Tuesday, March 27, 2012

Me-Too Drugs?!?!

I have to say that I was a little, okay maybe a lot frustrated when I was reading about these me-too drugs. I honestly had no idea about these "leftover" drugs which are so prominently created and sold by drug companies every single year. Basically, drug companies can get away with producing a drg that they claim to be better than the original, right after the past drug is about to go off patent? How can the FDA not realize this? Or maybe they do but just do not care enough to make note of it. Obviously these drug companies are doing a great job of passing all of their clinical tests so easily and getting these only slightly different drugs by them. Literally, all the drug companies do is increase the dosage of the new drug they are trying to get approved on all the clinical trials and of course it will look like it works better. But when a person buys this drug, are they really going to take that high does that it was tested at? No, and this is why the people are being completely misinformed about new, specialty prescription drugs that will help their pain a lot better and will adhere to a wider variety of their symptoms, which is not true at all. The drug companies are the only ones benefitting because they are able to make much higher profits because the people are so easily persuaded to buy drugs that will help ease their pain. If they see a commercial or an advertisement for a new drug that everybody is switching too that will treat all of their symptoms, they will witch to it. And the best part is that the medical doctors know that the past drugs were just as good, however, they cost a hell of a lot less money and will make them and the pharmaceutical companies no profit so they keep on prescribing these "new," me-too drugs. It also saddened me a little when Angell was talking about how success in the me-too market forms. She sai that basically drug companies do not focus their attnetion at all on people with tropical illnesses such as malaria, sleeping sickness, etc because those are Third World diseases and the companies know that people there cannot pay for such drugs to treat them. Wow, that stunned me because so many people out there are onstantly dying and decaying and suffering daily because they have these diseases and have no way of getting treatment for them. All that these companies care about is making money, they are truly not concerned about the people's health, which in my opinion should be there main concern, because if majorities of the populations in different societies are suffering than how are these people supposed to pay for anything? They pretty much seem to not care about our health specifically, but whether we are able to PAY in order to keep our health in tact and where it should be. A quote that really got me was "Once upon a time , drug companies promoted drugs to treat diseases...now..they promote diseases to fit their drugs," (Angell, 86). This section reminded me a lot of Conrad's discussion on medicalization of  certain symptoms that are now being labelled as diseases. Why are so many things all of a sudden becoming diseases? It is so that the drug companies and all others associated with them can make higher profits. Nothing beneficial of this is coming to anybody else in any society.

Monday, March 26, 2012

The Frustrating Reality of Drug Companies

One of the most shocking points that I found in Marcia Angell's book, The Truth About the Drug Companies, is how companies are creating "me-too" drugs. These drugs are essentially identical to other drugs already existing and are marketed to seem like they are lowering prices by offering alternatives and giving patients more options for viable drugs.  However, often the prices of these drugs are identical to their original drug. Additionally, since the active ingredients in the me-too drug are the same, with only the inactive ingredients differing, it is unlikely that a patient will find a significant change in reaction from one drug to the other. Angell notes that, "Seventy-seven percent of the pharmaceutical industry's output consisted of leftovers." This is a staggering percentage because this means that more effort is being put into reproducing existing drugs in new packagers rather than the creation of new, more inventive drugs.

In terms of how to fix the issue of the over-saturation of me-too drugs in the market, it is first important that patients learn about the truth and myths shrouding the generic brand drugs that they buy.  While it is not to say that one generic is better than another, at least if the public knew about the attention that is focused on rehashing old drugs rather than coming up with new solutions, it would be able to put pressure on congress to create reforms in legislation. The FDA needs to be strengthened so that it can create checks on the the pharmaceutical industry, and it also needs to create a more stringent regulations on the approval of similar drugs before entering the market.   The drug companies need pressure to create and fund more innovative solutions to new problems, instead of coasting and producing similar products for their own monetary benefit.

