In this Peabody Award-winning edition of Vanguard, correspondent Mariana van Zeller travels to South Florida–the “Colombia of prescription drugs”–to expose a bustling pill pipeline that stretches from the beaches of Ft. Lauderdale to the rolling hills of Appalachia.
“The OxyContin Express” features intimate access with pill addicts, prisoners and law enforcement as each struggles with a lethal national epidemic.
Drug companies have been accused of conning the public by hyping up patented medicines with little new to offer while downplaying their side-effects.
An estimated 85% of new drugs offer few if any new benefits while having the potential to cause serious harm due to toxicity or misuse, a study has concluded.
The author of the research delivered a damning attack on “Big Pharma” at a meeting of sociology experts in the US.
Professor Donald Light described the pharmaceutical industry as a “market for lemons” – one in which the seller knows much more than the buyer about the product, and takes advantage of this fact.
“Sometimes drug companies hide or downplay information about serious side-effects of new drugs and overstate the drugs’ benefits,” said Prof Light, a professor of comparative health policy at the University of Medicine and Dentistry in New Jersey, US.
“Then, they spend two to three times more on marketing than on research to persuade doctors to prescribe these new drugs. Doctors may get misleading information and then misinform patients about the risks of a new drug. It’s really a two-tier market for lemons.”
He alleged that the pharmaceutical industry owned companies in charge of drug testing and provided “firewalls” of legal protection behind which information about dangers or lack of effectiveness could be be hidden.
Companies were assisted by the “relatively low bar” for effectiveness that had to be crossed to get a new drug approved, he claimed.
Prof Light presented his paper, entitled “Pharmaceuticals: A Two-Tier Market for Producing ‘Lemons’ and Serious Harm” at the American Sociological Association’s annual meeting in Atlanta, Georgia.
The study includes data gathered from independent reviewers which suggest that 85% of new drugs provide few, if any, new benefits.
As prescription drug abuse is on the rise, the Washington State Department of Health reports that overdoses have replaced car crashes as the leading cause of injury-related deaths. From 2003 to 2008, the rate of prescription overdoses and hospitalizations rose 90 percent.
The most prevalent drug overdose and death culprits appear to be Vicodin, Oxycontin and Methadone, all opiods. The overuse of Vicodin can lead to increased tolerance and addiction. One risk of Vicodin addiction includes liver toxicity, which increases for users without a tolerance to the drug. Oxycontin users may suffer from respiratory depression or arrest, skeletal-muscle flaccidity, blood-pressure and heart-rate reduction, coma and death.
As for Methadone, the FDA has issued a public health advisory warning that deaths and life-threatening side effects have been reported for both new users and those that switched to Methadone after being treated for pain with other strong narcotic pain relievers. The drug can cause slow or shallow breathing and change in heartbeat that may not be felt by the patient.
The trend of drug use has evolved since popular use of certain drugs each era – from LSD in the 1960s, heroin in the 1970s, crack cocaine in the 1980s, crystal meth in the 1990s to the current prescription drug abuse.
This year’s latest drug control strategy emphasizes anti-drug programs and encourages health care providers to screen for drug problems before addiction sets in, marking a change in policy. The policy requires early detection of patient drug use and database tracking of physicians that overprescribe addictive painkillers.
Policy reform also allocates drug control budget funds to a 13 percent increase in spending on alcohol and drug prevention programs. A 3.7 percent increase in addiction treatment was also approved for the budget.
The aim for policy reforms includes goals to reduce the rate of youth drug use and drug-induced deaths by 15 percent, and drug use among young adults by 10 percent. The administration also hopes to reduce the number of chronic drug users by 15 percent.
Approximately 70% of our patients are addicted to opiates for pain management and the majority are on opiates due to back pain. Back pain is one of the most common reasons people see a pain management doctor and start on opiate drugs. Up to 80% of the world’s population will suffer from back pain at some point in their lives, with the lower back as the most common location of pain.
Although most episodes of low back pain last less than two weeks, research has shown that recurrence rates for low back pain can reach as high as 50% in the first few months following an initial episode or injury.
While it is difficult to resolve lower back pain, the use of acupuncture has increased dramatically in the past few decades. Placebo-controlled studies have validated it as a reliable method of pain relief. The results of a recent study published in the Clinical Journal of Pain provide further proof that acupuncture is a safe and effective procedure for low-back pain, and that it can maintain positive outcomes for periods of six months or longer. Seeking acupuncture therapy may be an answer to relieving pain without the use of opiates that can have many negative side-effects and cause addiction.
Study Shows Many People Who Are Told They Have the Disorder Don’t Meet Standard Criteria
By Charlene Laino
WebMD Health News
Reviewed by Louise Chang, MD
Many people who have been told by their doctors that they have bipolar disorder don’t really have it.
