Overmedication in America Essay

Introduction

In the recent past there has been a tendency for people in the United States to take medicines that they really don’t really need. Long term taking of the drugs can lead to these people getting addicted to these drugs hence in a sense; they get hooked to their needs. This phenomenon can be partly attributed to the aggressive marketing of pharmaceutical products by the drug companies. This paper seeks to discuss the impact of advertisements by pharmaceutical companies and the resultant effect of overmedication in children with Attention Deficit Hyperactivity Disorder.

The overmedication of American children

Many Americans have over time developed a habit of taking medication for almost any problem they may have; from migraines to insomnia to chronic disorders and ailments such as attention deficit hyperactive disorder. As much as many of the uses of such medications is legitimate and quite necessary, a good number are not, consequently, a huge number of people become dependent on medications both physically and mentally. It is unfair to blame only the individual for this unfortunate occurrence, the pharmaceutical companies that manufacture these drugs and the medical community as a whole are also to blame (review essays)

The American public is literally bombarded by television adverts by the pharmaceutical companies advertising drugs such as Aspirin, Zoloft, Ritalin or Pepto Bismal, just to name but a few. There is no secret that these pharmaceutical companies are purely motivated by the need to maximize their profits, the well being of the patients’ using the drugs comes to these companies as a second thought. These pharmaceutical companies usually have aggressive marketing campaigns and also recruit marketing representatives who visit medical practices to market these products. These representatives are normally rewarded handsomely for any rise in the prescription of their drugs. The only factor that should determine whether or not medicine should be prescribed is necessity. A clear example of over medication is in the case of Attention Deficit Hyperactive Disorder (review essays)

Attention Deficit Hyperactivity Disorder and Attention Deficit Disorder have literally become household names as a result of the commonality of their diagnosis. Symptoms of these disorders were first observed in children in the turn of the twentieth century. A British pediatrician described this condition as a “defect of moral control”. In 1937, amphetamines, which are addictive and also highly potent, began being tested by doctors in the treatment of hyperactive and impulsive behaviors. The use of stimulants such as methylphenidate which is today called Ritalin and amphetamines began in the 1950’s in an effort to treat impulsivity and hyperactivity. In the 1960’s, a researcher by the name Stella Chase, came up with the term “Hyperactive Child Syndrome” in describing the symptoms of Attention Deficit Hyperactive Disorder. From then on, stimulants were widely used to treat both ADHD and ADD in the United States During the 1980’s and 90’s, children who had been diagnosed with either ADD or ADHD, received stimulant medications twice or thrice daily in a bid to control their behavior. In the year 2000, came the introduction of Concerta, which was the first 12 hour slow release medication. In November 2002, the Food and Drug Administration released Strattera for public use. The United States produces and consumes about 85% of global Ritalin supply. Stimulant drugs are easily abused because they can become addictive. Due to the increase in the diagnosis of ADD and ADHD, has resulted in school nurses being inundated with drugs to administer to children on a daily basis right from Pre School (review essays).

The medication of children that have been diagnosed with Attention Deficit Hyperactive Disorder is a controversial subject, to say the least. It is a fact that some professionals at times over diagnose and even overmedicate the children suffering from this condition. Dr. Gretchen LeFever, a researcher in the Eastern Virginia Medical School, conducted a study where she compared the rates of the medication of ADHD in Virginia with a few other states in a bid to come up with a national picture of the medical treatment of ADHD. The rates of ADHD drug treatment in two Virginia school districts, records revealed, was about two to three times higher than the countrywide estimates. She also found that about 84% of kids suffering from ADHD had at one point received medication; 70% were on medication during the study and only uninsured children had never received medication. (O’Connor, Eileen, M.)

