Archive for November, 2011

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ABC World News: Study Shows U.S. Government Fails to Oversee Treatment of Foster Children With Mind-Altering Drugs

Wednesday, November 30th, 2011

By DR. MARK ABDELMALEK, BRINDA ADHIKARI, SARAH KOCH, JOSEPH DIAZ and CLAIRE WEINRAUB

Watch the year-long investigation tonight on “World News with Diane Sawyer” at 6:30 p.m. ET

Children in foster care are more likely to take multiple antipsychotic medications for longer periods of time than any other group of children. (Fuse/Getty Images)

“I was almost despondent to believe that the kids under the age of one, babies under the age of one were receiving this kind of medication.” —US Senator Thomas Carper.

The federal government has not done enough to oversee the treatment of America’s foster children with powerful mind-altering drugs, according to a Government Accountability Office (GAO) report to be released Thursday.

ABC News was given exclusive access to the GAO report, which capped off a nationwide yearlong investigation by ABC News on the overuse of the most powerful mind-altering drugs on many of the country’s nearly 425,000 foster children.

The GAO’s report, based on a two-year-long investigation, looked at five states — Florida, Massachusetts, Michigan, Oregon and Texas. Thousands of foster children were being prescribed psychiatric medications at doses higher than the maximum levels approved by the Food and Drug Administration (FDA) in these five states alone. And hundreds of foster children received five or more psychiatric drugs at the same time despite absolutely no evidence supporting the simultaneous use or safety of this number of psychiatric drugs taken together.

GAO Key Findings:

Overall, the GAO looked at nearly 100,000 foster children in the five states and found that nearly one-third of foster children were prescribed at least one psychiatric drug.

The GAO found foster children were prescribed psychotropic drugs at rates up to nearly five times higher than non-foster children, with foster children in Texas being the most likely to receive the medications compared to foster children in the other four states.

Watch the year-long investigation tonight on “World News with Diane Sawyer” at 6:30 p.m. ET

Although the actual percentages of children who received five or more psychiatric drugs at the same time were low in the five states included in the GAO report, the chances of a foster child compared to a non-foster child being given five or more psychiatric drugs at the same time were alarming.

In Texas, foster children were 53 times more likely to be prescribed five or more psychiatric medications at the same time than non-foster children. In Massachusetts, they were 19 times more likely. In Michigan, the number was 15 times. It was 13 times in Oregon. And in Florida, foster children were nearly four times as likely to be given five or more psychotropic medications at the same time compared to non-foster children.

Initially part of GAO’s investigation, Maryland was later excluded from GAO’s analysis “due to the unreliability of their foster care data” according to the report, a problem ABC News learned many states face.

Foster children were also more than nine times more likely than non-foster children to be prescribed drugs for which there was no FDA-recommended dose for their age.

For the most vulnerable foster children, those less than 1 year old, foster children were nearly twice as likely to be prescribed a psychiatric drug compared to non-foster children.

When Sen. Thomas Carper, D-Del., lead requestor of the GAO report, first learned of the report’s findings, he said, “I was almost despondent to believe that the kids under the age of one, babies under the age of one were receiving this kind of medication.”

ABC News has reviewed dozens of medical studies published in recent years that echo GAO’s findings — research showing foster children receive psychiatric medications up to 13 times more often than kids in the general population.

In some parts of the country, as many as half of foster kids are on one or more psychiatric medications. This, compared to just 4 percent of kids in the general population.

http://abcnews.go.com/US/study-shows-foster-children-high-rates-prescription-psychiatric/story?id=15058380#.Tta8ymrjWSo

 

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Time Magazine: Why Are So Many Foster Care Children Taking Antipsychotics?

Wednesday, November 30th, 2011

11/29/2011 by Maia Szalavitz

More than 8% of children in foster care have received antipsychotic medication, and just over one quarter of those in foster care who also receive disability benefits take these drugs, according to a recent studyin the journal Pediatrics.

The question is why? Children in foster care have typically been neglected or abused — indeed, simply removing a young child from his or her parents, even abusive ones, is in itself traumatic — so, not surprisingly, kids in foster care are more likely to suffer from psychiatric and behavioral problems than those who have stable families. Previous data suggest that foster-care children are about twice as likely as those outside the system to receive psychiatric medications.

Whether these problems are leading to higher rates of antipsychotic use, however, is not clear. “I think we have clinicians facing some very challenging situations,” says Susan dosReis, associate professor at the University of Maryland School of Pharmacy and lead author of the study. “But we don’t have information as to why the prescribers decided on these medications for [these particular] youths.”

The numbers suggest that the influence of pharmaceutical company marketing cannot be overlooked. Ninety-nine percent of youth receiving antipsychotic medications in the study were given atypical antipsychotics — the newer generation of these drugs, which are expensive and mostly unavailable in generic form and have been heavily advertised.

All of the major manufacturers of these drugs have been fined by the Food and Drug Administration for illegal marketing practices — in part, for marketing the drugs for unapproved use in children — with some convicted of criminal charges.

