November 2011 - Page 2

Define Better: Too Many Prescription Medications for Kids

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Medication Madness

This hard-edged rap video flew around the social media outlets last week- Define Better. The music video tackles the issue of over-medicating our children and calls into question the industry that regularly pushes to expand its market share for old drugs. Two markets that have seen an exponential increase in market share, particularly for psychiatric drugs, are women (including pregnant) and children.

Prescription Medications during Pregnancy

Where in generations past, pregnant women were prohibited from taking any medications lest these meds cross the placenta and harm the fetus. As of 2006, 30% of all pregnant women were taking at least one psychotropic medication (DeVane et al. 2006), despite the documented birth defects and other complications associated with these medications.

Giving Children Antidepressant Medications

Similarly, it was unheard of to prescribe antidepressants to children under the age of 16; not only because these medications have neither been tested nor proved effective in children, but because they cause ‘paradoxical’ reactions – elicit suicidal ideation and suicide itself.

A recent report in the Journal Health Affairs supports these claims. Researchers found that “between 1996 and 2007, the number of visits where individuals were prescribed antidepressants with no psychiatric diagnoses increased from 59.5 percent to 72.7 percent and the share of providers who prescribed antidepressants without a concurrent psychiatric diagnosis increased from 30 percent of all non-psychiatrist physicians in 1996 to 55.4 percent in 2007.” Similarly, another study published in the American Journal of Public Health found that the very medications drug companies marketed most aggressively frequently offered the least clinical benefit and had the potential for the most harm to patients.

Understand what these two reports are saying, drug companies are aggressively marketing those drugs that offer the fewest clinical benefits and the most harm to patients – and we’re buying them! Whether we’re buying them because our doctors prescribed them readily or because we’re demanding the drugs from our doctors, is unclear. What is clear, is that we’ve relinquished personal control over our own health and our children’s health to marketing. We need to regain that control and to do so requires that we ‘Define Better’.

DeVane, CL, Stowe ZN, Donovan JL, Newport DJ, Pennell PB, Ritchie JC, Owens MJ, Wang, JS. Therapeutic drug monitoring of psychoactive drugs during pregnancy in the genomic era: challenges and opportunities. J Psychopharm. 2006; S 20(4):54-59.

Healthy Behavior No Longer A Personal Choice

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It’s a strange state of affairs when the comedy channels break more important stories than the news shows. Just last week a report by Wyatt Cenac, from the John Stewart show set off a firestorm of discussion on the blogosphere.  HR 3472, a bill proposed by former Congresswoman Kathy Dahlkemper, would have offered incentives (insurance discounts) for healthy behavior (not smoking, losing weight, controlling cholesterol) was defeated in committee not by partisan politics (both parties were in favor of the bill) but by intense lobbying efforts from the American Diabetes Association (ADA), the American Heart Association (AHA) and the American Cancer Society (ACS).

Why would the big three associations, which are supposedly for health and prevention, oppose legislation that rewards improved health? According their perfectly jumbled released statements:

ADA
The impact of these provisions would have been to penalize people with pre-existing health conditions and certain health risks who could not meet these targets by charging them more for their health care. In addition, the legislation would have applied to health plans sold in the individual market, where people do not have the support of a formal workplace wellness program to help them achieve these goals.”

AHA
This bill might open the door for discrimination of people with pre-existing conditions, and also those who are genetically predisposed to these conditions. Most importantly it would restrict access to healthcare to those who need it most and research has shown that this has a negative effect on health.”

ACS
In fact, the bill would have enabled employers to reduce the health care premiums of people who met specific health targets (such as not smoking or maintaining low blood pressure), but also penalize people with pre-existing conditions who could not meet the targets by charging them more for their health coverage.  The Society supports comprehensive wellness and health promotion programs that utilize incentives, such as discounted gym memberships, for employees. But we oppose restricting access to health care for those who need it most.”

If their stated opposition is understood correctly, it boils down to, unless everyone benefits from these discounts, no one can benefit. Aside from the absurdity of this argument for the essentially capitalist endeavor that is our insurance industry, in what strange twist of reality did smoking and eating junk food cease to become choices?   And how does offering incentives for eliminating said activities, equate with penalizing those who choose not to partake? Even those with genetic predispositions to high blood pressure, high cholesterol or diabetes would benefit from not smoking, from eating healthier and exercising more.  What do you think?

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