Archive for May, 2011

Another Prescription Drug Abuse Problem: The Overmedication of Foster Kids

Thursday, May 5th, 2011

The Huffington Post – May 5 2011

by Michael Piraino

Recently the Obama administration announced that it is taking action to address the growing problem of prescription drug abuse. Of course this is good news, and more must be done to raise awareness of this issue and crack down on those who abuse the system. It reminded me of another problem related to prescription drug use: the inappropriate use of psychotropic drugs for children in foster care.

A recent study by the Tufts Clinical and Translational Science Institute found that over that past decade the use of psychotropic medications — those used for the treatment of behavioral and mental health issues — for children between the ages of 2 and 21 has risen significantly. Moreover, while during the same period an estimated 4 percent of the general youth population was prescribed these medications, the figure for kids in foster care was much higher — anywhere from 13 to 52 percent. Recent studies in Texas and Georgia arrive at similar findings.

We could debate the precise meaning of such statistics, but they are supported by many instances of foster youth who have been so heavily medicated that they can barely talk, or who felt more imprisoned than cared for while on a mixture of these drugs. It’s no longer possible to ignore the conclusion that there is a serious problem here. In many cases, psychotropic drugs are being prescribed for foster children not on the basis of legitimate medical diagnosis, but on demand or worse — for convenience.

Several factors might explain why our foster youth are being prescribed psychotropic medications at rates far higher than for the general population. They are particularly vulnerable and many of the adults responsible for their care are extremely busy with responsibilities for too many children. Yet, the use of psychotropic drugs requires careful monitoring and adjustment. They are only one tool, best used in conjunction with other therapeutic work, under the supervision of a trained mental health professional.

We could come up with lots of reasons why our foster children are being overmedicated: not enough time, not enough money, lack of qualified medical personnel. But, in the end, there simply is no excuse.

Imagine you’re a child who has been maltreated at home, who is temporarily living elsewhere, bounced from one unfamiliar home to another. I’ll bet you’d be angry too. I certainly would. It’s entirely natural to be mad and upset in such circumstances — this is a normal reaction, not a mental disorder.

If my own child were prescribed any of these medications, I would insist on knowing what’s in it, what it will do, and what to watch out for. I would also monitor usage and follow up regularly with the prescribing health care professional to see if any changes were needed or the dose could be reduced or even eliminated at some point.

Read the rest of the article here:  http://www.huffingtonpost.com/michael-piraino/prescription-drug-abuse_b_855547.html?icid=main|htmlws-main-n|dl6|sec3_lnk1|212254

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FDA approved Big Pharma drugs without effectiveness data

Thursday, May 5th, 2011

Natural News May 4, 2011

by S. L. Baker

Consumers constantly are told how complicated it is to get a new drug on the market. After all, researchers have to jump through all sorts of hoops to assure safety before new therapies are approved for the public, right?

It turns out they may be missing some of those hoops or not jumping through some of the most important ones.

In fact, huge red flags are being raised about how drugs are tested and approved in two new studies, including one just published in the May 4th issue of the Journal of the American Medical Association (JAMA).

A case in point: it turns out that only about half of the new prescription medications pushed onto the market over the last decade had the proper data together for the U.S. Food and Drug Administration – yet the FDA approved them anyhow.

The information  in question is known specifically as comparative effectiveness data. And it is – or should be – a very big deal when it comes to deciding whether a drug should be approved and sold to the public

According to the Institute of Medicine, comparative effectiveness data is defined as the “generation and synthesis of  evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition or to improve the delivery of care.”

In other words, how does a new drug stack up against other treatments – is it more beneficial, safer, or does it have more potential dangers?

Comparative effectiveness information on drugs is especially important when doctors are making decisions about whether to prescribe a med, and to whom, soon after a drug is approved. That’s because when Big Pharma medications first hit the market, physicians are relying on what drug companies and the FDA tell them about a medication. It takes a while for real life reports to come in as people report reactions, side effects (including deaths related to a drug) to become clearer.

Also, there are usually not data from large head-to-head trials comparing multiple treatments available when a medication first hits the marketplace. “Comparative effectiveness is taking on an increasingly important role in U.S. health care, yet little is known about the availability of comparative efficacy data for drugs at the time of their approval in the United States,” according to background information in the new JAMA study.

It’s not like there’s not money to come up with this information, either. In 2009, Congress allocated $1.1 billion of taxpayers’ money to comparative effectiveness research.

For the JAMA study, researcher Nikolas H. Goldberg and colleagues from Brigham and Women’s Hospital and Harvard Medical School, Boston, investigated the proportion of recently approved drugs that had comparative efficacy data available at the time they were authorized by the FDA to be sold in the U.S. They also examined the availability of this information over time and by therapeutic indication by checking out approval packages publicly available through the online database of drug products (dubbed new molecular entities, NMEs, for short) approved by FDA between 2000 and 2010.

The researchers found that only about half of 197 eligible approved NMEs between 2000 and 2010 had comparative efficacy data available at the time they were approved to be marketed.

Meanwhile, another recent study throws needed light on the limited data behind the safety and effectiveness of some Big Pharma drugs.

