I was back in North Carolina for my grandmother's funeral yesterday. Her death was sad but peaceful. She lived a great long life, and was ready to go. The funeral was perfect -- the eulogy, service, flowers, and presence of her friends and family reflected her life and were just what she would have wanted.
I prepared a post last week responding to CNN's recent coverage of America's "pill problem" and it seems timely in light of my grandmother's death. My grandmother spent the last few years trying to control excruciating pain with powerful painkillers. Her meds improved her quality of life enormously during that time.
Although my grandmother benefited from the meds, I also recognize that the same drugs can be powerfully addictive for some people, ruining their lives. In its coverage, CNN chose to focus on this downside almost exclusively--a move I think is misleading and one-sided. True, some states (Florida) have a massive "pill problem". But in other places doctors are too hesitant to prescribe much needed treatments, causing a massive "pain problem".
CNN labels the recent increase in prescriptions for (largely new and patented) pain killers and psych meds as "alarming". But it's hardly surprising that the use of new medications has increased as doctors and patients become familiar with them. According to CNN's logic, the rise in the use of automobiles since the 1920s is also an "alarming" cause of all sorts of social ills like lethal accidents, obesity, and urban flight. But few would argue we should go back to horse and buggies.
CNN's article criticizing the use of psychiatric medications in children (Are kids overmedicated?) is especially disturbing. We hear all the time about how antidepressants aren't much more effective than placebo in most patients, but for many people -- especially the most severely afflicted -- these drugs are proven to relieve symptoms and save lives. Children, especially, need access to every treatment available in order to get a fair start in the world. Without exploring the debilitating effects of the wide-spread undertreatment of children, the article is misleading.
The article was poorly researched in a number of ways--it fails to note that medications are supposed to be used in conjunction with therapy, lifestyle changes, and good parenting techniques. And although the author seems most concerned with the over-medication of mild disorders amendable to non-drug intervention, he profiles an extreme case of a severely ill boy who obviously needs medication to function normally.
The author also adds an unnecessarily sensationalist detail -- the number of pills, not prescriptions, that the child takes. True, more than 100 pills a week is probably still a lot of prescriptions, but we don't yet have "magic bullet" to cure most mental disorders. Multiple symptoms are ameliorated with multiple drugs. Moreover, sometimes it makes more sense to take multiple small-dose pills rather than a single large one so that dosages can be tweaked more easily.
I admit that even though I sometimes feel like a walking pharmacy, I have a quality of life I couldn't imagine without these medications. Taking dozens of pills is hardly a bad trade-off for my mental health.
Finally, I hate that the author implies "lazy" parents are medicating their children instead of actually "parenting". The decision to medicate their children is not one many parents take lightly. Moreover, where necessary, medicating a child is GOOD parenting--no parent should let their child lose out on a normal childhood because of undertreated mental illness. Many parents may hold off too long in reaching for medication.
In covering this issue the way it has, CNN is giving credence to an anti-medication bias that masquerades as a "concern for children". Anti-med bias is the the new face of mental health stigma--one that is causing some children to suffer more than they should.
I'm not endorsing BigPharma. I'm as skeptical of it as anyone. Of course pharmaceutical companies would like us all to take 100 pills a week, however unnecessary. The goal of these companies is to make a profit for investors by selling medications. I work in the field of corporate governance and know that the fiduciary duties of company directors ultimately run to the company and investors--not the public that consumes the company's product (although "constituency statutes" in some states allow directors to consider customers and, of course, the operations of pharma companies are heavily regulated to protect consumers).
Despite the questionable motives of BigPharma, a levee of trained doctors and concerned parents stands between pharma companies and children. Give those professionals and parents some credit. We can't simply presume kids are overmedicated because they take more pills than we're used to. Whether kids are overmedicated or undermedicated is an empirical question that the author of the CNN article can't answer.
Watch this much better MSNBC clip on recognizing childhood mental illness--according the the doctor on the show it takes an average of 2 years for parents to get appropriate treatment for their children. That's a lot of childhood lost.
MSNBC clip on childhood mental illness
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