If the title doesn’t make it clear that I’m upset, let me start by saying that an article I’ve just read on nytimes.com (registration required) has me neck-vein-throbbing apoplectic. (It’s my blog, and I’ll use 50¢ words if I want to, 50¢ words if I want to.)
In short, I don’t understand how the marketing people responsible for shaping the heads of psychiatrists to prescribe off-label uses of dangerous, highly-toxic drugs like Risperdal, Seroquel, Zyprexa, Abilify and Geodon for adolescents can freakin’ sleep at night.
Hey, I am a marketing guy, and I try everyday to get people to try to use the products I market in novel ways.
But nothing I market turns adolescents’ muscles into grotesque knots. What I market has been tested, in contrast to these drugs, none of which have been tested on adolescents. And nothing I market is based on pure voodoo, camouflaged by 400 years of Western intellectual thought that has made psychiatry a “science” because we’re just too damn civilized to admit that the guy in the white coat is just the local shaman.
On the face of it, a doctor who prescribes an off-label use for a dangerous drug to kids is simply guessing. Hedge it anyway you want, but that’s what it is — a freakin’ guess. Sure, they can veneer it with plenty of pseudo-scientific talk, but the bottom line is they’re playing “20 questions” with your kids’ lives.
Why do they do it? It’s because the village diviners have no value unless they medicate (since they haven’t got a clue of what else to do). They do it because parents demand it (it makes them feel like they’re accomplishing something in the treatment of their children). They do it because the FDA lets them do it. (Consumer Reports says in its June 2007 issue that something like 21% of all drugs are prescribed for off-label uses.)
But mostly, they do it because the marketers at the pharmas tell them to.
Check out this quote from the article. This guy thinks it’s his “science” that convinces him to give kids prescription stimulants related to amphetamines. But we know it’s J&J’s marketing dollars, sent to him by marketing managers whose marketing logic is Mengele-esque:
Ten years ago, Dr. Realmuto [a University of Minnesota psychiatrist] helped conduct a study of Concerta, an attention deficit hyperactivity disorder drug marketed by Johnson & Johnson, which also makes Risperdal. When Concerta was approved, the company hired him to lecture about it.
He said he gives marketing lectures for several reasons.
“To the extent that a drug is useful, I want to be seen as a leader in my specialty and that I was involved in a scientific study,” he said.
The money is nice, too, he said. Dr. Realmuto’s university salary is $196,310.
“Academics don’t get paid very much,” he said. “If I was an entertainer, I think I would certainly do a lot better.”
Folks, save your kids from these very dangerous marketing people. Remember that your doctor has been bought and paid for. Snake-oil kills.