Eli Lilly, which manufactures the atypical antipsychotic Zyprexa, paid out $1.42 billion in 2009 — $615 million of that to settle criminal charges. The charges against Lilly involved selling Zyprexa to doctors for use in children, despite the fact that it was not approved for this age group.

Bristol Myers Squibb paid $515 million in 2007 to settle charges that it also illegally pushed its antipsychotic Abilify to child psychiatrists. Pfizer paid out $301 million in a similar case related to its drug Geodon. AstraZeneca paid out $520 million to settle charges over the drug Seroquel. In all of these cases, the drugs were sold for unapproved use in youth.

Read the rest of the article here

Watch one foster kid’s story:

 

 

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Is the American Psychiatric Association in Bed with Big Pharma? Answer: Yes

Tuesday, November 29th, 2011

Note from CCHR Int:  We’re happy to see more and more press running stories containing the facts about psychiatric diagnoses, that mental disorders are not diseases on par with real medical diseases as the psychiatric/pharmaceutical marketing teams would have you believe, but lists of behaviors and emotions repackaged as disease in order to sell billions of dollars worth of pharmaceutical ‘solutions.’   CCHR was the first organization to point out that psychiatric disorders were not medical conditions discovered in labs, but disorders invented in committee by pharmaceutically funded psychiatrists.  We’re very pleased we’re no longer the only ones reporting the facts about psychiatry and its marketing campaigns.  Get the facts here

Do we really need more mental disorder diagnoses creating the need for more drugs in a society that some would say is already over-medicated?

The Fog City Journal – 11/29/2011
by Ralph E. Stone

“The critics — and the public too — have a stake in the proposed DSM-V. More mental disorders may mean just more drugs in our over-medicated society.”

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is published by the American Psychiatric Association. The DSM provides a common language and standard criteria for the classification of mental disorders, which is used in the United States and to some extent internationally, by clinicians, researchers, psychiatric drug regulation agencies, health insurance companies, pharmaceutical companies, and policy makers. The DSM is produced by a panel of psychiatrists, many of whom have financial ties to the pharmaceutical industry. It is considered the “bible” of American psychiatry. The latest edition — DSM-IV — was published in 1994.

In 1952, the DSM was a small, spiral-bound handbook (DSM-I), but the latest edition (DSM-IV), is a 943-page magnum opus. Over time, psychiatric diagnoses have increased in the American population and in turn, drugs that affect mental states are then used to treat them. The theory that psychiatric conditions are caused by a biochemical imbalance is often used as a justification for their widespread use, even though the theory in unproven. Since there are no objective tests for mental illness and what is normal and abnormal is often unclear, psychiatry is a particularly fertile field for creating new diagnoses or broadening old ones.

Medications are widely used to treat the symptoms of mental disorders such as schizophrenia, depression, bipolar disorder, anxiety disorders, and attention deficit-hyperactivity disorder. Sometimes medications are used with other treatments such as psychotherapy.

While I am sure research in mental disorders account for some of this increase, I cannot help but believe that there is a certain amount of disease-peddling going on. That is, instead of promoting drugs to treat diseases, diseases are promoted to fit the drugs. For example, shyness as a psychiatric illness made its debut as “social phobia” in DSM-III in 1980, but was said to be rare. By 1994, when DSM-IV was published, it had become “social anxiety disorder,” now said to be extremely common, thus, boosting sales of antidepressants. Now, social anxiety disorder is “a severe medical condition.” In 1999, the FDA approved a drug for social anxiety disorder. After a successful marketing campaign, the sales of Paxil soared.

Presently, a revised version of the DSM is set for publication in 2013. The proposed revision has proven quite controversial. A group of psychologists with the Society for Humanistic Psychology, for examle, has filed a petition objecting to many of the revisions, arguing that they broaden the definition of mental health disorders, which, in turn, could lead to over treatment with drugs. Some, but not all, of the objections of the Society — along with the British Psychological Society and the American Counseling Association — to the proposed DSM-V include:

- The proposed DSM “fails to explicitly state that deviant behavior and primary conflicts between the individual and society are not mental disorders. Given lack of consensus as to the ‘primary’ causes of mental distress, this proposed change may result in the labeling of sociopolitical deviance as mental disorder.”

- “Several new proposals with little empirical basis also warrant hesitation: For example, ‘Apathy Syndrome,’ ‘Internet Addiction Disorder,’ and ‘Parental Alienation Syndrome’ have virtually no basis in the empirical literature.”

- “…clients and the general public are negatively affected by the continued and continuous medicalization of their natural and normal responses to their experiences; responses which undoubtedly have distressing consequences which demand helping responses, but which do not reflect illnesses so much as normal individual variation.”