Vitamin R

Advertisements by pharmaceutical companies on television together with the tendency of over diagnosing and overmedicating of children who are thought to be suffering from ADHD has led to a number of problems. In Washington DC, Ritalin is commonly abused together with other drugs. In an article that was written by Laura Sessions Streep, in the Washington Post, she observed, “Because it is a legal drug, many young people see no harm in either snorting it or in gulping down larger than therapeutic doses”. In Washington, the young people refer to Ritalin as either “Vitamin- R” or “R –Ball”. It is also called “the smart drug”. In a number of private schools, students have been found selling their prescribed doses of Ritalin to their colleagues (Bregin, Peter,R. pg 99).

Ritalin makes the “Most Wanted List” of Drug Culprits

The agency of the united nations that has the responsibility of monitoring drug abuse and addiction the world over, The International Narcotics Control Board, has raised a red flag on the over prescription of Ritalin that is rampant in the United States together with the diversion of the drug as an abuse substance ( Bregin, Peter, R. p101)

Novartis

The psychopharmaceutical industry is worth billions of dollars. Not only is it one of the richest industries globally, it is also one of the most powerful; consequently it has a lot of sway in government sand society. These companies allocate a huge amount of money to specifically advertise their products. Ritalin, a drug that is used in the treatment of Attention Deficit Hyperactivity Disorder, is manufactured by a division of Novartis, CIBA Geneva which is also known as Ciba-Geigy. The company markets Ritalin in almost all forms of mass media and networks as the choice drug in the treatment of ADHD. In 1996, Novartis made sales of over 18 billion Dollars and an “operating profit” of 3.2 billion Dollars.  (Bregin, Peter, R., p222).

Pharmaceutical companies have the habit of spending huge amounts of money especially in advertising their products. Despite the fact that these advertisements, for instance in the treatment of ADHD can result in over medication of the children with this condition, the media industry always appears to be sympathetic towards the pharmaceutical companies and have a tendency to protect them whenever controversies whirl up around these companies. According to IMS America, there has been a dramatic rise in the purchase of Ritalin by consumers; in 1991, the sales totaled to 95.3 million Dollars and in 1995, the figure rose to 349.3 billion Dollars (Bregin, Peter, R., p222).

Selling an Industrial Product

Medical and psychiatric drugs are in fact industrial products just as like clothes, motor vehicles or detergent. Despite the fact that pharmaceutical companies are among the most profitable in the world, they still face the same market place pressures as far as sales and profits are concerned; just like any other giant industry. These companies will often go to great lengths to protect their profit margins. The government evaluates the products of these pharmaceutical companies on their safety but it cannot fully guarantee the wholesome quality of the scientific research that resulted in the production of a given product, the promotion of the given product or products and practices of drug prescription. On the contrary, the government has on occasions become part of the problem; more often than not the government has responded to political pressure and ends up being quite lenient on these pharmaceutical companies (Bregin, Peter, R., pgs222-223).

The Physician Sales Force

Pharmaceutical companies have their own sales representatives; however, they rely heavily on physicians who play the important role of getting the product to the patient. These companies spend huge amounts of money in a bid to appeal to physicians and medical organizations so as to earn their loyalty and sympathy and overall support for the drugs that they produce. Novartis, for instance has a force of 2,300 sales representatives in the United States alone; a good number of physicians rely on these representatives to get information on the given drugs (Bregin, Peter, R., p223).

Stimulant use in the treatment of ADHD

Of all the stimulants, the use of methylphenidate is ranked first in children. It is now known that Attention Deficit Hypertensive Disorder continues into adulthood in most of the children who were diagnosed with this condition while they were in elementary school. This has prompted physicians to employ the use of stimulants in treating ADHD. Even though stimulants have proved to be quite effective as far as the treatment of the symptoms associated with ADHD is concerned, concerns have been raised especially about the issue of overmedication of the children with these stimulants (Barkley, Russell, A., p611)

The dangers of overprescribed ADHD Medications

Many drugs used in the treatment of ADHD are stimulants; they contain amphetamine and various side effects have been reported as a result of their use. Some of these drugs have the effect of suppressing feelings of any kind making the children using them sad. Some have the potential to become additive and are therefore prone to substance abuse. The overmedication of these drugs may result in the children being depressed and they may develop suicidal thoughts or even actions. Ritalin, which is given to children to make them concentrate better, has side effects that include insomnia, weight loss, dizziness, headaches, nervousness and stomach ache. In some cases, children who use Ritalin have suffered cardiac arrhythmia. Effects of its long term use have not been established but it has however been associated with stunted growth and abnormal development of the brain in little children. Aderall, which is a combination of various amphetamines, is another drug that is also commonly used in the treatment of ADHD. The side effects associated with these drugs include; insomnia, dry mouth, dizziness, restlessness and weight loss (Children Concentration).