The Truth About Drug Companies

Prior to reading The Truth About the Drug companies I've never really thought about the world of drugs and how corrupted the system is. I think it is outrageous how much money is spent each year just so they can "improve" older drugs, which also don't guarantee you better results and don't have tested side effects. I also find the network between physicians and pharmaceutical companies outrageous, and it is almost hard to believe that doctors perform these clinical studies on us to test the drugs to see if they will be the next big thing. Learning about how easily we can be deceived by our doctors is frightening because they are supposed to be helping us live better, but instead a lot of them are in their professions just for the money. Another thing I find fascinating is how these pharmaceutical companies come up with many illnesses and or diseases just to sell their drug and make money. Many have minor symptoms that are so closely related that any person on a bad day can come across the list and convince themselves that they are suffering, yet once they convince themselves they are ill they fail to realize that the side effects probably are a lot more harmful compared to their current symptoms.

Innovation and Alternatives

In The Truth About Drug Companies, Marcia Angell describes how she believes “Big Pharma” is both corrupt and corrupting. The current system of the pharmaceutical industry in America is a failing alliance of medicine, politics, and capitalism. Pharmaceutical companies blame high drug prices on research and development expenses, yet they spend more on marketing old drugs to physicians and consumers than developing new ones. As a result of the amount of money drug companies spend on lobbying Congress, pressuring the FDA, manipulating patents through the legal system to extend marketing rights, and influencing doctors, the consumers are left with disproportionately high drug prices.

The system in place now has also negatively affected the current state of scientific knowledge and development. There is an absence of innovation in the pharmacology field to due to the financial risks involved in the development of a new drug. While national academic and research institutions are often the sites of major intellectual breakthroughs, they often lack the resources to fund the development of a drug or bring it to the market. As a result, outside investments are necessary. There has also been a change in the pathology of disease today. Infections are mostly easy to treat, but it is more difficult to treat diseases that are chronic or accompany old age. Scientific transition must occur between the earlier breakthroughs such as that as antibiotics to new things like anti-cancer agents and gene therapies, a process that “Big Pharma” is hindering.

While there must be changes to the corporate culture that is dominating the pharmaceutical industry that would most likely occur in the legal arena regarding things such as patent rights and bribes, I believe that the creation of an alternative system to the current mode of producing and selling drugs could be a viable solution. I believe that profit and the marketplace should not drive pharmacological discovery and distribution. A parallel system that includes different entities in charge of drug discovery, production of drugs in large quantities, clinical trials to test for safety, and marketing drugs to doctors and the public could possibly decrease the influence of drug companies, thus reducing marketing expenditures and lowering the prices of drugs. However, there are many legal and licensing changes that must be made to sustain such a system. For a long-term solution, I believe that it may be a better idea to create a new, alternative system rather than attempt to make changes to the current system.

American Ideals and Ethical Medicine

Among other things, I thought Peter Conrad’s book was a delightful introduction to how healthcare and medicine are becoming but another American consumer commodity. The factoids concerning the medicalization and practices of pharmaceutical companies appear disturbing and unethical. There is no question that duping the public through the marketing and distribution of drugs is a disturbing occurrence, particularly since health and trusted physicians is involved. But to me these issues merely reflect the American heritage of politics and business. Capitalism and meritocracy both have conflicting interests with the ethical treatment of patients. Universal healthcare contradicts on some level the basic notion relating hard work the allocation of resources among Americans. Most Americans would agree that everyone should have complete and equal access to medical care, but it does not translate so smoothly to our markets. The consumption and sale of pharmaceutical drugs however, fits seamlessly into profit making and capitalist venturing, as apparent by the success of “andropause” medication. Most physicians and studies agree that prescribing testosterone for this unrecognized disorder is questionable, and that progressive androgen deficiency is perfectly natural as one ages. But if there is a market for such products, it is perfectly patriotic for these pharmaceutical companies to advertise and sell them.

It is also disturbing to hear about the gifts and vacations allocated to physicians for prescribing expensive medication, however this is also a problem deeply rooted in our culture and politics. Apart from some silent veil expecting physicians to act devoid of monetary incentives, the current healthcare system has some very distinct routes for medical students to pursue a profit driven career. And after rigorous years in school and graduating with considerable debt, who is to blame physicians for opting for a career in dermatology, a free vacation or Montblanc pens?

