approved intervention in the general population and to collect information about any adverse effects associated with widespread use over longer periods of time.  They may also be used to investigate the potential use of the intervention in a different condition, or in combination with other therapies.

Proven efficacy: Adderall.

Adderall and Mydayis are trade names for a combination drug called mixed amphetamine salts (a mix of four salts of amphetamine).  In all Western jurisdictions  Belonging to a class of drugs known as stimulants, Adderall is a prescription medication and it contains two active ingredients: the amphetamines and dextroamphetamine.  As a prescribed medicine, primarily Adderall is used in the treatment of attention deficit hyperactivity disorder (ADHD), a neurobehavioral disorder characterized by symptoms such as inattention, hyperactivity, and impulsivity.  Adderall works by increasing the levels of certain neurotransmitters (most critically dopamine and norepinephrine) in the brain, these both mechanisms which play some role in regulating attention, focus, and impulse control.  Beyond ADHD, Adderall is sometimes prescribed off-label for the treatment of narcolepsy, a sleep disorder characterized by excessive daytime sleepiness and sudden, unpredictable episodes of sleep.

Adderall also has something of a cult following among those who seek to experience some of its more desirable side-effects.  Like many of the earlier amphetamines (most famously Tenuate Dospan (diethylpropion or amfepramone) an appetite suppressant of legendary efficacy), Adderall can assist in weight-loss and can safely be used for this by most people but because of its potential for dependence, it should be taken (for whatever purpose) only under clinical supervision.  For those prescribed Adderall, in some circumstances, it may continue to be taken (at the prescribed level) even if one is in a substance rehabilitation facility as was the case in 2013 when Lindsay Lohan completed a 48-hour drug detox at the Betty Ford Clinic in Indio, California.  Ms Lohan was prescribed Adderall after being diagnosed with ADHD but the standard protocol used by rehab clinics is that doctors routinely re-evaluate (1) the ADHA diagnosis and (2) the efficacy of the treatment regime.  Depending on their findings, doctors can prescribe alternative drugs or cease drug intervention entirely.  Ms Lohan was quoted as saying she’d been using Adderall "for years" and that she cannot function without it and her choice of rehab facility was once which would permit both smoking (tobacco) and the use of Adderall.

As she earlier explained it: “I have severe ADD. I can’t stand still.  So, I take Adderall for that; it calms me.”  Ms Lohan further noted she was not unaware there were those who took Adderall for its side-effects, notably weight loss or the ability to function effectively for extended durations without needing to sleep but that she wasn’t someone who needed to regulate her weight and that her sleeping patterns were normal.  However, the cult if anything is growing and in the US shortages of Adderall were reported (not for the first time) in late 2022.  The US Food and Drug Administration (FDA) responded by issuing a statement noting that while there was nothing unusual about episodic shortages of generic drugs at any given time because the profit margins are low and production is sometimes restricted to avoid a sacrifice in the opportunity cost vis-a-vis higher margin products, Adderall was “a special case because it is a controlled substance and the amount available for prescription is controlled by the Drug Enforcement Administration (DEA).”  The FDA added that because there had been “a tremendous increase in prescribing” because of virtual medicine (e-consultations) and a general trend towards over-prescribing and over-diagnosing, the periodic shortages were likely to continue.  THE FDA’s conclusion was that “if only those who needed these drugs got them, there probably wouldn't be a [stimulant medication] shortage” but the diagnosis of ADHD continues to grow and the desire for rapid weight-loss solutions remains strong.

Myriad

Myriad (pronounced mir-ee-uhd)

(1) Originally, ten thousand (10,000) (archaic).

(2) A very great, innumerable or indefinitely great number of something; having innumerable phases, aspects, variations, etc.

1545-1555: From the French myriade, from the Late Latin mȳriadem (accusative of mȳrias (genitive myriadis)), from the Ancient Greek μυριάς (muriás) and myrias (genitive myriados) (the number 10,000), from μυρίος (muríos (plural myrioi)) (numberless, innumerable, countless, infinite; boundless).  In Ancient Greek, myriad was “the biggest number able to be expressed in one word”.  The ultimate origin is unknown but there may be a link with the primitive Indo-European meue-, the source also of the Hittite muri- (cluster of grapes), the Latin muto (penis) and the Middle Irish moth (penis).  The cardinal (ten thousand) is myriad, the ordinal (ten-thousandth) is myriadth, the multiplier (tenthousandfold) is myriadfold and the collective is myriad.  Myriad is a noun and adjective, myriadisation is a noun, myriadth is an adjective, myriadfold is an adjective & adverb and myriadly is an adverb; the noun plural is myriads.

