|Blog Archive: Jan. 2003|
Wednesday, January 29, 2003
Forget the war on Iraq. What is President Bush doing to addiction-treatment in the United States? Just when I thought that the mental-health industry might be moving away from the glorified superstitions that have traditionally formed the basis for most rehab programs, this comes over the news wire:
Bush Touts Religion-Based Drug Treatment
President Bush's Support for Religion-Based Drug Treatment Draws Fire From Civil Libertarians
President Bush has long preached of the power of prayer to aid drug addicts. Now he's putting dollars behind the rhetoric, asking Congress for $200 million for a new drug treatment program that would welcome the participation of religious groups.
The proposal sparked conflict even before Bush touted it before Congress. Opponents fear government will pay for programs that replace professional counselors with prayer and Bible study.
“The president wants to fund untested, unproven programs that seek to pray away addiction,” said the Rev. Barry Lynn, executive director of Americans United for the Separation of Church and State. “People with addiction problems need medical help, not Sunday school.“
Bush and his supporters argue that faith can accomplish what secular programs cannot.
“Our nation must recognize that if we can change a heart, we're more than likely to change someone's habits and addiction on drugs and alcohol,“ Bush said last month, previewing his State of the Union address.
Monday, January 27, 2003
I'm famous! Well, sort-of. My blog was mentioned in a column that appeared on the Current Psychiatry website. (See the third paragraph down. A footnote contains a link to the blog.)
Sunday, January 26, 2003
The Los Angeles Times has a good analysis of the recent Yale study showing that pharmaceutical funding is leading to biased clinical trials.
The New York Times reports on the questionable relationship between many oncologists and pharmaceutical companies. The article is called, “Drug Sales Bring Huge Profits, and Scrutiny, to Cancer Doctors”.
Thursday, January 23, 2003
More evidence that the pharmaceutical industry is corrupting science:
Review Notes Medical Research Conflicts
CHICAGO — About one-fourth of university-based medical researchers receive funding from drug companies – ties that sometimes distort study results, according to a review done by two researchers with industry connections of their own.
Yale University researchers Justin Bekelman and Dr. Cary Gross said they found “strong and consistent evidence that industry-sponsored research tends to draw pro-industry conclusions.”
The U.S. Food and Drug Administration (FDA) is warning pharmaceutical company Purdue Pharma over illegal ads for their opiate painkiller, OxyContin.
Time magazine recently ran a moderately skeptical article about the (infamous) psychiatric bible, the Diagnostic and Statistical Manual of Mental Disorders (DSM). The article is called, “How We Get Labeled ”.
Monday, January 20, 2003
Far be it from me to defend pharmaceutical marketers, but these anti-Metamucil people are ridiculous.
And speaking of pharmaceutical marketing, some drug sales reps are apparently being allowed to sit in on medical exams.
Saturday, January 18, 2003
Two days ago, National Public Radio (NPR) had an excellent segment about the underhanded way that pharmaceutical company Parke-Davis (now a part of Pfizer) promoted its drug, Neurontin (generic: gabapentin). The show profiled parents whose son committed suicide while he was taking Neurontin. I heard the show on the radio as I was driving home from work. NPR has a whole page devoted to the topic, or you can go directly to the 13-minute-long audio segment.
Thursday, January 16, 2003
Another article about the recent study of children and psychotropic medications:
More Kids Receiving Psychiatric Drugs
Question of 'Why' Still Unanswered
“There are fewer options other than medication,” said Michael Jellinek, chief of child psychiatry at Massachusetts General Hospital, who reviewed the new study.
Insurers have increased their profits by decreasing the use of psychotherapy, which is more expensive than drugs in the short run, he said. “The insurance system gave an incentive for medications and a disincentive for therapy.”
The insurance industry disputes that interpretation, suggesting instead that more children are getting drugs because more effective medicines have been developed. Most psychiatrists say that a combination of psychotherapy and medication often provides the best treatment.
The new research found steep increases in the use of most classes of medicines, including antipsychotic drugs. Such powerful medications, normally meant to treat schizophrenia, were increasingly being prescribed to children on Medicaid, said the study's lead author, Julie Zito – possibly as a way to restrain difficult children.