Do we really need more mental disorder diagnoses creating the need for more drugs in a society that some would say is already over-medicated? Let’s look at some statistics. According to the Centers for Disease Control and Prevention (CDC) the percentage of Americans who took at least one prescription drug in the past month increased from 44 percent to 48 percent over the past ten years. The use of two or more drugs increased from 25 percent to 31 percent. The use of five or more drugs increased from 6 percent to 11 percent. And in 2007-2008, 1 out of every 5 children and 9 out of 10 older Americans reported using at least one prescription drug in the past month.

And Americans are spending more on drugs. According to the CDC, spending for prescription drugs in the U.S. was $234.1 billion in 2008, which was more than double what was spent in 1999.

And the pharmaceutical industry is profiting. According to Fortune 500 (May 3, 2010 issue date), the profits for the twelve largest pharmaceutical companies was almost $64 billion in 2010. Clearly, Pharma has a financial interest in a DSM with more mental disorders because it will mean a demand for more drugs to treat them.

The critics — and the public too — have a stake in the proposed DSM-V. More mental disorders may mean just more drugs in our over-medicated society.

Supreme Court Justice Oliver Wendell Holmes once quipped, “If all the drugs were thrown in the ocean, everyone would be better-off . . . except for the fish.” While this is a an overstatement, it does contain a grain of truth.

http://www.fogcityjournal.com/wordpress/3217/is-the-american-psychiatric-association-in-bed-with-big-pharma/

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Medical mafia in Australia to force parents to drug children diagnosed ‘ADHD’

Tuesday, November 29th, 2011

Natural News – 11/20/2011

Australian government is actually considering mandating parents of diagnosed children accept the prescribed drug treatments or else face the wrath of child protective services.

The typical treatment recommendation for children diagnosed with psychiatric or mental health conditions such as bipolar disorder or attention deficit hyperactivity disorder (ADHD) includes a combination of behavior and drug therapies. Such treatments are legally optional, but the Australian government’s National Health and Medical Research Council (NHMRC) is actually considering mandating that parents of diagnosed children accept the prescribed drug treatments or else face the wrath of child protective services.

Australia’s Sky News reports that authorities originally crafted the proposed measure as a guidance for doctors in how to treat children with such conditions, writing in a draft paper that “combined behavoural-pharmacological treatment is most effective” for normalizing child behavior. In the process, these authorities are essentially pushing a draconian form of medical tyranny that will eliminate health freedom of choice, and force parents to take the drug route with their children.

The entire field of psychiatry and its mental health screening process is questionable to begin with, as ADHD, bipolar disorder, and depression are not verifiable medical conditions like heart disease or cancer. There are no legitimate scientific tests to determine without a doubt the presence of these ambiguous “conditions” — and yet the entire psychiatric industry is built on pushing $84 billion worth of pharmaceutical drugs every year as treatment for them (http://www.cchrint.org/psychiatric-…).

Psychiatric drugs cause drastic changes in the cognitive and behavioral profiles of children. Drugs are not necessarily for the better. Most of these drugs also cause severe side effects, including mind-altering hallucinations, and they are typically far more addictive than illicit drugs like marijuana, cocaine, and heroin, all of which are illegal.

But certain government officials, likely influenced by Big Pharma, are continuing to propagate the lie that psychiatric drugs are the only option for these often-fictitious mental disorders. West Australian Labor MP, author, and anti-ADHD medication campaigner Martin Whitely is quoted in News Tonight as saying that ADHD drugs are “the only possible medical interventions” and that parents who refuse to use them “may see their child put in care.”

Earlier this year, a SWAT team raided the Detroit home of Maryanne Godboldo for refusing to medicate her daughter with dangerous psychiatric drugs. These thugs actually kidnapped the young girl, who was eventually released after it was determined that Maryanne had every right to choose her own daughter’s medical care (http://www.naturalnews.com/032089_a…).

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ONE DRUG TO MAKE YOU HAPPY

Monday, November 28th, 2011

NewsWithViews.com – 11/28/2011
by Jonathan Emord, Constitutional Attorney and Author

Psychiatric drugs are big sellers. They are among the best selling drugs made. In 2010, Americans or their insurers doled out some $16.1 billion for anti-psychotics; $11.6 billion for anti-depressants; and $7.2 billion for ADHD treatments.

Within the last two decades the field of psychiatry has mushroomed from a fringe body of Sigmund Freud admirers to a mainstream player in the field of medical pharmacology, largely because of an unseemly union between that profession and the drug industry, leading to the creation of many never before known disease states and profitable ways to exploit those alleged diseases with psychiatric services and drugs.

The field of psychiatry has persistent and well-informed critics who point to the excessive drugging of institutionalized patients, of children commonly misdiagnosed as suffering from Attention Deficit Disorder or Attention Deficit Hyperactivity Disorder, and of the elderly misdiagnosed with treatable dementia, among others. The drugs given these patients have their own side-effects, including increased risk of depression, suicidal thoughts, birth defects, and even death. Because of the movement of psychiatry from the fringe of medicine to its heart, a majority of Americans are likely to come into contact with psychiatric drugs, either recommended for use by their children or for use by them at some point in their lives. Indeed, presently some 1 in 5 adults take anti-depressants, anti-psychotic, or anti-anxiety drugs.

