Sunday, August 28, 2011

Old post 2

First, the usual disclaimer:

Okay, I've been listening and reading altogether too much about psychiatric medication and my brain is starting to fry. I've also been trying to write and respond to everything and it's simply hopeless. It's too big. . .this is a blog. . .I'm not a Real Writer. . .

And then, the attempt at writing:

Here's the thought that's been kicking around in my head for days, the one that I'm trying oh so hard to find a fancy framework in which to set, but can't:

Are doctors really so stupid?

Well, yes and no. Some are smart. Some aren't.

How about the rest of us folks?

Lately, I'm starting to wonder about the answer to that one.

One thing that's got me asking these questions is the ridiculous questionnaires for folks who are wondering if they are depressed. Let me pose the notion that if you are taking a questionnaire about depression, unless you're simply incredibly bored (which might be a sign of depression) you are probably depressed. Do you really need to take a test designed by a drug company to get you to ask your doctor for their drug to give you an answer?

I've been wondering lately what one could possibly do to make an anti-psychiatry blog fun enough for folks to want to read it. I really have no idea how to be snarky, but I can be mean. Maybe I should start writing from my inner nasty person. I do have one, believe me, but I don't care to feed that beast.

Written right now: I keep trying to write about the "are doctors really that stupid?" question, which has been joined by the unsettling second question "are some doctors really that nefarious?"

The awareness of the push towards diagnosing younger and younger children with bipolar disorder is disturbing in the extreme. For a brief moment in time, we were aware of this because of the death of Rebecca Riley, whose parents were convicted of intentionally overdosing their daughter with psychiatric medication. Why wasn't the prescribing psychiatrist ever charged with a crime?

The uneducated parents of this four-year-old child claimed they were just following doctor's orders. I have no idea what the truth is, but it's certainly possible that this is indeed true. Who is the jury to believe? This is one of those cases where "a jury of one's peers" is just a bad idea. The accused needed a jury of experts. Most people believe that a doctor's diagnosis is a scientific fact, and the prescribing of medication is a hard science. Neither is true. So, we have a young child who is diagnosed with an idea, not a disease, and she is prescribed drugs that have not been tested or approved for the use in children. The parents say that the doctor told them to give the child a drug "as needed." That's rather a license to keep the kid sedated, and sedation sometimes results in death.

Most psychiatrists understand that diagnoses are a construct, and they freely admit that prescribing is "hit and miss." Some say they use the "shotgun approach," which means one is given a lot of drugs simply to see if any of them work. There's nothing particularly scientific about that. People who use street drugs take the same approach, don't they? I'll try x, y, and z. . .until I find a drug that makes me feel good.

I once had a long and honest conversation with a psychiatrist about the hypocrisy of the bad drugs/good drugs dichotomy. In this doctor's opinion, the only reason doctors did not prescribe heroin, cocaine, and marijuania to patients (aside from their illegality) is the fact that these drugs are cheap, easy to make, and the raw ingredients for them are generally grown in third world countries. If any of the big pharmaceutical companies had a piece of that pie, there would probably be a bigger push to un-demonize them.

It strikes me that the real drug war in America is the war between legal and illegal drugs. This is no big revelation, neither for me, nor for you (hopefully), but when one looks at some numbers, the truth of this is pretty stark.

Heroin: 2000

Cocaine: 2500

Alcohol: 80,000

Prescription drugs: 32,000

The number of prescription drug related deaths is probably much higher than this, for people who die while under the influence of prescription drugs is not included. This number is "just" people who died as a direct result of a drug. 

There are no statistics for how many people died while taking any of the drugs that have black box warnings. This is crazy. These drugs are considered so risky that there''s a *WARNING* on it, yet most people do not know what a black box label is. When one goes to the drug store and picks up a prescription, pharmacists are not obligated to point out that one is receiving a drug with some major risks. The pharmacist may ask if you want to be "counseled," but that's rare, even though everyone must sign an electronic or paper form that says whether or not they received any advice. We've all signed consent forms, but we do this without a thought. They're pushed through a window before we see a doctor. 

I often ask people if they know anything about the drugs that they or their children are taking. Most people do not know anything about them. Do you? Have you researched any of your prescriptions on sites that are not affiliated with drug companies? If you haven't, do yourself a favor and do so. Yes, the language is hard to understand, but you can go to an online dictionary and look up every unfamiliar word. 

Even if you do, you still might be flummoxed. I sure was after I read an ad for Seroquel while waiting in a physician's office recently; fours pages of sheer nonsense about the possible risks of taking an antidepressant drug. Seroquel is not an antidepressant. It is, officially, an "atypical antipsychotic." It is now being used as "adjunct therapy for treatment resistant depression and bipolar disorder." This is what is called "off label prescribing." Why this is legal is beyond me. Drugs are approved (rightly or wrongly) for specific purposes. If they are not tested for other purposes, we are the guinea pigs, pure and simple. 

Okay, I'll stop beating this poor horse. . .for now.

Image note: Jacopo Da Ponte (aka Jacopo Bassano), "The Good Thief on the Cross," Pastel over charcoal, later half of 16th century.

1 comment:

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