Rob:
What I'm concerned about is this is no small change. Because of how influential the DSM has
become, it could change our American culture, and I'm curious if you have had
any thoughts on that really big picture?
DSM 4 really took off, and DSM 5 is going to drastically expand the
percentage of people who are diagnosed or medicated. How do you see that changing the American
culture as compared to other places where they don't do it this way?
Allen: I think that a lot of the damage has already been done. I think we have a situation where we are
using way too many medications for way too many fake diagnoses. I think that DSM 5 will make that worse; DSM
5 will turn the temper tantrums of children into something called a Disruptive
Mood Disregulation Disorder. It'll turn
the normal forgetting of old age into something called Minor Neurocognitive
Disorder. It'll turn gluttony into Binge
Eating Disorder. It'll make grief into
major depression. So these are some
serious problems, but I wouldn't underestimate the problems we already have
before DSM 5. It may help to turn what
is already a severe diagnostic inflation into something of a diagnostic
hyper-inflation, but we already have the problem. It's not just DSM 5's fault; it's something
that we are living with now, and I think the major hope that this can be
reversed is the tobacco industry. Thirty
years ago the tobacco industry was all-powerful, and who would have thought
that at this point smoking would have been reduced from 60% to 20% or less in
the population. It went from a sexy
habit to a dirty secret in the lives of the people who continue doing it. The odds were against this ever happening
because of the huge financial power of the tobacco industry, but it did
happen. And, I think the pharmaceutical
industry has tremendously overstepped, and that even though it has enormous
resources and tremendous political pull, that people may come to their senses
and realize that we have to pull back and try to use the medications more
thoughtfully where they belong. The
companies are constantly being fined.
There have been- over the last ten years- more than a dozen very large
fines: the biggest is three billion dollars, another 1.5 billion dollars for
off-label illegal marketing, in some cases criminally illegal, of their
products- anti-psychotics and anti-depressants particularly. So, there has been a government push-back
against illegal drug company practice, but the fines- even the three billion
dollar fine- is just the cost of doing business when the profits are so
large. I think that if some of the
company directors wound up being hit more with personal fines or going to jail,
if patents were shortened or illuminated for drugs where there had been illegal
marketing, if the penalties were greater I think the companies would be under
better control. I think the idea that
companies are allowed to market to consumers is outrageous, not done anywhere else
in the world; that should be stopped.
It's better now than it was years ago, so there have been efforts to
monitor the pharmaceutical industry, and think that they are successful to some
degree but a lot more needs to be done.
I have to go.
Rob: Ok. Thank you so much!
You have been a great interview, and keep up writing about this. We need people warning us what is going on
here.
Allen: Thank you; and you ask good questions. You're a smart guy. Thanks very much.
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