Some of you may remember 1982, when some twisted humanoid put cyanide into extra-strength Tylenol capsules. Seven people in Chicago died after taking the capsules.
Well, forget about 1982. Today the danger is not some sociopath lacing pills with poison, but the drug companies themselves.
“Iatrogenic” is a great scrabble word, but it’s also a word that you should remember if you or your kids see doctors or take prescription drugs. It means: induced inadvertently by a physician or medical treatment, including prescription medications. If, in the course of a procedure, a doctor nicks an artery and you die, that is an iatrogenic accident. If your son gets the antidepressant Wellbutrin for his bipolar disorder and he commits suicide in a manic psychosis, that is an iatrogenic “event,” as the drug companies call it.
In the United States, 225,000 deaths per year may be iatrogenic, making it the third leading cause of death. Of that, the prestigious Journal of the American Medical Association (JAMA) reports that 106,000 deaths per year are from “non-error, adverse” effects of prescription meds, making this the fourth leading cause of death in the U.S. This dwarfs yearly automobile accidents and, in fact, accounts for more deaths than all other accidents combined.
Only heart disease, cancer and strokes kill more Americans than prescription drugs. This shocking figure does not include drugs administered erroneously, nor does it include purposeful overdoses in suicide attempts.
If medication errors were included in this statistic, the death toll would probably be as high as 140,000 deaths per year. To make matters worse, Dr. David Kessler, Chief of the U.S. Food and Drug Administration, believes that “only 1 percent of all serious drug reactions are reported.”
Less deadly but certainly more pervasive is the indiscriminate mindfuck of our kids by the prescription and over-the-counter drug industry, or Big Pharma. Because, unlike the old days of “miracle” drugs and “better living through chemistry,” the name of the game now is profits and indiscriminate placement of as many drugs in as many households (and young bodies and minds) as possible.
Kelli — only one diagnosis needed
Kelli is a Ventura girl who, as a student at Montalvo Elementary and Balboa Middle Schools, “always kept to myself, couldn’t pay attention, and had no friends,” although she did well in English and graduated from Buena High School. At home, “because my father was emotionally abusive and in a constant rage, I stayed in my room and read.”
“It got to the point where my teachers begged my parents to get me on some kind of drug for what they called my ADD and depression.”
So Kelli’s childhood was an endless array of tests; meds like Prozac, Zoloft, Paxil, Effexor, Cymbalta, Xanax, Zyprexa, Adderall, Dexedrine and Ritalin; therapists, counselors and diagnoses. One diagnosis led to another, and Kelli has been, at various times, diagnosed with clinical depression, attention deficit disorder (ADD), bipolar disorder, generalized anxiety disorder and borderline personality disorder (BPD).
There is no valid chemical test for any of these things. The diagnoses are completely subjective.
From the age of 11, Kelli used alcohol, speed, cocaine and marijuana, and at 13 began to “cut” (use razor blades to inflict small nonsuicidal wounds), and binge and purge on food.
Kelli’s most recent diagnosis, in 2004, was borderline personality disorder, and after that she was prescribed three more drugs, even though many experts believe BPD does not respond to drug therapy. The borderline (usually a woman) is constantly crossing the “borderlines” between psychosis, neurosis and normalcy, and it’s difficult to pinpoint which condition to treat.
Throughout all this, Kelli was never diagnosed with the one diagnosis that trumps all others, polysubstance dependence, or addiction to several drugs at once. Her “experimentation” with drugs was often alluded to as “self-medication” by her therapists and counselors, but, in a futile quest to “get to the root” of her substance abuse, no one thought to use this as her primary diagnosis and get her off the drug merry-go-round.
Today Kelli takes only one drug, a mild dose of the antidepressant Wellbutrin, runs marathons and attends support groups like Narcotics Anonymous and Overeaters Anonymous. She has a job as a drug counselor and lives a “normal” life; she has not had a drug or drink, cut or purged in three years.
“The single most important thing a psychiatric patient can do is to stop taking illegal and nonprescribed drugs, including alcohol,” says Dr. Lee Bloom of Pasadena Recovery Center. Sometimes this single act undoes years of damage, and can be the “cure,” if accompanied by a program of support groups and sponsorship, that the prescribed drugs are not capable of providing yet.
The blame for Kelli’s fiasco is not all Big Pharma’s — therapists, physicians, parents and school counselors are too often too quick on the diagnosis and prescription trigger. But the real culprits in the disgraceful overmedication of our children are the drug companies.