In a hangover from the medieval habit, in the sixteenth century myriad initially was used in accordance with the Greek and Etymology meaning (ten thousand (10,000)) but as early as the late 1500s was used to refer to “a countless number or multitude of whatever was being discussed” and thus assumed the meaning “lots of; really big number of”.  From at last the mid-eighteenth century, when modifying a plural noun, it predominantly meant great in number; innumerable, multitudinous” and that’s long been the default meaning and references the exact numeric origin (10,000) exist only to list the earlier sense as archaic or as a footnote explaining the use in some historic text.  The most pure of the style guides (the editors used to fighting losing battles) still note than when used as an adjective the word myriad requires neither an article before nor a preposition after.  The result of that strictness is that a phrase like “a myriad of stars” where “myriad” acts as part of a nominal (or noun) group is said to be tautological but so much has the pattern of use evolved that most probably would find the alternative, though elegant, somehow lacking. 

The still rare noun myriadisation (crowdfunding) was a creature of social media, the idea being attracting funding in small increments from many (maybe 10,000 or more) and the concept was one of the (many) reasons Barack Obama's (b 1961; US president 2009-2017) campaign in 2008 to secure the Democratic Party nomination for that year's US presidential election was better funded than that of crooked Hillary Clinton (b 1947; US secretary of state 2009-2013).  One topical variant was permyriad, the construct being per- + myriad.  The per- prefix was borrowed from Latin per-, from the Proto-Italic peri- and related to per (through).  As a word-forming element, it's now rare except in science where (1) its used to form nouns & adjectives denoting the maximum proportion of one element in a compound and (2) it was added to the name of an element in a polyatomic ion to denote the number of atoms of that element (usually four).  Historically, in verbs it (3) denoting the sense "through", (4) denoting the sense "thoroughly", (5) denoting the sense "to destruction" and (6) in adjectives and adverbs it denoted the sense of "extremely".  Permyriad means “One out of every ten thousand” (ie one percent of one percent), a concept which was discussed in the aftermath of the Global Financial Crisis (GFC 2008-2011) when the idea spread of “the one percent” as the section of the population which held a disproportionate and socially destructive of the world’s wealth and property.  The point was made that the extent of the distortion was better illustrated were the math done with the “one percent of the one percent” so the definition of permyriad was in the news although the word never staged much of a revival.

Myriad is often a word of choice when writers are searching for a fancy way to say “lots” and it’s over used.  It no longer is used to convey “10,000” or even a number close to that but it should evoke thoughts of a big number.  Synonyms for myriad in its modern sense include countless, endless, infinite & innumerable and (even in Los Angeles) rehab options may not be quite that plentiful.  A better fancy would have been plethora, the synonyms for which include excess, abundance, glut, surfeit, superfluity & slew.  It’s true plethora & myriad are often used interchangeably but they really are subtly different.  Plethora (the plural plethorae or plethoras) was from the Late Latin plēthōra, from the Ancient Greek πληθώρη (plēthṓrē) (fullness, satiety), the construct being πλήθω (plḗthō) (to be full) +‎ -η (-ē) (the nominal suffix).  It means “an excessive amount or number; an abundance”.  In use, plethora is usually followed by “of” except for the technical use in clinical medicine where it describes “an excess of blood in the skin, especially in the face and especially chronically”.

It’s probably not true that during Antiquity the Athenians never spoke of matters where values higher than 10,000 were discussed but they appear never to have created a single word descriptor of anything bigger.  The structural functionalists among linguistic anthropologists would find that unremarkable because in the society of the age, the need was so rare.  Doubtless, there would have been Greeks who speculated on the number grains of sand on the sea-shore or the stars in the night sky and their astronomers even attempted to estimate the distances to stars but these wouldn’t have been things often heard in everyday conversation and such calculations were expressed in equations.  The need for words came later and advances in the sciences including cosmology, particle physics and virology meant millions, billions, trillions and later multipliers became genuinely useful.  The standardization however didn’t happen until well into the twentieth century.  Until then, in British English a billion was a million millions (1,000,000,000,000), something then really of use only to cosmologists whereas in US use it was calculated as a thousand millions (1,000.000,000) and thus a word with some utility in public finance (although in Weimar Germany’s (1918-1933) period of hyper-inflation (1923) the UK’s definition could have been used of the Papiermarks).

50 trillion (50 Billionen, 5×10¹³) mark note, Weimar Germany, 1923.

