"Drowned In A Stream Of Prescriptions"

[Barbara]

New York Times, by Allen Schwarz
3 February 2013

VIRGINIA BEACH — Every morning on her way to work, Kathy Fee holds her breath as she drives past the squat brick building that houses Dominion Psychiatric Associates.

It was there that her son, Richard, visited a doctor and received prescriptions for Adderall, an amphetamine-based medication for attention deficit hyperactivity disorder. It was in the parking lot that she insisted to Richard that he did not have A.D.H.D., not as a child and not now as a 24-year-old college graduate, and that he was getting dangerously addicted to the medication. It was inside the building that her husband, Rick, implored Richard’s doctor to stop prescribing him Adderall, warning, “You’re going to kill him.”

It was where, after becoming violently delusional and spending a week in a psychiatric hospital in 2011, Richard met with his doctor and received prescriptions for 90 more days of Adderall. He hanged himself in his bedroom closet two weeks after they expired.

The story of Richard Fee, an athletic, personable college class president and aspiring medical student, highlights widespread failings in the system through which five million Americans take medication for A.D.H.D., doctors and other experts said.
Medications like Adderall can markedly improve the lives of children and others with the disorder. But 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.

Richard Fee’s experience included it all. Conversations with friends and family members and a review of detailed medical records depict an intelligent and articulate young man lying to doctor after doctor, physicians issuing hasty diagnoses, and psychiatrists continuing to prescribe medication — even increasing dosages — despite evidence of his growing addiction and psychiatric breakdown.

Very few people who misuse stimulants devolve into psychotic or suicidal addicts. But even one of Richard’s own physicians, Dr. Charles Parker, characterized his case as a virtual textbook for ways that A.D.H.D. practices can fail patients, particularly young adults. “We have a significant travesty being done in this country with how the diagnosis is being made and the meds are being administered,” said Dr. Parker, a psychiatrist in Virginia Beach. “I think it’s an abnegation of trust. The public needs to say this is totally unacceptable and walk out.”

Young adults are by far the fastest-growing segment of people taking A.D.H.D medications. Nearly 14 million monthly prescriptions for the condition were written for Americans ages 20 to 39 in 2011, two and a half times the 5.6 million just four years before, according to the data company I.M.S. Health. While this rise is generally attributed to the maturing of adolescents who have A.D.H.D. into young adults — combined with a greater recognition of adult A.D.H.D. in general — many experts caution that savvy college graduates, freed of parental oversight, can legally and easily obtain stimulant prescriptions from obliging doctors.

“Any step along the way, someone could have helped him — they were just handing out drugs,” said Richard’s father. Emphasizing that he had no intention of bringing legal action against any of the doctors involved, Mr. Fee said: “People have to know that kids are out there getting these drugs and getting addicted to them. And doctors are helping them do it.”

.....



http://www.nytimes.com/2013/02/03/us...anted=all&_r=0

[Luc]

It was there that her son, Richard, visited a doctor and received prescriptions for Adderall, an amphetamine-based medication for attention deficit hyperactivity disorder.

But try to make/take it if you are not Big Pharma... 30 years in prison guaranteed.

[Sheila]

I read the whole article. It's very good that people are saying that ADD meds are being prescribed recklessly, and that it's very easy for young people to fake the symptoms to get the meds.

[Chris]

Adderall: "add em all"-- all the drugs you can get hold of. Add er here, add er there, add er all everywhere.

In the 70s there was a slogan on signs/graffiti that was everywhere: "speed kills." This was a time of lots of drug experimentation and the purpose of the message was to warn the dabblers of the especially dangerous nature of amphetamines.

In around 2000, when I realized the colossal marketing/medical fiasco that is ADs, I thought well, we just have to educate people about what these drugs really are.
Then I found out about Adderall --amphetamines for children-- and I was extremely discouraged because everyone knows Speed Kills, right? Clearly lack of knowledge wasn't the only problem because many of those prescribing docs recall the ubiquitous slogan (even dumb hippies know speed kills)

So, can someone explain this adderall thing
I mean beyond the overall explanation-- that no one ever went broke selling addictive drugs to the American public. I just don't get giving a drug that is absolutely proven addictive to a child that is intended to be taken every day, and how is it they aren't supposed to become addicted?

Of course it's great that this is the headline of the NY Times , and I understand why the article is written very "evenhandedly." I write that way too--always qualifying claims and being very careful not to overgeneralize, be fair to all sides, etc. But this makes no sense: "Medications like Adderall can markedly improve the lives of children (NEEDS CITATION]and others with the disorder. But 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 . . . psychiatrists continuing to prescribe medication — even increasing dosages — despite evidence of his growing addiction and psychiatric breakdown.