In the end, these costs do come out of the pockets of the patients. And this is difficult to face, as on some level they are being manipulated and entering a market they do not fully comprehend. But this is the tragedy of the American consumer across the board. We are constantly being alienated from the true origins and implications of our purchases. When we are buying food for our family, toys for the kids, or pumping fuel into our vehicles. We are kept distanced from intelligent consumerism. This is a particularly complex issue in health, as the theory and intricacies involved in choosing which medicine to consume usually require years of training to fully understand. If we as a nation soldier up and opt for ethical and equal care for patients (which may resolve many healthcare cost issues) we need to decide where the buck stops. I personally believe the political and commercial sectors (i.e. government and drug companies) cannot be expected to make such decisions due to aforementioned American ideals. Medical institutions and education need to instill a sense of greater obligations in physicians, and have a pure emphasis on healing and quality of care. There needs to be a penalty for a system that pays doctors and hospitals set fees for providing services regardless of quality or efficiency, and a discouragement for prescribing profit-driven drugs (such as the propublica information).

Testing Behind the Drugs


In The Truth about the Drug Companies, Marcia Angell presents some very frightening information about pharmaceutical companies.  The parts about the marketing are not that surprising to me, especially considering how we just read about the medicalization of society.  However, what shocked me was the actual make-up of these drugs, and the process they undergo before entering the market.  First of all, most of the new drugs that enter the market each year aren’t that different from already existing drugs.  These variation drugs are referred to as me-too drugs, and are marketed as being better than the old ones, when in fact they aren’t that different.  However, most of the time when these drugs are tested, the study is biased to turn results in their favor.  For example, the me-too drugs aren’t compared to the existing drug during clinical trials so it is unknown if the me-too is better.  In fact, it is usually just compared to a placebo so it looks like it is better just because it is effective. 
The process of testing behind the drugs, and the fact that most of them are just variations, shocks me because I think this is the information that most people are completely unaware of.  People are exposed everyday to the marketing of the drugs.  While some people are persuaded by these commercials and turn to their doctors asking for these drugs, others realize the marketing tactics behind them.  However, I think it is even a smaller group that truly knows the science behind the drugs, or lack thereof.  With all the money that goes into the industry, I don’t understand how new drugs can’t be made to address all the diseases we still need medication and even cures for.  Angell answers this question, and yet again it has to do with money.  Companies will make drugs based on their market, which has to consist of paying customers.  As a result time, research, and money will not be spent on treating diseases that affect non-paying customers (such as malaria pg 84).  I think this is where the problem lies. 
On another note, in class autism was mentioned and how some mothers believe it is due to vaccinations.  As a result, some people refuse to vaccinate their child or delay the process.  Angell writes, “Perhaps the worst shortages are of childhood vaccines” (pg92).  While this is frightening for those who want to receive the vaccines, I wonder if it is connected with the increasing rate of autism and skepticism of vaccines.  

Sunday, March 25, 2012

The Medicalization of Society

Peter Conrad's book The Medicalization of Society opened my eyes to a lot of things that I have never really thought of before or knew about in the medical and health care industry. The medicalization of certain human problems and issues seems to be not beneficial at all in my opinion. As a follow up to the book, I read an article in a science magazine about medicalization as well in order to understand the concept better. I found out that such medicalization of things that are clearly unnecessary like erectile dysfunction and menopause are contributing to the fact that we spend altogether $77.1 million as a collective nation on treatments for "diseases" like these and that accounts for 3.9 percent of domestic health care costs. This is absolutely ridiculous. Why do these conditions need to be medicalized and considered diseases? I understand that as humans we are very concerned about our health and when one little thing goes wrong we immediately want to take medicine and get treatment for it, but this is going overboard. Conrad's book states how pharmaceutical companies and drug companies are looking at health as a consumer industry. They are marketing in order to appeal to a customer so that people will buy this medicine. For example, he noted that Paxil, an SSRI wanted to expand the scope of what the drug treats so that they will get more people to buy it. Therefore, the FDA approved them to put additional applications of the product such as little side branches that come with depression like GAD and SAD. This apparently contributed to the drug being able to medicalize straight emotions such as shyness and worry. That just seems a little bit over the top. There is a definitive line between what you can call a disease and what is just a symptom resulting from the tresses of every day life or a daily occurrence, like a headache that will eventually go away. There is no need to medicalize things that are so small scale in comparison to what really needs to be treated and advertised for and sold to "consumers."