Since then of course, because a billion dollars isn’t what it was, we now routinely hear of trillions (often in the form of public debt) while billionaires are the new eligible bachelors and divorcees.  For those dealing with things like atoms, neutrinos and such, there is a point (probably anything beyond a billion) where writing out all those zeros becomes either tedious or impractical so the words are useful.  For mathematicians, the numbers are expressed using exponents: In the expression xⁿ, x is the base and n the exponent; n is the power to which x is raised, thus the common expression "to the power of" so 10²=100 and 10³=1000.  Of course, numbers being infinite, even this convention can in theory become unmanageable, hence the attraction of something like 10^googol to represent a googolplex, a googol being 10¹⁰⁰.  If the need arises (say the discovery that the universe is much bigger than thought or Elon Musk gets really rich) words may make values easier for humans to follow than numerals.

Can

Can (pronounced kan)

(1) A sealed container for food, beverages etc, by convention made from aluminum, iron coated with tin or another metal (has now become a common form even on parts of the English-speaking world where “tin” was the traditional use (the form “tin can” covering all bases).

(2) A receptacle for garbage, ashes, etc (often as “trash can”)

(3) A bucket, pail, or other container used usually for holding or carrying liquids.

(4) A drinking cup; a tankard.

(5) A shallow, cylindrical (usually aluminum, cardboard or plastic) container made in various sizes and used for storing and handling film on cores or reels (often used in the phrase “in the can” to indicate the completion of something).

(6) In slang (mildly vulgar), of US military origin, the latrine; the toilet.

(7) In slang, jail; prison (often in the phrase “in the can”).

(8) In slang (mildly vulgar), the buttocks (always in the plural).

(9) In audio engineering, a set of headphones which cover the ears (always in the plural).

(10) In admiralty slang, a depth charge (in the US Navy used also as a slang term for a destroyer, the “utility” warship in size historically between a frigate and cruiser).

(11) In slang, to discard something; to throw away.

(12) In slang, to throw something away;

(13) In slang, to stop something (a project, discussion etc).

(14) In many places, an alternative to “canx” as an abbreviation for “cancelled” (notably by those who have standardized on three-character codes)

(15) In military ordnance, a standard abbreviation for “canon”.

(16) For some purposes, the abbreviation for “Canada” & “Canadian”.

(17) To be able to; to possess the necessary qualifications, skill or knowledge; to know how to; to have the power, authority or means to.

(18) To have the possibility.

(19) To know (obsolete).

(20) To seal a substance (usually food) in a can; to preserve by sealing in a can (can also be used of substances stored in glass jars etc.

(21) In slang, to dismiss from employment; to fire.

(22) In film & television, to record on film, tape or some other medium (based on the physical “cans” in which films were stored).

Pre 900: From the Middle English, from the Old English cunnan (to know, know how) and cognate with the German & Gothic kann (know), the Old Norse kunna, Old High German kunnan, the Latin cognōscere (to know) and the Sanskrit jānāti (he knows).  The use to describe the receptacle emerged some decades later and was from the Middle English canne, can & cane, from the Old English canne and cognate with the German Kanne, the Old Norse and Old High German kanna, the Irish gann and the Swedish kana, all of which may be of West Germanic origin.  In the Late Latin, a canna was a “small drinking vessel”.  Can is a verb & noun, canned & canning are verbs; the noun plural is cans.

In Singlish, “can” is a versatile word.  Singlish (the construct a portmanteau of Sin(gapore) + (Eng)lish)) is still known by some language specialists as Colloquial Singaporean English but the blend is a more popular description and aligns the variation with flavors like Spanglish (Spanish influenced English), Hinglish (Hindi influenced English) & Konglish (Korean influenced English).  In Singapore, Singlish is used in parallel with Singaporean Standard English (differing usually from British English only in the accents although standards in the Far East tend generally to be higher) and it’s been documented since the 1960s although the linguistic tradition is much older.  In Singlish, the meaning of “can” can vary according to the relationship between the speakers and the tone of voice used although essentially it means “yes”, the nuances learned through use. For example Can or not? means “Can you do this?” to which the reply is Can (yes).  As a politeness, that might be responded to by Can meh? (Are you sure?), the expected answer being Can lah! (Yes of course!).  Inevitably, that begat Cannot lah!

