Our Drugged-Out Nation

I doubt that I watch as much television as Tom Nichols does, but I have still been exposed to a dizzying batch of pharmaceutical ads. (via Maggie’s Farm)

And I, as he, have been puzzled by the purpose of these ads. If the drugs they are touting are so wonderful, whyever would you imagine that your physician does not know about them? And if the illnesses they are promoting are so painful, one suspects that you know whether or not you have it, regardless of having seen an ad on television.

Nichols exposes the veritable pharmacopeia of the latest in pills and injectables:

If there’s a problem with my skin, Dupixent can heal it from within. Cyndi Lauper and I can trade stories about Cosentyx, and then we can sing about Otezla to the tune of the 1974 pop hit “Magic,” which is not as catchy as the Skyrizi song (written, I swear, by someone named Richard Cheese). At the end of it, I can emerge Tremfyant with…well, with Tremfya.

And that’s just for my skin. I haven’t even thought about my atrial fibrillation, HIV status, toe fungus, overly thick (or thin) blood, diabetes, Hep C, or my many cancers, none of which might matter if I am undergoing a manic-depressive phase or suffering from schizophrenia.

All of these conditions and more now have treatments marketed directly to the consumer. And that’s unhealthy.

Agreed. It’s decidedly unhealthy to invite people to become consumers of medications that they believe that they can self-prescribe.

If you wonder why we are a self-absorbed, querulous, neurotic society, it might have something to do with a barrage of ads meant to turn us into hypochondriacs who are determined to make our doctors prescribe us the thing we just saw.

Nichols says that pharm ads have become a plague. One feel compelled to agree with him, or at least to respect his expertise:

But pharmaceutical advertising has become a plague. A woman should be able to stream reruns of The Good Wife without being pummeled about how one more breast-cancer drug can buy her another 10 months of life. Indeed, maybe she’s watching those old reruns because she’d rather not think about her condition. On a far lesser scale, perhaps we might be able to get through just one dinner without an exhortation to bombard our bowels with Linzess or Humira.

Want some more? Here they are:

One ad for depression shows a child looking with deep concern at a crying mommy—because that’ll certainly help someone who’s depressed. Another shows a woman running around like Claire Danes’s bipolar CIA spook from Homeland, trying to do a million things, and then living a happy orderly life after another pill. And speaking of spooks, the makers of a drug called Fanapt actually mimicked the world of schizophrenics—complete with delusions of people staring at them and taking pictures of them—in order to market a drug to people with schizophrenia.

In principle, the manufacturers are selling relief from pain and suffering. But, are they really? Aren’t they inviting us to define ourselves by our meds, and to become good consumers of the latest drug. 

Anyway, the net effect of all this advertising is that we’re prescribing more and more drugs to a nation that is, to judge from watching a random few hours of television, composed of depressed heart patients and diabetics who keep picking at their bad skin while running for the office bathroom to deal with their leaky bladders and spasming colons but can’t get in the door because their Parkinson’s tremors or their tardive dyskinesia keeps making them drop their keys.

I am not making light of any of these conditions. I am suggesting that flooding us with ads for conditions we have—and that many of us don’t have—is bad for our mental health, undermines the relationship between patients and doctors, and pollutes the public sphere with invitations to hypochondria.

Those last points deserve emphasis. It is all bad for our mental health because it tells us to define ourselves by our suffering. It certainly undermines relationships with doctors, because it makes us all feel like we know something about something that we know nothing about. And it is inviting hypochondria, because you will in time feel that you are not one of the in-crowd if you are not ingesting one or all of these substances.

Nichols continues, that people now go to doctors to tell them what to do. And doctors, being highly professional and totally competent, find it easier to give in and write the prescription than to argue with a self-righteously uninformed patient. After all, if the doctor refuses, the patient might very well go elsewhere for his prescriptions.

This has had an effect. American doctors are prescribing more drugs, even though it’s not clear that more prescriptions are doing us any good. And it’s inflaming the dangerous and narcissistic problem—one I wrote about in the book The Death of Expertise—that people think they know enough to tell their doctors what to do. As one M.D. put it to me, people no longer come in for a diagnosis of a problem; they walk in and say, “This is what I have, and this is what you’re going to prescribe.”

In an environment where patients are now consumers and consumer happiness is everything, there are plenty of doctors who will shrug and write the prescription.

He concludes:

… there must be a way to not inundate people who have HIV, breast cancer, or bipolar disorder with constant high-speed babble about the promise of treatment and the risks of death.