So say researchers who used a standardized, comprehensive, psychiatric diagnostic interview to evaluate 700 adult psychiatric outpatients.
About 20% had previously been diagnosed with bipolar disorder. But only 13% met the criteria, says Mark Zimmerman, MD, associate professor of psychiatry and human behavior at the Warren Alpert Medical School of Brown University in Providence and practicing psychiatrist at Rhode Island Hospital in Providence.
“In about half of patients previously diagnosed with bipolar disorder, we couldn’t confirm the diagnosis,” he tells WebMD.
There are real dangers to overdiagnosis, chief among them unnecessary exposure to mood stabilizers and all their powerful side effects, Zimmerman says. There’s also the stigmatization of having a serious, possibly lifelong mental illness.
The study is being published online by the Journal of Clinical Psychiatry and presented at the annual meeting of the American Psychiatric Association.
Why Is Bipolar Disorder Overdiagnosed?
Bipolar disorder used to be called manic depression because it is characterized by bouts of depression and bouts of mania. Patients experience dramatic mood swings between euphoria and severe depression; they may have hallucinations or delusions.
Patients with anxiety, agitation, irritability, and restlessness that does not persist are sometimes misdiagnosed with bipolar disorder, Zimmerman says.
“These could be symptoms of bipolar disorder. But they really have to be accompanied by other criteria, such as hyperactivity, feeling energetic despite just a few hours of sleep, or inflated self-esteem,” he says.
Ironically, one reason the disorder is being overdiagnosed is “because so much has been written about it being under-recognized,” Zimmerman says.
“It’s difficult to go to a lecture on bipolar disorder that doesn’t begin with, ‘Make sure you don’t miss…,’” he says. “So clinicians are loathe to miss it.”
The increased availability of medications for the treatment of bipolar disorder may also play a role in overdiagnosis, Zimmerman says. “Physicians have a tendency to diagnose something that they feel they are comfortable treating,” he says.
So what should you do if you think you’ve been misdiagnosed with bipolar disorder?
“If you’re at all uncertain about the diagnosis, speak to your doctor and make sure you understand why you’ve been given that diagnosis. If you remain unconvinced, get a second opinion,” Zimmerman says.
A Note from Rapid Drug Detox
According to several researchers, marketing tactics by the drug industry are contributing to a huge overdiagnosis of bipolar disorder. Studies have shown evidence that fewer than half of patients who were given a diagnosis of the disorder actually had it, as reported in the Journal of Clinical Psychiatry. Their finding contradicts previous claims that the illness was underdiagnosed. Results from this study suggest that bipolar disorder is being overdiagnosed, and, given the serious side effects that the treatments can cause, patients need to be aware of this.
The psychiatric and pharmaceutical industry compare psychiatric disorders such as Bi-Polar Disorder, Depression, Attention Deficit Disorder (ADD/ADHD), Post-Traumatic Stress Disorder, etc. to medical conditions such as cancer, diabetes and heart disease. However, no scientific tests can verify the medical existence of psychiatric disorders.
The psychiatric industry claims that there are certain medical conditions that exist without verifiable tests, therefore there does not exist one for mental illnesses. While there may exist rare medical conditions without verifiable medical tests, there are no psychiatric disorders that can be verified medically as a physical abnormality or disease.
Often brain scans used to prove schizophrenia or depression have not been conducted on people not taking antipsychotic drugs. Such scans have been documented to cause brain atrophy, or shrinkage. Other brain scans have compared brains of smaller children to show smaller brains in comparison to larger and older children. The scans were used to claim that children with ADHD have smaller brains. However, none have been conclusively proven to verify mental disorders as abnormalities of the brain.
This is not to say that people don’t get depressed, troubled, or even sometimes act psychotic. For example, can soldiers returning from war experience extreme and often debilitating stress? Yes, but it is less likely to be a medical condition of the brain. Can mothers become distraught after a joyous occasion such as the birth of a child? Yes, but again, it is unlikely to be a brain abnormality or mental disease. It may not be the best decision to prescribe these people certain drugs documented by international regulatory agencies to cause mania, psychosis, worsening depression, heart attack, stroke and sudden death. Additionally, new or nursing mothers may risk birth defects or damage to infants from prescription drugs.
Any drug taken influences behavior or mood, whether it be cocaine, alcohol, marijuana or heroin. This does not mean someone who acts or feels differently on cocaine does so because they had a cocaine imbalance, with which the cocaine then corrected. It means that drugs change moods, emotions and behavior. But while the illicit use of drugs is universally frowned upon, psychiatric drugs are conversely viewed as “good” drugs, despite the fact many are more addictive than cocaine or heroin. Drug addiction leads to the greater issues of drug abuse and withdrawal.