The Truth About Lobbyists

Marcia Angell doesn’t seem too fond of lobbyists, mentioning the pharmaceutical industry’s presence in the lobbying world of D.C. and the conflict of interest that exists when lobbyists are related to members of Congress. Jonathan Rauch coined the term “demosclerosis” in his 1995 book Demosclerosis: The Silent Killer of the American Government to describe the gridlock that lobbyists cause in D.C., likening them to a hardening of the Nation’s political arteries as bills can’t get through with so many interest groups vying for attention from members of the House and Senate. Granted, by the Nownes count there are 85,000 registered lobbyists in D.C. alone, and an estimated 1.2 million nationally, but this really doesn’t tell the whole story.

Here’s the thing about lobbyists: we tend to see them as the source of evil in American politics, but they serve an important role in advocacy and policy-making. In fact, the majority of lobbyists are in the nonprofit sector and don’t see as large of a financial return for themselves or the organizations they represent, as Angell would have us believe. A lot of the representation for and communication with the American public can be attributed to lobbyists—sure, in the case of drug companies there may be some misrepresentation of information happening, but for every big pharma lobbyist, there’s one pushing back from the other side. Because of the connection they provide between the public and government, they are a source of great mobilization, which leads to public opinion and increasing public involvement and action. This ultimately has a hand in effecting policy, which often times works in the public’s benefit. For example, lobbyists were a big motivator in the passing of the Affordable Care Act when Blue Cross Blue Shield jacked premiums up by 39% after the bill seemed dead, helping to channel American’s distress to politicians.

I think Angell presented lobbyists rather poorly, making it seem like the pharmaceutical industry dominates lobbying and has a direct pipeline to politicians, a grand oversimplification of who lobbyists represent. Everyone is represented by a lobbyist—NYU even has a few! So, yes, big drug companies have lobbyists that they send to D.C. to push their products, but just about every other industry does, too. Without lobbyists, we’d lose a connection between the public and the government.

Tuesday, March 20, 2012

Defining Disease: Obesity vs. Eating Disorders

Reading the passages from Conrad's book and our class discussion made me think about the reasons we use to determine whether or not something is a disease. Particularly, I find it interesting that most people in the US would more readily label eating disorders such as anorexia and bulimia as diseases whereas the definition of obesity as a disease is usually up for debate. Both eating disorders and obesity come from unhealthy eating habits and result in an array of symptoms that can lead to death and decrease life expectancy, but being obese or overweight has become more accepted as a lifestyle choice rather than a medical disease. 

I think this issue of defining disease may come down to what (or who) we believe is responsible for the symptoms. Eating disorders like anorexia and bulimia are widely viewed as stemming from a mental disorder such as depression, whereas people who are obese are commonly seen as being personally responsible for making the choice to overeat. This is illustrated by the fact that people who are very thin, either naturally or unnaturally, are more likely to hear comments on their body type and encouragements to eat more from both strangers and people they know, but it is uncommon for anyone to point out a person who is overweight or obese and encourage them to eat less. I've always found this surprising. I would think that it would be the other way around since our society values being thin so much. Maybe because obesity is seen as a result of personal faults like being lazy or undisciplined people are less sympathetic and less concerned about the health of those who are obese, and see it as a personal problem, as opposed to those who could be anorexic or bulimic and generally are offered more outside help such as drugs and inpatient treatment to cure the disease.

Monday, March 19, 2012

The Medicalization of Society by Peter Conrad made me apply what we learned in the first half of the course to the health care industry and medicine. As a pre-med student at NYU, I can say that the courses that we are required to take do not delve into the influence of society on medicine and health care. While we do talk about the influence of the environment on biology/genetics, as we have discussed in the first half of this course, rarely do we ever discuss the influence of society on the changes in what is considered a disease, which Conrad points out, is inevitably intertwined. This is seen in his examples, such as the demedicalization of homosexuality, and the medicalization of the male aging process, which have both changed over time.

These changing definitions have both their positive and negative attributes, as society becomes either more lenient or firmer on what is considered acceptable. As seen in the ADD/ADHD example, consumerism in the health care industry steers the definition of the “disease” from neurological to a wider range of symptoms, thus including more people under the treatment umbrella than previously before.

