Why Are We All Taking So Many Drugs?
I despise conspiracy theorists. Paranoia is for losers. But I have to admit, something that happened during a recent visit with old friends from London gave me pause. At our first breakfast together in their rental house in Boston, the Londoners, Michael and Barbara, watched in astonishment as I and another guest, Laurie, took out our pill bottles and counted out our morning doses. Nothing exciting, just the usual medicines to treat the usual boomer ailments: high blood pressure, arthritis, stuff like that. Counting vitamins and probiotics, Laurie and I each swallowed five or six pills before our first cups of coffee.
“What is all that stuff?” Michael marveled.
Laughing, a little embarrassed—getting old is no fun—we explained what we were taking and why.
“In Britain, nobody takes that many pills,” Michael said.
Laurie laughed again. “Well. Socialized medicine,” she told him. But it got me thinking: Why do I take so many pills? If my doctor, whom I like very much, had her druthers, I’d take more: She swears glucosamine chondroitin will help my arthritis. I tell her: It’s been scientifically proven that the stuff doesn’t work. I don’t like taking pills. And I really don’t like taking them forever and ever. I’m working to lose weight and changing my diet in hopes of getting off my high blood pressure meds. My doctor doesn’t seem to think this is going to work—that I should just resign myself to my morning pill regimen. Most people do.
That’s why I was so interested in a report earlier this month that the inspector general’s office at the Department of Health and Human Services is going to review the use of anti-psychotic drugs in children. According to the Wall Street Journal, the number of Americans under age 20 who are getting Medicaid-funded prescriptions for such drugs, which were developed to treat psychoses like schizophrenia and bipolar disorder, tripled over the decade between 1999 and 2008. Medicaid paid $3.6 billion for antipsychotics in 2008, compared to $1.65 billion in 1999. Kids on Medicaid are prescribed anti-psychotics four times more often than kids who are privately insured. Almost 20,000 kids age five and under were prescribed such drugs through Medicaid in 2008, and in some states, they’re given to kids as young as five months old. The review will examine whether the drugs are actually medically indicated and not being administered simply to subdue troubled children and keep them sedated.
This past weekend, the New York Times reported that one in 10 Americans is now diagnosed with depression. Among women in their 40s and 50s, the rate is an astonishing one in four. Damn, I’d better add one more pill to my daily stash.
Then there’s Adderall, which I took for a week in an experiment I wrote about here. A few days ago, the Times reported a quadrupling in the number of emergency-room visits by people ages 18 to 34 that were related to the use of prescription stimulants like Adderall and Ritalin in the past few years, from 5,600 in 2005 to 23,000 in 2011. More than half these young people reported that they got the drugs for free from a friend or relative. If the drugs were really needed to treat attention-deficit disorder by the people for whom they’re prescribed, why would they be giving them away to their buds?
And the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders, the DSM-5, has made diagnosis of ADHD even easier. Great! Already, 48.4 million prescriptions for these drugs were written in 2011, up 39 percent just since 2007. Doctors are generating new monthly ADHD drug prescriptions at a rate of 14,000 a month now, according to Forbes.
Why are we all taking so many drugs?
Well, for one thing, the “experts” who decided to broaden the definition of ADHD for the DSM-5 more than likely have a stake in the ever-more-prescriptions game. A spanking-new study of who serves on the panels that make recommendations about how to define diseases showed that an average of 75 percent of members had been paid by the prescription-drug industry. Three-quarters of those experts, in fact, had financial ties to Big Pharma companies with “direct interests in the therapeutic area covered by the panel.” Here’s what the study says:
The researchers identified 16 publications in which expert panels proposed changes to the disease definitions and diagnostic criteria for 14 conditions that are common in the U.S., such as hypertension (high blood pressure) and Alzheimer disease. The proposed changes widened the disease definition for 10 diseases, narrowed it for one disease, and had an unclear impact for five diseases. Reasons included in the publications for changing disease definitions included new evidence of risk for people previously considered normal (pre-hypertension) and the emergence of new biomarkers, tests, or treatments (Alzheimer disease). Only six of the panels mentioned possible harms of the proposed changes and none appeared to rigorously assess the downsides of expanding definitions. Of the 15 panels involved in the publications (one panel produced two publications), 12 included members who disclosed financial ties to multiple companies. Notably, the commonest industrial ties among these panels were to companies marketing drugs for the disease being considered by that panel. [emphases added] On average, 75 percent of panel members disclosed industry ties … to a median of seven companies each.
Hmm, now let me get this straight. Doctors who are paid by drug companies serve on “expert” panels that recommend more people should be prescribed those drugs. What could possibly be wrong with that?
As I said, I’m no fan of conspiracy theories. But I’m starting to feel a little healthy paranoia might be in order when it comes to the pharmaceutical industry.