April 13, 2009

Microchip Tells Docs If Patients Have Taken Their Pills, Why That's Scary

News is out in the UK of a US-made microchip (in capsule or pill form, swallowed) that would monitor (from one's stomach) whether or not a patient has complied with a prescribed drug therapy and, then, report back to the patient's doctor in real time (via a transmitter on the patient's back and, then, by cell phone). Yes, you read all this right and, yes, this technology, developed by Proteus Biomedical, will undergo two clinical trials in the UK later this year.

On one level, this kind of technology is fascinating and interesting for all the usual dorky techie reasons (wow, telemetry has gotten that advanced and so have transmission technologies--it's all so very sci-fi and high tech triumphant), but on another more important level it's downright frightening. That's because I see this "intelligent medicine" technology as a potentially massive intrusion on individual freedom and privacy.

In the above news article, look at the range of prescribed meds that's discussed as being monitoring-worthy (and in an unquestioning way): psychotropics, heart meds (statins, etc.) and even birth control pills.

Do any women really want their docs monitoring what they put in their bodies in such a fashion? Is there anyone who takes anti-depressants who wants his or her doc probing their medication compliance so intimately? I doubt it. What would the doctor even say if a woman missed taking the Pill for a week? "Hi, we've noticed a disturbing pattern in your estrogen intake. Oh, you are trying to get pregnant? Come into my office for mandatory counseling and depression screening? I need to sell you pills of some kind."

OK, so I'm being flippant, but if anyone thinks that such a scenario isn't somewhat realistic, then they are naive.

Now, if someone does voluntarily wish to be monitored and consents to being monitored, so be it. But just about the only scenario were I could see such monitoring being acceptable--assuming it even works--is in cases where psych patients have a proven track record of violence (as determined by a court, not a social worker) and there's a court order in place to allow such monitoring. Other than that, the mandatory use of such technology would violate individual liberties.

Even more worrisome to me is that such chip-in-a-capsule technologies could be used to monitor what people eat and drink and be used to report back to some central authority who could then determine if you've had too much soda (beer, wine, etc.) and send the public health department over to "counsel" you.

But there's another worry I have over the potential misuse of this technology:

"Professor Nick Peters, a cardiologist at Imperial College London, who is co-ordinating trials, said the technology was ‘transformative’.

"'This is all about empowering patients and their families because it measures wellness, and people can actually be tracked getting better,' he said."

"'Psychologically speaking, that’s hugely helpful for patients and enormously reassuring for carers.'"

This kind of thinking relies on two assumptions: One, that medicine always provide wellness and, two, that all people respond to medicines the same way.

Apply that to statins, which are very widely-used in the US. They are presumed to be benign meds and while I'm not questioning their cholesterol lowering powers, let me point you to the FDA's adverse events database on Lipitor, which has just under 50,000 reports through the third quarter of 2008.

Just as with anti-depressants, not everyone responds to allegedly benign meds the same way. For some people, statins are clearly awful drugs and I know of multiple cases from my personal orbit where people have been put on Lipitor and had powerful muscle cramps, liver problems, lost their memory and so on. When they went to their prescriber, they were told in each case that Lipitor couldn't be the cause and that they had to stay on the drug or they would die (cadiologists may approach psychiatrists for their religious attachment to their specialties' meds). In case, the people blew their docs off and away went the cramps and nerve problems and back came their memories. Interestingly, none of them re-developed problems with high cholesterol.

Think of that kind of thing when you think of "intelligent medicine."

Posted by Philip Dawdy at April 13, 2009 01:37 PM
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Comments

Creepy. I bet E. Fuller Torrey's thrilled with the idea, though.

Posted by: Francesca Allan at April 13, 2009 03:00 PM

"But just about the only scenario were I could see such monitoring being acceptable--assuming it even works--is in cases where psych patients have a proven track record of violence (as determined by a court, not a social worker) and there's a court order in place to allow such monitoring."

If only these drugs did, what they're marketed to do, and didn't have the horrible side effects, they do have, I'd agree. But if that were so, no one would want to stop taking them in the first place, I guess.

If I were to choose between psych drugs and being locked up, I'd clearly choose to be locked up. That's for sure.

Posted by: Marian at April 13, 2009 03:27 PM

The current erosion of human rights and forced consumption of illness-producing medication reminds of "Stasi jars" and Soviet-style antipsychotic drugging for dissidents in "mental hospitals". Medicine needs an emetic...or in other terms, just spit it up.
Bill Moyers, where are you?

Posted by: Lilly NC at April 13, 2009 04:24 PM

Uhm ... so if I'm walking around psychotic and claiming I've been implanted with a monitoring chip, they're going to implant me with a monitoring chip?

