Live From Babylon

America loves her pills, recent studies show that nearly 70% of Americans are on at least one prescription drug. Thanks to Reagan we wage a war on drugs, while drugs are being force fed to us by direct-to-consumer advertising. In the good old days pharmaceutical companies used to be led by clinicians and medical experts who unanimously agreed that DTC was an unethical practice, this sentiment was not maintained when businessman found themselves at the seat of authority influencing the Reagan administration to pass DTC for pharmaceutical drugs in 1981. We are one of 2 countries in the entire world who think that unrestricted DTC should be a legal practice, the other being New Zealand. Coincidentally, according to the 2009 WHO study on prevalence estimates of mental disorders, there is a 47.4% and 39.3% occurrence respectively, which are the top two regions beating out countries such as Japan or Germany (18% and 25.2%). Is this a genetic or cultural occurrence? As a nation, we have at least double the rate of mental health disorders as compared to some other countries. Stay at home moms tuning into daytime dramas, or businessman watching the night time news are asked “Happy? Sad? Are you satisfied with your eyelashes? Is life stressful at times? Well ask your doctor if _______ is right for you!” to the imagery of sunshine and rainbows and erection innuendos.  These normal human emotions and conditions are quickly turned into afflictions, and the seed is planted into the nuclear family. They go to see their doctor who just got back from his golf trip with Pfizer, and ask for the drug they saw after Dateline. A rep just recently dumped off some samples at his office, the patient has subscribed to the idea of magic in a capsule, and the doctor says, “Sure! Why not, we can give it a try”. Now Pfizer has another prescription cow often times for the rest of his or her life and the machine keeps chugging. In 2015 the largest lobbying industry was big pharma, spending $238,086,761 to maintain influence and I think we all know people don’t give away money for no reason. The FDA also started an “accelerated approval” fast track process in 1997 which coincided with the renewal of DTC in which companies can basically pay a fee and have their drug put to the top of the line, negating years of clinical trials which are crucial for our safety. As a result we have seen a boom in drugs on the market, and thus the Zoloft effect.

    In 2015 DTC advertising was up 72% from 1999, from which our antidepressant use has more than doubled. Part of the beast of mental health is that it’s so subjective and susceptible to influence, much like pain is. We consist of 5% of the world population and yet we consume 75% of the world’s prescription drugs including over 80% of the world’s prescription opiates. In the 90s physicians were educated that opiates had no potential to cause addiction, and to prescribe them to everyone for pain. Well, they did, and now we have the FDA backing off now that we have a major drug addiction epidemic in the US. Those who were subjected to those prescribing practices, mainly people with chronic pain have been on high doses of opiates for over ten years and are now finding it difficult to satisfy their physical dependence because prescribers are just now backing off. Are we causing our own problems in the US? We have drugs for things that aren’t even diseases (Latisse) and we have arguably made up diseases to use drugs for new indications (restless leg syndrome). Clearly there are clinical roles for most drugs and there are a wealth of life saving ones, but many of the DTC drugs are what make me question our role as healthcare providers.