The next edition of the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-5), the profession’s so-called diagnostic bible, will soon be published in 2013. It comntinues the trend of identifying as “diseases” conditions that have previously been considered within the normal range. It adds to the list of “disease” states “apathy syndrome” (i.e., not caring enough); “internet addiction disorder” (i.e., liking the web too much); “parental alienation syndrome” (i.e., not liking your parents enough); “mild neurocognitive disorder” (i.e., age-related decline in mental function); “absexual” disorder (i.e., disliking sex); and “sluggish cognitive tempo” (i.e., daydreaming too much). Characteristics that we all used to think within the realm of normal brain function (such as teenage angst at parental rules; parental angst at teenage rebellion; a loss of quick wittedness in the elderly; youthful exuberance or youthful preoccupation with daydreams beyond the confines of academia) are all fast becoming “diseases.” The APA’s overall movement has been one of calling into question characteristics of eccentricity, leading to an unscientific conclusion that anything different may be rightly called a disease and rightly prescribed a treatment.

Every newly identified psychiatric disorder begets a new slate of psychiatric drugs for their treatment, giving leading pharmaceutical companies new opportunities to profit from the expansion of psychiatric diagnoses.

Psychiatric drugs are big sellers. They are among the best selling drugs made.

In 2010, Americans or their insurers doled out some $16.1 billion for anti-psychotics;

$11.6 billion for anti-depressants;

and $7.2 billion for ADHD treatments.

Profit lies in designing drugs for the treatment of these conditions. As the drug industry continues to pump out new elixirs that, in turn, leads to more reliance on psychologists and psychiatrists, which leads them in turn to prefer identifying more conditions as disease. The perverse incentives abound, and the FDA is pleased to approve the drugs at the behest of the drug company sponsors.
Everyone standing to profit from the sale of these agents wins at the expense of patients.

The drugging of America is an enormous problem, having spill-over effects that include drug addiction and destruction of the family, productivity, even national security. With an ever rising population taking these drugs which alter cognitive function, it becomes ever more apparent that the very fabric of our society, its common commitment to stable family life, self-sacrifice for the greater good, and adherence to laws that protect life, liberty, and property are all imperiled. As the drug industry and psychiatric profession profits enormously with each new declared disease state, there is a loss of free agency in the population, a movement that saps self-control from the individual in favor of control by the medical community over basic life-affecting decisions. Patients become dependent, event addicted, to drugs, and ever more dependent on their medical counselors to cope with life.

Whatever may be said for use of psychiatric drugs in those who cannot function in society, the expansion of those drugs to embrace those who can, including those with virtually any characteristic that exceeds the norm, represents a horrific sacrifice of the very promise of life that lies in those eccentricities. It is particularly horrific to watch beautiful, energetic children with all their great promise become addicted to drugs that alter brain chemistry in ways that yield drug dependency and lessen their perception of and enthusiasm for life and their ability to achieve. A majority of children prescribed anti-depressant and anti-psychotic drugs are wrongly prescribed those drugs, even by accepted psychiatric standards. That misguided course is itself a form of deviant behavior by this profession, calling into question the mental stability of those who would profit off of misdiagnosis and mistreatment.

The psychiatric drugging of America is bearing and will continue to bear for generations to come toxic consequences, whether in the form of the destruction of the family, increases in crime, or decreases in productivity and inventiveness. It’s high time for a rebellion against this drugging for the sake of sanity.

http://www.newswithviews.com/Emord/jonathan220.htm

Jonathan W. Emord is an attorney who practices constitutional and administrative law before the federal courts and agencies. Congressman Ron Paul calls Jonathan “a hero of the health freedom revolution” and says “all freedom-loving Americans are in [his] debt . . . for his courtroom [victories] on behalf of health freedom.” He has defeated the FDA in federal court a remarkable eight times, six on First Amendment grounds, and is the author of Amazon bestsellers The Rise of Tyranny, and Global Censorship of Health Information. He is also the American Justice columnist for U.S.A. Today Magazine. For more info visit Emord.com.

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Psychiatry’s Diagnosis Manual Under Fire – will feed culture of overdrugging/overdiagnosing

Saturday, November 26th, 2011

San Francisco Chronicle – 11/26/2011
by Erin Allday

"Another diagnosis, dysphoric mood dysregulation disorder, is basically temper tantrums," Robbins said. "Next thing you know, you could have 2-year-olds on psychotropic medications."

The “bible” of American psychiatry – a manual of mental health used around the world by doctors, consumers and insurance providers – has come under fire from a growing group of psychologists who worry that proposed revisions will feed into a culture of overdiagnosing, and overtreating, otherwise healthy people.

The Diagnostic and Statistical Manual of Mental Disorders, or the DSM, is undergoing its fifth major revision in the more than 60 years since it was first published by the American Psychiatric Association. The last update was in 1994, and the new manual is expected to be released in spring 2013.

