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.