In idiomatic use, a “can of worms” is a complicated, difficult, distasteful problem and if applied in retrospect it’s often of something which proved insoluble.  To “carry the can” is to take responsibility for something (particularly if challenging or troublesome); when used in the form “left carrying the can” it implies the task has been “dumped on one”, all others having evaded task.  It’s believed “carry the can” has its origin in the undesirable task of “latrine duty” in the military which required one literally to carry away from the temporary latrines “cans of shit” (also the origin of “can” as a slang word for “toilet”.  To “kick the can down the road” is delay dealing with a problem, the idea being of not then picking up the can as one eventually must.  “In the can” indicates something is complete, arranged, agreed or finalized and was from film production, the cores or reels of processed and edited films being stored “in the can” (a shallow, cylindrical (usually aluminum, cardboard or plastic) container made in various sizes to suit different film stocks.  To be a “can do” sort of person is to be dynamic, positive and anxious to accept a challenge.  The politician Campbell Newman (b 1963; premier of the Australian state of Queensland 2012-2015) described himself as “Can do Campbell” and enjoyed a fine election victory but it ended badly; in the next he suffered one of the bigger landslides in modern political history losing even his own seat.  “Canned laughter” was the process by which “laughter tracks” were spliced into the recordings of television comedies for subsequent broadcast, emulating a live (and appreciative) audience.  It’s often been regarded cynically but all the research suggests it really did work.  The popular phrase ”no can do” indicates an inability or unwillingness to do something.

Yes we can

Barack Obama (b 1961; US president 2009-2017) more than once observed he thought the speeches he wrote were better than any which came from his speechwriters and one can see his point but one of the reasons his presidency is regarded as insubstantial is that his words were more impressive than his deeds.  He was elected president and awarded the Nobel Prize for the same reason: He wasn’t George W Bush (George XLIII, b 1946; US president 2001-2009).  He promised much, exemplified by the phrase “…yes, we can” which expertly he worked into a speech he delivered in Nashua, New Hampshire on 8 January 2008, during the Democratic primaries while campaigning against crooked Hillary Clinton (b 1947; US secretary of state 2009-2013) for the party’s nomination:

…and tonight, I think about all that she's seen throughout her century in America — the heartache and the hope; the struggle and the progress; the times we were told that we can't and the people who pressed on with that American creed: Yes, we can.

At a time when women's voices were silenced and their hopes dismissed, she lived to see them stand up and speak out and reach for the ballot. Yes, we can.

When there was despair in the Dust Bowl and depression across the land, she saw a nation conquer fear itself with a New Deal, new jobs and a new sense of common purpose. Yes, we can.

When the bombs fell on our harbor and tyranny threatened the world, she was there to witness a generation rise to greatness and a democracy was saved. Yes, we can.

She was there for the buses in Montgomery, the hoses in Birmingham, a bridge in Selma and a preacher from Atlanta who told a people that "We Shall Overcome." Yes, we can.

A man touched down on the moon, a wall came down in Berlin, a world was connected by our own science and imagination. And this year, in this election, she touched her finger to a screen and cast her vote, because after 106 years in America, through the best of times and the darkest of hours, she knows how America can change. Yes, we can.

America, we have come so far. We have seen so much. But there is so much more to do. So tonight, let us ask ourselves: If our children should live to see the next century; if my daughters should be so lucky to live as long as Ann Nixon Cooper, what change will they see? What progress will we have made?

This is our chance to answer that call. This is our moment. This is our time — to put our people back to work and open doors of opportunity for our kids; to restore prosperity and promote the cause of peace; to reclaim the American Dream and reaffirm that fundamental truth that out of many, we are one; that while we breathe, we hope, and where we are met with cynicism, and doubt, and those who tell us that we can't, we will respond with that timeless creed that sums up the spirit of a people: Yes, we can.

As a rhetorical device, the repetition of “yes we can” worked well and he deserves credit also for the skill with which it was delivered; few US politicians since Ronald Reagan (1911-2004, US president 1981-1989) have shown such a flair for timing and effect and Reagan had the advantage of decades of practice under the tutelage of some of the best film directors.  But in office, reality bit and Obama soon understood why so many of his predecessors had commented that one surprise as president was how difficult it was to get anything done and the more that involved change, the harder it was.  On the night, “yes we can” thrilled many but among Republicans and even some factions in his own party, the spirit was somewhere between “no we probably shouldn’t” and “no we won’t”.  Still, he may have convinced himself because in his farewell address in Chicago in January 2017 he reprised “yes we can” before pausing for effect and adding “…yes we did”.  Dutifully, the audience applauded.

Soda agnostic Lindsay Lohan with (clockwise from top left) can of Rehab, can of Coca-Cola, can of Red Bull, Can of Pink Ginseng, can of Sunkist Soda & can of Pepsi Cola.  The car is the "Rehab" shot is a 2006 Mercedes-Benz SL 65 (R230; 2004-2011) which would later feature in the tabloids after a low-speed crash.

In the matter of can & may.

