#8 Drug Companies Influence Doctors and Health Organizations to Push Meds

Washington Monthly
May 12, 2000
Title: Drug Rush
Author: Stephen Pomper

MOJO Wire Magazine
November/December 1999
Title: Prozac.org
Authors: Ken Silverstein
www.motherjones.com/mother_jones/ND99/nami.html

Dendron #43
Spring, 2000
Title: NAMI: The Story Behind the Story
Author: David Oaks
www.MindFreedom.org/DENDRON/dendron43/namislush/namislush.html

Networker
March/April 2000
Title: Exposing the Mythmakers
Authors: Barry Duncan, Scott Miller Jacqueline Sparks
www.familytherapynetworker.com/

Faculty evaluators: Victor Daniels, Ph.D., Cindy Sterns, Ph.D.

Student researchers: Bruce Harden, Karen Parlette, Licia Marshall, Steve Quartz

More than 130 million prescriptions were written in 1999 for depression and mental health related symptoms at a cost of $8.58 billion. Physicians know that antidepressants are only part of the answer for mental health, but marketing by drug companies has created the mythology of pills as cure-alls. A 1999 federal research study found that the newer antidepressants were effective in only half of the cases and only outperformed placebos by 18 percent.

Drug companies spend $5 billion annually to send sales representatives to doctors’ offices. Sales reps keep FBI-style dossiers on physicians that include information such as the names of family members, golf handicaps, and clothing preferences. Hard sales tactics and small gifts are part of the pitch. In addition, pharmaceutical companies provide perks (such as tickets to sporting events) and outright compensation to doctors for their participation in the prescribing of particular drugs to their mental health patients.

On another front, pharmaceutical companies are reaping big profits by promoting forced drug use through programs at the National Alliance for the Mentally Ill (NAMI). With drug company funding, NAMI promotes a program of in-home forced drug treatment, called the Program of Assertive Community Treatment (PACT). The money is funneled through a suborganization of NAMI called the NAMI Campaign to End Discrimination. While PACT has some features that clients like, it also puts an emphasis on "medication compliance." For instance, PACT at times includes daily psychiatric drug deliveries to people’s doorsteps and living rooms, backed up by court orders. PACT enforces medication compliance by visiting clients’ homes daily to stand and watch as clients take their medicine—involuntarily—in their own living rooms. There is a clear conflict of interest here since the pharmaceutical companies are reaping profits from the drugs the patients are forced to take.

The psychiatric drug industry is pouring millions into a NAMI-controlled slush fund, which is the monetary force behind one of NAMI’s central goals: to get PACT into every state by 2002. NAMI leaders claim their hands are clean of drug money.

They bill NAMI as "a grassroots organization for individuals with brain disorders, and their family members." However, Janet Foner, a co-coordinator of Support Coalition International, an activist organization of "psychiatric survivors," says NAMI does a good job in some areas, but argues that the group’s corporate sponsors help shape its agenda. "They appear to be a completely independent organization, but they parrot the line of the drug companies in saying that drugs are essential [in treating mental health disorders]."

NAMI has a policy of never disclosing its drug company funding. Mother Jones researchers used internal documents to prove that NAMI received $11.72 million from the psychiatric drug industry in just two-and-a-half years. NAMI’s leading donor is Eli Lilly and Company, which is the maker of Prozac.

Update by Stephen Pomper

"Drug Rush" explores the lopsidedness in the FDA’s regulation of new drugs. Over the last decade, AIDS activists seeking quicker access to breakthrough treatments and pharmaceutical companies eager to get their products on the shelves have successfully pressured Congress to ramp up the process for approving new drugs. But once drugs are on the market, the FDA has scant resources for monitoring their safety. The agency is short on medically trained epidemiologists to track the bad effects of new drugs. The nation’s safety monitoring system relies on voluntary (and unreliable) reporting by private physicians. And at the same time, the pharmaceutical industry encourages the rapid uptake of new products through consumer advertising (including, thanks to newly relaxed regulations, television advertising) and physician-focussed promotions ranging from free pens to complementary basketball tickets.

