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. Confident of their abilities and often skeptical of psychiatrists' expertise, they choose to rely on their own research and each other's experience in treating problems like depression, fatigue, anxiety or a lack of concentration. A medical degree, in their view, is useful, but not essential, and certainly not sufficient.Oh, these young people. They used to just smoke marijuana.
They trade unused prescription drugs, get medications without prescriptions from the Internet and, in some cases, lie to doctors to obtain medications that in their judgment they need.
November 16, 2005
"I acquire quite a few medications and then dispense them to my friends as needed."
Says Katherine: "I usually know what I'm talking about." This is, apparently, a big trend:
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23 comments:
Reefer madness may well have taken hold with some of the older generation. They may not be as open as the younger generation is about swapping pilld. I know several older people who do swap and dispense pills. Conversely are the doctors who will presribe what a patient asks for, though they are not abundant in my opinion.
I'm telling you -- it all starts with Halloween candy or that first sip of Pepsi...
Halo: Thanks for reminding me to rip that slip of paper up into tiny pieces as I did with the last 2.
All that research takes the fun out of it, but I understand they feel they *need* them. The right to self-medicate, is that one of those hidden in the Constitution? Well at least we know how the 9th Circuit would rule.
Or, you could make a little extra money on the side.
I am really somewhat ambivalent on this (btw, interesting discussion on by Eugene today on Volokh on misusing words, including "ambivalent"). A lot of physicians really don't know all that much about the drugs they prescribe. That is why some practices are bringing in PharmDs to handle such. Often, they seem to depend on the drug reps - who have a serious conflict of interest (i.e. they are paid for selling the stuff). Add to this that there is a lot of drug information on the Internet these days. So, I would expect that at least some patients have a better idea of what meds they need than do their physicians.
On the other hand, I have seen it abused. I know of one older guy who fires his doctors if they don't give him the diagnosis that he expects. He tells them what is wrong with him, and they had better agree, or they get fired. Yes, he is smart, and does homework. But he has been wrong as often as he has been right.
My point in the later is that with the ease of information acquisition today on the Internet, we sometimes discount the expertise of people who have spent their lives in a certain area. Sometimes, they have forgotten more about your malady than you have learned about it on the Internet.
In the end though, I come down on the side of these kids. My libertarian side shows through again. If they want to kill themselves this way, then, fine, that is (IMHO) their perogative.
Bruce Hayden wrote: My libertarian side shows through again. If they want to kill themselves this way, then, fine, that is (IMHO) their perogative.
If these people have insurance, they are quite likely going to stick someone else for the bill if anything goes wrong, not to mention driving up costs for their carriers by getting unneeded prescriptions.
Does your libertarian side think it's okay if we throw all of these people out of their insurance programs, because they're bad risks and are abusing the system?
Well, what did you expect? As long as our government permits its subjects to eat and drink whatever they choose, some of them will be tempted to extend those liberties of ingestion to pharmaceuticals. Government must step up to its responsibility to completely and ruthlessly control every aspect of our lives...otherwise horror stories like this will continue.
If these people have insurance, they are quite likely going to stick someone else for the bill if anything goes wrong
While I don't necessarily disagree, that is a pretty slippery slope argument. Using that logic, I could go on all day about people living in flood plains, eating bacon, driving a car without airbags, jaywalking, parachuting, scuba diving, etc.
Insurance by its very nature is a shared risk.
When are people going to start operating on their buddies?
Cheers,
Victoria
It's that damnable internet again. Everyone seems to think that they can educate themselves and make their own decisions about their own bodies based on their own research.
Personally, I think any adult should be able to buy anything they want when it comes to drugs (both licit and illicit).
As far as insurance, they would probably only reimburse people for prescribed medicines, and that would be fine, too.
Legalize the purchase of drugs, write big scary warnings to ward off lawsuits, and ban the direct advertising of same would be my solution, but then I'm crazy.
but then I'm crazy.
I got Percodan, Paxil or this bluey pill I don't know the name of, but my friend told me it works great. Say when!