Very few people who misuse stimulants devolve into psychotic or suicidal addicts." [Needs citation]This last statement is completely unsupported. What does he mean by misuse? Become slobbering meth addicts? This is supposedly objective factual reporting, but where does he get his "statistics" supporting "very few." His statements remind me that jounalistic reporting now defines objectivity as including both sides even when there are not two equal sides. he talks about tunnel focus, extreme drug seeking behaviour (the hallmark of addictive drugs), psychological dangers, psychosis inducing. This is his support for saying "Adderall can markedly improve the lives of children" It's as if he has to throw in a quote from the drug company's advertising in order to be "fair to all sides"

[Chris]

what I was trying to say (in my sputtering outrage) and tell me if I'm wrong. Aren't these common knowledge to physicians:
fact 1: amphetamines are addictive if taken every day
#2: amphetamine addiction is frequently accompanied by varying degrees of psychosis (e.g. paranoia)

The author describes amphetamines as "highly addictive medications," then he says that very few people who misuse stimulants become addicts.

What is so frustrating to me is that while we try to get the word out that ADs are addictive (while not fitting neatly into the traditional definition of addiction), this author can't even seem to bring himself to say straight out that one of the 50 pound gorillas of addiction --amphetamines--is addictive. He is unable to say straight out that there is no "other side" to the fact of amphetamines' extreme addictiveness. What does he think happens to most people who "misuse" amphetamines?
It's discouraging that he feels he must be fair to amphetamines because they are manufactured by companies that probably advertise in the NY Times.

[Luc]

So, can someone explain this adderall thing
I mean beyond the overall explanation-- that no one ever went broke selling addictive drugs to the American public. I just don't get giving a drug that is absolutely proven addictive to a child that is intended to be taken every day, and how is it they aren't supposed to become addicted?

I get your point, Annie. It all is a theatre - the way it functions. Looking at it from a more individual level; some of those working in the industry surely don't care (the financial incentive in their case overrides other, more basic human values, or it is of sociopathic nature in other instances), some don't even realize what is really going on, others trust the "authority". Or, it's just a systemic enslavement - you have to operate within the allowed parameters; if you dare cross them, off with your head. Because of my work, I knew some people that worked in a pharmaceutical industry (sales reps of different levels, or people in the state health care; though, my work as such had nothing to do with it). What always struck me, was that, during the conversation, whenever the subject of drugs and their side-effects was mentioned (as well as the dysfunctional way the entire industry functioned) majority of them knew about it. I can clearly see their faces today; Mr. X was in the "I-don't-care" camp, Mr. Y would care a bit, but "he had several debts to pay off", so he felt better *with* his head, Mrs. Z had no debts, and seemed to not care for the sole reason of trusting what "medical literature" says (though, you could feel something wasn't sitting right with her about the whole situation - a clear-cut in-denial case). And on and on.

[Chris]

I sent this letter to the editor of the Times:


Dear Editor,

Alan Schwarz (2/3/13) describes amphetamines as "highly addictive medications that carry serious psychological dangers;" then he writes “very few people who misuse stimulants” become suicidal or dangerously addicted. Some hard numbers here would help to flesh out “very few.” Does the writer think the majority of people who “misuse” amphetamines experience only benign effects? Why replace the common language of addiction, “abuse,” with the term “misuse”? Is there a need to soften the effects of amphetamine addiction? In the interest of even-handedness? Whose interest would that serve?

Amphetamine addiction can cause varying degrees of psychosis (e.g. paranoia), not to mention an over tendency to clean. This is that wonderful hyper focus the article mentions -- that tunnel vision that makes children more manageable in the classroom.

How is it that daily administration to a child of a ”highly addictive” drug would not lead to addiction?

One wonders how the facts of this article support the conclusion, "medications like Adderall can markedly improve the lives of children.”

Perhaps the writer feels he must include a pro-amphetamines perspective from drug company literature in order to be "evenhanded," or because they are advertisers. But in the context of this article, defending the practice of giving a drug of abuse to children seems like a non sequitur.

In the 1970s there was a ubiquitous graffiti slogan: "speed kills.” The purpose was to warn hippies of the particular dangers of amphetamines. Even dazed stoners knew to steer clear of this class of drugs.

[Sheila]

Excellent letter, annie. Thanks for sending it.

Maybe it has to do with the culture’s impatience, intolerance of complexity, and mistrust of depth and shadow. We want kids who are perky and high-achieving. We don’t want to have to deal with their problems. We certainly don’t want to face the pscyhodynamic truth that their problems may have something to do with their relationships with their parents. And we want everything fixed *now*.

These are another form of “shut ‘em up” pills. Like mother’s little helper.

[Luc]

So great to see you are actively Changing Things for the better, Annie. Doing it helps a lot in WD. Very empowering.

[Barbara]

Hi Annie,

It really made my morning to see that you had read the whole article and then actually sent a letter to the editor. I'm very interested to see if it gets printed.

The out-of-state, psychologist friend, who told me about this article in the first place, pointed out that it was on the front page of the Sunday edition of the NYT, and that it will be seen by millions of people. It seems like, over the last several years, writing about problems with psych meds has moved from the occasional op ed piece through the occasional science reporting to now the front page.

I just wrote to her about your writing to the editor. Please, keep us updated on any response.