Revisions to the DSM are often hotly debated, but after two decades of major, and frequently controversial, shifts in how mental health problems are diagnosed and treated in the United States, this latest update has become especially contentious, many mental health providers say.

Last month a group of psychologists with the Society for Humanistic Psychology posted a petition against many of the suggested DSM revisions, citing what they see as a broadening of the definition of mental health disorders, which, in turn, would lead to overtreatment with drugs.

7,000 signatures

The petition now has more than 7,000 signatures, and last week it won the support of San Francisco’s Saybrook University, with roughly 60 faculty members who emphasize a holistic approach to treating mental illnesses.

“There’s this propensity to push pills instead of looking at what’s really going on with the person,” said Saybrook President Mark Schulman. “When we saw in the DSM-5 that there was going to be a push in the direction of a more medical, less holistic way of doing things, we felt we should take a stand.”

A work in progress

The American Psychiatric Association has posted an online response to the petition, welcoming critiques to and comments on the proposed revisions. Their response notes that the manual is still a work in progress and, as more scientific evidence becomes available, some of the changes may become more palatable to critics.

Since the last diagnostic manual update, research has increasingly pointed to biological causes for a wide variety of mental health conditions and, in response, treatment has turned toward pharmacological answers, some psychologists say. Drugs are being used to solve mental health problems that aren’t problems at all, they add.

In 2010, 1 in 5 American adults was using some type of mental health medication, a 22 percent increase over the past decade, according to a report released last week by Medco Health Solutions, a pharmacy-benefits management company.

Therapy is still popular, but part of the problem is that there simply aren’t enough trained counselors to fill the mental health need. Patients are turning to primary care doctors for medical relief from symptoms for everything from depression and anxiety to attention deficit disorder, many mental health providers say.

Because many primary care doctors rely on the DSM to help them understand and diagnose mental health problems, it’s critical that the manual be as accurate and science-based as possible, say psychologists who have signed the petition.

While trained psychiatrists might be able to distinguish between a mental health disorder that needs medical intervention and a so-called normal human response to a difficult time or situation, primary care doctors may struggle.

Critics’ concerns

Critics of the DSM update say that the task force assigned to make the revisions has suggested broadening the definitions of too many mental health problems, opening the door to even more diagnoses and treatments.

Grief after the death of a loved one, for example, may be included under the diagnosis of major depressive disorder. That means a person’s grief could be labeled a pathological disorder, and not a normal human experience, said psychologist Brent Robbins, a professor at Point Park University in Pittsburgh and an author of the petition.

2-year-olds on meds

“Another diagnosis, dysphoric mood dysregulation disorder, is basically temper tantrums,” Robbins said. “Next thing you know, you could have 2-year-olds on psychotropic medications.”

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Instead of drugs, children need a good dose of parenting

Friday, November 25th, 2011

The Australian – 11/26/2011

by Frank Furedi

As far as the American Academy of Pediatrics is concerned you can never drug children early enough.

It is important to realise that what drives the steady expansion of the diagnosis of ADHD among children is not the discovery of a hitherto unknown medical condition, but the cultural redefinition of some of the normal existential problems of childhood

In their recently published guidelines they recommend that children as young as four can be treated with the psycho-stimulant drug Ritalin.

These new guidelines issued by the academy at its annual conference in Boston proposed that preschool children who show symptoms of inattention and hyperactivity should be evaluated for pharmacological intervention. “Treating children at a young age is important, because when we can identify them earlier and provide appropriate treatment, we can increase their chances of succeeding in school,” was how Mark Wolraich, one of the authors of the guidelines, justified this proposal.

The targeting of preschoolers by the academy is an integral part of a disturbing tendency to advocate medical and pharmaceutical intervention as a legitimate option for the management of childhood behaviour. The campaign, which has as its premise the conviction that children’s behavioural problems represent a marker for mental illness, implicitly assumed a coercive and intrusive form. In Australia, draft guidelines being considered by the National Health and Medical Research Council threaten parents who refuse to medicate children diagnosed with ADHD with being referred to child protection authorities. The proposed guidelines assert that “as with any medical intervention” the “inability of parents to implement strategies may raise child protection issues”.

Regardless of whether these authoritarian draft guidelines will be accepted by the NHMRC, they demonstrate a dangerous tendency to transform child-rearing into a form of professionally dominated behaviour management. The guidelines should not be seen as simply the work of a handful of insensitive and zealous Ritalin promoters. Parents throughout the Anglo-American world face considerable pressure to medicate their children. In the US and Britain, numerous parents have been given an ultimatum by their children’s school either to start giving their child Ritalin or leave. Consequently the number of children diagnosed as suffering from ADHD is continually on the increase. According to the academy, one in 12 children suffer from this condition.

