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The legal drugging of America: A status report

by Arianna Huffington

http://www.jewishworldreview.com --

TWO REPORTS OUT THIS MONTH highlight the continuing trend toward the legal drugging of America.

The Surgeon General's report on the state of the nation's mental health found "that 22 percent of the population has a diagnosable mental disorder.'' At the same time, a study by the National Institute of Mental Health concluded that we are under-medicating our children and that for those diagnosed with attention-deficit hyperactivity disorder, drugs -- specifically Ritalin -- are more effective than therapy.

The big drugmakers will no doubt use these studies as additional weapons in their ongoing war to make mood-altering drugs the solution to all life's problems. Our magazines are already stuffed with ads portraying pharmaceutical giants as noble enterprises, engaged in nothing but the pursuit of pure science and the public good. And our television screens are filled with commercials for drugs to cure shyness and so-called "social phobias.''

The Food and Drug Administration has recently approved Effexor XR, a drug for "generalized anxiety disorder'' -- the garden-variety free-floating anxiety that has plagued humanity since the expulsion from Eden. Mark Twain summed it up this way: "I am an old man, and have known a great many troubles, but most of them never happened.''

These days, the assumption seems to be that drugs can take care of everything unpleasant in the human condition. "At Pfizer,'' one ad boasts, "we look to the future with the knowledge that the only thing incurable is our passion.'' What the ad doesn't mention is that drug company profits (Pfizer's last year were $3.35 billion) are often spent not on finding cures for serious diseases but for "lifestyle'' maladies -- baldness, toenail fungus, and of course any interruption to a perpetually sunny mood. Not one major drug company in the United States has an in-house research program on malaria, for example, but sales of pharmaceutical drugs for pets are approaching $1 billion annually.

The major flaw of the Surgeon General's report is the lumping together of dramatically disparate conditions. According to Surgeon General David Satcher himself, "tragic and devastating disorders such a schizophrenia, depression, and bipolar disorder, Alzheimer's disease, the mental and behavioral disorders suffered by children, and a range of other mental disorders affect nearly one in five Americans in any year.'' This is a classic example of pseudo-scientific sleight of hand: linking schizophrenia to childhood behavioral problems as though they are in any meaningful sense on the same continuum.

It is this mind-set that has led to the Ritalin epidemic -- with the number of kids taking the powerful drug skyrocketing from 1 million in 1990 to 4 million today. And now along comes a study that says the answer to those many instances where Ritalin has proved ineffective is to simply up the dosage. As Dr. Peter Jensen from the National Institute of Mental Health put it, "You find the dose that achieves the absolute possible total benefit for this child ... That's the dose you want, not the lowest possible dose that you can get by on.'' It's ingenius, if Ritalin is't working, try more Ritalin. As they used to say in the '60s, "Why do you think they call it dope?''

It's doubly tragic that these reports have arrived at a time when we're facing a crisis in managed health care. Because a diagnosis of a mental disorder will almost always prompt managed care companies to take the cheap way out -- drugs rather than therapy, no matter how potentially dangerous the long-term side effects, especially on children's growing brains.

Making this growing emphasis on drugs especially troubling is the conclusion by federal investigators that the FDA has "no quality control system'' to track adverse drug reactions. Currently, doctors and hospitals are not even legally required to report patients' drug side effects to the FDA. As a result, in one year, from the beginning of June 1997 to the end of May 1998, the agency got only 13,825 such reports even though in hospitals alone approximately 180,000 patients die every year from drug reactions.

Even if the FDA moves from a voluntary to a mandatory reporting system, the agency has only 80 employees to monitor more than 3,000 prescription drugs. Over the past year and a half, the agency has banned only five drugs that it previously had approved but now deems dangerous. But every year 2 million Americans are hospitalized due to drug side effects.

"Most errors are not caused by stupidity, incompetence or neglect, but by system failures that allow them to occur,'' said David Lawrence, head of Kaiser Permanente, suggesting that the safety tests done by drug companies are not enough, and that the companies fail to educate physicians and hospital workers on the proper administration of their drugs.

As drugs, and the conditions treatable by drugs multiply, can we continue to tolerate such slipshod oversight of a powerful industry that so affects our lives -- and our deaths? Or continue to rely on reports tainted by the drug industry's assumption that millions of Americans are suffering from mental disorders whose cure is just a pill pop away? Oh, the infinite possibilities of an America where everyone has finally admitted to a mental disorder, and everyone is blissed-out on appropriately high doses of the newest wonder drugs.

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