Americans Have Entered the Age of the Needle - The Atlantic

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My generation—which is to say, the pillbox generation—came of age during the 1990s. The number of adults who were taking five or more prescription drugs doubled in that decade; the use of medications for depression and cholesterol more than tripled. If pills had once been used from time to time to curb a headache or stifle an infection, now they were a daily ritual for tens of millions of Americans. Popping meds, whether by catapult or tweezers, became the norm.

In the 2020s, we’re living through a second such transition: the dawning of the needle age.

For the past five years, the nation’s shots have multiplied to levels never seen before. Injected medications were once unusual, and mostly limited to diabetics who needed insulin. Now millions of diabetics use syringes of Ozempic, and millions of other people are on Mounjaro for weight loss. In 2025, some 12 percent of all U.S. adults partook of these injections or others in their class. GLP-1 shots were so commonplace last year that they accounted for about 7 percent of all prescriptions in America.

Even this is just the tip of the needle. Americans’ use of IVF has doubled in a decade, and now requires something on the order of 10 million to 20 million self-administered hormone shots a year. By 2024, 10 million rounds of Botox (or other wrinkle relaxants) were given out, along with 8 million filler treatments. Although some cosmetic shots are administered in doctors’ offices, many of the rest are received at the 10,000 “medical spas” that have lately come to dot the country. These are puncture parlors, more or less, and they offer a growing list of services: not just treatments for the skin but also vitamin injections, IV-dripped electrolytes, and minerals delivered through a tube. One needle-forward wellness chain, called JECT, has locations in Miami Beach, West Hollywood, the Hamptons, and, as it happens, right around the corner from my house in Brooklyn. If I were ever in the mood, I could head over for a “24K gold micro-dosing” process that will supposedly inject my face 2,400 times a minute.

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These needle trend lines have been building for a while. Botox was approved for cosmetic use in 2002, and the first GLP-1-based drug for diabetes reached the market three years after that. But today’s rampant culture of injection did not have its breakthrough moment until early summer 2021, when the FDA signed off on semaglutide, the ingredient in Ozempic, as a treatment for obesity. That kicked off the weight-loss-medication craze. A month later, Joe Rogan told his millions of podcast listeners that injecting peptides—not insulin or Ozempic, but other, less established ones—can have miraculous results. Rogan said he’d tried one in particular called BPC-157, which cured his elbow tendinitis in two weeks. Peptide fever built from there, on glowing testimonials from tech bros, celebrities, and eventually officials at the highest levels of the U.S. government. “I’m a big fan of peptides; I’ve used them myself,” Health and Human Services Secretary Robert F. Kennedy Jr. told Rogan earlier this year. (RFK Jr. has also promised that regulators will soon be easing restrictions on the sale of peptides.)

The funny thing about our growing love for getting shots is how utterly at odds it is with human nature. Who, exactly, has any sort of love for getting shots? Needlephobia is natural and indeed appears to be widespread, even among grown-ups. Although formal research on the topic has been somewhat limited, a 2018 review of several dozen studies found that for adults under 40, the rate of needle fear may be as high as 30 percent. According to the same analysis, 16 percent may skip their flu shots simply to avoid the stress of an injection.

Read: Should your flu and COVID shots go in different arms?

This last point in particular was worried over in summer 2021, just as our needle age was starting. New vaccines had been developed to reduce the risk of death from COVID-19, and experts worried that anxiety over needle sticks would hamper uptake. One paper out that June concluded that one-tenth of all COVID-vaccine hesitancy could be explained in just this way. Some people even called for a needle-fear exemption to be added to the mandates for vaccines.

And yet none of this posed a challenge to the rollout that ensued, which became without a doubt the largest mass injection effort in the nation’s history. By the end of 2021, more than half a billion doses of the COVID shots had been plunged into our deltoids. Let’s put that in “24K gold micro-dosing” terms: Americans received an average of 1,000 COVID shots a minute, every single minute of that year.

Read: The good news about vaccine hesitancy

Yet a wariness about vaccines persists; perhaps it’s even grown, in certain quarters, since we started getting immunized against COVID....