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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 15 to 39 of 57. Go back in thread:
Posted by Phillipa on November 16, 2005, at 23:29:14
In reply to Biased Research and Free Gifts - for who?, posted by Nickengland on November 16, 2005, at 19:07:07
She E-mailed me and I did not answer. If this article nails the drug reps and cuts down on prizes rewards, etc. then its a good thing. I myself hope the doctors will see how unhappy their pts are with their advise. And yes pdoc's aske their pts which med they would like to try. Where is their knowledge? Pdocs needs school for medication education not some dug rep peddling pills and samples in return for using their meds for doctors earnign vacations etc. Fondly, Phillipa
Posted by Iansf on November 17, 2005, at 1:36:03
In reply to Re: Article in NYT RE: Self-Prescribing/Medicating » willyee, posted by Nickengland on November 16, 2005, at 18:30:13
> Hi willyee,
>
> I'm no way a fortune teller, but something told me that when I last saw Amy's thread when she was gathering information about her story, I knew there would be aspects of it I would agree with, but also I knew there would be parts of the truth which were not put into print and these aspects although may notbe relevant to the average joe (make the first page etc) are relevant in a sense to the reader as it shows what lengths people with mental illness have to go to gain relief...The people with mental illness seem to always have the short straw with stigma etc so to speak..
>
>
She interviewed me, but it became clear very quickly that I didn't fit the pattern she had in her head, which was that self-prescribing was something only people in their 20s and 30s do and it's happening to a large extent because of the Internet. I'm in my 50s. I have friends who are in their 40s, 50s and 60s who also try to take control of their treatment. I started doing my own research 10 years before I even heard of the Internet. But because this information didn't fit her thesis, she ignored it. She even told me she'd spoken to several other people who were in their 40s and 50s. But all of us got left out because it disrupted her premise. Rather than adjust her premise, she preferred to adjust reality. It doesn't necessarily negate much of what she said, but I do find it rather insulting.
Posted by med_empowered on November 17, 2005, at 1:54:51
In reply to Re: Article in NYT RE: Self-Prescribing/Medicating, posted by Iansf on November 17, 2005, at 1:36:03
hey! I am very sorry that my post (which completely violated psycho-babble rules+regulations) was the **only** post from this excellent website that was posted. At the same time...I'm kind of disturbed that this whole article focused on self-prescribing while ignoring what psycho-babble and many other wesbites are *really* about--patient information and empowerment, with the goal of working towards a more equal doctor-patient collaboration, rather than the traditional mode in which a patient is "worked on" or "treated by" a certain physician. I'm also alarmed that the author alleges there is some sort of trend towards self-prescribing without offering up any sort of hard evidence (numbers, quanititative data)...everything seems to be based on a few interviews which, as one poster stated earlier, seem to have been hand-picked to fit the author's "theme".
Its taken so long for patients, particularly in psychiatry, to give a voice and be able to assume an active role in their treatment. The concept of "patient-centered therapy" is pretty new, which seems ridiculous when you realize that it is, in fact, the patient whose very LIFE is being affected by whatever treatment is offered. I can't help but feel that this article has portrayed many of us as being misinformed, uninformed, or simply drug-seeking. Much of this article strikes me as being poorly supported, highly biased, and ultimately damaging to well-informed patients seeking the very best possible treatment for themselves and those they care about. That said...I *am* sorry that my post (again, sorry I broke babble rules with that) was the **only one** selected from this site.
Posted by blueberry on November 17, 2005, at 4:08:31
In reply to Article in NYT RE: Self-Prescribing/Medicating, posted by hawkeye on November 16, 2005, at 9:42:03
When Amy Harmon first came to this board, I asked whether the NYT had a liberal slant or a conservative slant. Once I found out, it was a slam dunk to know in advance how this article would be biased. That's why I didn't participate. It was an interesting article though, and actually wasn't quite as extremely biased as I had expected, though still considerably biased.
Posted by pseudoname on November 17, 2005, at 6:05:47
In reply to I'm sorry everyone, posted by med_empowered on November 17, 2005, at 1:54:51
m_e,
I hope I didn't sound as though I was shaking my finger at you for the post that she quoted. Clearly, she would've found another example if you hadn't put a small toe over Bob's line. Your post in fact was much more about how to warn people away from a particular illegal source.
