How Big Pharma Intends to Create a Generation of Drug Addicts

(RFF) The diagnosis of attention deficit hyperactivity disorder (ADHD) is 15% in high school children, according to recent data from the Centers for Disease Control. The number of children on medication for this disorder has risen from 600,000 in 1990 to 3.5 million today. Is this epidemic of children using psychostimulant drugs real or manipulated?

According to Dr. Kevin Conners, a psychologist and professor emeritus at Duke University, and one of the doctors who lead the fight to legitimize ADHD in the 1970′s, this is not an epidemic.

The numbers make it look like an epidemic. Well, it’s not. It’s preposterous… This is a concoction to justify the giving out of medication at unprecedented and unjustifiable levels.

Sale of Stimulants Soars

In 2002, there were less than 2 billion in sales. Today there have been over 8 billion in sales for prescription stimulants.(source)

Coincidentally, there has been a very successful campaign run by the pharmaceutical companies that manufacture these drugs. As with most pharmaceuticals, once there is a “cure”, suddenly the “disease” is much more prevalent and treatable.

For example, there was never the great concern for osteoporosis, until bone building drugs came on the market. Doctors are educated by the pharmaceutical companies and given incentives to write prescriptions. Given that, patients are now screened for osteoporosis and at the slightest hint of a problem, given bone building drugs with questionable efficacy and dangerous side effects.

The problems of over-screening and over-treating encroach upon every aspect of medicine including cancer.

ADHD Signs and Symptoms Now Include Common Everyday Behaviors

In support of medicating as many kids as possible, drug company marketers characterize normal behaviors, such as carelessness, impatience and poor grades or poor motivation to do school work as indications that treatment is needeed. They tout the drugs as the solution to these so called problems.

The Food and Drug Administration has cited every major ADHD drug, such as, Adderall, Concerta, Focalin and Vyvanse, as well as nonstimulants like Intuniv and Strattera — for false and misleading advertising since 2000, multiple times. That is a tell right there. Interestingly, the FDA does not seem to burden these companies with significant penalties.

However, these drugs are regulated in the same class as morphine and oxycodone because of the known potential for abuse and addiction.

Marketers Play on Parents’ Fears

Marketers create ads showing kids getting excellent report cards and making new friends and being totally happy. They even market directly to kids via comic books using super heroes suggesting to the reader (the child) that medication may help to control behavior and ability to pay attention.

According to the Sunday New York Times front page article, The Selling of Attention Deficit, not everyone in Big Pharma believes that this aggressive marketing is ethical. Roger Griggs, the pharmaceutical executive who introduced Adderall in 1994, said,

… he strongly opposes marketing stimulants to the general public because of their dangers. He calls these drugs  “nuclear bombs,” warranted only under extreme circumstances and when carefully overseen by a physician.

The Side Effects

Aside from keeping one focused and attentive, many users also experience insomnia, loss of appetite and hallucinations. Worse, psychotic episodes and suicidal thoughts are rare, but we have all heard and read about instances in the news with devastating consequences.

The same author, Alan Schwartz, in February 2013, reported in the New York Times, about the tragic case of the popular college class president and aspiring med student who became addicted to Adderall with the help of several doctors and ended up committing suicide. According to his parents, he had never had ADHD as a child and he didn’t have it as an adult. They begged the doctors to stop prescribing it to their son, to no avail. The son misrepresented himself to the doctors because he had become addicted to it.

According to Schwartz,

…the tunnel-like focus the medicines provide has led growing numbers of teenagers and young adults to fake symptoms to obtain steady prescriptions for highly addictive medications that carry serious psychological dangers. These efforts are facilitated by a segment of doctors who skip established diagnostic procedures, renew prescriptions reflexively and spend too little time with patients to accurately monitor side effects.(source)

Additionally, national data released by the Substance Abuse and Mental Health Services Administration in 2011 show that Ritalin, Adderall, and other ADHD drugs resulted in 23,000 young adults to the emergency room in 2011.This is more than four times the 5,600 visits reported in 2005. The age range was 18-34, but the rise was most dramatic among 18- to 25-year-olds.

