By: Yesenia N Garcia
There are many things that people fear, one of them is death. The whole notion of death troubles even the most secure and confident individuals. As we know, death is part of the human cycle that at one point everyone must encounter. So why do we fear diseases and disorders? This has been done via media and medical organizations. With a constant reminder through physicians, magazines, television, media, fear of death and disease is instilled in us. So how do we react to this? I’ll tell you. We become submissive to the idea that medicine is the best policy. Whenever you feel sick or have certain symptoms it is not rare to go check yourself with your primary physician, sometimes even a hospital right? Yes, that is what everyone assumes to be the smartest decision, but what happens when you are diagnosed with a disease? Worries start to occur. The real question is not what to do next, but to analyze if you are actually sick. Is this a medical problem or is it a wrong turn in your life that is causing troubling symptoms? For example, since when did being shy become a sign for Social Anxiety Disorder? This is the problem with healthcare; you never know if what you are being diagnosed is correct in its entirety.
In a presentation given by Mathew Emmens, he describes how the ups and downs of life have become (interpreted) a mental disorder. He presents the topic of ordinary people turning into patients without realizing it. With less than 5% of the world population, the United States makes 50% of the global market in prescription drugs! How does this happen you might ask. Aside from it being a large percentage, we as the population engage in such expenditure when we decide to buy prescription drugs. There is a drug for almost anything and when we are aware of having a disease or a disorder we think of the consequences that it can bring later. It is there when we become interested in taking prescription drugs to help us cure or treat our illness. Now, notice that there is a $500 billion dollar pharmaceutical industry who in a very discreet way advertises the condition to link to the medicine in order to sell it. For the purpose of this essay, I will be focusing in Attention Deficit Disorder, sometimes referred to as ADD or ADHD and the drugs available for it.
Attention Deficit Disorder is “a problem of not being able to focus, being overactive, not being able control behavior, or a combination of these.” (National Library of Medicine) In order to be diagnosed with ADHD the levels must be out of normal range for a person’s age and development. It is regarded as a biological chemical problem in the brain or can also be a result of a complexity of social, physical, and cultural factors. It is not clear what causes ADHD, because the causes remain speculative as not enough evidence exists to classify it as a brain disorder. Who gets diagnosed with this medical problem then? Unfortunately, it is the younger generation for the most part. This behavioral disorder is usually diagnosed during a person’s childhood but can continue as an adult. It is more common for a male (13.2%) to get diagnosed than a female (5.6%) with such disorder. Symptoms include the following: having a hard time resisting temptation, having trouble taking turns, having difficulty getting along with others, and so on. Based on epidemiology data about 4% to 6% of the U.S. population has ADD/ADHD, roughly about 8 to 9 million people. In a California survey of 2007, 6.2% of people were diagnosed with the disorder. There is not proper documentation or evidence to determine if social class is a factor or not to getting the disorder.
Because this is labeled as a disorder, the only way people try to cure or treat is by medications. As mentioned before, when fear is instilled people opt to what the doctor says is correct. Rates of ADHD diagnosis increased an average of 3% per year from 1997 to 2006 and an average of 5.5% per year from 2003 to 2007. The highest rates of parent-reported ADHD diagnosis in children were covered by Medicaid and multiracial children. There has been real concern with pharmaceutical companies because it seems like the rates of drug use has increased tremendously.
There are many pharmaceutical industry companies who supply the drugs needed for the disorder such as Shire, Lilly, and Novartis. Shire is a recent global company to the industry where it sells more than half a billion dollars of an amphetamine drug called Adderall every year. In a New York presentation given by Mathew Emmens, he notes that in 1996 the total sales of Adderall was $10 million dollars and increased to $520 million in the course of six years. Adderall constitutes more than 40 percent of the total company’s revenue. “…According to CHADD, medication is the most effective foundation for treatment.” (Cassel,Moyihan,2005) Although there are different types of treatment the drug industries are still encouraging that the most effective treatment is the use of medicalization. Pharmaceuticals companies contribute to making healthy people into patients. How sure do they know people have such disorder yet no actual test is available to determine ADHD? The companies create doctor alliances because they are the ones to prescribe the medications. In return these huge companies give grants to them and other organizations as they also seek to gain something by granting the money.