I agree that patient-empowerment psychiatry is a much bigger deal than her drug-diversion angle.
You are right that "the author alleges there is some sort of trend towards self-prescribing without offering up any sort of hard evidence (numbers, quanititative data)." I guess because it *seems* to me personally like there's "more" self-prescribing, I was buying her premise, too, without actually thinking about it. I could ask myself, "More" compared to what?
In Slate's Press Box column a few weeks ago, Jack Shafer criticized the NY Times for asserting numerically unverified "new trends" and using weasel-words like "many" instead of quantitative data. On Sept 20, for example, the Times said there was a new trend for "many" young Ivy-League women to choose babies over careers. Problem? The Times reported the exact same new trend TWENTY-FIVE YEARS AGO!
Posted by med_empowered on November 17, 2005, at 6:23:32
In reply to NYT ''new trends'' » med_empowered, posted by pseudoname on November 17, 2005, at 6:05:47
You have a point. For instance, a friend of mine was talking about how the NYT proclaimed that "feminism is dead" recently. I live in a college town, so I can tell you...feminism is *not* dead. Sweeping pronouncements such as this are inappropriate and unsupported by data (im in social sciences; data is my life blood). Plus, without getting too political here...I've lost pretty much all respect for the NYT after the whole Judith Miller thing. These days, I read "The Utne Reader" "Harper's" ""The Progressive" "Mother Jones" and "In these Times" (I double quoted everything to see if the amazon.com magical thing would happen).
Posted by Glydin on November 17, 2005, at 6:37:34
In reply to Re: NYT ''new trends'', posted by med_empowered on November 17, 2005, at 6:23:32
I don’t want you to feel badly over the fact ONE (as in ONE example) post of yours was cited for the article. You are a part of this community and you took this particular encounter private at which time it then became a private matter between you and another poster. This encounter happened to fit the angle of the article. You contribute to this board in ways other than the exchange cited.
Posted by linkadge on November 17, 2005, at 8:45:04
In reply to med_empowered, posted by Glydin on November 17, 2005, at 6:37:34
What I think is the most dangerous part of it all, is that we are overestimating the safety of the drugs.
If we were mixing raspberry and blueberry fruitloops it would be a different issue.
Doctors may appear "dumb" may just be rightly conservative.
Linkadge
Posted by pseudoname on November 17, 2005, at 9:27:38
In reply to Re: NYT ''new trends'', posted by med_empowered on November 17, 2005, at 6:23:32
In an email this morning, I suggested to Jack Shafer that Amy Harmon's article was an example of unsupported NYT trend-spotting like the earlier Ivy-grad motherhood article he criticized. He replied,
> I read this one closely. I don't think they
> crossed the line and asserted that their
> information was anything but anecdotal.In truth, the drug-diversion article wasn't as empty and "hand-waving" as the motherhood article. And there was a little hard data (the study that found 14% of one college's students admitting diverting prescription drugs to/from friends). Also I don't think the overall picture is fallacious, as it may have been in the motherhood story.
But I think the article implied that it proved more than it actually proved about self-pharmacy trends.
Posted by linkadge on November 17, 2005, at 10:34:51
In reply to Shafer on Harmon's article » med_empowered, posted by pseudoname on November 17, 2005, at 9:27:38
Ritalin abuse in university is very common. In my university it is very common.
Linkadge
Posted by Laurie Beth on November 17, 2005, at 10:38:57
In reply to Shafer on Harmon's article » med_empowered, posted by pseudoname on November 17, 2005, at 9:27:38
"But I think the article implied that it proved more than it actually proved about self-pharmacy trends."
I agree.
For example:
"For a sizable group of people in their 20's and 30's, deciding on their own what drugs to take - in particular, stimulants, antidepressants and other psychiatric medications - is becoming the norm."
Technically, this might be true. Perhaps for several young adults (out of how many millions in the US?), the "norm" is to decide what meds to take (and, also implied by context, to obtain them illegally). But the very use of word "norm" is intended to mislead the reader into thinking that she's saying that the NORM AMONG YOUNG ADULTS is to decide on their own what meds to take. Saying that "some people in their 20s and 30s decide on their own" what psychotropic meds to takewould hardly be news, right?