The consumerism of health care then begs the question of ethics. Is it ethical to have someone take medication for a disease when it is possible that he/she can live a normal life without medical treatment, such as ADD/ADHD? Consumerism in the health care industry, I think, goes against the basic principles of medicine, which should aim at treating individuals, rather than targeting them with advertisements that destigmatize certain diseases, thus making it socially acceptable to receive unnecessary treatments that are covered by medical insurance.

Social Constructivism and Medicalization

Peter Conrad's Medicalization of Society was a truly enlightening read that clarifies a lot of questions on the origins of certain "diseases" prevalent in our society today which were virtually unheard of a few years ago. We touched upon the phenomenon of social constructivism in class today--the concept that social interactions breed awareness and shared cultures and values within microcosmic groups. This idea certainly seems to apply to Conrad's book, especially as he delves into the more recently publicized gender-specific "diseases."
It seems that the medical and pharmaceutical industries have taken on heavily capitalistic undertones, almost mimicking the economic system and values of the United States by providing "consumers" (formerly known as patients) with goods (medications.) Furthermore, many of these drugs, especially the most lucrative on the market, are provided to abate socially constructed "diseases" which undermine culturally defined norms of behavior and gender stereotypes. This concept definitely aligns itself with the social constructivist phenomenon in conceding that most societal values are not innately human but constructed and reflections of a specific culture. This idea is further justified in how familiar/common discussion has become surrounding these "diseases" which once went "untreated" because of their taboo like qualities (i.e- erectile dysfunction, PMS.) Nowadays, discussing menstruation, selling erection pills or advertising for the new and improved bionic penis surgery is common, strewn throughout newspapers, even. It seems as if modern medicalization conveys how society has evolved from one embracing privacy to a more liberal forum. After all, just a few decades ago seeking out and discussing the need for psychological/psychiatric help was unheard of and now it seems everyone has a shrink.
Throughout Conrad's book I found myself continuously asking the same questions. Does modern, evolving medicalization create a better quality of life for our society by utilizing capitalistic rituals within the healthcare system? Or does modern medicalization stigmatize natural occurrences which once went undiscussed for a reason? Is our medical system creating more insecurities for an already vulnerable society?

Talk to Your Doctor

I found the reading very interesting as it provided a solid background and answered some previous questions of mine. For example, I’ve always been interested in the fact that many drugs are able to be advertised to patients, or consumers, I’m torn between which is the proper term. So, it was useful to read about the increase in the ability for pharmaceutical companies to advertise directly to consumers as opposed to just physicians not only in magazines but also in television commercials. I was surprised to read that $4.5 billion was spent advertising medications in 2005 (Conrad, 17). I was even more surprised to read about how effective that advertising is on consumers with every $1 spent on advertising translating into $4.20 spent on pharmaceutical drugs (http://prescriptiondrugs.procon.org/sourcefiles/Impact-of-Direct-to-Consumer-Advertising-on-Prescription-Drug-Spending-Summary-of-Findings.pdf )** That’s a pretty amazing return and explains why pharmaceutical companies do spend so much on advertising their drugs. But it raises the question of whether it’s ethical. Should they be able to leverage so much influence on patients? Do you think that patients should be able to ask their doctors to try particular medications or should doctors recommend the medications? I’m personally slightly ambivalent in regards to this question. I think patients should have the ability to do research and make a decision about which prescription is right for them without being entirely influenced by the doctor, but I’m also wary about the influence that advertising or social groups might have on the individual’s decision. I I question how much of a role they should have in advertising, if any. There are certainly some perverse incentives for them to market certain illnesses as if to convince consumers they are suffering from the symptoms described in the commercial or magazine ad and that they should do something to get treated. I’m certainly looking forward to our next reading assignment on drug companies.

