www.tallahassee.com/mld/democrat/news/opinion/6908288.htm

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 Thu, Oct. 02, 2003

 Over-medication: a growing crisis
 Aggressive marketing a major culprit

 By Lou Dobbs   TRIBUNE MEDIA SERVICES

 The federal government spends nearly $1 billion a month to fight the war
 on drugs. But while we focus on eradicating illicit drugs, we ignore the
 worsening problem of over-medication.

 From 1998 to 2002, sales of antidepressants increased 73 percent to more
 than $12 billion, and sales of analeptics (drugs that stimulate the
 central nervous system, such as Ritalin and Adderall) increased 167 percent,
 according to IMS Health, a pharmaceutical information and consulting firm.
 Even more distressing, physicians wrote more than 1 million prescriptions
 for Strattera, a nonstimulant treatment for attention deficit/hyperactivity
 disorder, in its first six months on the market.

 Something is very wrong here. These dramatic increases in the sales of
 these pharmaceuticals not only suggest that Americans are well on their way to
 becoming depressed, anxiety-ridden and incapable of the focus necessary to
 understand the world in which we live, but also that we are on our way to
 becoming a drug-dependent nation.

 No one would deny that ADHD, depression and anxiety disorders afflict
 millions of Americans. But to what degree? Through a combination of
 pharmaceutical companies' increased marketing, quick diagnoses from
 physicians and lack of proper referrals from doctors, we are simply
 inundating incredible numbers of people with unprecedented medication.

 The issue is all the more sensitive and heartrending when it comes to our
 children. According to the Archives of Pediatric and Adolescent Medicine,
 a study of 900,000 youths showed that the number of children taking
 psychiatric drugs more than doubled in one group and tripled in the two
 others over a 10-year period ending in 1996.

 "Any time a child reads a little more slowly, we're talking learning
 disability and administering Ritalin," says Dr. Arthur Caplan, chair of
 the department of medical ethics at the University of Pennsylvania School of
 Medicine. "Or any time a kid acts up a bit, instead of giving him
 detention, we're drugging him. These are definitely problems in that it's expensive,
 it may not address the cause of the problem, and I've never met a drug yet,
 including aspirin, that didn't have some side effects."

 In other words, some pharmaceuticals create greater problems than they
 treat. In June, British drug officials, later backed by the U.S. Food and
 Drug Administration, warned physicians and consumers that
 GlaxoSmithKline's antidepressant Paxil carries a substantial risk of prompting teenagers and
 children to consider suicide. Two months later, Wyeth warned doctors of
 the same risks in its Effexor. U.S. sales of both drugs totaled nearly $4
 billion last year.

 The driving force behind the surge is aggressive direct-to-consumer
 advertising, Caplan says. Following the relaxation of a 30-year drug
 marketing agreement in 1997, pharmaceutical companies have tripled their
 annual advertising to consumers, resulting in a 37-percent increase in
 sales of prescription stimulants for children. Also, roughly one-third of adults
 have asked their doctor about a drug they saw advertised, according to the
 Kaiser Family Foundation.

 And those doctors are quick to dole out prescriptions. According to the
 American Psychiatric Association, primary-care physicians now write
 upwards of 60 percent of all antidepressant prescriptions.

 "I think (doctors are) just overwhelmed now with too much marketing,"
 Caplan says, "and it drives them toward too much prescribing,"

 In fact, American consumers, mostly children, account for more than 90
 percent of global consumption of such stimulants.

 "If we have four or five times the learning disability or depression or
 other neurotic illnesses that the Europeans do," Caplan says, "then either
 we got a really bad gene pool through immigration, or we're
 over-medicating."

 A crisis looms. The pharmaceutical companies, the FDA and Congress must
 confront this issue now, and the physicians' credo is an appropriate
 starting point: First, do no harm. That concept simply must take
 precedence over profit motives and casual prescriptions.
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 Lou Dobbs is the anchor and managing editor of CNN's "Lou Dobbs Tonight."
 E-mail: lou@cnn.com.