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article imageOp-Ed: Over-prescription of child psych medication is now a plague

By Paul Wallis     May 7, 2013 in Health
Sydney - The issue of child psychiatric disorders and prescription of drugs has been around for years. Allegations of over-prescription and slap-happy medication for non-existent disorders are rampant. New studies indicate problems are getting worse.
The evidence is mounting that “business psychia-tricks” and Big Pharma are behind it.
Arguably infinitely worse is the emerging and ever-narrowing definition of “normal” kids. Apparently children are becoming progressively less “normal” as new diagnoses are added to the psychiatric list of disorders. The old stat of 1 in 100 kids with a disorder in the 1950s has been replaced with a stat of about 1 in 6.5. Demographer’s dream, or parents’ nightmare?
An absurdly over-stressful, hysterical (not to say actually psychotic) society could certainly be to blame for some extra, actually stress-related, disorders. Bullying could produce a range of symptoms. That still doesn’t satisfactorily cover a 650% increase in incidence of medical disorders.
The Daily Mail in the UK deserves some real kudos for addressing the matter in depth in one article in particular.
You must read this article in full to appreciate the horrendous scope of the issues. (Also read the comments. The world isn’t impressed with the latest way of giving Big Pharma some more spare change.) I’m not going to regurgitate it on principle, but the selection of quotes below will explain some of the issues:
One major issue is the progressive increase in documentation of psychiatric disorders on a far less than rigorous basis. After reeling off some nasty statistics, the article goes on:
…This is as defined in manuals such as the psychiatrists’ ‘bible’, the Diagnostic and Statistical Manual of Mental Disorders (DSM) or its close equivalent, the International Classification of Diseases (ICD), which they use as the basis of making diagnoses.
The DSM also turns out to be the conveniently ever-expanding frame of reference which the psychiatric profession is giving itself. Many of the new “disorders” are questioned by experts. Even the science behind the DSM is referred to as “a shambles”, which seems to be a particularly polite way of describing it given the impact on kids and families.
On the subject of shambolic:
The act of blushing is now a “disorder” according to psychiatry, because it relates to “social anxiety”. It used to relate to embarrassment before someone took over the task of defining normality. The result is a literal industry of blushing treatments. This is the Google search for blushing+psychotherapy. There were 11 million results in the search I did.
There’s even a social anxiety institute, if you want your social anxieties institutionalized. There is definitely such a thing as “social anxiety”, but think about how far down the tube you’d have to be to require actual therapy.
Meanwhile back on the Medicated Kids R Us ranch: The indications of ineffective drugs and drugs which achieved results which were no different to placebos are stacking up. Meaning that this expensive, worrying regime of over-medication has a bad habit of doing nothing useful on a regular basis.
Other problems included “changed”, but not “better” kids. Zombification, not quite, but not pleasant. Over prescription for ADHD is one of the typical scenarios. The result is often “better or worse”, and you get to guess.
Of course there are such things as kids with behavioural problems. There are two forms- Real problems and real discipline problems. Thanks to the endlessly-reviled PC prohibition against parental discipline in any shape or form, the real discipline problems are a lot worse. The rise of spoiled, revolting, uncontrollable brats dates from exactly that era. That’s not a psychiatric disorder, though. Quite the opposite. It’s about getting away with murder and knowing they’re getting away with it.
If that behaviour becomes endemic and sociopathic, no prizes for guessing where it started. That’s not part of the psychiatric motif, though. Apparently everything is a potential behavioural problem to over-prescribing psychiatrists, which, of course, can be treated with medication. Is over prescribing remunerative for psychiatrists? The general theory is that it must be. It is for everyone else. Even multibillion dollar lawsuits haven’t prevented Big Pharma from putting more crap on the market.
The DSM, inevitably, is the backup for diagnosis, but, as the Daily Mirror reports with a certain deadpan tone:
Unlike in other areas of medicine, where a doctor can conduct a blood or urine test to determine whether they have reached the correct diagnosis, in psychiatry no such methods exist.
Such scientifically objective tests don’t exist because psychiatry has yet to identify any clear biological causes for most disorders listed in the DSM, which has grown bigger and bigger with each edition.
So it’s really a psychological diagnosis. That’s not particularly reassuring, when the actions of therapeutic drugs are entirely biological.
There’s a famous story of a guy who went to see a different psychiatrist to his normal therapist one day. He told the new psychiatrist his issues and showed him what he was taking. “Stop taking them,” said the new psychiatrist. He did, and he was fine in a week or so.
Exactly how much misdiagnosed or inappropriate medications can cause problems is obviously also not a subject for discussion in the profession. It may become one, however, if you consider the possible ramifications of applying strong new drugs to growing kids. Particularly the sloppily-barely-hardly researched things coming on the market every year.
What if the new drugs cause something as mundane as liver or kidney failure? What if they cause reactions? Even the most basic medical considerations don’t seem to be getting much traction. Any paediatrician or GP will be thoughtful and thorough about what’s given or not given to a kid, but psychiatry has an Easy Bake recipe book?
What amuses me (and believe me there’s not much to be amused about reading this sorry saga) is that all these new “disorders” are now being “discovered”. What wasn’t a problem before is now being solemnly written up and included in the DSM like a new Bible. “In the beginning, God created a whole range of excuses for diagnosis and prescriptions”?
You’d think so. Worried parents (is there another kind?) are trying to do something for their kids, but now things that nobody has ever considered problems require medication? The logic is absurd. Unfortunately, the results aren’t.
In fairness, the current regime is also attracting a lot of flak from real psychiatrists. Experienced professionals are questioning every part of this marketing exercise. They’re not getting a lot of publicity globally, although in the US this is a boiling-point issue within the community.
As usual, business is running the marketplace. Market farces rule. Neither professionals or parents are getting a hearing. Washington is being its usual irrelevant/inexcusable self in health care. That’s setting the tone for global responses to what’s becoming yet another spreading, uncared-for health issue.
A few suggestions:
To hell with quackery. Talk to a GP and/or paediatrician, someone who’s qualified to assess issues.
Quantify the issues (if any) get some tests done to check facts if required. Make sure you have a clear, documented picture of your kid’s issues and non-issues.
Bear in mind that harmful effects of prescription are legally actionable. If you live in the US, you could probably rent an NFL stadium for participation in a class action for many of these drugs.
Don’t simply accept a drastic solution. You don’t have to do anything if you don’t believe in it. Get a second opinion or be guided by your GP/paediatrician . If two people who are supposed to know what they’re doing come up with the same diagnosis, either they’ve both found the same page on the DSM or they’ve independently arrived at the same opinion.
If you accept a prescription, (You don’t have to do that, either. Think about that, O mighty pill-pushers.) use your independent GP/paediatrician to verify effects. Document any negatives, and proceed merrily and homicidally to your nearest lawyer with a few numbers and a currency symbol of your choice in front of them.
It is rather sad that the world’s governments are so totally useless in managing health. They set no standards, demand no level of ethics or anything else. Perhaps the public should take matters into its own hands.
In the past, witch doctors and healers had a good reason to want cures to be successful- They’d be killed or worse if the cures didn’t work. Perhaps we need to revive this grim but sincere approach to health and those who supply “cures”?
The fewer useless scum “managing” kids, the better. This generation of kids has hell to look forward to in coming years just in surviving nutcase global economics. It can do without hobbyist psychiatry.
This opinion article was written by an independent writer. The opinions and views expressed herein are those of the author and are not necessarily intended to reflect those of
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