You can't make this stuff up. Too much. Posted by: David B. at April 13, 2009 05:03 PM

While this does raise alarm bells (I personally envision Orwell meets Gattica), I'd like to propose one possible defence, not for the means being proposed to reach the end, but a defence of the spirit of the intended end, which I take to be ensuring that those who truly need drug therapy, be given better means to keep them on track.

Let me be up front about one of my opinions: de-institutionalization has been an utter public policy disaster, here in my native Canada, and I suspect in the US as well. A nice civil libertarian pipe dream to give the sickest of our citizens free choice, but clearly this policy has failed to produce the desired effect. Instead it's resulted in huge social problems: Homelessness, drug addiction, petty crime - all of these problems have been intensified by de-institutionalization of people who really have no business wandering the streets, sleeping in doorways and being forced to self-medicate on narcotics and alcohol.

My response to the computer chip solution: perhaps there's an underlying good intention here to ensure the sickest, especially schizophrenics, get the meds they need to function as healthy citizens. BUT, there is no computer or technological substitute for good old fashioned human-to-human care and treatment of mental illness. Aside from the civil liberties quagmire a Gattica-type solution to mental health care presents, it avoids the reality that the sickest among us need comprehensive, multi-pronged treatment, and need it, in extreme cases, in an institutional setting.

This sounds like a fancy tech advance on something that's been around for decades: a daily pill reminder!

For me, I find those $149 plastic pill reminders (little compartments marked Mon, Tue, Wed...) just fine, thanks. What I really need are the extras: good talk therapy, a good balanced diet, encouragement to get off my ass and exercise at least once a day, and these sorts of things.

A computer chip planted under my skin is a quick fix to a very complex solution.


Posted by: The Skeptic at April 13, 2009 05:10 PM

Fuller Torrey and Stanley Foundation will be happy to use this along with the Haldol under the skin disk.

Posted by: Stephany at April 13, 2009 06:16 PM

Wow, this is truly awful. I feel like I want to run as far away from this as possible. But where can I go, the moon?

By the way, if they were to do such monitoring, they would find that I'm always much, much better off when I'm NOT on the meds. Of course they'd find some other reason to explain that away, though.

Posted by: kimbriel at April 13, 2009 06:52 PM

No more knives, even for little chip cuts. No more pschotrops that kill. And no more death, until it either comes naturally or a friend helps out in the end (or a morphine drip..whatever).

Yes to human-to-human contact. Human-to-nature. Human-to-art. All A plus. Everything else is just bogus. Greed and death - be gone!!

Posted by: nonononononononono at April 13, 2009 08:23 PM

As Red Buttons used to say, "Strange things are happening."

To paraphrase David B.: What do you say to a psychotic person who claims someone has planted a microchip in his/her stomach?

While all this new technology is interesting, even fascinating, I have to admit that we are approaching Orwell's "1984".

Speaking of strange items: USA Today published an article tonight that claims Eric Harris was not taking an antidepressant. Everyone who is half knowledgable about the case knows he was taking the SSRI antidepressant Luvox and he had just withdrawn from Zoloft. I wonder what the payoff was for USA Today?? Was it in the thousands or hundreds of thousands -- $$$, that is.

Here is the story: Second paragraph reads: "Their rampage put schools on alert for "enemies lists" made by troubled students, but the enemies on their list had graduated from Columbine a year earlier. Contrary to early reports, Harris and Klebold weren't on antidepressant medication and didn't target jocks, blacks or Christians, police now say, citing the killers' journals and witness accounts. That story about a student being shot in the head after she said she believed in God? Never happened, the FBI says now

http://www.usatoday.com/news/nation/2009-04-13-columbine-myths_N.htm?POE=click-refer

Posted by: Rosie at April 13, 2009 09:04 PM

Irony of ironies - in the last psychotic episode of my killed child (death from Zyprexa)some of the imagery was about a computer chip placed in the back of his head by the government. Living near D.C., it was clear to me that the imagery had a real base in reality.

With all my heart, I want him back, though I know he is with me, always.

Posted by: sorrowful at April 13, 2009 09:12 PM

Folks please. Read "Brave New World" and get your dystopias straight. I am very serious about this.

We are gonna keep getting hit by these issues. We have to know what we are talking about.

In brief, in BNW, the govt is designed to give everyone maximal contentment. Not joy, not freedom, etc. But contentment. Through a few means, but specifically, three: one: a place in society (job and interests/entertainment provided for you by your magnanimous govt), 2. drugs - to entertain or control or both, 3. deciding who gets born when.

So, when the govt comes up with ways to monitor who is getting pregnant when, they are one step closer to that goal.