In the months since the article appeared, the FDA has been increasingly active in trying to bolster its safety monitoring programs. An internal report, released in November 2000, concluded that the FDA should do more to monitor drugs once they’re approved. Officials within the FDA’s Office of Post-Marketing Drug Risk Assessment have said that they’d like to see organizations like the Agency for Healthcare Research Quality receive more money to monitor prescription drugs once they are on the market. They have also called for funds collected under the Prescription Drug User Fee Act to be earmarked for safety monitoring. As FDA Commissioner Jane Henney wrote in a letter to the Washington Monthly: "Although [monitoring for drugs on the market] has been updated, the monitoring system requires a significant infusion of resources to make it stronger."

Readers interested in exploring the FDA’s regulation of new drugs should begin with Public Citizen’s website, David Willman’s excellent coverage of the Rezulin crisis in the L.A. Times, and the Washington Post’s recent six part series on the conduct of U.S. drug testing in foreign countries.

Stephen Pomper: pomper_andersen@hotmail.com

Update by David Oaks

The guinea pigs are fighting back. You haven't heard much about this rebellion in the mainstream press, but there's a 30-year-old social change movement led by people who have experienced human rights violations in the "mental health system." These are the activists who educated me about the issues described in my piece.

For centuries, the psychiatric industry has churned out new methods and models to profitably control people diagnosed with mental disabilities. The difference this time is that an increasingly sophisticated and united "mad movement" is resisting the latest corporate trend.

The involuntary psychiatric drugging of people living in their own homes, in their own neighborhoods, is an especially alarming phenomenon. Since my article was published, the use of coerced outpatient psychiatric drugging is accelerating. In the USA, psychiatric drug industry front groups have won increased federal support for this authoritarian approach. In Canada, UK, and Australia, similar front groups are making headway. We are witnessing the globalization of a new "chemical prison" industry.

The guinea pigs did win a major battle since my article was published. In July 2000, hundreds of mental health consumers and psychiatric survivors in California stopped a proposal in the State Assembly that would have legalized involuntary outpatient psychiatric drugging.

The mainstream press perspective on forced psychiatric drugging has almost always been from the wrong end of the needle. Corporate media typically ignore the marginalized individuals who feel violated by forced psychiatric procedures.

For example, the popular press is not reporting a related news story that has emerged in mainstream medical industry publications: Recent studies indicate that long-term use of the drugs most commonly administered during involuntary procedures has been linked to such extreme changes in the size and shape of the brain that these drug-induced brain alterations are visible under MRI and CT scans.

The dominant media tend to either glorify the drug industry's most recent "magic pill," or vilify the supposedly "dangerously mentally ill." While it is important to respect the many clients who willingly choose to take prescribed psychiatric drugs, the public deserves to hear more about holistic alternatives to the corporate "biopsychiatric medical model."

Readers seeking more information about, or involvement in, the "guinea pig revolt" may contact these non-profit groups:

Support Coalition International, which I direct, is open to the public, and is led by "psychiatric survivors." Support Coalition unites nearly 100 grassroots groups in a dozen countries, and publishes Dendron News. Web site: www.MindFreedom.org. Phone (in the
US): 1-877-MAD-PRIDE.

National Association for Rights Protection & Advocacy (NARPA) holds an annual conference of advocates, attorneys, and activists working for the rights of people diagnosed with psychiatric disabilities. Web site: www.NARPA.org.

International Center for the Study of Psychiatry & Psychology (ICSPP) is a hub for psychiatrists, psychologists, and other mental health workers who are bravely challenging their own industry's ethics. Several of these mental health professionals have authored relevant books. I especially recommend recent books by Ty Colbert, Ph.D., Loren Mosher, M.D., and ICSPP's director, Peter Breggin, M.D. Web site: www.icspp.org

David Oaks: dendron@efn.org