“Other than zonking you, we don't know that behavioral management by drug control is the way to learn to behave properly,” said Zito, a researcher at the University of Maryland in Baltimore. “If we are using drugs to control behavior, that doesn't change the underlying problem if someone doesn't know how to get along with their peers.”
The Canadian newspaper the Globe and Mail reports: “Antidepressants may lead to early menopause: study”.
More about antidepressants: “Newer Antidepressants May Increase Bleeding Risk”
Tuesday, January 14, 2003
The New York Times reports on the increased use of psychiatric drugs to treat children:
On one hand, the findings reflect the emergence of new treatments, advances that have spilled into the care of severely troubled children. On the other hand, little research exists to indicate whether psychiatric drugs are being responsibly prescribed or whether they are overprescribed, in part because health insurers are reluctant to pay for “talk” therapies and other nonmedication treatments.
The Food and Drug Administration specifically approves just a few psychiatric medications for children, despite their widespread use. This month, Prozac was approved to treat depression in children ages 7 to 17.
The long-term effects of such drugs, particularly on the brain, are largely unknown.
I wish these types of articles would at least mention the research suggesting that antidepressants are largely worthless, and that antipsychotic drugs may actually do more harm than good. Some people have almost a knee-jerk antipathy toward the use of drugs such as Prozac or Risperdal. I wouldn't be opposed to psychotropic medications (either in adults or children) if I thought that the drugs might actually help people who are in distress.
Monday, January 13, 2003
Alcoholics Anonymous (AA) has a great “heads-I-win-tails-you-lose” strategy going for it. If you stay sober and go to AA meetings, then AA gets the credit. If you go to AA but don't stop drinking, then it's not AA's fault. See, for example, this story about Kelly Welsh, a 40-year-old special education teacher who died from alcoholism. I don't want to discourage people from seeking a 12-step program, if that's what they think will help them. But it's about time that society realized that AA and NA aren't all they're cracked-up to be, and that there are lots of alternative approaches to staying off drugs and alcohol.
Saturday, January 11, 2003
Reuters reports on the further medicalization of life's problems: “The drug industry is attempting to 'medicalize' female sexual problems under the umbrella term 'female sexual dysfunction,' creating a disorder to build a market for new drugs, according to some experts.” (See also this similar article from the BBC.)
Thursday, January 9, 2003
Lots of pharmaceutical news today:
Wednesday, January 8, 2003
The BBC has an article about the safety of antidepressants (note that Paxil is called “Seroxat” in Britain):
Anti-depressant safety reviewed
Experts are looking at the safety of widely used antidepressants including Prozac and Seroxat.
The review will look at a range of options, including whether the drugs should be banned.
The government review began after members of the public and doctors raised concerns that the drugs can be addictive, contrary to manufacturers' claims - and increase the risk of suicide in some patients.
Prozac (fluoxetine) and Seroxat (paroxetine) are drugs called selective serotonin reuptake inhibitors.
Their selling point was that people are not supposed to become physically dependent on them...
The New York Times reports on a movement to create specialized addiction-treatment programs for teen-aged substance abusers. I'm encouraged by some of the information (such as the push to keep the kids in school), but I'm also more than a little skeptical (see the blog entry for Sunday, Jan. 5). The article states:
Dr. David Lewis, a physician at Brown University and the lead author of the physician group's report said: “You can't just apply the adult model [of rehab] to teenagers. We need a new investment for what we know works for children.”
The physician group wants more money devoted to prevention and treatment and less money spent on incarcerating juvenile drug offenders.
Effective drug treatment programs for teenagers, many addiction experts say, are different from those that work for adults. Parents and other family members have to be involved, and treatment has to allow for continued school work.
Also, because teenagers' thought processes often differ from those of adults, different approaches to psychological counseling are required.
The article assumes that adult rehabs are effective. This is an unwarranted assumption (remember Robert Downey, Noelle Bush, and Darryl Strawberry?). Alcoholics and addicts who undergo rehab are no more likely to stop their active addictions than are comparable control groups that don't receive treatment. I'm reminded of what Mahatma Gandhi allegedly said when asked for his opinion on Western civilization: “Yes, that would be very nice.”