In 1984, the govt controlled not thru providing everything you think you need (because you are too entertained/doped up to figure out your own existential challenge), but by controlling information and freedom. If you can't go anywhere, and don't know any better, you can be stultified into compliance, and have the answers to any nagging questions - things are fine because we are at war in the right war, and the govt obviously is doing well per the newspapers - even though I myself have quite an inkling that the newspaper is totally false / revisionist.

So, most of what we are discussing and seeing here is a BNW type of happy dystopia, not a controlling type of 1984 dystopia.

Other dystopias to consider, as we give over our freedom to the ever-encroaching govt (which has hit the height of audacity with the confidence to control the weather) are: Walden II (psychologists engineer behavioral circumstances to guidedly develop maximally fulfilling lives rather than let the random experiences of life as we know it produce the self that emrges from experiences) and Farenheit 451 (y'all hopefully know this one since they forced us to read it in school) similar to BNW.

Oh -Animal Farm - myself, not impressed - but maybe it is fitting as we get a bunch of ppl marching around believing their college and law degrees make them social experts, able to run society like a business.

Sex: Stranger in a Strange Land, although BNW includes the sextertainment dimension.

The only remaining dystopia for which I do not readily know of a best-seller is the dystopia of economic happiness: if we can only control the economy, a nip here and a tuck there, issue some bonds, buy back some t-bonds, etc., we can retain power and make everyone maximally happy so we can stay in power and control - control out of fear of economic uncertainty.

So - bottom line: the drug dystopia is Brave New World, not 1984. you can grab this at any used book store or garage sale for 50 cents. It is not that long. But eerily prescient, when I hear stories about how technology will monitor our pill-popping to ensure social control, er, to ensure happiness.

Posted by: MedsVsTherapy at April 13, 2009 09:57 PM

the lipitor issue: i learned abt this from a family member. not cramps as much, but aches and pains. the doc swore by the stuff, but family member finally quit it - after months of misery, and getting fairly depressed by restricted activity due to aches/pain.

the doc was always insistent (boat payment). when the a/b pattern became undeniable, family member finally quit it AMA. and discovered total relief from this misery. went on to control cholesterol thru behav changes - diet, exercise.

Posted by: MedsVsTherapy at April 13, 2009 10:01 PM

Many of the 29 actual causes of schizophrenia - and other "mental illnesses" - are deficiency disorders and can be easily corrected through diet:
http://www.alternativementalhealth.com/articles/causesofschizophrenia.htm

Psychotropic medications are known to cause problems such as obesity, diabetes, bipolar disorders, addictions and many more.

I think that this is one heck of a make-work scheme.

Posted by: Lilly NC at April 13, 2009 11:06 PM

"...I have to admit that we are approaching Orwell's "1984"."

Rosie,
We are already there.
We are being monitored in so many areas that...
Mummy!
The worst it that with the consent of people that are indoctrinated to think that it's all for their own sake: to protect them from the axis of evil, to protect from natural catastrophes, violence... blah blah blah...
Do we have any opposition to all this? People are choosing the color of their eyes and hair child...
I will not be alive to see the consequences of all that is being done to the next generations.
I hope they think very differently from me and have other morals, values and ethics.

Posted by: Ana at April 14, 2009 02:57 AM

They have ankle bracelets on people sentenced to house arrest. I believe they could add this to the ankle device. Forced drugs-medications for life because the psychiatrist says the patient is sick.
Outside but-in-jail is cheaper than an hospital-jail-institution.
No way to (lab test) prove ones innocence or guilt of "mental illness". Better behave "right" or else.

This will be only for the fringe of people who don't voluntarily take the "right" medicines for their illness's.
You are sick.

Posted by: mark p.s.2 at April 14, 2009 05:23 AM

Not to be crass, Mark, but the Prison Industrial Complex, one of our few thriving "industries", will never stand for "outside-but-in" prisoners. Unless they could get an equivalent rate-per-day, that is~! Just recently had a discussion w/someone about whether patients "deemed" mentally ill and in prison are/aren't given meds because the prison has to pay versus Medicaid has to pay.

I just have seen the most beautiful performance of dancers who are totally deaf - in China. It is called the 1000 hands Guan Yin. If really interested in a break, email phil as I am sending it to him (hope that's ok phil) to distribute to anyone who needs five minutes of serenity.

Posted by: sorrowful at April 14, 2009 08:48 AM

As far as this microchip goes, I can see a place for it in helping pinpoint dosage-related side effects, maybe, and in ensuring med compliance in those with a history of violence. But it does seem rather creepy.

How long does the chip itself stay in one's system? Does it pass through the gastrointestinal tract in the same way that swallowable cameras and temperature probes do? That would have a lot to do with its potential uses.