The epidemic is not in ADHD. It is in the abuse of the ADHD drugs which are prescribed by doctors.

Now Targeting Adults

Shire pharmaceuticals, who markets Adderall and several other ADHD drugs, is now targeting adults with ADD via aggressive online quizzes which people can take on their own, designed to encourage them to seek treatment.

Like many psychiatric conditions, there is no marker or definitive test for ADHD — it is a diagnosis of exclusion and based on symptoms reported by the person.

The marketing addresses three issues: that the disorder is (supposedly) underdiagnosed, that the drugs are safe and effective, and that if left untreated, ADHD can lead to significant risks, such as, academic failure, drug dependence, car accidents and legal problems.

However, there are no studies to show that treating with stimulants will affect these risks.

Relaxed Criteria for the Diagnosis

Recently, the American Psychiatric Association, (which receives funding from drug companies), has gradually relaxed the official criteria for the disorder. The criteria now includes common childhood behavior like “makes careless mistakes” or “often has difficulty waiting his or her turn.”

Marketing for Life

In typical fashion, pharmaceutical companies entertain doctors at ritzy hotels and spas in exchange for their time to listen to a peer presentation on how to talk to patients about the lifelong nature of the disorder and the benefits of the drug treatment.

The side effects are minimized and the lack of studies glossed over.

On the front page of the Sunday New York Times (December 15, 2013) Alan Schwartz reported on this meeting and the Times even obtained the powerpoint document,

…which asserted that stimulants were not “drugs of abuse” because people who overdose “feel nothing” or “feel bad.” Yet these drugs are classified by the government among the most abusable substances in medicine, largely because of their effects on concentration and mood. Overdosing can cause severe heart problems and psychotic behavior.

Slides described side effects of Adderall XR as “generally mild,” despite clinical trials showing notable rates of insomnia, significant appetite suppression and mood swings, as well as rare instances of hallucinations. Those side effects increase significantly among patients who take more pills than prescribed.

Another slide warned that later in life, children with A.D.H.D. faced “job failure or underemployment,” “fatal car wrecks,” “criminal involvement,” “unwanted pregnancy” and venereal diseases, but did not mention that studies had not assessed whether stimulants decreased those risks.

This is how primary care doctors are educated and influenced. The pharma companies want to market these dangerous drugs to people to use for life.

In an interview with the doctor who gave the powerpoint, Dr. Dodson of Denver (by New York Times writer, Alan Schwartz),

{Dodson} … said that concern about abuse and side effects is “incredibly overblown,” and that his longtime work for drug companies does not influence his opinions. He said he received about $2,000 for the 2002 talk for Shire. He earned $45,500 in speaking fees from pharmaceutical companies in 2010 to 2011, according to ProPublica, which tracks such payments.

Schwartz goes on to report,

Many of the scientific studies cited by drug company speakers involved Dr. Joseph Biederman, a prominent child psychiatrist at Harvard University and Massachusetts General Hospital. In 2008, a Senate investigation revealed that Dr. Biederman’s research on many psychiatric conditions had been substantially financed by drug companies, including Shire. Those companies also paid him $1.6 million in speaking and consulting fees. He has denied that the payments influenced his research.

Right.

Shire agreed last February to pay $57.5 million in fines to resolve allegations of improper sales and advertising of several drugs, including Vyvanse, Adderall XR and Daytrana, a patch that delivers stimulant medication through the skin.

That’s a slap on the wrist — a drop in the bucket in the face of billions in sales.

A Deeper Problem

While the drugs may actually help some children and adults, at certain times in their lives, no one is addressing the underlying problem.  The drugs are addressing the symptoms only.

This is a problem inherent to our culture of instant gratification, fast food and over stimulation.

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