The Truth About Psychotropics

Despite the 5 Billion dollar marketing campaign by Big Pharma, the science underlying the widespread and long term use of psychotropic medication is woefully inadequate. These medications are expensive, have sometimes very serious side effects, may create the very problems they purport to cure, and their long term safety has not really been established. Are they useful for some patients in some circumstances? Yes. Are they useful for most patients in most circumstances? No. Should they be used as a first line and exclusive treatment for the complicated life circumstances that lead to emotional and behavioral disorders? Never.

The Truth About Psychotropics

Big Pharma Rip Offs

"Even during a two-year recession with people losing their homes and jobs, pharma is still the nation's third most profitable sector. How does it do that? In part by cheating the government, misrepresenting science, bribing doctors, patients and pharmacies, and squeezing the FDA. Other than that, the industry plays completely fair."  

Check this out if you want to see one reason why health care costs are so high. 

Big Pharma Rip-Offs

Epidemic or Marketing?

Robert Whitaker's "Anatomy of An Epidemic" discusses the so-called biological psychiatry revolution of the past 30 years. In essence, there has been an explosion of psychiatric disability coinciding with the widespread adoption of the antipsychotics, mood stabilizers, anxiolytics, and stimulants. These drugs have resulted in more disability rather than less and, Whitaker argues, do more harm than good, often creating the very disturbance in brain chemistry they purport to treat. The diagnostic criteria for "mental illnesses" have broadened to the point where a wide variety of human experience has been medicalized and pathologized. It is no coincidence that this has occurred in the context of multi-billion dollar marketing campaigns by the big pharmaceutical companies. Formerly rare disorders have now become, quite literally, epidemics. Bipolar disorder is, perhaps, the best example. Prior to the marketing of the mood stabilizers and anti-psychotics, this was a disorder that occurred infrequently and a had a brief, limited and often non-recurring course. Now, if you have anger issues or are moody, especially if you are female, or if you abuse alcohol or drugs, the odds are you will be diagnosed bipolar. The criteria for the disorder have been broadened so much as to be meaningless. Worst of all, if you believe the marketing hype, there is now an epidemic of bipolar disorder among children. We are now medicating children as young as three or four for a condition that, prior to the introduction of these drugs, was thought not to occur in children. The biological psychiatry revolution has, in essence, expanded the profits of the drug companies by creating disease and disorder. More insidiously, the drug companies have promoted the belief that the individual can do nothing to change his or her life.  Their pitch is that for every human discomfort or distress, well, "there's an app for that" in the form of an expensive medication.

Anatomy of An Epidemic

Better Living Through Chemistry?

The last half-century and, in particular, the last 20 years have witnessed the marketing of scores of psychiatric drugs. It seems there's now a pill for every human dilemma and difficulty. Are you shy? You must suffer from the disease of Social Anxiety Disorder! Zoloft will help that! Your anti-depressant not improving your satisfaction with life? Well, have no fear! The anti-psychotic Abilify will do the trick! Your marriage, finances, kids, and job got you worried? You have Generalized Anxiety Disorder! Take Xanax and all your worries will go away!  Have difficulty getting things done? You must have the disease of Attention Deficit Hyperactivity Disorder and, you guessed it, you need Ritalin, Concerta, Strattera, or Adderall for that! Moody, irritable, and angry some of the time (especially while female all of the time?) You must have Bipolar Disorder and need Abilify, Risperdal, Zyprexa, or Geodon for that! Experiencing side effects from all your meds? Not to worry, there are other meds to counteract the side effects!

Here's the question. Has the widespread promotion and use of these medications been beneficial? Or, have they caused as much or more harm than benefit? This is a complicated issue and I will be writing about it a lot on this blog. My basic position is as follows. In some instances and usually for the short term, some of these medications can be very helpful. In most instances and for the long term, they are more likely to harm than help, both psychologically and physically. The expansion of psychiatric diagnostic categories to cover just about every discomfort encourages the belief that every problem is a disease and the only solution is a drug. It also disempowers people and discourages them from taking control of their own lives. 

This is not in any way to minimize the suffering caused by emotional and behavioral problems! My argument is that people, if they know how, can often solve these problems themselves or with professional help. And they can do so without perturbing their brains. Much more to come.

It's Insane to Let Crazy People Purchase Guns

Jared Loughner

Virginia Tech Shooter and his first gun, a Glock 9

The Arizona gunman is, unfortunately, not the first and most certainly won't be the last example of a crazy person with easy access to weapons causing havoc and grief. I've written about de-institutionalization previously in this blog. Nobody really gives a damn about the seriously mentally ill until something like this happens, and the current concern will pass in a few weeks. And you can't even bring up the issue of reasonable gun regulations - the gun lobby and the Republican Party have made that the true third rail of American politics.

The closing of the psychiatric centers was due to several factors, primarily financial. The promise was that de-institutionalization was supposed to be accompanied by shifting resources to MH services in the communities. That didn't happen, in part because societal and political pressures favored tough "law and order" policies that were and are extremely expensive – and the mentally ill don’t vote in large numbers. The mental health disaster is not strictly a Republican or Democratic problem; there is plenty of blame to go around. As for mental patients getting guns, I'm afraid that's on conservative politicians and the all powerful NRA. The Clinton era laws that restricted access to semi-automatic weapons expired in 2004 when the Bush Administration and Republican Congress refused to renew them largely due to the NRA. Thus, Jared Loughner could walk into a store and legally purchase a Glock 9. Those are the facts.

  

What Next?

This is a very thoughtful analysis in the Sunday NY Times by Matt Bai of the political rhetoric and the Arizona shootings. The question is what's next. I'm afraid nothing will change. There's too much money in flame-throwing.

The end or the beginning?

Health Care in America is a Disaster

Health care in America is a disaster. We spend more money on health care than any other developed country and get less for it. Consider this:

• Medicare is the single largest Federal spending program and if it isn't reined in will consume almost all federal tax revenues in another few years.
• Medicaid is bankrupting the states (New York, for example, spends $1,000,000,000 per week on Medicaid, that's right, a billion dollars every seven days.) 
• Big Pharma and Big Insurance lobbies dominate health care policy in this country and they are making us sicker and poorer. The new Congress will be no different. Just this week high ranking staff appointments to the committees that regulate insurance and health care came directly from, you guessed it, the insurance and health care companies they are to regulate. 
• Patients pressure their physicians for the newest - and most expensive - drugs in response to Big Pharma's $10 billion advertising campaign even though there is little evidence that these drugs are better than the generics they compete against.
• More money is spent on psychiatric drugs than almost any other category. Yet the rate of psychiatric disability has exploded in the last twenty years, the era when psychiatric "wonder drugs" have been promoted for just about every conceivable problem people might experience. (Much more to come on this topic.)

I'll be writing more about this and other topics as we go along. What are your thoughts about the state of health care and what needs to be done about it?

My Broken-Down Upstate City

This site will be about health care, behavioral health care in particular, and politics, local, state, and national. First, though, I'd like to call your attention to another blog.

My wife, Cindy Day Bepko, has started a blog about Upstate New York and Utica in particular.  It's called My Broken-Down Upstate City. Check it out! 

http://mybroken-downupstatecity.blogspot.com/