Many of the 29 actual causes of schizophrenia - and other "mental illnesses" - are deficiency disorders and can be easily corrected through diet: http://www.alternativementalhealth.com/articles/causesofschizophrenia.htm


We've been through this before.

According to the author of this site, "The term 'schizophrenia' is an inadequate and misleading diagnosis. 'Disperceptions of unknown cause' is a better term."

He then goes on to list his 29 "causes of schizophrenia," which he just described as "disperceptions of unknown cause." So how is it that he knows the cause of these "disperceptions" since by his own definition they're of "unknown cause"?

We don't know the cause of schizophrenia. We do know that many conditions and substances can induce psychosis, but psychosis doesn't automatically equate with schizophrenia.

Posted by: lkhllywd at April 14, 2009 11:07 AM

Ikhllywd,

You raise good points, but most importantly for most people is this one, " third of so-called "chronic schizophrenic" patients released from Vermont State Hospital in the late 1950s completely recovered, reported psychologist Courtenay Harding in 1987; and she found that patients in the "best-outcomes" group shared one common factor: all had stopped taking antipsychotic drugs."

and then there's this:

"In March, the New England Journal of Medicine published a study of 6,000 critically ill ICU patients that suggested the protocols had it exactly wrong—survival rates for patients whose doctors followed the blood-sugar protocol were lower than those for patients whose doctors ignored the protocol. "Human beings are not uniform in their biology," Groopman and Hartzband explained. "A disease with many effects on multiple organs, like diabetes, acts differently in different people." Moreover, "Medicine is an imperfect science," and the best-available information about treatments is subject to frequent change."

How are we all alike, in that we all deserve to be treated differently, as individuals. These microchips have the potential to ruin our chance at a human life, and yet, possibly, used correctly, could reveal interesting info. For example, if someone takes drugs regularly and shows no improvement, perhaps finally the doc will look at the drug as the problem, though not of course in psychiatry where the patient and their biology is always to blame.

Posted by: Sally at April 14, 2009 12:19 PM

Ilky! We actually agree on something.. Never could make those diet deals work in my family. More psychosis than I ever want to discuss in my immed. family. DX was bipolar after mis dx and old antipsychotics for three L O N G years and finally lithium - stability, mostly, for many years. Until the EVIL ZYPREXA pushed by Medicaid came knocking at our door.

If you defend Seroquel one more time, I will ask to have this post deleted.

Posted by: sorrowful at April 14, 2009 01:25 PM
You raise good points, but most importantly for most people is this one, " third of so-called "chronic schizophrenic" patients released from Vermont State Hospital in the late 1950s completely recovered, reported psychologist Courtenay Harding in 1987; and she found that patients in the "best-outcomes" group shared one common factor: all had stopped taking antipsychotic drugs."

I didn't raise that point. I said we don't know what causes schizophrenia, which is true. We don't.

If you defend Seroquel one more time, I will ask to have this post deleted.

As this thread isn't about Seroquel, I won't be addressing it. I'm not sure why you did.

Posted by: lkhllywd at April 14, 2009 02:12 PM

Could this technology introduce a new generation of patent extenders, ex. [any antipsychotic] Wi-Fi ?

Posted by: Joe at April 14, 2009 03:25 PM

Ilky, I mentioned that you not mention Seroquel one more time because you mentioned it all the other times. Yes, they were Sero. threads, but one never knows in anonymous posting WHAT people will mention, and where they will mention it.

Having a dead son from a drug in that class is what makes me not want to hear ONE positive thing about antipsyschotics.

I would give anything to have lived in a third world country or had a Soteria House nearby or even available but no such luck. We ran into a crooked, bribed Medicaid System - the best breeding ground of all for pushing killer psyc. drugs.

Even a third world country would have been better. Yes, we all would have died younger due to malnutrition or some preventable disease but it would have been in the natural order of that country. Not like here, where the un-natural order happens and parents lose their children to GREED.

Posted by: sorrowful at April 14, 2009 04:34 PM

Ilkhllywd posted this, in fact boxed it:

"Many of the 29 actual causes of schizophrenia - and other "mental illnesses" - are deficiency disorders and can be easily corrected through diet: http://www.alternativementalhealth.com/articles/causesofschizophrenia.htm -"

We DO know what the causes of schizophrenia are.

Posted by: Lilly NC at April 15, 2009 08:19 AM

I would like to know if the monitoring micro-chip is being utilized in Law enforcement cases where offenders must adhere to a medication regimen that is court-ordered to determine if offenders are taking their medications and on time and continue on with the prescribed plan of care? I think this would be a very useful tool to Law enforcement officials and offenders being monitored and would assist the determining of many Law enforcement cases to handle offenders of all ages effectively and their cases.

Posted by: pixie at November 15, 2009 05:58 PM
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