"Can" and "may" are modal verbs and the grammar Nazis police their use with some relish and for those who care about such things, there are frequent instances of misuse.  Can & may are sometimes interchangeable: just about anywhere on the planet it can at some time rain but it’s as correct to say it may at some time rain.  In some cases too, neither can nor may might be the appropriate word to use even if both are grammatically correct:  It’s really not helpful to ask: “Can I believe anything said by crooked Hillary Clinton?” or “May I believe anything said by crooked Hillary Clinton?” because the better choice is “Should I believe anything said by crooked Hillary Clinton?”  The answer is of course: “No”.  Still, the general principle is “can” is used of possibilities and “may” of permissions”, illustrated by the companion sentences “I can swim” & “May I go swimming”.  One of the quirks of English which may account for some the undue popularity of “can” is that while can’t has since the eighteen century been one of the language’s most commonly used contractions, “mayn’t is listed by most authorities as rare or archaic (though extinct might more reflect reality).  That was probably because can’t more effortlessly rolls from the tongue.

Campbell's Soup Cans (1962), acrylic with metallic enamel paint on canvas by Andy Warhol (1928–1987).

One of the landmarks of pop-art, Warhol’s Campbell's Soup Cans (1962), is a piece which depends for its effect, not on its content but its intent and there was a randomness of chance in the choice of subject.  The artist explained it by revealing for some twenty years he’d been having a can of the stuff for his lunch, thereby accounting for the motif of “the same thing over and over again”, a idea he’d reprise with variations for the rest of his life.  Had his habit been to enjoy sardines for lunch instead, the painting would have looked different but the meaning would not have changed.  It’s was also an coincidence of capitalism that 32 cans appear, that happening because at the time the company offered that many flavors but had they offered 36, the work would have contained that many.  Presumably, had the range been 29, 31 or some other number symmetrically more challenging things might have differed in detail but the concept would have survived.  Repeating the nearly identical image, the canvases stress the uniformity and ubiquity of the product’s packaging and subvert the idea of painting as a medium of invention and originality.  Although pop-art had at the time a newness about it, Campbell's Soup Cans was another step in the path art had taken since 1917 when Marcel Duchamp (1887–1968) had submitted a porcelain urinal for display in an art gallery, his purpose being to have people question whether art was defined by what it was or the context in which it appeared.  Does anything become art if it's put in an art gallery?  It was an confronting question and we’ve been living with its implications since, none more so than Ted Cruz (b 1970; US senator (Republican-Texas) since 2013), cans of "Campbell's Big'n Chunky Soup" his favorite food.  In 2016 he told US Weekly: "When I'm away from the family, in Washington DC, my dinner is a can of soup.  I have dozens in the pantry" and in that count he may be being untypically modest; his wife revealed that after their honeymoon, he returned from a trip to the grocery store with (literally) 100 cans. 

Campbell's Soup (Limited Editions).

On several occasions, the Campbell brand has taken advantage of the famous association and produced editions of soup cans with Warhol style labels complete with the artist's printed signature.  The first two runs used color schemes close to those which appeared in the 1962 work but the most recent was rather more garish with some changes to the layout.  A notable difference was the customers weren’t required to purchase 32, the cans sold individually.  In a development which Warhol would doubtless have applauded, the cans soon appeared on sites like eBay for three figure US$ sums, a healthy appreciation for their original RRP between US$1-2. 

Rehab

Rehab (pronounced ree-hab)

(1) A clipping of rehabilitation.

(2) In slang (though also sometimes used formally), a programme or facility for treating substance abuse (those addicted to narcotics or alcohol.

(3) In slang (though also sometimes used formally), a programme or facility for treating those recovering from certain medical conditions:

(4) In slang, a building which has been renovated, usually in the context of urban renewal and re-development being.

(5) Of or relating to rehabilitation.

(6) In the vernacular of post-war New Zealand English, the informal short form for the Department of Rehabilitation, a government institution established to cater for the needs of injured military personnel.

(7) To rehabilitate (something, someone, a concept or idea).

(8) In political science, to restore an individual to their previous status (drawn from late medieval civil & canon law and associated particularly with Soviet-era Russia and undertaken to rectify those unpersoned).

(9) In environmental science, a defined area (land or aquatic) in which a programme of rehabilitation is being undertaken or has been completed.

1948 (as documented although there may have been previous ad-hoc use in various oral traditions):  The original form emerged in the vernacular of post-war New Zealand English NZ the informal short form for the Department of Rehabilitation, a government institution established to cater for the needs of injured military personnel.  It worked in conjunction with the civil organization the Rehabilitation League, formed in 1931 with similar aims.  By the early 1970s, the word as a slang term was used in relation to housing and urban renewal programmes.  The extension of the meaning to “an action of restoring anything to a previous condition” emerged in the mid-nineteenth century and was soon used of land, buildings, machinery etc and in the 1940s it began to be applied to programmes designed to re-educate & re-train criminals, addicts and such for a successful re-entry to society.  Rehab is a noun & verb, rehaber is a noun & rehabbed & rehabbing; the noun plural is rehabs.

