All cultural shifts are not created equal. When the culture shifts to the point where most Americans no longer find it unthinkable or undesirable for a woman or a black man to become President, that is progress. That is cultural growth. However, in a different milieu, when the culture shifts to the point where most Americans come to believe or expect that the solution to every physical, emotional, or behavioral problem lies in a pill (rather than, say, a healthier and more balanced lifestyle), that is not progress. That is cultural brainwashing, which only serves to stunt growth.
The young men and women who have cast their ballots for a presidential candidate for the first time this year have grown up in an era in which the widespread promotion and use of prescription drugs is more the rule than the exception. The wired generation has only known a time when the television shows that they watch, the magazines that they peruse, and the websites that they surf through have been saturated with ads from the pharmaceutical industry. They have only known a time when their physicians have been subjected to a full-court press from drug company sales representatives and been exposed to an increasing amount of medical research paid for by those same companies (while public funds for research have continued to dry up). They have only known a time when a good number of their peers have been labeled ADHD or depressed or bipolar and been placed on any number of medications (which have frequently not been formally approved for use on children). As our youth enter adulthood, they are in danger of accepting these practices and the rampant profiteering that underlies such as the norm. They are in danger of not only buying the drugs that are pushed upon them but buying the paradigm that the drugs are the answer to whatever may ail them. That is not progress.
From the New York Times:
John C. Lechleiter, an Eli Lilly official who is about to become the companyâ€™s top executive, wrote an e-mail message in 2003 that appears to have encouraged Lilly to promote its schizophrenia medicine Zyprexa for a use not approved by federal drug regulators.
Mr. Lechleiterâ€™s comments came in a March 2003 e-mail message he wrote to other Lilly executives, after he traveled to Cincinnati to watch Lilly sales representatives talk to doctors.
The e-mail message was discussed this week in an Anchorage courtroom in a lawsuit against Lilly by the State of Alaska. The suit seeks reimbursement for the medical costs of Medicaid patients who developed diabetes while taking Zyprexa.
The drug causes severe weight gain and cholesterol problems in many patients and has been linked to diabetes.
Zyprexa is federally approved only for use by adults diagnosed with schizophrenia or bipolar disorder. While doctors are free to prescribe it â€œoff labelâ€? for any patients for any use, it would be a violation of federal law for Lilly to actively encourage off-label use of the drug.
The federal government has investigated drug companies before for off-label promotion of their medicines, but Mr. Lechleiterâ€™s note provides rare documentation of a senior drug executiveâ€™s openly discussing the practice.
A spokeswoman for Eli Lilly said Mr. Lechleiter was not advocating off-label promotion in his note but simply wanted the company to respond to physiciansâ€™ requests for information.
In his e-mail message, Mr. Lechleiter discusses the use of Zyprexa by children and teenagers.
Mr. Lechleiter, who was then the companyâ€™s executive vice president for pharmaceutical products, noted to other Lilly officials that company representatives were already promoting Strattera, a second Lilly psychiatric drug, to pediatricians and child psychiatrists. The representatives could also discuss Zyprexa with such doctors, he said.
â€œThe fact we are now talking to child psychs and peds and others about Strattera means that we must seize the opportunity to expand our work with Zyprexa in this same child-adolescent population,â€? Mr. Lechleiter wrote in the message.
He also encouraged Lilly to get data on the use of Zyprexa in treating â€œdisruptive kidsâ€? in order to increase the drugâ€™s sales.
The company declined to make Mr. Lechleiter available for comment.
Because of Zyprexaâ€™s physical side effects, many psychiatrists now say it is appropriate only for severely mentally ill patients. Clinical trials have shown that its tendency to cause dangerous weight gain appears to be especially pronounced in younger patients. The Food and Drug Administration has for more than a year declined to act upon an application by Lilly to broaden the drugâ€™s label to allow its use in people under 18.
No worries for Eli Lilly, though, as the article goes on to say:
Since 2003, as information about the drugâ€™s risks has spread, prescriptions for Zyprexa have fallen sharply in the United States. But Lilly has repeatedly increased the drugâ€™s price to counteract the slumping prescriptions, and Zyprexa remains by far Lillyâ€™s best-selling product, with worldwide sales of $4.8 billion last year, about half in the United States. Zyprexa now costs about $8,000 a year at commonly prescribed doses. [full text]