September 5, 2008

Undue Influence On Psychiatrists, Or The Public?

This is an example of why the controversy over Pharma influence on doctors is, while accurate, likely irrelevant.

In Psychiatric Times, the Time Magazine of psychiatry, there appears a powerful juxtaposition of stories that was likely not appreciated by the editor.

The first story, "Vermont Psychiatrists Unduly Influenced" says what it looks like it would say.  The attorney general finds that Pfizer, Lilly, etc spent $3M on marketing to doctors, a 33% increase over last year. 

The second story is literally in the next column. "30% [of Americans] Have Received [Psychiatric] Treatment"  especially people in their 20s-30s.  Furthermore, the article notes there are still significant barriers to treatment-- so more people would have gone if they could.

Doctors are being paid to write these meds?  Wait-- what, exactly, are they being paid to do?  Write Zyprexa instead of Geodon, not with Geodon.  And only to the people who show up in their offices.   Right?  These marketing efforts should result in skewed prescribing, but not more prescribing.  In theory, the best Pharma can do is get everyone who shows up on meds. 

The problem, bluntly, isn't that Pharma is getting docs to write prescriptions.  The problem is that our beloved country is going completely insane.  The supply of pills isn't the issue, the issue is the demand for them-- for anything, for relief.

At some point, someone needs to stop asking why docs are writing Zyprexa, and ask why people are rushing to psychiatrists.  Did the gene for bipolar suddenly get activated by a viral pandemic?  Or are there social reasons for this?

As if to further support my premise, the next article immediately below that one is "Drugs Easy To Get Online," saying that people are getting pills from online pharmacies without prescriptions.  People want the meds, not even because they work, but simply because they are hope, they are a chance.

These meds are the wrong solution for what are largely social/economic/family problems.  However, not only are there no other solutions; not only is no one even suggesting that these are social problems; current policy is to label these social ills as psychiatric.

I get it, it buys you about a generation.  But not much more time than that.