More prescriptions might be caused by increased drug dependence

There has been a recent jump in prescription medication in the United States. U.S. Food and Drug Administration researchers found that in 2010, 3.3 billion prescriptions were dispensed to adults, an 11 percent increase from 2002 after population size adjustments.

While there is not a definitive explanation for this trend, it can be examined in two ways, said Psychology Department Chair and professor Robert DeRubeis. He explained that while patients may be looking for an easy fix, it is also important to look at the way physicians are trained, what kind of information is out there for consumers and how these two components fit together.

“Where there is training in diagnosis and matching that to a medicine, there is very little training in powerful behavioral methods,” he said.

According to DeRubeis, nonpharmacological methods are time consuming to learn and deliver and people do not invest in the websites, DVDs and books that behavioral therapy relies on as much as they do in medicine. “There’s no capital involved. There’s no profit for anyone really,” he said.

DeRubeis addressed the diagnosis and prescription of ADHD medication. “There are lots of people around who are diagnosed with ADHD and are given medicines to address problems of inattention or hyperactivity,” he said. “We have to ask ourselves, ‘Why is that? Is it that humans are just not matched up well with the world…? Is it that society … or other aspects in the environment have changed in some way that makes it harder for people to attend to the things they are being asked to attend to?’”

He asks the same questions in his research on depression. “If we understand that about 11 or 12 percent of adult Americans are on anti-depressants and if we assume that some other percentage … would benefit from [them], now we have to ask the question, ‘How is it that 15, 16 or 17 percent of us need anti-depressant medications?’”

“I think if you talk to five experts, they may have five different views as to how best to understand that,” he said.

Director of Counseling and Psychological Services William Alexander said that “medicine is an amazing thing,” but recognizes that “some parts of our society are overly-dependent on an immediate cure.”

DeRubeis explained that we are designed to have reactions to life events, and these reactions — whether positive or negative — have value.

“Our society tells us [that] if you’re really upset about something for a week or a month … that’s a sign of something wrong with you,” he said. “Well it might be a sign that something’s right with you to a point.”

Chaplain Le’ Roi Gill, who provides counseling and spiritual programs for elderly members at the Living Independently for Elders Center, agrees. “There is value in human suffering. We want to avoid all forms of pain. People sometimes grieve; they should grieve,” he said.

“It’s tough to say because we have some amazing medicines nowadays — both in mental health and physical health — but I think in the search for an immediate cure, people sometimes [find it] difficult to maybe examine … life circumstances,” Alexander said.

CAPS “encourage[s] therapy in addition to medicine, because that’s what’s most effective.”
He explained that society might be getting more comfortable and casual with using medicine despite the possibility of serious side effects. “I think it’s a tough area … you have consumers who look at the TV and read the newspaper and say, ‘Hey doc, I think I could use a little Prozac.’”

The direct-to-consumer advertising of prescription medications may factor into this trend.
Annenberg School for Communication doctoral student Andy Tan recently completed his dissertation on this topic.

“In terms of benefits, DTCA have been shown in some contexts to play an educational role for consumers — increasing awareness about health conditions, common symptoms or new approved treatments,” he said.

He added that DTCA could also encourage people to participate in their own health care choices and even prompt earlier diagnoses. “Conversely, DTCA may strain patient-doctor relationships, lead to unnecessary treatment and increased side effects or health care costs.”

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