Palm Beach Post
COLUMN: Americans' legal drug abuse
By Rhonda Swan
Palm Beach Post Editorial Writer
May 21, 2009
Maxine is not the woman she used to be.
She looks the same, except for the white Afro that used to be black.
But gone is her zany sense of humor, sharp tongue and sassy wit.
She stares into space with vacant eyes. Walks like a zombie. She speaks primarily when spoken to, her conversation devoid of her familiar quips. She complies rather than commands.
I've known Maxine my entire life - she taught me how to play pinochle and how to bake a cake - yet she seems more like a stranger I've just met.
That's because she's among the millions of U.S. seniors taking psychotropic drugs, antidepressants, antipsychotics and Alzheimer's medicines. The traits that used to make people take notice of Maxine, who suffers with post-traumatic stress disorder from an abusive marriage decades ago, are swallowed daily with her anti-psychotic Zyprexa pill.
And now, she's hardly noticeable.
The number of people older than 65 taking these drugs doubled between 1996 and 2006, according to a study released this month. Doctors prescribed 73 percent more drugs for adults with mental-health issues and 50 percent more for children during that period.
Children such as 7-year-old Gabriel Myers, who was taking Symbyax - a combination of Zyprexa and the anti-depressant Prozac, known to cause youngsters to have suicidal thoughts - when he hanged himself at his Broward County foster home last month.
An author of the study, which appeared in the journal Health Affairs, attributed this astounding increase in the use of these powerful drugs to improved access to mental-health care, which has become more mainstream, and more insurers willing to cover the drugs. But it's also because more doctors prescribe psychotropic drugs as the first and often only treatment, even when they're not warranted.
Years ago, when I told my primary-care doctor that I was suffering stress-related anxiety and insomnia, he handed me a prescription for Prozac. I trashed it, opting instead to exercise and change my diet.
In February, when my mother was in West Palm Beach's Columbia Hospital recovering from surgery, I requested a psychiatric consultation because she wasn't eating. I thought she might benefit from a session with an objective professional.
The hospital psychiatrist visited with her for less than 10 minutes, diagnosed her as depressed based on her answers to five questions, and then prescribed the antidepressant Zoloft and went on his merry way. Counseling wasn't even considered as an option.
What happened to psychotherapy, once the hallmark of psychiatric treatment? Because of managed care, it's going the way of the lobotomy. Why engage the human mind and heart to ease mental suffering when popping a pill is so much cheaper? According to a 2008 National Ambulatory Medical Care Survey, only 29 percent of visits to psychiatrists in 2004 and 2005 included psychotherapy, compared with 44 percent in 1996-97. Insurers reimburse more, says the report, for three 15-minute medication management visits than for one 45-to-50-minute outpatient psychotherapy session. Not surprisingly, the patients more likely to receive therapy are those who can pay out of pocket.
Granted, not everyone with a mental-health diagnosis would benefit from therapy alone. Many need these mind-altering, chemical-balancing drugs. But many others could achieve optimal mental health without the assistance of pharmaceuticals.
While we've been busy losing the multibillion-dollar war on illegal drugs, a government-sanctioned, multibillion-dollar legal drug industry has blossomed, churning out robots void of personality like Maxine and suicidal children like Gabriel.
When life is lost - mentally, spiritually or physically - does it really matter whether the drug dealer had a medical degree?