It is important to realise that what drives the steady expansion of the diagnosis of ADHD among children is not the discovery of a hitherto unknown medical condition, but the cultural redefinition of some of the normal existential problems of childhood. In the eyes of the supporters of early-years medicalisation, virtually every manifestation of a child’s behaviour can be diagnosed as a medical issue. That is why they argue that doctors should evaluate children from four onwards for signs such as fidgeting, excessive talking, reluctance to concentrate and abandoning homework or chores. Apparently such normal forms of misbehaviour are symptoms of ADHD. So according to these experts, ADHD is characterised by many of the traits that would, in the absence of a medical definition, be frowned on as bad behaviour: inability to concentrate, lack of application, unruliness.

Although most sensible people are likely to be appalled by the proposal to drug preschool children, it is likely that the medicalisation of childhood will continue to gain institutional support. The main reason why children’s behaviour has become a target for pharmacological intervention is because of the difficulty that adults have in exercising authority over the life of young people. Parents have always found it difficult to deal with their toddler’s defiance and with adolescent discipline. Today, however, this age-old problem has become far more difficult to manage because of the tendency to devalue adult and parental authority.

Read the rest of the article here

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NY Times—Payments to Doctors by Pharma Raise Issues of Conflicts, CCHR warns of tainted mental health policies

Friday, November 25th, 2011

New York Times November 24, 2011

The financial relationships raise questions about the influence of drug companies on prescribing patterns or research results. The practice “puts patients and tax dollars at risk,” said Lee Spiller, the policy director for the Texas branch of the Citizens Commission on Human Rights,  a nonprofit mental health watchdog. “It taints the whole process. I’d hate to think donations were shaping state mental health policy in particular.”

State records show that of the 74 doctors and psychiatrists statewide who have routinely prescribed the highest number of costly antipsychotic drugs to patients on Medicaid, the joint state-federal health insurance program for the disabled, children and the very poor, 10 received payments from drug companies in 2009-11 — from $11,000 to $180,000 each.

By EMILY RAMSHAW and RYAN MURPHY
Published: November 24, 2011

Thousands of Texas doctors, researchers and medical experts — including more than 100 who are employed by the state and are paid with taxpayer dollars — routinely supplement their salaries with income from pharmaceutical companies.

Drug companies pay medical professionals for a wide range of activities, from speaking engagements to consulting. While legal, the practice raises questions about potential conflicts, and whether the interests of patients may be compromised.

From 2009 to early 2011, at least 25,000 Texas physicians and researchers received a combined $57 million — and probably far more — in cash payments, research money, free meals, travel and other perks, according to data culled from 12 drug companies and provided by the nonprofit investigative news organization ProPublica.

Dozens of these medical professionals were paid more than $100,000 each during that period. And 114 were professors, physicians, psychiatrists or researchers who were already paid a salary by the state — in some cases more than a half-million dollars a year. These state employees brought in nearly $3 million combined from pharmaceutical companies from 2009 to early 2011, according to a Texas Tribune analysis of the ProPublica data.

Nationwide, pharmaceutical manufacturers routinely pay medical professionals to assess a new product or to help contribute to the drug company’s sales. The companies fly medical professionals to seminars and conferences and may also pay speaking fees. State-employed doctors and researchers are generally no exception, though they are supposed to comply with their individual institutions’ conflict-of-interest policies.

“It’s important to state out of the gate the importance of these interactions, the value they bring to physicians, to health care professionals in general and ultimately to patients,” said Karl Uhlendorf, vice president of Pharmaceutical Research and Manufacturers of America.

But the financial relationships raise questions about the influence of drug companies on prescribing patterns or research results. The practice “puts patients and tax dollars at risk,” said Lee Spiller, the policy director for the Texas branch of the Citizens Commission on Human Rights, a nonprofit mental health watchdog. “It taints the whole process. I’d hate to think donations were shaping state mental health policy in particular.”

Dr. Stanley Self, a part-time psychiatrist at Texas’ state-run Rusk psychiatric hospital, earns $166,000 a year from the state. He also earned at least $145,000 from drug companies in 2009-10, largely for speaking engagements. Dr. Self did not return calls seeking comment on his work for drug companies, but his receptionist said he is “not doing much of that anymore.”

Christine Mann, a spokeswoman for the Department of State Health Services, said agency employees, like Dr. Self, are allowed to hold a second job as long as there is not a conflict of interest. The agency “is looking into this issue further and will examine its policies to see if there are provisions that need to be strengthened,” Ms. Mann said.

Dr. Joseph Bailes, an oncologist and the vice chairman of the executive committee at the Cancer Research and Prevention Institute of Texas, earned roughly $250,000 between 2009 and 2010 as a consultant for Pfizer. Dr. Bailes said that he has advised Pfizer on Medicare policy — not on drug development — and that it has no bearing on his role with the institute, a $3 billion endeavor financed by voter-approved bonds, for which he is an “unpaid volunteer” specializing in efforts to bring new cancer therapies to market.

“It doesn’t influence anything I do,” Dr. Bailes said, adding that his committee is not responsible for selecting projects for financing.

