Every day, psychotic patients present to Emergency Rooms, desperate to be stopped before they wreak havoc. They hear voices or “command auditory hallucinations”, telling them to harm themselves or others, see things aren’t there – terrifying, threatening apparitions. They are treated with antipsychotic medications, tranquilizers, and other stabilizing chemicals and are often sent home thinking clearly, at peace, and without hallucinations. This is the proper application for psychiatric medications. However, forty-four MILLION prescriptions written for Xanax every year to folks who have never suffered true mental illness.
Top Twenty-Five Psychiatric Prescriptions for 2009
This is INSANITY, which is caused by the big pharmaceutical companies’ zest for profits. Big Pharma spends significantly more for advertising than for research, while health-promoting, peace-inducing practices such as lifestyle modification, nutritional support, counseling, meditation, acupuncture, and many other modalities are not vigorously promoted because they don’t generate profits.
In fact, there is an alarming, burgeoning trend. Influenced by the barrage of television promotions, patients run to doctors demanding to be treated with this medication or that. By law, pharmaceutical ads must announce the possible side effects, but have you ever noticed how unobtrusive and manipulative these declarations are? You’ll see a perky, happy family romping through a meadow, carefree, filled with love and light, as the announcer speaks in a background in an easily ignored monotone about liver damage, seizures, or even death. When I watch those commercials, it has a contrary effect. I don’t want anything to do with those drugs.
And what about the staggering epidemic of ADD in this country? Are there really that many kids with ADD? What did they do before the advent of mind-enhancing amphetamines? How did they get their homework done? Back in the day, there was a very effective method for combating ADD. Parents! What a concept! If your kids don’t buckle down, they suffer the consequences. Bring home a D, lose your Wii. Can’t concentrate? Take your mind off parties for a couple of weeks and do your homework! Still don’t perform? Set up a meeting with teachers. Do some hands-on parenting. Hire tutors. Believe me – that works! It’s far easier to put a kid on amphetamines then beam proudly while an artificially enhanced child reads six chapters in an hour, stays up all night, and vroom-vrooms through the school day with eyes like ping-pong balls. Another unfortunate consequence is that may kids then turn around and sell every last one of their pills then proceed to get in more trouble with their new-found wealth.
As an orthopedic surgeon, the majority of what I prescribe is antibiotics and narcotics. Many patients do require narcotics after surgery to get through that initial postoperative pain, but the dosages being prescribed are ridiculous. The good news is that these narcotics are only needed short-term. If on them long-term, severe problems arise. Nevertheless, drugs are being over-prescribed for several reasons, not only because patients insist, but because physicians often have little choice. Despite having strict policies about how long I prescribe narcotics for, I’m always finding patients that are getting these drugs from multiple prescribers under different names. It’s a horrible game.
What’s the solution? A ban on pharmaceutical advertising directly to consumers? How about stricter controls with the consent process? Patients must sign iron-clad consent forms before every surgical procedure and demonstrate an understanding of the risks involved. Yet every medication has two to three pages of side effects. Perhaps we should have patients sign consent for the drugs as well. The list of side effects should be required reading – maybe with a quiz given afterwards. If a patient passes the quiz, they get the script?
Obviously, we want to do what we believe to be “best” for the patients, but if there’s a magic pill that makes the patient feel better, that allows doctors to effectively treat their problem expeditiously . . . it’s potentially a win-win.
If it boils down to physicians spending 50 minutes with a patient trying to address their multiple pain, anxiety, depression and/or addiction issues . . . versus ten minutes and prescribing a some sort of wonder- pill (anti-depressant/anxiolytic/narcotic) . . . which one do you think gets used more often?
There are multiple types of care-givers, not just MDs. Over fifty percent of their patients are having anxiety or depression, and patients are looking for magic bullets so they can feel “better”.
In the long run, healthy lifestyles, simple pleasures of nature, family, music, art, and spirituality are far more powerful and long-lasting than any drug. Let’s advertise THAT!
Dr. Dan Ivankovich (@ReverendDoctorD)