Pharmaceutical Nation

The Census Bureau yesterday released its 2008 Statistical Abstract of the United States, a publication that is almost always fascinating for what it tells America about itself by the numbers. Pharmaceutical drugs stand out in the new abstract--which if you've never read, I suggest that you look it over sometime online or at the library because it is nothing if not revealing--but then if you read this site, then that's probably not a shocker. Some numbers:

"Prescriptions have increased over the past decade to 3.4 billion annually, a 61 percent increase. Retail sales of prescription drugs jumped 250 percent from $72 billion to $250 billion, while the average price of prescriptions has more than doubled from $30 to $68."

I had too long of a day--I worked two eight-hour shifts inside of 24 hours and then was stranded downtown at midnight in 28 degree weather by Seattle's terrible bus system and finally had to give up and take a cab 45 minutes later--to dig into whether the report actually broke out the psych meds component of this. My rough estimate is that all anti-depressants, anti-psychotics, ADHD drugs, mood stabilizers, and so on sold in the US amount to $35 billion to $40 billion a year, almost 20 percent of all pharmaceuticals sold. Why consumers don't have more market power is beyond me. There are, after all, some very bad psych meds on the market which continue to ring up multi-billion dollar sales each year.

What's more troubling to me is that I've spent many hours working somewhere where I can legitimately point to the failure of the anti-depressants, anti-psychotics, ADHD drugs, mood stabilizers, and so on sold in the US. The shelter where I work is literally an all-comers situation--we take people other shelters won't touch because they are straight from a psych unit or the streets or detox or jail or just drift in from God knows where--and I can tell you that there's a lot of raw mental illness on display. There are also loads of people who are current or recent abusers of crack cocaine and alcohol as well as a few who are victims of sheer bad luck and economic hard times. The failure of the war on drugs and the presence of economic disparities in our culture are likely more prevalent in what I see at the shelter than is mental illness.

At any time, there are about 180 residents in the shelter, about 50 women, the rest men. Many of the residents, or clients, are over the age of 60, which disgusts me in so many ways. Much of my work involves trying to keep the place reasonably clean, dishing out food, and keep a lid on behavior. Two highlights: I had to clean feces from one of the women's toilets (not in the job description, but had to be done); and, I had a nice little chat with a young man with schizophrenia who keeps playing with himself in front of other residents. Generally, that gets people booted from the shelter (even all-comers shelters have limits), but the guy is so vulnerable that if he goes to the streets (no other place will take him outside of a psych unit and they are pretty much maxed out anyway) he'll either wind up in jail or dead, so we are trying to slowly work with him. There are only four of us working with almost 200 people, so we are kind of busy trying to keep a lid on everything else. I can assure you that the psychopharmacological revolution sure isn't helping matters.

Anyway, I could go on for days, but I won't. Christmas is in a few days, and I'll be away from this site until Dec. 26 or so, when I'll do a year end wrap up and shoot off my mouth about how the City of Seattle recently made the decision to clear out homeless encampments (ie, out of doors camps) in this city right before Christmas.

In the meantime, John Grohol at Psych Central has already done his year-end post. It's a very good one which you should read.