But in some instnaces, it seems to me that she DOES cross the line between misleading the reader into thinking that more is being claimed, and actually claiming more but not supporting it. Take this:
"The behavior [referent unclear, she seems to be referring to 'trad[ing] unused prescription drugs, get[ting] medications without prescriptions from the Internet and, in some cases, l[ying] to doctors to obtain medications that in their judgment they need'] ... is on the rise" [along with the "use of marijuana and cocaine"].
And what about the reference to "increasing casual misuse of prescription medications by young people"? Where is the support for this statement?
I don't really see any support in the article for a trend.
But what I find more problematic is (1) as medempowered says, people who are trying to become knowledgeable about their medical care and question or make suggestion to their pdocs or GPs about medication are being lumped with people who break the law by obtaining meds and dispensing meds illegally, and (2) people who are trying to get adequate treatment for serious mental illnesses are being lumped in with those who want to "party" or clean their house late, those who try to "regulate every minor mood fluctuation" will illegal obtained meds, and those who "want to enhance their performance at school or work" with same.
-Laurie
Posted by linkadge on November 17, 2005, at 10:57:42
In reply to Re: Shafer on Harmon's article, posted by Laurie Beth on November 17, 2005, at 10:38:57
I have an unsubstantiated theory, that antidepressants themselves can be condusive to this type of behavior.
Before I ever took an AD, I never obsessed so much with drugs, neurotransmitters, bla bla bla.
Its when I took an antidepressant all of this behavior started.
It was the same with my mother. When she first started a TCA back 20 years ago, she started buying all of these books on drugs, started memorizing all of the names of the TCA's etc, started hording benzodiazapines etc.
After she started lithium, she just stopped caring about all of that.
I think its a deceptive path to take. For a short while I thought I could determine my fate by which drugs I took, but then I realized the more time I spent obsessing about drugs, the less time I spent doing the things that were *actually* going to improve the quality of my life.
In short, I think some drugs can actually create a psudo drug seeking behavior.
Linkadge
Posted by pseudoname on November 17, 2005, at 11:36:35
In reply to Re: Shafer on Harmon's article, posted by linkadge on November 17, 2005, at 10:57:42
> I think some drugs can actually create a psudo drug seeking behavior
It's certainly possible. People *do* get hung up on finding "the perfect med."
But the obsessive sort of behavior you describe in your mother and yourself reminds me of nothing so much as my experience with (medication-free) psychoanalysis and other therapies. I spent WAY too much time, money, and energy believing I could determine my fate by solving some unconscious conflict or by engaging some technique thoroughly enough or by reading enough original psychology texts to gain true insight. I invested heavily in those pursuits and in various "therapeutic dyads" for YEARS rather than doing the things that could actually have improved the quality of MY life.
I think the potential pitfall you describe is not something inherent in medication; it's in the promise of finally obtaining that elusive relief from persistent, mysterious problems.
Posted by pseudoname on November 17, 2005, at 11:38:53
In reply to Re: Shafer on Harmon's article, posted by Laurie Beth on November 17, 2005, at 10:38:57
Posted by mcd on November 17, 2005, at 12:54:25
In reply to obsessing about treatment generally » linkadge, posted by pseudoname on November 17, 2005, at 11:36:35
I found this blog by a psychiatrist who is furious about the article.
http://shrinkette.blogspot.com/
"A doctor with intensive training can have trouble with these meds...and these patients are going to do better on their own?"
Sometimes.
"They are as careful with themselves, they say, as any doctor would be with a patient. No doubt, that's true...if their doctor is an incompetent criminal."
Doesn't have to be a criminal...sometimes incompetent, usually just indifferent and rushed during a 15 minute (every two or three months) appointment. Or influenced by the Florida golfing vacation (um, I mean "conference") put on by the drug company.
It's also interesting to read the responses, mostly from other psychiatrists.
Posted by Emily Elizabeth on November 17, 2005, at 13:06:07
In reply to I'm sorry everyone, posted by med_empowered on November 17, 2005, at 1:54:51
I agree w/ others that you don't need to appologize. (In fact, I appologize if my post sounded like it was scolding you.) You offer so many helpful insights. You certainly are worth quoting, but it was a poor choice of a quote to use. Also, it was taken out of context. I guess that is the danger of the media, huh?