One step forward, two steps back
There was a time when the phrase “miracle drug” meant something. In the 1940s and 1950s antibiotics, Salk’s polio vaccine, cortisone and potent psychiatric meds, like Thorazine, changed lives and saved lives.
Americans came to believe that Big Pharma was capable of anything, forgetting that these new drugs also had powerful side effects. Antibiotics sometimes actually make people more prone to infection. Cortisone causes gross systemic changes, and Thorazine sometimes turns people into zombies.
Yet there is still a lingering belief that drugs can cure anything, and Big Pharma takes advantage of this belief.
Today, spending on prescription medicines for patients younger than19 years of age has increased by 85 percent over the past five years, according to an analysis by Medco Health Solutions, a pharmacy benefits management company and subsidiary of Merck, the pharmaceutical concern. Dr. Robert Epstein, Medco Health’s chief medical officer says, “More young people are taking medicine today than five years ago and are taking drugs for longer periods.”
Moreover, American children are three times more likely to be prescribed psychotropic medications for psychiatric conditions such as attention deficit hyperactivity disorder (ADHD) and bipolar disorder than European children are, according to a report published in Child and Adolescent Psychiatry and Mental Health.
So not only are our kids taking more drugs than ever before, but they’re taking them more than children and young adults in almost every other part of the world, and there’s no evidence that prescription drug-happy societies like ours are doing any better at making our kids mentally sound.
In fact, the prosperous, politically influential drug companies, or Big Pharma, may be wreaking havoc on the minds and bodies of our youngsters, turning them into potential drug addicts, predisposing them to look for a chemical cure for every neurosis, ache, pain, sleepless night and distress, when often a simple thing like exercise or music works much better.
In the battle for our children’s minds, drug companies have created a cute, oversimplified metaphor that helps them lull parents and kids into a feeling of security about their drugs: the chemical imbalance theory.
Just a theory
Helping to fuel the current psych med craze is the almost blind acceptance by doctors, therapists, parents, school counselors, parents and consumers of the still-unproven chemical imbalance theory.
The chemical imbalance theory is a useful metaphor, and it is often cited in articles on depression, bipolar disorder, anxiety, obsessive compulsive disorder (OCD), ADD and ADHD, but it is not a valid hypothesis. (The chair of the Federal Drug Administration Psychopharmacology Advisory Committee agrees.)
Drug companies would like us to think that psychiatric disorders are the result of a systemic glitch and that, if we take just the right combination of psychiatric medications, our systems will be restored to a “normal” state and all will be well.
Why do the drug companies disguise an unproven theory as fact in describing the way their drugs work? Because it’s easy for the patient (and the doctor) to understand, and because it sounds so, well, scientific.
Jessica, a 19-year-old patient, describes it this way: “I have depression because I don’t have enough serotonin in my body. Serotonin is the chemical that gives people pleasure. My Lexapro contains serotonin and when I take my Lexapro every day, it keeps my serotonin at a constant level, and it keeps my moods consistent.”
That would be a beautiful thing, if it were remotely true. The official Forest Pharmaceuticals Web site for Lexapro, a commonly prescribed antidepressant, says that people with depression:
“Have an imbalance of the brain’s neurotransmitters. These chemicals in the brain allow nerve cells to communicate. One of these neurotransmitters is serotonin. An imbalance in serotonin may be an important factor in the development of depression and anxiety. Serotonin is released from one nerve cell and passed to the next. In the process, some of the serotonin released is reabsorbed by the first nerve cell. Selective serotonin reuptake inhibitors (SSRI) block the reabsorption of serotonin into the first nerve cell. It is this blocking action that causes an increased amount of serotonin to become available at the next nerve cell.”
You may not understand that (and most therapists and many doctors don’t either,) but it certainly sounds impressive. And it’s even better when accompanied by beautiful cartoon drawings and animations of neurotransmitters and synapses.
But the cute cartoons ignore this salient fact: The brain chemistry of depression and anxiety is not fully understood. Dr. Lee Bloom, chief psychiatrist at Pasadena Recovery Center in Pasadena, says, “Drug therapy is a little better than witchcraft, but not much. There are at least 100 chemicals in the brain that relate to brain function, and we know something about maybe six of them.”
Big Pharma wants us to believe that drugs restore the body to a “normal state.” The primary fallacy here is that almost no drug restores the normal. Drugs act on different systems in different, sometimes very powerful, ways, and in the course of that they may produce an effect that makes the patient feel better or respond in a positive (or at least positive to the parents or doctors) way.
Think about it. Of all the people you know who have been diagnosed with a “chemical imbalance,” how many were tested chemically to arrive at this diagnosis?
