Monday, February 04, 2008

Much Ado About Something

As most people know, main stream media, the medical community, pharmaceutical industry insiders, bioethicists, consumer protection groups, parent support groups and religious organizations have been engaged in a raging debate regarding the use of psychoactive drugs in the US. The primary focus of the debate has been the use of psychoactive medications in the pediatric population. The concerns are legitimate considering how few of these drugs have actually been evaluated in adequate and well-controlled studies under the Pediatric Rule and recent allegations that "negative" data (i.e., data indicating lack of efficacy and/or significant safety issues) from those studies has been squelched by big Pharma. These headlines and the often tragic tales behind them have left the FDA, pharmaceutical industry and medical establishment with a seriously black eye and advanced the agenda of those in a quest to eradicate psychiatry & psychological therapy (except that conducted under the guise of lucrative and tax-exempt religious activities).

Contrary to the beliefs of Xenu-phobes, psychiatry is not what is drugging our youth, our impatient culture is. Changing thresholds of diagnosis and treatment, development of new (which equates better in Americanese) drugs, DTC advertising coupled with the plethora of "medical" information on the web and a willingness to self-diagnose have lead to an exponential rise in the number of prescriptions for psychotropic medications over the years. My guess is that the majority of prescriptions for psychotropic drugs are being written by GPs and that they are doing so at the behest of teachers/schools, the media, parents and patients alike, all of whom seem to be looking for a cure for what ails them/their children, regardless of whether said ailment is truly present and warrants pharmacological intervention. The ADHD drugs have become the new Haldol (aka "vitamin H"), except they’re being used to quiet children regardless of any actual disorder instead of used to keep the institutionalized mentally ill patient quietly drooling in the corner.

In this country, one of our biggest problems is the dangerous attitude that anything and everything can be corrected if you take a pill. This leads to too many people being prescribed drugs that they don’t need for a condition that they don't have or one in which other modalities of treatment should be sufficient. This attitude is not limited to mental health issues, we have the same attitude about pretty much everything (for the record, that attitude is no small part of the reason why we've been facing a rise in drug-resistant bacteria). Sadly, the resulting onslaught of side-effects to medications used inappropriately may end up hurting those patients who could actually benefit from these drugs by creating new barriers to treatment. As a society, we'll never be able to rectify the situation until we take a more logical and pragmatic approach to addressing [mental] health issues.

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