This paper outlines the deliberate marketing of harmful drugs to children as a direct result of the drug industry take over of the American mental health system. My point of departure is Ivan Illichs broader assertion that The medical system has become a major threat to health. (1976) Time has proven Illich to be a prophet: medicine is now the leading cause of death in America. (Null 2005) What is wrong in American medicine is also wrong in psychiatry. Pharma marketeers claim psychiatric drug treatment is a scientific miracle. However, the outcome evidence on psychiatric treatment shows otherwise: the recovery rate for treated schizophrenia has fallen from 70% in the mid-nineteenth century to 11% today, while the death rate for the new atypical antipsychotic drugs is double that of the older typical class. These outcomes contrast with 49-51% recovery Third World countries, like India and Nigeria, where these drugs are not used consistently. (Whitaker 2004) The suicide rate for treated schizophrenia in the UK has increased 20 fold since the introduction of antipsychotic drugs in 1954. (Healy et al 2006) Five times as many people are being defined as permanently mentally ill (disabled) today than before the introduction of drug treatment. (Whitaker 2005) Yet, inspite of these ominous facts, millions of American children are routinely being given these dangerous drugs.
How did this happen?
The drugging of American children is not accidental. It is a part of the larger problem of the premeditated medicalization of modern life discussed by Illich (1976), McKnight (1999) and others. However, the issue goes beyond the use of drugs: it is about freedom. The massive pharmaceutical corporations, which barely existed before World War II, are the most profitable legal businesses in human history. They have the money, the plan and the ruthless determination to medicalize our lives to sell us as many drugs as possible. They are a major threat to the basic human rights, as well as the health, of every person on the planet.
By medicalization I mean Pharma is deliberately and systematically promoting ideas about illness and disease to explain everyday life. (Summerfield 2002) By blurring the boundaries between sickness and health, Pharma convinces healthy people they are sick (Moynihan & Cassels 2005), and that lifestyle drugs, like Viagra, are necessary to happiness as well as health. (Abramson 2004)
Medicalization is an iatrogenic disaster of unbelievable proportions: it is inflicting harm on the lives of tens of millions of people. As our culture becomes a biomedical folktale we are being robbed of our traditional ways of managing illness and meeting death. And, in addition, the high cost of drugs threatens to bankrupt the American health care system, if not the entire American economy.
More frightening still, as I will show, the Presidents New Freedom Commission on Mental Health (NFC) is a creation of pharmaceutical interests. Two of its central policy recommendations are bald-faced drug marketing schemes. The first targets 52 million American school children for mental health screening by a program known as TeenScreen. While the second irrevocably links the mental health treatment psychiatric drugs - - not coincidentally, the most expensive and dangerous psychiatric drugs - - using the pseudo-scientific Texas Medication Algorithmic Program or TMAP.
Lets begin with a look at the money trail of legal drugs and some Pharma history.
The US government contributes more money to the development of new drugs in the form of tax breaks and subsidies than any other government. Of the 20 largest pharmaceutical corporations, nine are based in the United States. Yet drugs are more expensive in the United States than in any other part of the world, and the global drug companies make the bulk of their profits in the United States.
The pharmaceutical and health products industry has spent more than $800 million in federal lobbying and campaign donations at the federal and state levels in the past seven years No other industry has spent more money to sway public policy in that period its combined political outlays and lobbying and campaign contributions is topped only by the insurance industry. (Ismail 2005)
Most of the industrys political spending paid for federal lobbying. Medicine makers hired about 3,000 lobbyists, more than a third of them former federal officials, to advance their interests before the House, the Senate, the FDA, the Department of Health and Human Services, and other executive branch offices. Yet, The drug industrys huge investments in Washington [are] meager compared to the profits they make [from] a series of favorable laws on Capitol Hill and tens of billions of dollars in additional profits They have also fended off measures aimed at containing prices, like allowing importation of medicines from countries that cap prescription drug prices, which would have dented their profit margins In 2003 alone, the industry spent $116 million lobbying the government Congress passed, and President George W. Bush signed, the Medicare Modernization Act of 2003, which created a taxpayer-funded prescription drug benefit for senior citizens [in] Medicare, the government program that provides health insurance to some 41 million people, the [drug] industry found a reliable purchaser for its products. Thanks to a provision in the law for which the industry lobbied, government programs like Medicare are barred from negotiating with companies for lower prices Critics charge that the prescription drug benefit will transfer wealth from taxpayers, who provide the funding for Medicare, to pharmaceutical companies. (Ismail 2005)
Pharmas influence saturates every aspect of our lives and culture with harm like DDT once saturated our physical environment. Heres how it began.
