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Posted on Thu, Oct. 02, 2003 story:PUB_DESC
Over-medication: a growing crisis
Aggressive marketing a major culprit

TRIBUNE MEDIA SERVICES

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 nation.

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 unprecedented medication.

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 1996.

"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 prescribing,"

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 prescriptions.


Lou Dobbs is the anchor and managing editor of CNN's "Lou Dobbs Tonight." E-mail: lou@cnn.com.
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