Where is the Real Drug Problem?

Let me begin this post by stating that pharmaceuticals have a role in psychological treatment. But I will also state unequivocally that the role of drugs in psychological treatment has been totally distorted by the vast amounts of money made by big drug corporations, certain universities, and many, many individual clinicians. There is a big pharma-university-psychiatrist complex that makes a scientific basis for national mental health policy pretty much impossible at this point in time.

If you want to read an excellent, moving, and well written book that asserts some profound benefits of medication for people diagnosed with Bi-polar disorder try Kay Redfield Jamison's
An Unquiet Mind. If you would like to read up other sides of the issue, try this blogpost from Psychology Today or this good summary of a point of view that accepts the premise that psychological disorder have a "medical" reality, or this view that such a diagnosis is more socially driven than biological, or this rather convincing (to me) overview of the criticism leveled at the whole assumption that neurochemicals and behavior have a proven, causal relationship.

There is alot out there to read. Basically, the drugs are largely unproven and have dangerous side effects. But the behavior to be treated can be fantastically destructive of human potential and causes enormous suffering. Some drugs seem to work sometimes, but usually not much better than placebo. The universities, big corporations, publications, and clinicians that profit from the drugs are not honest brokers.

Now look at this (from Furious Seasons):

Many of you are already aware of the two-year-old lawsuit brought by the State of Texas against J&J/Janssen over allegations that the drugmaker worked to influence the Texas Medication Algorithm Project to favor its star atypical antipsychotic Risperdal and made payoffs to state officials, among other allegations. A similar children's medication project is under investigation by state officials.

Yesterday, the state amended its complaint to include allegations that the company gave out false marketing materials and used fake advocacy groups to get its then-expensive drug (which is now a generic) used in the state MedicAid program. Although the state isn't naming names in its complaint (who is the mysterious fake advocacy group?), the complaint is worth reading. You can download it from the Dallas Morning News' website.

I've read the complaint and it's the usual set of allegations that J&J/Janssen took a drug designed to treat schizophrenia--not a very efficacious drug at that--and pressed to have it used off-label in adults and children for a number of other indications. In the process, the company used state officials as pitchmen for its drug and somehow got its drug on the children's list--which was never implemented and was recently suspended altogether--eight years before it was approved for use in kids and teens by the FDA. Earlier this year it was revealed that Texas officials and researchers wanted to use McDonald's gift certificates as inducements to get kids on medication trials.

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Justice

Over the last year or so we have instituted a number of substantial, if subtle, changes around Tinicum Art and Science. Our Ass't Principal, Stephanie Kenney, oversees all academic issues, from scheduling to class content to teacher performance. We have developed two sets of procedures, one for holding staff accountable for good educational and therapeutic performance, another for holding administration responsible for setting the proper tone and for follow through on issues big and small.

The students now meditate four days a week in the morning, and have short periods of meditative silence just before lunch and at the very end of the day. We offer courses in yoga and meditation, as well as in a psychology class that is oriented towards well-being and self-observation.

We have also used a quirk in our current enrollment- that we have a large group of seniors and freshman, but little in the middle- to structure more deeply the orientation for the young students and the oversight for senior projects and college applications. We currently have one current student teaching study skills that she learned this past summer at Phillips Academy, and a recent graduate- a prolific and able writer- teaching an intro to writing course.

What is next? A more integrated music program. Also, building on the work we accomplished last year with getting students to evaluate and more forcefully shape the curriculum here. This will require a greater degree of self-knowledge on their part, and much clearer, more collaborative advocacy on ours.

Most heavily on my mind has been the role of social justice at school. There is a program nearby that helps families wracked by domestic violence. One of their difficulties has been getting presents together for their older children. Everyone donates the little kid stuff. So our students gave a hundred dollars of the money they have raised over the last couple of years, and raised another one hundred fifty more to fill that need. Efforts such as this are admirable, but they don't require an integrated view of the world. They address a problem without raising questions of justice.

Can social justice be addressed non-ideologically? Is it even desirable to try? At TAS we don't preach "buddhism". We teach certain techniques and emphasize few rituals. Students who wish to go deeper can, and do. They learn to treat each other justly because they are treated justly. But is that enough. Should we be instilling a stronger ethic, a broader awareness? Or do we plant a seed and let it be?