There is a variety of prescribed medications that can be given to treat this medical problem. Treating ADHD is collaboration between the health care provider and the patient. Stimulants are the most widely used treatments and best known as well. Between 70-80 percent of children with ADHD respond positively to these medications. In addition, non-stimulants are also approved for treating ADHD since 2003. This medication seems to have fewer side effects than stimulants and can last up to 24 hours. Ritalin is a stimulant used and it is in a tablet form administered by mouth. Some of the side effects of this drug are that it often causes rebound and roller coaster effects, and can be very abusable. Another drug that is prescribed is called Dexedrine. It may take up to one hour to be effective and usually lasts about 6 to 8 hours. For the most part people will take it twice a day with six hour intervals. In addition, Adderall is one of the most common prescribed drugs for many of those who are affected by ADHD. This tablet usually last 6 hours and may be given once or twice a day. Common side effects of these drugs are as follows: appetite suppression, sleep disturbance, mood changes, rollercoaster effect (a continuous cycling of the blood level, either rising or falling throughout the day), irritability and anxiety. There have not been studies whether the drugs are addictive, but there is research saying they are abusive.
So if these drugs are not necessarily addictive, why has there been an increase in drug use over the past several years? What role do these pharmaceutical companies play in such increase? In Marcia Angell’s “The Truth about Drug Companies”, she discusses the many different strategies used by the industries that are causing more and more patients to obtain prescription drugs. First she addresses the basic component of advertising. This is the most important factor in my opinion because this is the way the companies appeal to the patient, the bystander, the professional, everyone in general. When these drug industries are advertising, they make sure what they advertise will lengthen your life, make you happier, and make an enjoyable experience to live. Prescription drugs are expensive, but the way they are sold is basically telling you that you get what you pay for. For instance, Americans spend about $200 billion dollars on average a year on prescription drugs, while it seems to increase at a rate of 12% since 1999. Another way of great marketing skills is the use and how the new product or “mee-too” (a past drug that is modified and improved and sell it as new) drug uses words such as research, innovation, and American research to make it seem that the drug has already been tested and guaranteed to work.
Not only are people getting brain washed but so are other institutions like clinics, nursing facilities and so on. Marcia Angell is not only referring to prices but also the regulations needed for such companies. The important thing to note is that pharmaceutical industries are hardly a model for free enterprise. These companies are free to price their own drugs and are dominantly funded by a government institution. It may seem a little too convenient that where the support is coming from is where regulation of prices and advertising can occur, however not happening. For example, the Food and Drug Administration (FDA) have given companies the right to exclusive marketing even if it is not particular in discovering new drugs but only building a monopoly as their marketing efforts are focused on influencing doctors since they are the ones to write prescriptions
All in all, these prescribed medications are set to treat your disorder. The problem is that not everyone who are prescribed these medications like young children are exactly 100% sure they have ADD/ADHD. It is not just because people are experiencing similar symptoms to those of the disorder that entitles them to be diagnosed. As mentioned before, the pharmaceutical companies have created a patient-group where “we’ as a population become an element for marketing strategies. By that I mean that when the drug companies advertise they appeal to the emotion of the people and doctors. They target it with the long term effects of a certain disease or illness then link it to death if you don’t take care of it. In which they convey that the medicine is the best option. Thus, creating a market where we consume drugs that for some the long term effects of it are worse than the disease you have or disorder. As a society we are submissive to what physicians tell us is and regard it as the better option for us. So how convenient is it for them to just prescribe medication for everything when we are not sure exactly we have.
Whether you are healthy or unhealthy, pharmaceutical industries have made all of us patients by making us think that medicalization is the better option for our illnesses. In the past two decades it is clearly seen that pharmaceutical industries have moved from its original purpose of creating and producing useful drugs. Now days, it is treated and operated as a marketing machine to sell the drugs as the companies use their power and wealth to “co-opt” the institutions they grant money to including FDA, US Congress, and medical centers as mentioned by Marcia Angell in “The Truth about Drug Companies”
Yesenia is a Blogger and Student at Cal State San Bernardino. Health Administration Major.