Straight Dope.

I watched a couple of documentaries this week and I want to write about my take on this subject:

Prescription Drug Abuse.

Not only by what most of us picture as “the addict” but also by what these two films bring to light. The abuse by General Practitioners prescribing medications that they have little to no knowledge about for conditions that they have little to no knowledge about. The abuse by pharmaceutical reps by planting falsified information into these Doctors and the abuse  by the pharmaceutical companies themselves by pushing out medications that they know may cause harmful side-effects (that they can also then sell another pill for) and manipulating legislation to allow it all to happen.

Here’s what I mean.

The U.S. makes up 5% of the global population and yet we consume 75% of the prescription drugs available world wide. Now, my immediate argument was that it’s because we can afford them and they are readily available; however we only rank 37th in the world for  health care systems according to W.H.O .

You learn in these films that drugs are just that, drugs. Opioids are basically the same as heroin, Adderall is chemically the same as meth. I shit you not, you are giving your ADHD kid meth to settle down and focus.

heroin_oxy_diagram

1-fuLSIjHwAt54mrk4BahBXQ

You learn in these films that Ronald Reagan started this whole thing by allowing Pharmaceutical Companies to advertise directly to the customer, despite the presidents of all 3 drug companies writing letters to him urging him to reconsider. This deregulation was furthered by Bill Clinton later on and these actions gave birth to what people call “Big Pharma”.

The films both tell you that pharmaceutical companies used to be driven by science (sometimes mad science) but is now driven by profits.

I filed that under “No Shit” real quick.

I know drug manufacturers aren’t looking to cure shit. There isn’t any money in curing things! The money is in the treatment and management of conditions, not the cure.

Everyone knows this.

What everyone doesn’t know is that what I consider to be the worst drug problem in America (and it’s all based on ignorance and misinformation) happens daily in doctor’s offices everywhere and it is covered in these films in one way or another.

Let me explain.

The first film that I watched was Off Label which starts with talking about drug trials. Deeper into the movie it talks about exactly what it’s title means:

off-la·bel
adjective
  1. relating to the prescription of a drug for a condition other than that for which it has been officially approved.

It goes into how pharmacy reps will ask doctors about any “interesting cases” they have had in which their product has been used and if the doctor says “Yes” then the sales rep will offer to send the doctor a ton of medical research for their pill and it’s billions of new uses that they can now prescribe it for instead of the other drugs that actually have proven to treat whatever issue for years.

Now, in some cases, this works out; however in some it does not. The film also touches on that a lot of people that are on psychotropic medications and  are getting them from their primary care physicians or general practitioners. To me this is a horrible way to get psych meds and the worst drug problem we have in America, because of my experience with the first time I ever sought treatment for my mental health issues. When I first came to terms that “something was wrong with me” I saw my PCP, actually I saw my PCP’s Nurse Practitioner, because let’s face it, none of us ever really see our “actual” doctor. We see their Physicians Assistant, Nurse Practitioner or whatever other pseudo-doctor that helps them out. When I told her that I was having bouts of depression and then a few minutes/hours later would be dealing with mania and then I would return back to depression again (mind you, I didn’t use those exact terms, but I know now what I was dealing with) I was given a prescription for Prozac and Xanax. I wasn’t diagnosed as bipolar at the time (There were no diagnostics at all, that happened about a year or two later when I tried to have myself committed), so she didn’t know that giving an SSRI to me would have this effect:

In people with bipolar disorder, SSRIs and other antidepressants carry a risk of inducing mania, making it essential to monitor for signs of excess energy, decreased need for sleep, or abnormal and excessive mood elevation.

So, needless to say, I felt AWESOME on Prozac! It was fucking amazing! I understood why EVERYONE was on this shit!

Then I got diagnosed as bipolar and that was the first thing to go.

So, I completely agree with this film’s take on the reason why the market is flooded with psych meds is because PCPs are scripting them out and not knowing what they will do to their patients. There is one woman in the film that is bipolar and is on 20+ medications. She is so zombified that it is just sad. The thing that made me absolutely angry is that the film mentions that her psychiatrist will not see her anymore; however still issues her medication.

That’s some bullshit.