Sunday, January 5, 2003
Writer/journalist Maia Szalavitz consistently writes excellent articles about issues related to alcoholism and drug abuse. In her latest piece, she once again takes a hard, critical look at the addiction-treatment industry in the United States:
America loves its quick fixes. Think your child might be on drugs? Test him. Think your child's school is full of addicts? Test them all. Institute a policy of zero tolerance: One strike and it's off to a drug treatment program. Get those rotten apples out and clean them up before they can poison the whole batch. Last year's Supreme Court decision in Board of Education v. Earls allowed for a massive expansion of drug testing in schools. And increases in drug testing increase the numbers of offenders. As a result, schools and juvenile courts are increasingly turning to both “zero tolerance” and “treatment, not punishment” as a remedy.
The number of teenagers in drug treatment as a result of court coercion and school diversion increased by nearly 50 percent between 1993 and 1998 according to the U.S. Department of Health and Human Services' Substance Abuse and Mental Health Services Administration, and the number of teen admissions to treatment programs in general rose from 95,000 in 1993 to 135,000 in 1999. But what if drug “treatment” doesn't work for teens? What if, rather than decreasing drug use, teen treatment actually encourages it by labeling experimenting kids as lifelong addicts? What if it creates the worst sorts of peer groups by mixing kids with mild problems with serious drug users who are ready and willing to teach them to be junkies? What if suggestible kids respond poorly to the philosophies that have made Alcoholics Anonymous and Narcotics Anonymous successful for many adults? Then we'd be using “treatment” to turn ordinary adolescents into problem drug abusers.
See also Szalavitz's book, Recovery Options: The Complete Guide. Another excellent book about addiction and recovery is Anne M. Fletcher's Sober for Good, which received a glowing review in the New York Times.
Thursday, January 2, 2003
School children should be educated about the dangers of drug abuse, but these government-sponsored programs are usually useless at best (and some studies show that they actually do more harm than good):
Critics take issue with antidrug campaign
With stark pictures and dire warnings, the federal government's anti-ecstasy campaign strikes exactly its intended tone: scientific fright.
In schools around the country, counselors are showing students sleek and sharply contrasting images of the brains of habitual ecstasy users and nonusers. The brain scans of nonusers show plenty of colorful activity. The users' scans are full of ominous black blotches resembling holes.
“We tell them, 'Ecstasy eats your brain like a moth eats an old sweater,' ” said Susan Billy, who directs the Chester County student-assistance program, a group of teachers who coach public school students on the dangers of drugs and addiction.
It's a powerful message. But is it true?
There is increasing debate in scientific circles about the validity of the research behind government claims about the dangers of ecstasy.
By overdramatizing its hazards, the critics say, antidrug campaigners may be achieving the opposite of what they seek. Like the crusaders against alcohol and marijuana before them, the anti-ecstasy forces may be persuading a generation of already skeptical youths that adults are more interested in scaring kids than informing them.
The government's campaign is based on research that is “seriously, seriously flawed,” says Charles Grob, a professor of psychiatry at UCLA and a leading ecstasy researcher.
Wednesday, January 1, 2003
Happy New Year! And speaking of happiness, the Washington Post has a good article about psychologist Martin Seligman (at the University of Pennsylvania) and his research into the hot new field of positive psychology. Incidentally, Seligman's recent book, Authentic Happiness, is excellent. The Post also has two related articles: “How to get Happy”, and “Happiness: Who Needs It, Anyway?”
Today is J. D. Salinger's 84th birthday. The Catcher in the Rye (1951) is among my favorite novels. Holden Caulfield (the main character) has the right attitude about marketing:
Where I want to start telling [my story] is the day I left Pencey Prep. Pencey Prep is this school that's in Agerstown, Pennsylvania. You probably heard of it. You've probably seen the ads, anyway. They advertise in about a thousand magazines, always showing some hot-shot guy on a horse jumping over a fence. Like as if all you ever did at Pencey was play polo all the time. I never even once saw a horse anywhere near the place. And underneath the guy on the horse's picture, it always says: “Since 1888 we have been molding boys into splendid, clear-thinking young men.” Strictly for the birds. They don't do any damn more molding at Pencey than they do at any other school. And I didn't know anybody there that was splendid and clear-thinking and all. Maybe two guys. If that many. And they probably came to Pencey that way.
I can just imagine what Holden Caulfield would have said about pharmaceutical marketing
© 2004 Alex Chernavsky email@example.com