The Collins Dictionary tracks patterns of word use and while the pre-modern statistics are neither comprehensive or exact to the extent revealed by analysis of the wealth of modern data, it's thought still usefully illustrative.  Clearly there was a trend of use in the eighteenth century but this is thought not indicative of "rehab" being treated as a stand-alone word but as a contraction to save space when printing legal and ecclesiastical documents, a required technique in an era when ink and paper were both expensive.  Rehab, as currently used, is very much a word of the twenty-first century.

The noun rehabilitation (act of reinstating in a former rank or standing) dates from the 1530s and was from the French réhabilitation or the Medieval Latin rehabilitationem (nominative rehabilitatio) (restoration), a noun of action from the past-participle stem of rehabilitare, the construct being re- (again) + habitare (make fit), from the Latin habilis (easily managed, fit).  At least some etymologists suspect the derived verb rehabilitate may have emerged concurrently but the earliest known citation is from 1583.  The process originally applied exclusively to those who, having earlier been punished for some transgression by being stripped for rank or status, were for whatever reason restored to their former position.  The verb was from the Medieval Latin rehabilitatus, the past participle of rehabilitare and the processes were at various times codified in both civil and canon law.  The process is now best remembered from the practices in the Soviet Union where comrades guilty of especially unworthy acts (or thoughts) could be “unpersoned” (ie erased from all records).  In some cases, circumstances could change and the unpersoned were rehabilitated.

Lindsay Lohan with broken wrist (fractured in two places in an unfortunate fall at Milk Studios during New York Fashion Week) and 355 ml (12 fluid oz) can of Rehab energy drink, Los Angeles, September 2006.  The car is a 2006 Mercedes-Benz SL 65 (R230; 2004-2011) which would later feature in the tabloids after a low-speed crash.  The R230 range (2001-2011) was unusual because of the quirk of the SL 550 (2006-2011), a designation used exclusively in the North American market, the RoW (rest of the world) cars retaining the SL 500 badge even though both used the 5.5 litre (333 cubic inch) V8 (M273).

Doubtlessly, substance abuse has existed ever since substances became available to be abused and just a certainly, over the millennia, individuals, families and societies have devised their own methods to rehabilitate those afflicted.  There was great variation in the approaches but in the West, most tended to be influenced by the dominant ethos that addiction was a moral failing and personal weakness, the literature suggesting punishment and abstinence were there preferred course of treatment; “drying out” has a long history.  It was in the late twentieth century that the notion of “rehab” being not only a process but one which could be treated in a permanent structure, an institutionalization of earlier ad-hoc approaches of which Alcoholics Anonymous, beginning in 1935 is probably the best known although it was by no means the first and much of its success in attracting followers has been attributed to it distancing itself from the religious affiliations which characterized many of its predecessors.

Lindsay Lohan in rehab center, Sundance, Utah, 2007.  It is possible to purchase alcohol in Utah although the regulatory environment is more restrictive so presumably the state is more suited than many to host rehab centers.

Even by the 1970s, there was still much stigma attached to rehabilitation programmes and it was probably the admission by Betty Ford (1918–2011; US First Lady 1974-1977) that she was an alcoholic which was most instrumental in lending some legitimacy to the concept.  After leaving the White House she would found her own rehab clinic which continues to operate.  In the years since, there’s been an attempt to re-classify addiction as a treatable medical condition rather than a moral failing or something worse which need to be treated punitively.  To an extent that has worked and there’s probably a general public perception that addiction is exactly that, a chemical relationship between the substances and the physical brain but in some jurisdictions, such is the volume of addiction that it’s simply not possible to provide rehab services on the scale required.  There’s a critique also of rehab as something which has come to be seen by the TikTok generation as something almost fashionable, presumably because of the frequency with which pop-culture celebrities are clients and even addiction can now thus be rationalized as one of the corollaries of the creative mind.  There’s also of course the link between rehab clinics and wealth, the association created because (1) they’re places where even short-stay programmes can cost tens of thousands of dollars and (2) the only time they’re attract publicity is when a celebrity or some other famous figure attends.  Criticism has been extended too because there’s often little sympathy for those who use an admission of addiction in mitigation (“excuse” in the popular imagination) when on trial for this or that and there’s a perception rehab is an attractive alternative to actual punishment.

Monster Rehab energy drinks.