**note: I’m pretty sure this same statistic was mentioned in the reading too, but I couldn’t find it.

Thoughts on Medicalization of Society


While reading Peter Conrad’s book Medicalization of Society, there are many aspects of medicalization that I find very interesting. As someone who one day hopes to be a doctor, I find myself trying to justify the benefits of medicalization. But at the same time, having mother that often prefers the ideas of more Eastern medicine and believes that America is over medicalized leaves me a bit skeptical. My skepticism, however, does not stem from the disbelief in the effectiveness of more Western medicine but more in the distrust of the corporate giants of the biotechnology and pharmaceutical companies.
            I tell myself that having huge companies is the most efficient way to develop and produce many of the technological and pharmaceutical advances in medicine. But keeping in mind that the main goal of these companies is often to make a profit, failure does not seem to be an option for the huge investments they make. As Conrad quotes from Goode in the Medicalization of Society, “‘The impression often conveyed by commercials for the drugs is clear: almost anyone could benefit from them’” (19). Conrad also says how the companies seem to advocate the “problem” their drug “cures” as both common, to eliminate the stigma, and abnormal, as to justify medical interventions. This deception is what often leaves me skeptical. As a doctor one day, I hope to always keep the patient care as my top priority by having a healthy level of skepticism while not letting the skepticism interfere with the benefits of medicalization and potential medical advances. Doctors need to look at patients as patients, not consumers. 

Medicalization

I found this text stimulating, mainly because as Emily stated, we are living in the middle of "Medicalization," which is defining many oft-described conditions as new pathologies, in need of medical care.

I always seem to find myself on the fence about many of these conditions, such as ADD and ADHD. As Professor Jennings mentioned today, many feel that we are simply medicating people instead of working to provide an environment conducive to growth. I agree with that anti-medicalization stance, but I also recognize that many of these "new" conditions which have come about do in fact have symptoms which can be helped through medicine. As a result, I think the classic drop in expectations of the "diseased" must be changed along with the amorphous category. Many of these conditions in contention, such as ADD/ADHD should not only be treated with only drugs or only without drugs (most people seem to be on one side or the other), but should be treated with both lifestyle changes, as well as drug intervention if needed.

I find it extremely difficult to take sides on any of these diseases or conditions, because I see the point of view that a pathology causes most of the conditions, as well as idea that medical intervention is not needed for most of them. I feel that this is where the thin line between "necessary treatment" and "quality treatment" lies. Of course one does not need Ritalin to survive, but treatment for ADHD could improve a person's life considerably. Essentially Conrad's book once again reinforced the idea that the relationship between society and healthcare is extremely complicated, and changes as society does.

Expansion of Medicalization and Normalcy


In his book The Medicaliztion of Society, Peter Conrad defines medicalization as the “process by which nonmedical problems become defined and treated as medical problems, usually in terms of illness and disorders,” using medical terminology, medical framework, and medical treatment interventions (4). Over the last decade, due to not only physicians, but also individuals, social groups, and pharmaceutical companies, there has been a trend towards medicalization and medical jurisdiction leading to an increasing “number of life problems,” everyday life events, and “problems that previously were not deemed to fall within the medical sphere” now being defined as “medical” (3,4). Thus, medicalization encompasses deviance from and across a broad range of normal life activities.

Conrad touches on a number of positive consequences as a result of medicalization. These include reduction of stigma, allowance of individuals to function better in society, acceptance of various social groups, access to accommodations, extension of the sick role, legitimization of individuals’ concerns and ailments, increasing awareness of social pressures, and increasing insurance coverage.

At the same time, I believe Conrad notes one major problem with medicalization: the fact that it “transforms many human differences [and aspects of everyday life] into pathologies” (148).  These include differences in aging, learning style, sexual desire, stature, and shyness. In this respect, medicalization narrows “the range of what is considered acceptable” and normal and “diminishes our tolerance for and appreciation of the diversity of life” (7, 148). Additionally, over the course of time, the standards for what are considered “abnormal” (ex. high blood pressure, obesity, diabetes, etc) are continuously being changed and lowered. Thus, together, more and more people have been categorized as being unhealthy and “abnormal.” Since this has been the trend in the past, it seems that it will continue to be the trend in the future. Thus, medicalization, in a sense, seems to be a never-ending process where only more and more people are going to be categorized as unhealthy and “abnormal.” This warrants the question: what is/will truly be considered normal, expected, and acceptable in life and our society? What differences truly warrant/will warrant treatment? Eventually, all of them?
           