Best,
EE
Posted by Nickengland on November 17, 2005, at 14:36:23
In reply to Re: I'm sorry everyone » med_empowered, posted by Emily Elizabeth on November 17, 2005, at 13:06:07
Maybe its just me lol
I was just wondering with the title
"Young, Assured and Playing Pharmacist to Friends"
And with what other things are mentioned, when you read inbetween the lines..do you feel any level of sarcasium is in the title of the article?
I need to think about something else (after my long post to Amy!) but I can't help but feel that parts of her story gives the message that, we, (and a growing number) of mentally ill people are firstly - breaking the law ~ whilst at the same time playing.... Also suffering from Genetic mental illness?!!!!!
This doesn't sound very good for millions of readers to think about psychiatric people with what is already a big enough problem throughout the world with stigma?...that a growing number of the young generation is acting illegally - also playing?
To me I think the news story only touches the surface, of such a deeper issue which requires large amounts of investigation and research - then the title would perhaps read differently because it was touching on more of the core issues. Maybe i'm wrong. However, if I had afew months (Like Amy) to investigate this! LOL Of course my version would be UK-ish ;-)
But i'd provide a global prospective. I might start playing reporter as a part-tme job to my already media portrayed Pharmacist Job ;-) (joke) lol
Posted by ed_uk on November 17, 2005, at 15:13:29
In reply to Re: Shafer on Harmon's article, posted by linkadge on November 17, 2005, at 10:34:51
>Ritalin abuse in university is very common. In my university it is very common.
It's interesting. I never knew a single person at uni who took Ritalin.
Ed
Posted by ed_uk on November 17, 2005, at 15:16:46
In reply to Re: NYT ''new trends'', posted by med_empowered on November 17, 2005, at 6:23:32
Hi Med
I don't like it how the article mentioned your name. It feels like a violation because they didn't ask your permission. You don't have anything to apologise for Med. I didn't like the article personally - far too one-sided.
Kind regards
Ed
Posted by Nickengland on November 17, 2005, at 15:29:32
In reply to Re: NYT ''new trends'' » med_empowered, posted by ed_uk on November 17, 2005, at 15:16:46
Thats a relief Ed :-)
You said it well, what took me quite afew more words! lol
Kind regards
Nick
Posted by linkadge on November 17, 2005, at 15:39:27
In reply to Re: Shafer on Harmon's article » linkadge, posted by ed_uk on November 17, 2005, at 15:13:29
Oh its big alright (at least around here). I new a guy who nearly payed for all his texts and some of his tuition by selling his prescriptions.
Linkadge
Posted by jay on November 17, 2005, at 15:44:54
In reply to Article in NYT RE: Self-Prescribing/Medicating, posted by hawkeye on November 16, 2005, at 9:42:03
See my article below from Scientific American. This is about POLITICS, not SCIENCE. Chances are is you think you are smarter than your psych. doc, you are! Us North Americans are just too uptight about taking a pill. If we where given the knowledge to develop the technology of a pill, we should use it!
Jay
Posted by ed_uk on November 17, 2005, at 16:00:17
In reply to Re: Shafer on Harmon's article, posted by linkadge on November 17, 2005, at 15:39:27
I guess Ritalin is prescribed a lot in Canada? Here, people seem to come off it when they're about 16 - whether they like it or not I suppose!
Ed
Posted by ed_uk on November 17, 2005, at 16:00:48
In reply to Re: NYT ''new trends'' » ed_uk, posted by Nickengland on November 17, 2005, at 15:29:32
Thanks Nick :-)
Ed
Posted by Meri-Tuuli on November 17, 2005, at 17:01:27
In reply to Re: Shafer on Harmon's article, posted by linkadge on November 17, 2005, at 15:39:27
Hey there Link, interesting article huh!?
I don't personally know a single person who has taken ritalin (at uni or otherwise) but then I live in the UK....hahaha, and if I did, I'd get them to give me some....then I too could be one of the people in the trend!!!
Anyway, unfortunately, I'm the only one of my friends to become obsessed by pmeds etc. One of my close friends hates it when I even ask her how she is doing on one of them. They think I am abit weird for it....ah well. Maybe its the British weather or something.
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