The larger problem is that the biological drug model prevents governments from allocating funding to actual medical solutions to people experiencing difficulty. There are also viable, non-harmful medical treatments that do not receive government funding because the psychiatric/pharmaceutical industry spends much of its budget on advertising and lobbying efforts.
Opiate drug addiction can cause depression and many patients are prescribed antidepressants by psychiatrists. A blind study in 1998, whose findings were reinforced by landmark research in The Journal of the American Medical Association last month, concludes that antidepressant drugs thought to help with depression are not as effective as once thought. More studies being conducted suggest that benefits are often not much more effective than placebos.
Patients on a placebo improved about 75 percent as much as those on drugs. Yoga, relaxation imaging, meditation, Cognitive Behavioral Therapy and other forms of therapy can help combat this debilitating illness.
Most common side effects of antidepressant therapy include sexual problems, drowsiness, sleep difficulties, anxiety, nervousness and nausea. While some side effects may go away after the first few weeks of drug treatment, others can persist and progressively get worse.
In adults over the age of 65, selective serotonin reuptake inhibitors pose an additional concern. Studies show that SSRI medications may increase the risk for falls, fractures, and bone loss in older adults. The SSRIs can also cause serious withdrawal symptoms if you stop taking them abruptly. Once you’ve started taking antidepressants, stopping can be difficult; many people have withdrawal symptoms that make it difficult to get off of the medication and may require opiate detox.
If you decide to stop taking antidepressants, it’s essential to taper off slowly. If you stop abruptly, you may experience a number of unpleasant withdrawal symptoms such as crying spells, extreme restlessness, depression, anxiety, dizziness, fatigue, and aches and pains. These withdrawal symptoms are known as antidepressant discontinuation syndrome. Antidepressant discontinuation syndrome is especially common with Paxil or Zoloft. However, all medications for depression can cause withdrawal symptoms.
In general medicine, the standard for informed consent includes communicating the nature of the diagnoses, the purpose of a proposed treatment or procedure, the risks and benefits of the proposed treatment, and informing the patient of alternative treatments so he or she can make an informed, educated choice.
Psychiatrists often do not offer patients non-drug treatments, nor do they conduct thorough medical examinations to ensure that a person’s problem does not stem from an untreated medical condition. At times, they might fail to inform patients of the nature of the diagnoses, which would require informing the patient that psychiatric diagnoses based on behaviors with little scientific or medical validity (no X-rays, brain scans, chemical imbalance tests to prove anyone has a mental disorder).
All patients should have what is called a “differential diagnosis.” The doctor obtains a thorough history and conducts a complete physical exam, rules out all possible problems that might cause a set of symptoms, and explains any possible side effects of the recommended treatments.
There are numerous alternatives to psychiatric diagnoses and treatment, including standard medical care that does not require a psychiatric label or drug. Governments should endorse and fund non-drug treatments as alternatives to potentially ineffective and dangerous drugs. Limiting drug treatment can lead to the reduction of drug addiction.
Skeptics claim the numbers reveal a system of scientific fraud. “This rapid increase in diagnosis of bipolar disorder can only be explained by either a runaway epidemic infection or a medical fraud that seeks to label people as ‘diseased’ in order to sell them more drugs,” said consumer health advocate Mike Adams.
According the new study, nine of 10 individuals diagnosed as bipolar are treated with at least one medication, and two-thirds of them are treated with two or more drugs. These drugs create profitable, reliable revenue streams for drug companies.
The data for the study were taken from annual government surveys of doctors.
The skyrocketing rate of psychiatric diagnosis’ has many people arguing over whether a mental disorder was previously under diagnosed, or whether psychiatrists are now over diagnosing it.
“There’s no question that there is misdiagnosis going on,” said Gary Sachs, director of the bipolar and mood disorders program at Massachusetts General Hospital in Boston. “You can dispute whether it’s under- or over-diagnosis.”
Misdiagnosis, in turn, may lead to inappropriate use of drugs. These patients often become addicted to the unnecessary medication, needing to seek out addiction treatment. People need to lead healthier life styles, stop opiate and illicit drug use, seek exercise and practice good nutrition.
Chronic use of opiates has long been associated with multiple side effects, many of which are due to lower levels of androgens in this patient population.
Previous studies have shown that long-term opiate use may lead to opiate induced hypogonadism, resulting in significantly decreased testosterone levels in men. One area of chronic opiate use that needs to be looked at extensively is the correlation between opiate-induced hypogonadism and associated side effects such as osteoporosis and sexual dysfunction in male patients taking opiates. Marked testosterone deficiency is a well-established risk factor for both osteoporosis and altered sexual function, and recent information demonstrated that altered estrogen levels may play a role in these side effects as well.