Cheers,
Victoria
Dave, Adderal is most definitely cheating for the LSAT and or Bar exams...you'd be suspended 50 games by MLB.
On a serious note, is it possible that this is a consequence of the generally irrational and possibly completely corrupt stance of our government towards drugs of all sizes?
Prof. A brings up marijuana and that's a useful point in that I don't think there is a disagreement among rational people that treating pot and crack in roughly equivalent fashions while pot and alcohol are treated vastly differently is, at best, arbitrary. Once you are there in becomes easier to say "well, I can find out just as much about Welbutrin/Ambien, hell why not Oxycontin, as my MD, so who needs him and his gov't perscription pad?"
I meant crazy in the sense that I am a free-market libertarian who really trusts people to make their own decisions, even when those decisions may endanger themselves (and should only be punished if they endanger others in the process).
From the viewpoint of most people (it would seem) that makes me crazy, so I said that upfront, as far as meds go, sorry, don't need 'em, don't take 'em (not even aspirin for a headache).
(and yes, I know you were just cracking wise, I set them up, so that someone else can knock them down)
I do detect a certain degree of defensiveness from the medical profession when this subject comes up though, it would seem that they fear that most of their customers see them as mere pill dispensaries and should their gate-keeping function be ended then most visits to doctors would be cancelled.
XWL, my defensiveness is coming from the employer side of the arguement. If people want to make their own medical decisions, fine. But don't expect the employers and insurance carriers to pay for the additional risks of such behavior.
If this becomes a larger trend expect some companies to drop their medical insurance (or at least curtail their drug benefits) and expect for consumers to pay even more in terms of premiums, co-pays, co-insurance, etc. Just because the medical inflation trend has been bad doesn't mean it can't get worse.
Expecting consumers to make their own decisions regarding drugs would end a whole class of defensive medicine and lawsuits.
I believe that would greatly reduce overall medical costs which would also reduce the cost of insurance.
Medical practice could focus on prevention and healing, not CYA tests and fears of lawsuits from both under-prescribing and over-prescribing (which hit doctors and providers at both ends).
I understand peoples concerns, but I think the effects stated are the opposite of the likely outcome.
(freer markets lead to lower prices, can't think of too many times where the opposite has proven true)
Great idea, XWL. Now all you have to do is get everyone to drop their insurance (the carriers place too many barriers in the way of people excercising their free choices), get the government to close down Medicare and Medicaid, and we'll be on our way to truly free markets in health care!
I think I'll read up on do-it-yourself surgery. I'm thinking of opening a surgical practice in the newer freer marketplace. Victoria, got any good book recommendations on thoracic surgery?
definitely true.... adderall has become a necessity for collegiate potheads
Victoria, got any good book recommendations on thoracic surgery?
Erm, gosh what a question. I could have a look-see and get back to you, Icepick. :)
Cheers,
Victoria
The use of illegal drugs for self medication by individuals for medical problems is well known to doctors:
A well known secret
Of course the pharma companies dont like it. It cuts into profits.
The War On Unpatented Drugs
Fortunately in the case of the pharma companies government really does want to help.
Stever,
Dr. Benjamin Rush a signer of the Declaration thought that self medication ought to be in the Constitution lest we have a medical dictatorship.
Addiction or Self Medication?
Evidently he could see farther than you can.
So maybe self medication is one of those IXth Amendment Rights after all.
Bruce H.,
Did you say drug reps and conflict of interest?
Have I got a story for you. It is why some stimulants are prescribed for ADD/ADHD and why others are illegal.
The War On Unpatented Drugs
It is what is called in the political trade: rent seeking. i.e. only a doctor can tell you what you need and only a pharmacist can give it to you. Assuming prior government approval for the drug in question. Which is why big pharma loves the FDA. With the DEA a close second.
Alex Harrison,
PTSD is widely underdiagnosed and undertreated. Despite that fact anti-anxiety drugs are one of big pharma's biggest sellers.
Did you know that tobacco is an anti-depressant?
Perhaps that is a real clue to the magnatude of the problem.
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