Dr. Stanley Lemon, who left his post as the director of the Institute for Human Infections and Immunity at the University of Texas Medical Branch in April and is now at the University of North Carolina, made nearly $80,000 consulting for Pfizer in 2009-10. Dr. Lemon, who is still an adjunct professor at U.T.M.B. but is no longer on the state payroll, said consulting for the pharmaceutical industry has enriched his academic life and made him a more productive scientist.

“As long as they are properly reported and do not engender conflicts of interest or commitment, such interactions between industry and academia help to move drug development forward in a positive way,” Dr. Lemon wrote in an e-mail.

The analysis of Texas pharmaceutical payments comes as the state attorney general’s office prepares for a mammoth trial in January against Janssen Pharmaceuticals and its parent company, Johnson & Johnson. Janssen, which has vigorously denied any wrongdoing, has been accused of offering trips and kickbacks to state health officials to get the schizophrenia drug Risperdal on an approved drug list for medications that are paid for by the state.

Across the country, the reporting of such perceived conflicts has traditionally fallen short. Companies have not been required to disclose payments, and medical institutions have made limited efforts to police their employees.

The ProPublica data covers just a part of drug company payments — it represents about 40 percent of the 2010 pharmaceutical market in the United States — and includes manufacturers that have either begun disclosing their payments voluntarily, or as a result of legal settlements.

Beginning in March, federal law will require drug and device companies to report and disclose all of their payments to medical professionals and researchers; by September, the data is supposed to be displayed in a searchable online government database. Texas universities — whose doctors and researchers account for $2.7 million of the pharmaceutical money statewide from 2009 to early 2011 — are working to update their own conflict policies and monitoring systems.

The University of Texas System will require its faculty members to report every dollar they are paid by a drug or device manufacturer and all financial interests in their research beginning Jan. 1.

The U.T. Southwestern Medical Center in Dallas is working on an electronic conflict-of-interest filing system that will feed into a soon-to-be-released public disclosure Web site, said Tim Doke, U.T.-Southwestern’s vice president for communications.

“We’ve been working feverishly here for the last couple of months,” Mr. Doke said. “Transparency is the absolute key to the public being confident that conflicts that exist are being managed appropriately.”

At the University of Texas MD Anderson Cancer Center in Houston, university administrators monitor drug company databases to ensure that faculty-conflict filings match, and to set limits on how much doctors and researchers can accept, said Dr. Raymond DuBois, the center’s provost and executive vice president.

But such efforts at transparency vary widely depending on the institution, or may be nonexistent when there is no institution at all. State records show that of the 74 doctors and psychiatrists statewide who have routinely prescribed the highest number of costly antipsychotic drugs to patients on Medicaid, the joint state-federal health insurance program for the disabled, children and the very poor, 10 received payments from drug companies in 2009-11 — from $11,000 to $180,000 each.

All but one got the payments from the maker of the drug they most commonly prescribed.

http://www.nytimes.com/2011/11/25/us/payments-to-doctors-by-pharmaceutical-companies-raise-issues-of-conflicts.html?_r=1

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J&J drug protocols cost taxpayers millions—Lawsuit claims Investigator fired after going public on J&J’s anti-psychotic drug campaign

Tuesday, November 22nd, 2011

The Daily Record, by Michael L. Diamond
November 22, 2011

Allen Jones was curious.

Why did Pennsylvania use a computer program that often pointed to a Johnson & Johnson drug over other, cheaper medicine to treat certain mental illnesses, the investigator for the Keystone State’s Office of Inspector General wanted to know (article continued below video)

Video: Whistleblower Allen Jones on pharmaceutical ties to nation wide efforts to screen children for ‘mental disorders’

(Cont…) While the computer program mandated doctors use a new line of anti-psychotic drugs, including Risperdal, sold by J&J’s subsidiary Janssen companies, Jones said he couldn’t find government-funded medical studies showing that these new drugs were any more effective than their generic predecessors.

Jones’ 2002 inquiry into the drug added to a chain of events that ultimately led Texas to sue New Jersey-based health care giant Johnson & Johnson on claims it orchestrated a multimillion-dollar violation of the Texas Medicaid Fraud Prevention Act.

Jones said in an interview that it was his belief that the company “substituted opinion for science.”

Johnson & Johnson’s sales strategy turned Risperdal, a drug approved by the FDA to treat only schizophrenia and bipolar disease, into a blockbuster that the company sold for those illnesses and, unlawfully, many more, according to the Texas lawsuit.

Risperdal cost substantially more than older, generic drugs and generated more than $25 billion for the company before its patent expired in 2007, according to court records. But the drug often was no more effective at treating mental disorders than older drugs, the National Institute of Mental Health found. Because Medicare and Medicaid paid many of the bills, it cost taxpayers millions, according to federal and state lawsuits.

Twelve states, including Pennsylvania and Texas, have sued Janssen to recover some of the money they spent on Risperdal. South Carolina and Louisiana each were awarded more than $250 million last year. The case brought by Pennsylvania, where Jones first made his discovery, was dismissed in June 2010 after a state judge ruled prosecutors didn’t provide enough evidence. West Virginia lost its case on appeal. The cases in Louisiana and Pennsylvania have been appealed. The company said it intends to appeal the case in South Carolina. Texas and the seven remaining cases are awaiting trial.

