Business has never been better, thanks for asking.
As long as the public – you and I – continue to demand newer and better quick fix chemicals, we act as a sales force for this huge industry. Psychiatry, like any business, is subject to market pressure. Right now, there is pressure to create more and more chemicals for more and more “diseases.” Our demand is met, happily, by their supply.
Let’s take a quick look at “ADHD,” just one example out of hundreds of fake diseases. “ADHD” has been a financial boon for Big Pharma. It’s been increasing nearly 6% a year for the past decade. In America – like no other country on earth – one of every 12 children between the ages of 3 and 17 are given this tag, most of them prescribed an amphetamine (“speed”). That’s more than five million American teenagers, grammar school kids, and toddlers – most of them boys. (See CDC FastStat here)
And, dear parents, your doctor can choose from 61 different chemicals for “ADHD” – with more on the horizon. There are 78 chemicals for depression, and there are 7 “kinds” of depression. Antipsychotic chemicals? 26. There are 12 chemicals to treat autism, the most maligned of all children, as you will see in an upcoming essay. Anxiety disorder of some sort? There are 188 chemicals in 9 different “topics” to help you if you are too anxious. Anxiety “relief,” as you can tell, is a big seller. (See Drugs.com here.)
What’s A DSM?
Let’s get a picture of the growth of this industry in the past 60 years.
The Diagnostic and Statistical Manual (DSM) is psychiatry’s modern day witches brew. It contains all the American Psychiatric Association (APA) approved “diseases.” If it’s not in the book, it’s not a “disease.”
In 1952, there were 106. In 1968, the second edition of DSM was published. There were 182 “diseases.” The third edition, published in 1980, had 265, and then was revised in 1987 to total 292. And, finally, in 1994, the fourth edition contained 297 “diseases” – and if you count the “disorders,” it’s over 400 (see the entire list here). No cures, you may remember. Treatment only, usually forever, because mental health “diseases,” once diagnosed, according to the vast majority of psychiatrists, last forever. Ask them. (See more about the DSM here.)
The DSM is a billing device for the profession, nothing else. It has no other value. Still, as a billing device, everyone must use it. By everyone I mean government, big business, non-profits, academia, licensed individuals, public and private providers, schools – everyone. Without a diagnosis from the DSM, no services will be given; not without a designated name and number from this book of incantations. (See upcoming article “Diagnosing for Dollars” soon)
So, you can see, it pays to be in the book.
DSM V - Progressing Backwards
The DSM is being revised again, due in May of 2013. If you guessed there would be more diseases, you’d be right. One addition is particularly egregious. Grief. If you lose a loved one, and if you don’t snap out of it after six months, you are “diagnosable.” I’m not kidding. Complicated Grief Disorder (CGD) is in the book. Ethical professionals from all disciplines are screaming at this “medicalizing” of human sorrow.
For the record, and full of irony, no one is screaming louder than Dr. Allen Frances, the Chairman of the DSM IV Task Force. The irony is that the biggest foe of the fifth book of diseases is the psychiatrist who led the group that wrote the fourth book of diseases. For many of us, editions 1-4 are just as unscientific and nonsensical as the fifth, though the latest version is now, officially, the worst. (More about Dr. Frances and the DSM V controversy here.)
Not quite everyone is screaming, by the way.
Not the DSM Task force, for sure. They voted CGD into the book. Certainly not Big Pharma. They’re applauding. Their market was increased. Now that your new “disease” is in the book you can be prescribed one or more of those 188 “anti-anxiety” chemicals already available. This will have to do until the new and improved “anti-grief” chemical is developed.
Then there’s this.
At first it appeared – and then it was confirmed – that “70% of the DSM V Task Force members have reported direct industry ties.” New diseases are proposed every year. The people making those decisions are benefitting from those decisions, as are their “industry ties,” as they decide who wins and who loses. Many professionals, including me, are crying foul about the ethics of the task force whose members openly admit their connection to Big Pharma, mostly to deaf ears. (More about DSM V here.)
Who are the winners?
The scientists and doctors from Academia and Big Pharma corporations who get their newest “disease” in the book are the winners, and it’s very competitive. Major Universities and massive corporations – and individuals with “connections” – stand in line to present their self funded “research.” If you can get an unwanted behavior proclaimed a “disease” by the disease proclaimers – the DSM Task Force – and placed in the book, then the doctors, universities and corporations who invented the “diseases” will be enriched because, well . . . because we give them fistfuls of money for their products.
Big Pharma’s most important customer, by the way, is the doctor, not you. Doctors, after all, are the ones who sell their products to us. While these companies aim their endless advertisements to entice you, it’s the doctor who has the power to grant permission, and they are the focus of the Big Pharma’s substantial financial coffers. From an article from Time: Health & Family, “Psychiatrist Contends the Field Is Committing Professional Suicide,” October, 2012:
In 2004 alone, pharmaceutical companies spent about $58 billion on marketing, 87% of which was aimed squarely at the roughly 800,000 Americans with the power to prescribe drugs. The money was spent mainly on free drug samples and sales visits to doctors’ offices; studies find that both free samples and sales calls increase prescribing of brand-name drugs and raise medical costs without improving care. (Read more: here.)
And talk about lucrative. Global sales of pharmaceuticals was nearly 800 billion through 2008, and is likely to be closing in on a trillion dollars annual income now. Thanks to their customers – us – 90% of those sales occur in the United States.
5 Million and Counting
Finally, let’s talk just a bit more about those 5 million kids given doses of “speed” for “ADHD.” That’s a lot of kids. For this to be true, you have to believe American kids are much less healthy than kids in rest of the world. Or, is it that the rest of the world’s kids are just as unhealthy as ours, only they don’t know it?
Maybe it’s because our healthcare services are state-of-the-art, our workforce so well trained, the research and science from our Universities so sophisticated that we’re just that much better at “diagnosing” ADHD in kids who need medical help. This explanation, by the way, is what both Academia and Big Pharma wants us to believe. Our system, they say, is modern and compassionate, and that’s why we can, and do, provide so much needed medical care to “mentally ill” children.
By now, I trust, you know this isn’t true for a lot of reasons we’ve already discussed. The most important reason? I think you already know.
Your kids aren’t sick.
NEXT: Here’s Where We’re Going