The second film that I watched was called “Prescription Thugs” it was a follow up to another film that I watched during my “Top 100 Documentaries” called “Bigger, Faster. Stronger” regarding steroids (#86).  I won’t lie, this film come across that all pills are bad and bad for you; however the filmmaker lost his brother while making the film to pharmaceutical abuse and was abusing pharmaceuticals and alcohol while making the film. So, I really had to look into the subtext here, and towards the end he kind of ties things up.

One thing he also touches on is the over prescribing of psych meds. Now, everyone he talked to said “they went to their doctor”. So, this makes me think that again you have PCPs ,or their assistants, prescribing psychotropics that they don’t understand and are not actually diagnosing anything. The film also touches on Statin drugs and how they are ” a big fat lie”.  Basically, statin drugs are cholesterol pills.

“Statins” is a class of drugs that lowers the level of cholesterol in the blood by reducing the production of cholesterol by the liver. (The other source of cholesterol in the blood is dietary cholesterol.) Statins block the enzyme in the liver that is responsible for making cholesterol. This enzyme is called hydroxy-methylglutaryl-coenzyme A reductase (HMG-CoA reductase). Scientifically, statins are referred to as HMG-CoA reductase inhibitors.

http://www.medicinenet.com/statins/article.htm

Then I read this and it kinda scares me:

FDA is advising consumers and healthcare professionals that:

  • Routine monitoring of liver enzymes in the blood, once considered standard procedure for statin users, is no longer needed. Such monitoring has not been found to be effective in predicting or preventing the rare occurrences of serious liver injury associated with statin use.
  • Cognitive (brain-related) impairment, such as memory loss, forgetfulness and confusion, has been reported by some statin users.
  • People being treated with statins may have an increased risk of raised blood sugar levels and the development of Type 2 diabetes.
  • Some medications interact with lovastatin (brand names include Mevacor) and can increase the risk of muscle damage.

Yeah, I have been getting a little “foggy” lately and also, I was just diagnosed as diabetic. Now, I am willing to bet that the diabetes is because I am a fat guy that smokes and used to eat like crap, but it could have been this pill!

But, I am digressing.

Now, this film hit on something that the book I am reading actually talks about and that is we are a culture that is afraid of our feelings. We all want that happy “everything is great” feeling all the time and we do not feel out feelings. We have been taught to avoid emotion and I believe that is another reason why PCPs and their assistants are prescribing psych meds that they know little about without actually diagnosing their patients. The film has a kind of “all pills are bad” vibe to it, but really I think the filmmaker is saying that the current culture in America is what is driving this addiction to medication. Which is partially true, but I can see where someone would take that as an excuse to actually quit taking their psych meds.

Luckily, there is an ex-pharmaceutical rep that they interview that and actually mentions that doing stopping psychotropic medications cold turkey is a horrible idea and she actually lost a family member because they did exactly that.

(Not all pills are bad, stay on your meds kids)

I also think we, as a culture here in the U.S.,  overuse mental health terms (Example: OMG, that makes my OCD so flair up. Ugh, my taco fell and now I am so depressed about it) and because of that these illnesses have been marginalized. So, instead of referring their patient to a psychiatrist that better understands depression or any other emotional/behavioral health issue; general practitioners and their staff just prescribe what that nice pharmaceutical sales rep’s scientific study suggested would help with this condition. Mind you, I believe that medication works for mental health issues, when the diagnosis is correct and you are prescribed the correct medication(s). For that to work, you have to go to the correct type of doctor.

Here’s how I look at it.

If you have a cold, you don’t go to a psychiatrist for treatment. So, why the fuck would you go to your primary care physician for a mental health issue? That’s like taking your laptop to your auto mechanic because it won’t boot up. Also, people need to understand that if you are experiencing a behavioural/mental health issue that it’s more than just popping pills. You have to see a therapist. You have to feel your feelings and talk shit out. It’s a two step process for treatment.

So, is there prescription drug abuse in this country? Of course there is. Doctors aren’t referring patients to the specialist that they should, pharmaceutical reps are pushing drugs for uses that they possibly shouldn’t be used for and pharmaceutical companies are pushing out this research to those sales reps to give to the doctors so that they feel “educated” about the product.

 

My advice is to only get diagnosed and medicated for mental health issues from a psychiatrist or other mental healthcare provider. Other than that…

Ask your doctor*.

 

(Or trained and licensed medical professional)

 

 

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