Saving Normal

Mental health and what is normal.

A Pill Popping Society

We are fighting the wrong war on drugs

In Aldous Huxley's Brave New World, the populace finds chemical solace in Soma, a daily pill taking ritual that makes existence tolerable. Life unfortunately often follows art. The US may soon realize Huxley's dystopic vision.

Already, 20% of the US population regularly pops a psychiatric pill and many pop a whole bunch of them. All demographics are affected- from barely walking toddlers to the geriatric in nursing homes. Although women heavily predominate, men are also well represented. The US leads the world in pill popping, but other developed countries are catching up.

The most obvious casualties of excessive medication use are those who die from it. We are in the paradoxical position of having more overdose deaths come from prescription drugs than from street drugs.

But the costs go much further. The inappropriate medicalization of individual differences obscures social problems that would be better addressed directly. Vast sums of money are wasted on expensive ADHD drugs that would better be invested in smaller class sizes and more physical education. There would be less PTSD among vets if they got fewer meds and more job retraining, job placement, and other transitional services. Similarly, less mental disorder disability would be needed if there were better work opportunities for the unemployed.

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The following statistics gathered by Adrienne Erin adrienneerin77@gmail.com tell a frightening story. And she has wonderful advice on how to avoid the illegal diversion of prescription drugs.

"Over a lifetime, 52 million Americans have used prescription drugs for non-medical purposes, and 6.2 million Americans have used them in the past month. In the decade between 1998 and 2008, substance abuse treatment admissions for prescription painkillers increased 400%."

"That we over-prescribe medications is readily apparent: the United States consists of 5% of the world’s population but consumes three-quarters of the world’s prescription drugs. According to the Centers for Disease Control and Prevention, for every overdose death from prescription painkillers, there are 10 treatment admissions for painkiller abuse, 32 emergency department visits for the misuse or abuse of painkillers, 130 people who abuse or are dependent on painkillers, and 825 people who take prescription painkillers non-medically."

"Where are abusers getting all those pills? According to research by the Substance Abuse and Mental Health Services Administration, most medications were acquired for free from a friend or relative. A survey by the University of Texas found that the most common reason that teenagers misuse prescription drugs is simply that they are easy to find, right there in their parents’ medicine cabinets."

"Teach your teens about the dangers of misusing prescription medications, and don’t buy into the notion that prescription stimulants can boost school performance of children not diagnosed with ADHD."

"Keep medications out of sight and reach of younger children. Learn to recognize the signs of prescription drug addiction, which include faking or exaggerating an injury in order to get prescriptions, using more than the prescribed amount, using or stealing others’ medications, and switching frequently between different doctors (or doctor shopping)."

"Illegal diversion of prescription dugs has become a big problem affecting 30% of college and 10% of high school kids. To prevent others’ misuse of your prescriptions, be sure to always dispose of unused or expired medications properly. Look for community drug take-back events, or ask your local pharmacy if they offer such a service."

"If no drug take-back program exists in your area, dump the medication into a zippable plastic baggie filled with an undesirable substance, such as kitty litter or coffee grounds, and throw it away. When you dispose of empty prescription containers, always be sure to scratch out your name and Rx number to prevent others from using them falsely."

"And of course, never share, sell, or give away your medications to friends, even if they are seemingly suffering from the same ailments."

Thanks Adrienne. I hope people heed your wise advice. Careless doctors, demanding patients, and greedy drug companies all contribute to the misuse of medication.

The solutions are clear. Doctors need to be re-educated, patients need to be warned, pharmacy dispensing needs to be monitored, and (most important) aggressive drug company marketing needs to be tamed.

The careless prescription of psychotropic drugs is bad for the individuals involved and bad for the society. Our forty year war against the illegal drugs promoted by drug cartels has been a proven failure. If we devoted just a tenth of the effort to controlling the equally dangerous misuse of legal prescription drugs, we would most certainly succeed.

Allen Frances, M.D., was chair of the DSM-IV Task Force and is currently professor emeritus at Duke.

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