Research led jointly by Alexander Tsai of Harvard University and Nicholas Rosenlicht of the University of California San Francisco just published in PLoS Medicine zeroed in on the medication aripiprazole, which is prescribed treating bipolar disorder .

How was this powerful drug deemed safe and effective? Amazingly, the research team found the only evidence for the use of this medication came from a single trial. And, as they described in their paper, the scientists found key limitations of the drug study that clearly skewed the findings so they appear to support the use of aripiprazole for bipolar disorder.

Did this stop the FDA from approving the drug? No way. And neither did the fact that this single, poorly designed trial was sponsored by the drug manufacturer who produces aripiprazole.

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Three Recent Warnings On Antidepressants; Latest Is Stroke Risk

Wednesday, May 4th, 2011

Common Health—May 2, 2011

by Carey Goldberg

As we all know, three of anything makes a trend in journalism, and my trend alarm has just gone off concerning scary news about antidepressants. First, there was this review three weeks ago finding a “modest link” between antidepressants and cancer — though not in studies funded by the drug companies.

Then, author and former Globe staffer Alison Bass reported a week ago on her blog here that a researcher has found that serious flaws tended to skew the biggest study ever of antidepressants toward making the drugs appear more effective than they really are.

And now, Dr. Adam C. Urato, assistant professor of medicine at Tufts, has just sent over the latest: a paper in the current American Journal of Psychiatry that suggests that antidepressants increase the risk of stroke. He emailed:

This is an important study with real public health implications. We have so many patients on these drugs and use seems to be ever-increasing. If they are associated with stroke, as they seem to be, that’s information that patients and the public need to know.
When you combine this type of study showing a risk of stroke like this with the other studies that now show that antidepressants don’t appear to have a clinically significant benefit for most patients with mild to moderate depression (i.e. most users) then you really have to question why so many patients are on these drugs.

I leave it to others to defend antidepressants, but here are the basics on the latest study: It appears in the May edition of the American Journal of Psychiatry. It uses a “case-crossover” design, which aims to identify triggers for events. In this case, the event is a stroke. It included more than 24,000 patients who’d had strokes in Taiwan. The findings:

We found that antidepressant use was associated with a 48% greater risk of stroke, after taking confounding factors into account, and that the magnitude of associations was greater in high-potency inhibitors of the serotonin transporter than in low- and intermediate-potency inhibitors. Our findings are in agreement with those of previous studies showing that antidepressant use was associated with an increased risk of stroke, both ischemic (21) and hemorrhagic (22) types.

The authors note that depression itself is considered an independent risk factor for stroke. But their conclusions suggest that fending off stroke is not a good reason for prescribing antidepressants…

http://commonhealth.wbur.org/2011/05/antidepressant-stroke-risk/

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My Favorite Mistake — by Stevie Nicks

Monday, May 2nd, 2011

Newsweek – May 1, 2011

by Stevie Nicks

Photo Credit: Kristin Burns

The biggest mistake I ever made was giving in to my friends and going to see a psychiatrist. It was in the mid-1980s, and I had just gotten out of Betty Ford. I was feeling buoyant and saved and fantastic. But everyone said, “We’re sure you’re going to start using again. You should go to a psychiatrist.” Finally, I said, “All right!” and went. What this man said was: “In order to keep you off cocaine we should put you on the drug that we’re using a lot these days called Klonopin.”  Stupidly, I said, “All right.” And the next eight years of my life were destroyed.

Klonopin is in the Valium family, but Valium is fuzzy and Klonopin is insidious because it’s so subtle that you can hardly tell you took it. I got through 1986 and 1987. Thank God I’d already written the words for my record The Other Side of the Mirror. But what started happening was that if I didn’t take it, my hands started to shake. I felt like I had a neurological disease or Parkinson’s. I started not being able to get to Lindsey Buckingham’s house on time, and I would get there and everybody was drinking, so I’d have a glass of wine. Don’t mix tranquilizers and wine. Then I’d sing horrific parts on his songs, and he would take the parts off. I was hardly on Tango of the Night, which I happen to love.

The next six years were terrible. Looking back on it, I think this therapist was basically a groupie. He loved hearing stories of rock and roll and he started upping my dose. He watched me go from a beautiful, 125-pound, newly sober woman who had the world at her feet to a 170-pound woman who had the lights go out in her eyes.

Finally, in 1993, I’d had enough. I said, “Take me to a hospital.” I went in for 47 days, and it made Betty Ford look like a cakewalk. My hair turned gray and my skin molted. I could hardly walk. You can detox off heroin in 12 days. Coke is just a mental detox. But tranquilizers—they are dangerous. I was terrified to leave, and I came away knowing that that would never happen to me again.

I learned so much in that hospital. I wrote the whole time I was there, stuff that I consider to be some of my best writing ever. I learned that I could have fun and laugh and cry with amazing people and not be on drugs. I learned that I could live my life and still be beautiful and fun and still go to parties and not even have to have a glass of wine. I never went to therapy again after that—why would I?

http://www.newsweek.com/2011/05/01/my-favorite-mistake-stevie-nicks.html

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