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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 23 to 47 of 57. Go back in thread:
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.
Posted by linkadge on November 17, 2005, at 18:57:23
In reply to Re: Shafer on Harmon's article, posted by Meri-Tuuli on November 17, 2005, at 17:01:27
No, ADD/HD is a lifelong illness here in canada :) and so medicating for it goes on and on.
Linkadge
Posted by Phillipa on November 17, 2005, at 19:39:49
In reply to Re: Shafer on Harmon's article, posted by linkadge on November 17, 2005, at 18:57:23
Just wanted to say that only the college age and young professionals were included in the article. What about all the older people who post here and on other sites. We just get tired of doctors not listening to us. And it's impossible to abuse meds here anyway. The doctor can only prescribe for a month. The only way to abuse legally is to have a pdoc who prescribes more or higher doses than he means you to take. My old pdoc used to do this. He'd prescribe let's say lmg xanax l20tabs a month. And I was only taking .5pills. So I had extas each month. Down the toilet they went when the med was changed. Fondly, Phillipa
Posted by Phillipa on November 17, 2005, at 21:16:06
In reply to One More Thing, posted by Phillipa on November 17, 2005, at 19:39:49
In eating my dinner was watching TV, PBS-WUNG had a panel of experts from UNC and other Public Service Educators who are advocated for the mentally ill and in charge of improving care for the mentally ill. They brought up to the panel the article in the NYT. They all agreed a big problem was people sharing meds, using them to get high and how dangerous it was to take these AD'd and other meds without the supervision of a psychiatrist. They said the older antipsychotics were horrendous drugs that caused dystonia, akathesia, shaking hands. And the newer family of antipsychotics was not much better since they caused diabetes. And they said the reason young people are creating suicide with ADs. Was because when they took them they were really bipolar. They said the AD's caused them to become manic and that's why they committed suicide. They said young children who were fidgety in the classroom and given ritalin were really bipolar. They said only a psychiatrist was capable of diagnosing for anyone. A proper diagnosis is necessary so appropriate mediacation can be prescribed. They said with proper medication people would be productive in society. That the State was providing services to help the mentallly ill. And a nursing home enviorment was not appropriate for a young adult mixed in with an Alziemers pt. And that with support groups for self and family, theraphy and medication . A person would become well. And that people had to stay in the closet and not disclose that had mental illness. The show presented all types of mental illness as being the same as diabetes or heart disease. For anyone whatching the TV program it appeared just see psychiatrist, get dx and attend support groups for self and family. So they could understand what was going on and respite for families of pts with mental illness. They had an expert who said his problem was a frontal lesion of the brain. Who was now in charge of an agency for the mentally ill. It made it seem like mental illness was very common and no one would notice. That appropriate meds returned the person to an active and productive life. Does anyone else have all these services available. That suffering was a thing of the past and anyone could recover with meds. That all meds when they were no longer necessary be disposed of appropriately. That way meds would not be shared, sold or abused by those they were not prescribed for. Is this the real world or what?Fondly, Phillipa
Posted by med_empowered on November 17, 2005, at 23:51:31
In reply to Wow It's Now On TV!, posted by Phillipa on November 17, 2005, at 21:16:06
ugh...no, its not the real world. A bad response to an AD doesn't mean "you must be bipolar". Antidepressants raise the levels of neurotransmitters to *unusually high* levels--so really, you're inducing an unusual, patholigical state in the brain; any improvements you see are more from unusually high serotonin or whatever than they are from "restoring balance" or whatever marketing BS drug companies are saying these days. Whats remarkable is that MORE people DONT go crazy--I mean, you soak your brain in serotonin, for a LOOOONG time.
Now, Im not saying antidepressants dont help some people--they do--but lets be honest here: psychiatric drugs don't really "fix" any underlying problem. Yes, they can alter brain chemistry so that *symptoms* go away and life overall becomes easier, but this doesn't mean that they somehow *fix* a *disorder*.Weirdly enough, the newer breed of psychiatric meds actually seems to sometimes threaten *psychiatrists*--something like 70% of all psychotropic med RXs are written by non-psychiatrists; GPs, nurse practitioners, that kind of thing. Psychiatrists tend to see the affluent and the more complicated cases. Also, theres a move to allow psychologists to prescribe--they're doing this in New Mexico, with no apparent problems as of yet. Of course, shrinks fought against this and continue to fight against it. Its weird, isn't it--the idea that a 15minute session every 2-3 months could somehow offer them insight that other docs don't have? Plus, they don't usually do blood work or anything themselves so...really, many of todays shrinks are highly skilled drug pushers. This whole "we have all the answers" schtick is really just a power grab.
Posted by linkadge on November 18, 2005, at 9:08:10
In reply to Wow It's Now On TV!, posted by Phillipa on November 17, 2005, at 21:16:06
I think the explaination that antidepressants cause suicide via mania activation is "very convenient". It is another example of psychiatry directing attention away from itself, and back on to the patient.
I think that SSRI's can cause suicidal thinking independant of any bipoliarity via a little thing called "akathesia"
Linadge
Posted by linkadge on November 18, 2005, at 9:09:01
In reply to Re: Wow It's Now On TV!, posted by med_empowered on November 17, 2005, at 23:51:31
Posted by linkadge on November 18, 2005, at 9:12:25
In reply to Re: Wow It's Now On TV!, posted by med_empowered on November 17, 2005, at 23:51:31
My example is coffee. Drinking enough can make anyone nervous, it is not unmasking a latent anxiety disorder just because it makes you nervous.
Linkadge
Posted by thuso on November 18, 2005, at 13:04:28
In reply to Re: Wow It's Now On TV!, posted by med_empowered on November 17, 2005, at 23:51:31
> Weirdly enough, the newer breed of psychiatric meds actually seems to sometimes threaten *psychiatrists*--something like 70% of all psychotropic med RXs are written by non-psychiatrists; GPs, nurse practitioners, that kind of thing. Psychiatrists tend to see the affluent and the more complicated cases. Also, theres a move to allow psychologists to prescribe--they're doing this in New Mexico, with no apparent problems as of yet. Of course, shrinks fought against this and continue to fight against it. Its weird, isn't it--the idea that a 15minute session every 2-3 months could somehow offer them insight that other docs don't have? Plus, they don't usually do blood work or anything themselves so...really, many of todays shrinks are highly skilled drug pushers. This whole "we have all the answers" schtick is really just a power grab.
>I actually disagree with you on that. If that was true, then what is the point of going to any specialist? Any doctor can prescribe me the same meds any specialist can, but a lot of the times they don't because they understand that their knowledge is not at the same level as the specialist. Also, specialists should be more caught up in the literature than a general doctor. Now I think for simple cases a general doctor can administer the meds, but I think people should get their initial opinions and periodic checkups from specialists.
That's why I try and go to an Endocronologist for my thyroid issues. My regular doctor can very easily give me the meds I need, but they probably won't catch any subtle signs that my Endo will quickly catch. I've benefitted from this type of instance often. You will never see me getting any psychiatric drugs from my general doctor no matter how simple my problem. I trust the knowledge of a good specialist much more. <note that I said "good">
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