As Conrad notes, in our society, health is a high value-asset. In an essay titled “What’s Making Us Sick Is an Epidemic of Diagnoses” in the New York Times, H. Gilbert Welch, Lisa Schwartz, and Steven Woloshin make us consider that many of us are told that we are sick only because of the growing number of “medical diagnoses” existing as a result of medicalization. However, they state that doctors need to remember the value of reassuring people that they are not sick,” thereby once again valuing health itself.  They make a very interesting suggestion that “someone should start monitoring a new health metric: the proportion of the population not requiring medical care.” Perhaps looking at such a metric will help us re-value health as a society as well as help us reconsider the expansion of medicalization and the concept of normalcy.

Adult ADHD = Unhealthy habits?

During one summer, I taught at an after-school program and one of the students was diagnosed with ADHD. Teaching him in a classroom setting was very difficult especially since I never taught children with this kind of disorder. Also, his symptoms were distracting to the other students. It was very much of a shock to me that adults can also be diagnosed with the disorder because when it comes to ADHD in children, focus is on their "behavior". And so, you do not suspect this kind of behavior from adults which is why "performance" becomes the focus. I very much agree that ADHD in adults can be a "medical excuse" that ultimately reduces self blame for the symptoms. Some of the common symptoms mentioned online are: sense of underachievement, doesn’t deal well with frustration, easily flustered and stressed out, trouble staying motivated, tendency to take risk, getting bored easily, and etc. Looking at these symptoms, I feel like majority of people in general would have these symptoms. One of the symptoms that caught my attention was hyperfocus, where you are concentrated in one activity that you don't even know that time is passing by. Reading this, I just thought this was just another excuse for someone to be diagnosed easily.


I feel as if any of the symptoms can be personal insecurities that one can go through which is normal. It is no wonder that many adults self-diagnose themselves so easily because the symptoms are weaknesses people do not want to reveal to others. Living in a society where titles, degrees earned, and credentials are everything, we do not like to reveal signs of weaknesses. Also, as adults we have the capability to hide these symptoms and suppress them unlike children where we can clearly see their symptoms. Therefore, self-diagnosing yourself with ADHD can be a cover-up of one's unhealthy habits. Instead of trying to resolve the root of each problem, I feel that being diagnosed with ADHD is definitely an easy way out. I consider it to be an easy way out because through medication one can obtain faster results and people can continue on living with their bad habits. Overall, this is just my first reaction to this disorder. I hope to be able to understand this disorder better because I'm very unsure where the boundaries are when it comes to being diagnosed with ADHD. 

 

Thoughts on the Medicalization of Society


In The Medicalization of Society, James Conrad explores a societal shift which I have noticed in my lifetime, but never really knew how to define. According to Conrad, the concept of medicalization is defined as "a process by which nonmedical problems become defined and treated as medical problems, usually in terms of illness and disorders". For example, disorders such as depression or ADHD were not traditionally considered diseases, but are now being treated medically. I will say that I have always been critical of this movement. However, after reading Conrad's dissection of the topic in his book, I am a bit conflicted about my opinion.

Perhaps it's because I was raised with the "deal with it" school of thought, but I've always considered the shift towards medicalization a bit spoiled. As a child, I was taught to think of medicine as a last resort or "easy way out" for dealing with colds, mild fevers, etc. Instead food, rest, and other remedies targetted towards overall health were preferred. (One of my friends almost never gets sick and attributes his resilience to the fact that he was never allowed to take cold medicine as a child.)

It's not that I'm against the idea of medicine, I just feel like idea of labeling an ailment as a "disease" instantly frees the person from responsibility. For example, I have been tempted to say that I was "depressed" before, but in reality all I needed to do was go outside and blow off some steam or find a new hobby. I am sensitive to the fact that chronic depression is a very real and serious concern for some, but that's not what I'm talking about. What scares me is how easy it is to dismiss discomfort as "disease".

In the first chapter of Conrad's book, he discusses the evolving roles of physicians and medical authority. He cites the the widespread influence of physicians as a driving force behind medicalization. He states thats that his relationship is evident in the medicalization of "hyperactivity, menopause, child abuse, and childbirth, among others." This point made me redefine my idea of medical intervention. Maybe medical treatment does not always relieve the patient from responsibilty, but sometimes actually helps them realize that they are ultimately responsible for their own health. (I think this is true in the case of obesity and drug related disorders.) Perhaps the modern physician's role in society is not to treat problems traditionally thought of as disease, but rather to provide support for a wide range of discomforts.