The federal government spends nearly $1 billion a month to fight
the war on drugs. But while we focus on eradicating illicit drugs,
we ignore the worsening problem of over-medication.
From 1998 to 2002, sales of antidepressants increased 73 percent
to more than $12 billion, and sales of analeptics (drugs that
stimulate the central nervous system, such as Ritalin and Adderall)
increased 167 percent, according to IMS Health, a pharmaceutical
information and consulting firm. Even more distressing, physicians
wrote more than 1 million prescriptions for Strattera, a
nonstimulant treatment for attention deficit/hyperactivity disorder,
in its first six months on the market.
Something is very wrong here. These dramatic increases in the
sales of these pharmaceuticals not only suggest that Americans are
well on their way to becoming depressed, anxiety-ridden and
incapable of the focus necessary to understand the world in which we
live, but also that we are on our way to becoming a drug-dependent
No one would deny that ADHD, depression and anxiety disorders
afflict millions of Americans. But to what degree? Through a
combination of pharmaceutical companies' increased marketing, quick
diagnoses from physicians and lack of proper referrals from doctors,
we are simply inundating incredible numbers of people with
The issue is all the more sensitive and heartrending when it
comes to our children. According to the Archives of Pediatric and
Adolescent Medicine, a study of 900,000 youths showed that the
number of children taking psychiatric drugs more than doubled in one
group and tripled in the two others over a 10-year period ending in
"Any time a child reads a little more slowly, we're talking
learning disability and administering Ritalin," says Dr. Arthur
Caplan, chair of the department of medical ethics at the University
of Pennsylvania School of Medicine. "Or any time a kid acts up a
bit, instead of giving him detention, we're drugging him. These are
definitely problems in that it's expensive, it may not address the
cause of the problem, and I've never met a drug yet, including
aspirin, that didn't have some side effects."
In other words, some pharmaceuticals create greater problems than
they treat. In June, British drug officials, later backed by the
U.S. Food and Drug Administration, warned physicians and consumers
that GlaxoSmithKline's antidepressant Paxil carries a substantial
risk of prompting teenagers and children to consider suicide. Two
months later, Wyeth warned doctors of the same risks in its Effexor.
U.S. sales of both drugs totaled nearly $4 billion last year.
The driving force behind the surge is aggressive
direct-to-consumer advertising, Caplan says. Following the
relaxation of a 30-year drug marketing agreement in 1997,
pharmaceutical companies have tripled their annual advertising to
consumers, resulting in a 37-percent increase in sales of
prescription stimulants for children. Also, roughly one-third of
adults have asked their doctor about a drug they saw advertised,
according to the Kaiser Family Foundation.
And those doctors are quick to dole out prescriptions. According
to the American Psychiatric Association, primary-care physicians now
write upwards of 60 percent of all antidepressant prescriptions.
"I think (doctors are) just overwhelmed now with too much
marketing," Caplan says, "and it drives them toward too much
In fact, American consumers, mostly children, account for more
than 90 percent of global consumption of such stimulants.
"If we have four or five times the learning disability or
depression or other neurotic illnesses that the Europeans do,"
Caplan says, "then either we got a really bad gene pool through
immigration, or we're over-medicating."
A crisis looms. The pharmaceutical companies, the FDA and
Congress must confront this issue now, and the physicians' credo is
an appropriate starting point: First, do no harm. That concept
simply must take precedence over profit motives and casual