THORAZINE: The First Pill to Create Its Own Ill
David Healy (2002), the British psychiatrist and drug researcher, believes that the marketing of Thorazine in the US in 1954 created the modern drug era and ultimately gave us everything from Valium to Viagra. Smith-Kline-French (SKF, now Glaxo-Smith-Kline GSK) was a small, $50 million dollar pharmaceutical house, when it obtained the rights to market Thorazine. The drug was originally used as an anesthetic; however, it was introduced in the U.S. as an antinausea drug, which then made $75 million dollars (in 1954 dollars) as an antipsychotic in its first year on the market. Within five years it had elevated SKF to a $350 million dollar a year house. Thorazine taught the pharmaceutical industry how to market an ill for every new pill it discovers.
I should add that Doctor Healy also sounded the alarm on the danger that Selective Serotonin Reuptake Inhibitor antidepressants (SSRI) posed for children. Read as, Pharma is so powerful in the U.S. it prevented FDA action on SSRIs, so warnings had to come from the outside.
GADSDENS GANG: Double Your Pleasure, Double Your Fun
Thirty years ago, when the late Henry Gadsden was CEO of Merck pharmaceuticals, he candidly told Fortune magazine how unhappy he was that his companys potential markets were limited to sick people. He wanted Merck to be like Wrigleys, chewing gum, so that Merck would be able to sell to everyone.(Moynihan & Cassels 2005) Gadsdens dream did not die with him: although Americans make up only 5 percent of world population, they consume 50 percent of world pharmaceutical production. This kind of consumption isnt a social accident. The gang Gadsden left behind made this happen through careful planning, hard work and the infusion of obscene amounts of cash. One must admire Pharmas achievements, even while condemning the consequences they have brought down on us.
Pharma marketing has not only convinced Americans their drugs are necessary, but that Americans have the best health care system available. But according to John Abramson, while we have the most expensive health care system it is far from the best. Although we spend twice as much on health per person than any other nation, our healthy life expectancy ranks twenty-second out of twenty-three industrialized countries, better only than the Czech Republic. Two-thirds of American medicine is beneficial. However, one-third is ineffective, unnecessary and even deadly, as well as expensive. This one-third of medicine adds $500 billion dollars annually to the cost of our health care, while shortening our lives and even killing us outright. And, shamefully, America is the only industrialized nation that does not offer universal health coverage to all its citizens, 43 million Americans do not have health insurance benefits. This leads Abramson to conclude, Putting the pharmaceutical industry in charge of our health is like putting the fast food industry in charge of our diet. (2004)
MEDICINE AS MIRACLE: Modern Alchemy
A recent Glaxo-Smith-Kline (GSK) TV drug ad proudly claimed, Todays medicines finance tomorrows miracles. This five-word marketing slogan is a revealing self-portrait of the industry. In fact, drug sales finance three main activities: 1) drug research and medical research, 2) drug marketing and public relations, and 3) drug lobbying. These are Orwellian processes, not miracles, and they are larger, more complex and better coordinated than the invasion of Normandy. Allen Jones, who exposed the illegal influence that drug companies exerted on the state of Pennsylvania (and was fired for it), puts the matter this way:
This isnt a David verses Goliath battle. There is no stone big enough to whack the pharmaceutical industry in the forehead and knock it over. These guys are operating in the shadows. They are operating in the dark. They are operating by buying off decision-makers in an illegal manner. There needs to be exposure of that. Its like fighting vampires, not fighting giants Its an industry that is very organized and an industry that is ruthless. It is an industry with a long-term view and a long-term plan. (Whitehead 2005)
Similarly, Moynihan and Cassels say:
The extent of the pharmaceutical industrys influence over the health system is simply Orwellian. The doctors, the drug reps, the medical education, the ads, the patient groups, the guidelines, the celebrities, the conferences, the public awareness campaigns, the thought-leaders, and even the regulatory advisors - - at every level there is money from drug companies lubricating what many believe is an unhealthy flow of influence. Industry does not crudely buy influence with individuals and organizations - - rather its largesse is handed out to those considered to be most commercially helpful. The industrys sponsorship is strategic, systematic, and systemic. It is designed primarily to engender the most favorable view of the latest and most expensive products. But it is also used to maximize the size of the markets for those products, by portraying conditions like [Irritable Bowel Syndrome] IBS as widespread, severe, and above all, treatable with drugs. And, who is supposed to be fearlessly regulating this mess? The public agencies who themselves rely on the very same industry for much of their funding. (2005:171-172)
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