The U.S. Justice Department also is investigating the marketing of Risperdal. J&J said in an August filing with the U.S. Securities and Exchange Commission that it is negotiating a settlement and has agreed, “in principal,” to plead guilty to a misdemeanor for violating the Food, Drug and Cosmetic Act. No plea has been made yet.

New Jersey hasn’t filed a lawsuit. It isn’t clear how much the state spent on Risperdal in the last 10 years. New Jersey’s Division of Medical Assistance and Health Services refused to provide the information unless the Asbury Park Press paid a $5,071 processing fee. The Press declined to pay the fee.

The Risperdal legal dispute is an example of a problem that is endemic in the pharmaceutical industry, some doctors say. Government-funded studies about the drug’s effectiveness weren’t published until more than a decade after the drug was first approved.

In the case of Risperdal, “we’re spending money on a drug that isn’t superior and might be inferior to other drugs that cost a fraction as much,” said Dr. John David Abramson, a health care policy expert at Harvard University and author of “Overdosed America,” who investigated the drug for Louisiana’s lawsuit.

“It ought to make honest citizens … want to throw up to see that this money is being extracted from society for no gain, when our country is headed toward financial ruin,” Abramson said.

Whistle-blower fired

Allen Jones, the Pennsylvania investigator, was fired in 2004 after going public with his claims, but he continued to investigate, eventually becoming a plaintiff and whistle-blower in a Texas state lawsuit against Janssen. That trial is scheduled to start Jan. 9.

Risperdal was approved by the FDA in 1993 to treat patients with schizophrenia and, a decade later, patients with bipolar disorder. Janssen, on its website, also says the drug can help treat some symptoms of autism in children and adolescents.

With it came the chance for Janssen to replace Haldol, an anti-psychotic drug that Belgian scientist Paul Janssen himself helped develop in the 1950s, just before Johnson & Johnson bought his company in 1961.

Older anti-psychotic drugs had been available in generic form for decades. Risperdal and a new generation of anti-psychotics came to market in the 1990s at a cost that far exceeded the older drugs, according to the Texas lawsuit.

J&J said Risperdal not only would be safer and more effective than the first generation of anti-psychotic drugs, but also could treat mental disorders other than schizophrenia and bipolar disorder, according to the Texas lawsuit.

Janssen’s medical studies weren’t conclusive enough for the FDA to claim Risperdal was more effective than either Haldol and its generic versions or the new anti-psychotic medicine on the market, the Texas lawsuit said.

Unable to tout Risperdal’s superiority, Janssen got the message to doctors anyway, according to legal documents and interviews. The methods included:

Middlemen. Johnson & Johnson teamed with Omnicare, the nation’s largest pharmacy manager for long-term care facilities, to ensure Omnicare’s pharmacists would recommend Johnson & Johnson’s drugs, according to a lawsuit against J&J filed in Massachusetts in 2010 by the U.S. Justice Department.

Omnicare cared for 1.4 million clients in 47 states. Its annual purchases of Johnson & Johnson drugs climbed from $100 million in 1999 to $280 million in 2004. And its purchases of Risperdal alone exceeded $100 million a year, according to the lawsuit.

The lawsuit claims J&J paid Omnicare tens of millions of dollars in grants, rebates, sponsorships and educational funding — payments that the federal government considered kickbacks.

A substantial portion of the prescriptions were paid by taxpayers through Medicaid, the government said. (Omnicare in 2009 agreed to pay $98 million and settle separate charges by the U.S. that it took kickbacks from J&J. The company didn’t admit wrongdoing).

Read the rest of the article here

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Israel Health Ministry: Use of ADHD drugs soars by 76% in 2010

Tuesday, November 22nd, 2011

Ministry figures recently passed on to Citizens Commission on Human Rights, a psychiatric and human rights violations watchdog, show 621 kilograms of methylphenidate were issued in 2010, compared with 352 kilograms in 2009.

The 2010 figures show the steepest increase since surveillance on Ritalin and Concerta marketing in Israel began in 1993. The surveillance is required since these drugs contain the active ingredient methylphenidate, which is classified in Israel as a dangerous drug.

Ritalin, a central nervous system stimulant that affects chemicals in the brain and nerves, is used to treat attention deficit disorder (ADD ) and attention deficit hyperactivity disorder (ADHD ). Ritalin is also used in the treatment of a sleep disorder called narcolepsy (an uncontrollable desire to sleep ).

Ministry figures recently passed on to Citizens Commission on Human Rights, a psychiatric and human rights violations watchdog, show 621 kilograms of methylphenidate were issued in 2010, compared with 352 kilograms in 2009.

http://www.haaretz.com/print-edition/news/israel-health-ministry-use-of-adhd-drugs-soars-by-76-in-2010-1.396957

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