According to the helpful site Caffeine Informer, Monster's Rehab energy drinks (Peach Tea, Raspberry Tea, Orangeade, Watermelon, Strawberry Lemonade & Tea + Lemonade) contain 160 mg of caffeine (except the watermelon flavor which weighs in at 150).  A cup of black coffee will typically contain between 55-70 mg.  According to the manufacturer, the Rehab drinks are "packed with electrolytes, vitamins, and botanicals that deliver on advanced hydration helping you reduce fatigue and increase concentration."  Their target market is those who wish to "refresh, recover & revive" and their staccato advertising copy captures the moment they'd like customers to visualize:

It’s 2 P.M. Still sleeping, but who’s banging on the door?  “Housekeeping!”  Your eyes open to see a mermaid scoot her ass across the floor.  The housekeeper screams and mutters a prayer.  This can’t be right.  Your eyes close.  It’s after 4 now.  Your head’s pounding.  So many questions.  You’ve got to meet everyone downstairs in an hour to do it all again.  Not a problem.  You’re a professional.  You crack open a Rehab Monster Tea + Lemonade and let the lemon-infused electrolytes, vitamins, and botanicals work their life-giving, hydration magic.  Congrats, You’re back from the dead.

Vegan

Vegan (pronounced vee-guhn or vey-guhn)

(1) A vegetarian who omits all animal products from their diet and does not use animal-based or sourced products such as leather or wool.

(2) Someone from Vega, towns in Scandinavia, the US or (mostly in fiction) other places so named.

(3) A collective name adopted in the 1980s by fans of the singer-songwriter, Suzanne Vega (b 1959).

1944: A modern English construct, veg (contraction of vegetable) + an, coined by Donald Watson (1910-2005) to distinguish those who abstain from all animal products (eggs, cheese, etc) from those who merely refuse to eat the animals.  The -an suffix occurred originally in adjectives borrowed from Latin, formed from nouns denoting places (Roman; urban) or persons (Augustan) but now productively forms English adjectives by extension of the Latin pattern.  The suffix an, and its variant ian also occurs in a set of personal nouns, mainly loanwords from French, denoting one who engages in, practices, or works with the referent of the base noun (historian; theologian); this usage especially productive with nouns ending in ic (electrician; logician; technician ).  Vegan is a noun & adjective, vegansexual is a noun and veganism, vegansexualism & veganist are nouns; the noun plural is vegans.

Donald Watson was an English animal rights advocate who founded The Vegan Society in 1944.  Although the actual establishment of the society was either 5 or 12 November (the records are contradictory), World Vegan Day is each year celebrated on 1 November.  In 1984, a dissident faction broke from the group and formed The Movement for Compassionate Living and ever since, veganism has been a contested space, the factions including (1) radicals who pursue direct action against the slaughter industry and its customers, (2) purists who exclude to whatever extent possible the presence of animal products in their lives while variously tolerating, ignoring or disapproving of those who don't and (3), vegetarians who can't resist nice handbags and shoes.  Latest vegan news here. 

The Sexual Politics of Meat

While still an undergraduate at the University of Rochester, Carol J Adams (b 1951) was instrumental in having women's studies courses added to the syllabus.  A long-time vegan, she later gained a masters from Yale Divinity School but her core interest remained feminism and in 1990, building on earlier essays, she published The Sexual Politics of Meat, an exploration of her vegetarian-feminist, pacifist, intersectional critical theory.

Her most novel concept was the "absent referent", used to explain the consumption of meat and the objectification of women in pornography, the referent literally absent in the case of the life of the dismembered beast being consumed; metaphorically in the oppression of the life of the subjects of pornography.  Adams constructed parallels within the patriarchal system, men’s sense of entitlement over animals similar to their varying expectations of the right to abuse, exploit, or degrade women in the use of their bodies.  Structurally she noted, language is replete with terms and phrases which interchangeably can be used to describe either women or animals with a hierarchy of use based on speciesism depending on men’s perceptions of degrees of female attractiveness.  All such use she claimed, regardless of how else it could be classified, is hate speech.

Most graphic was the notion of the pornography of meat which drew a visual comparison between meat advertised for sale on shelves and the portrayal of women in various media; two different forms of consumption which use the same techniques of production and distribution.  Within the western consumer model, Adams found a construct of white male supremacy which relegated all others, different races, non-human animals and women, to inferior roles or places.

Linder Sterling in meat dress (1982).

Linder Sterling (b 1954) is a radical feminist artist.  In November 1982, as part of a punk performance in Manchester’s Haçienda club, she appeared in a dress made from meat, while packages of leftover raw meat wrapped in pornography were distributed to the audience.  The performance culminated with a quite aggressive critique of the exploitation of women which, at the time, seems genuinely to have been confronting.