The risk of overmedication among children who use drugs in the treatment of ADHD is high.   In the event that drugs are prescribed to treat patients suffering from this condition, the drug doses used should be the lowest possible and effective. Care must be taken to prevent the suffering of any kind as far as these children are concerned. (Findling, Robert, L., p10)

Impact of the Advertisements

Dr. Sidney Wolfe, the director of Public Citizens Research Group, a consumer advocacy group stated, “Given that parents obviously are anxious about their kids’ school performance, these ads really exploit theses parents’ concerns”. She went on to state, “This kind of ad is obviously not pushing for better teaching, better schools or more counseling, but is pushing for the easy fix, the drug solution”. She was speaking of advertisements for drugs for the treatment of attention deficit hyperactivity disorder that had a back to school theme. These adverts were sponsored by companies that were in charge of marketing those medications (Childs,Dan.)

In an editorial in the Los Angeles Times, pharmaceutical companies were taken to task over advertisements that featured drugs that are used to treat ADHD; the branding of the drugs in the advert appeared to be splashed in an imagery of back to school. The editorial read in part, “Powerful psychotropic medications should be an option of last resort and uninfluenced deliberation, not another brand name product to add to the back to school shopping list”. The regulatory agencies in the United States were not spared either; the article pointed a finger at the lax oversight of advertisements such as the one that marketed the candy flavored version of a powerful drug used in the treatment of ADHD. The representatives of these drug companies however, came out to defend those adverts which they argued that the said adverts served an important function of informing the general public about a condition that mostly goes untreated among children (Childs,Dan.)

Ken Johnson, the senior vice president of The Pharmaceutical Research and Manufactures of America (PhRMA) issued a statement in defense of the players in the pharmaceutical industry in which he stated “What the author failed to mention is that while more Americans are seeking treatment for mental illnesses, most of them fail to get adequate care”. He goes on further to state, “DTC advertising can help bridge this information gap by empowering patients, improving patient understanding of disease and available treatments and fostering strong relationships patients and their health care providers” (Childs, Dan.)

Although medication is useful in the treatment of children of symptoms associated with ADHD especially if behavioral and psycho-educational interventions have proved to be insufficient, the parents of these children should however not expect any benefits in the long term. Should the treatment of ADHD among children who exhibit these symptoms start with medication, then the probability of the parents and the learning institution to engage in non- medication treatments is significantly undermined (Stump, Elizabeth)

Isabella Rapin, professor of neurology and pediatric neurology at Albert Einstein College of Medicine in New York, cautions parents not to use stimulants in treating their children forever. She argues that drugs do not cure ADHD, and that they only help kids more attentive and available during education or even at behavioral interventions which are important. Dr. William E. Pelham Jr, Distinguished Professor of Psychology Pediatrics and Psychiatry at the University at Buffalo advises parents to insist to their doctors to be given evidence based psychosocial treatments and more importantly insurance should cater for those treatments. There is an apparent tendency to use medication as the first and only intervention of Attention Deficit Hyperactivity Disorder. Parents are being misguided that these drugs will help in the long run whereas the evidence suggests otherwise (Stump, Elizabeth).

Conclusion

The rate at which people in the United States are taking medicines which they do not require is alarming. The greatest beneficiaries in this instance are the drug companies because of the increased volume of prescription drugs being sold. The mass media in a sense collaborates with these companies by being lenient on the kinds of adverts that they air. The unfortunate victims are the innocent children who suffer from ADHD.