Jeffrey Lacasse, a Florida State University doctoral candidate and visiting lecturer in the College of Social Work, and Jonathan Leo, a neuroanatomy professor at Lincoln Memorial University in Tennessee, state, “The media’s presentation of the (chemical imbalance) theory as fact is troublesome because it misrepresents the current status of the theory.”
The Diagnostic and Statistical Manual of Mental Disorders, which virtually all psychiatrists and therapists use to diagnose patients, plainly states that the cause of depression and anxiety is “unknown.”
According to a report in the Public Library of Science and Medicine, pharmaceutical companies are inventing diseases in order to up their sales figures. Researchers said many conditions “are being medicalized” by the industry.
Restless leg syndrome, a relatively rare condition, is being promoted wildly by Big Pharma “detail men” because there are now drugs for it. Disease awareness campaigns funded by the industry are aimed at “promoting drug sales rather than informing people.”
And although ADD, ADHD, depression and bipolar disorder are valid and serious childhood diseases, Big Pharma has certainly broadened its definition of those disorders by promoting “tests” that almost guarantee that a great percentage of people will feel that they are suffering from those disorders.
The worst part of the whole fiasco is that you can’t really trust “scholarly” research on the drugs you or your kids might take. Big Pharma at least indirectly finances most studies on emerging drugs, and drug companies are allowed to “throw out” studies that don’t support their ends.
To make matters worse, many scholarly articles are ghostwritten by PR firms hired by drug companies.
An editorial in the April 16, 2008, issue of the Journal of the American Medical Association (JAMA) describe articles penned by Merck & Company ghostwriters. Then Merck had eminent academic doctors, who probably had nothing to do with the research, credited as primary authors. (These articles were about Vioxx, a drug that is no longer used because it sometimes kills people.)
This type of activity is shameful, but commonplace.
Creative drug uses
Today many drugs are vaguely altered versions of old products, to skirt patent laws. The market is filled with astonishingly similar drugs to treat depression, anxiety and bipolar disorder, while cheap and effective drugs like lithium are underpromoted.
For example, the new antidepressant Lexapro, which is more expensive than cocaine, is touted as “a cleaner, improved version” of Celexa. Actually, it differs only slightly (a molecule or two were modified) from the now generically available Celexa. Most doctors won’t tell you that, because Forest Pharmaceuticals gives away a lot of stuff to doctors to persuade them to recommend the more expensive product.
And there are many drugs that are now used for purposes that have little or nothing to do with their original intent. Adderall, for example, is today the most widely used ADHD drug for kids and teenagers. It’s actually four different kinds of speed.
Adderall was derived from the amphetamine-based diet pill Obetrol, which is no longer used for weight reduction because speed is one of the most abused substances known to man. Adderall sometimes helps kids with ADHD to calm down and focus, and many parents hail it as a miracle drug because it keeps their kids quiet.
But it’s still speed.
Rarely do you hear about prison time for executives implicated in pharmaceutical negligence crimes or bribery. Corruption and abuse by Big Pharma has lately become an American tradition, and we’re not likely to get any relief soon.
Sometimes, to the concerned professional, it appears that Big Pharma just throws drugs together, and if they don’t kill the first few people who test them, they are placed on sale.
But despite all the negative brouhaha surrounding Big Pharma, it must be said, unequivocally, that drugs save lives, and improve the quality of life.
In 1900, you could expect to live to the ripe old age of maybe 50. Today, that figure is almost 80 and going up all the time. In many ways, we Americans are healthier than ever. Much of that is attributable to better medical care and equipment, better diets and lifestyles, and more knowledge about health. But much of this improvement is due to pharmaceutical therapy.
Thousands of people with rheumatoid arthritis, HIV and AIDS, depression (yes depression) and cancer are alive and/or living better lives because of prescription drugs. And we don’t even think about polio, diphtheria, malaria, typhoid and other “obsolete” diseases because of amazing drug cures.
But we must still be concerned about what Big Pharma is doing to us, and how we are being hoodwinked into taking more drugs than we need to, and how our children are being overmedicated and sometimes set up for a lifetime of addiction.
George (Butch) Warner, M.A., M.F.T.I., CADCA, is an addiction specialist and psychotherapist, a member of the American Society of Addiction Medicine (ASAM), and is certified by the California Association of Alcoholism and Drug Abuse Counselors (CAADAC) and NAADAC (National Association for Alcoholism and Drug Abuse Counselors). His e-mail address is GeeFW@sbcglobal.net.