Lady Gaga in meat dress (2010).

By 2010, the "waves" had made feminism diffuse, the inherently post-modern platform of social media had imposed on pop-culture an inevitable equivalency of value and there was perhaps no longer a capacity to shock, just to be photographed.  Lady Gaga’s (b 1986) meat dress (asymmetrical, with cowl–neck), worn at the MTV Video Music Awards is now remembered as just another outfit, named by many as the fashion statement of 2010.  While there was cultural comment, the piece's place in history is as a frock, not for any meaning, implied or inferred.  Lady Gaga though remained phlegmatic, quoted later as saying, "... it has many interpretations.”  She later clarified things by saying the meat dress wasn't significant as a piece of clothing but was intended as a comment on the state of the fashion industry and the importance of focusing on individuality and inner beauty rather than superficial appearances.  One implication may have related to impermanence; because the garment was made wholly from raw meat, it had to be preserved with chemicals before and after the event but there are limits to what's chemically possible and the parts of the garment which had decomposed were discarded before the remains were dried and a permanent coating applied.  The preserved dress has since been displayed.  Lady Gaga no longer wears "meat-based" clothing.  

Tash Peterson letting people know how sausages are made.

Something of a local legend in the world of vegan activism, Tash Peterson (b circa 1995) is an animal rights activist based in Perth, Australia.  Not actually in the militant extreme of the movement which engages in actual physical attacks on the personnel, plant & equipment of the industries associated with animal slaughter, Ms Peterson's form of direct action is the set-piece event, staged to produce images and video with cross-platform appeal, the footage she posts on social media freely available for re-distribution by the legacy media, her Instagram feed providing a sample of her work in various contexts. Ms Peterson is a vegansexual (a vegan who chooses to have sex or pursue sexual relationships only with other vegans).

Her events have included approaching people in the meat section of supermarkets, wearing a blood-soaked butcher's apron while carrying the simulated carcass of a chicken, donning a rather fetching cow-skin (presumably synthetic) bodysuit in front of a milk and yoghurt display while carrying a sign surmising the processes of industrial dairy farming in anthropomorphic terms, wearing bloodied clothing to fast food outlets while using a megaphone to address queues of customers, explaining the details of what's done to animals so they can enjoy their burgers and, eschewing even the sensible shoes she usually wears, adorned in nothing but a pair of knickers and liberally smeared with (what she claimed to be her own menstrual) blood, staging a protest in Perth's Louis Vuitton shop, shouting at the customers and calling them "animal abusers".

Tash Petersen on OnlyFans.

Ms Peterson was banned from all licensed venues in Western Australia after storming pubs and restaurants, her critique of course the content of the meals rather than their sometimes dubious quality; after that, she travelled briefly to the eastern states but has since returned to Perth.  She has an active and apparently lucrative account on OnlyFans with all that that implies but there is an element of animal rights activism even there so whether her two interests should be thought vertical or horizontal integration might be an interesting question for economic theorists.

Fellow club member Lindsay Lohan who remained a carnivore.

Veganism can be merely a personal choice and there are many who have adopted at least the dietary aspects simply because they believe there are benefits for their health but it can also be a political statement and political statements need publicity, the preferred modern form being the celebrity endorsement and if need be, one paid for.  In 2010, the animal rights organisation PETA (People for the Ethical Treatment of Animals) offered to subsidize Lindsay Lohan's stint in rehab, on the condition she became a vegan.  For PETA, it was the chance to make the point that while undergoing treatment for substance addiction, Ms Lohan would be able also to rid herself "... of one more toxic substance: meat.", adding "As you know, a crucial part of any recovery is showing charity to others. One way to do this is to be kind to animals, the Earth, and your own body. You'll never regret it." 

Ms Lohan had previously attracted the attention of the organization, in 2008 making their "worst dressed list" after being photographed wearing fur.  According to E! Online, PETA offered to contribute US$20,000 towards the US50,000 cost of the court-ordered stay, half to be paid for adopting the vegan diet while in rehab, the remainder if the diet was followed for one year following her release.  The encourage acceptance of the offer, it was accompanied with a vegan-care pack including a DVD about the slaughter industry called Glass Walls (narrated by Paul McCartney (b 1942)) and a vegetarian/vegan starter kit.  While rehab went well, the offer apparently wasn't taken up and although she seems to now eschew fur, her Instagram feed continues to feature much leather (handbags & shoes) and meat (the odd recipe provided including a chicken pie and machboos, a favorite in the Middle East).