I would like to start by saying that currently, the USA is the largest producer and consumer of medicine and prescription drugs in the world, with the word ‘drug’ being a regular part of the life of virtually every adult American. The issue of the growing concern is the one related to the increasing number of children who just like their parents take drugs on a daily basis, raising the question of whether such medical treatment is necessary and whether or not there is over-prescription of medicines at large. The following essay will explore the over-prescription of different drugs taken by adults in the USA, present various educated findings together with my personal opinion on the given matter.
The major reason why adults take drugs is the Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) which over the past decade became an epidemic among the US adults. The most popular drug to fight ADD and ADHD is certainly Ritalin, mild amphetamine. Other substitute drugs of Ritalin are the Metadate CD, and Adderall has already developed ‘children packages’ to accommodate the growing demand for child drugs in the USA. The growth in demand for these drugs alone can be seen in the sales figures of Metadate Cd and Adderall that in 2001 totaled $820 million, a healthy 15% increase over the year 2000, with over 25 million monthly prescriptions being made in the USA alone. By the way, currently, the USA uses 90% of the world supply of Ritalin (Kepler, 40).
The usage of these drugs continues to grow as more and more people take it not only for medical reasons but also on a regular basis to alter mood and to remain more productive. There have been reported addictive features of these drugs, which currently appear to become socially acceptable and appropriate means of controlling ones mood in adults and children. The reason why there is a question of whether these drugs might be overprescribed is the fact that similar drugs in Europe and Asia are used 5 times as less as they are used in the USA. The adults’s prescriptions in Europe for mood ‘improving’ drugs similar to Ritalin, Metadate CD and Adderall occur 8 times less often than they do in the United States. The immediate response might be the growing influence of the US pharmaceutical companies that need to sell their drugs and the willingness of the US medical profession to support such large sales of drugs to the local consumers (Zimmerman, 122).
Another issue that certainly should draw the attention of every conscious US citizen is growing number of adults who start taking these drugs without having a clear diagnosis that requires the intake of such drugs. Because it is impossible to somehow properly assess whether or not a child has Attention Deficit Disorder by the means of formal blood/urine tests or X-ray screening, a great number of adults would get the prescription for these drugs based on the behavioral observation by the practitioner and the comments from the parents. There have been instances when teachers would recommend the parents to put their children on drugs, if they wanted to have a child succeed in school. There were social pressures to put children on mood-altering drugs, otherwise having the children being expelled from school (Lawrence, 223).
Another issue that raising numerous concerns is the addictive tendency of children who currently are on stimulant/anti depressant drugs to use these drugs later in their lives. No one has studied the long-term effects of Ritalin and other drugs on the emotional development of children (Murray, 137).
Apparently drug taking for no or little reason is but a denial of real causes of person’s learning and behavioral disorders. Drugs seem to provide a fast and effective remedy from the mental fatigues and disorders that adults get from eating foods low in vitamins and nutrient, watching TV, playing computer games and leading sedative lifestyle (Kepler, 43). The pressure from school, clubs, friends and technology certainly might also contribute to the development of numerous problems in kids and adults and instead of fighting the real cause, many choose to cover up the consequences and suppress such problems with drugs. The pharmaceutical companies also understand such modern trends in drug usage and have developed special drugs for use in the morning, afternoon, at night, let alone different combinations for different ages. Such corporate initiatives only reflect the growing demand for such drugs from people of different ages who need these drugs at different times during the day.
Furthermore, the hectic and busy lifestyle of most adults does not allow them to spend much time with their kids and give them a parental advice and love they need to overcome their difficulties and challenges. Instead many chose to give their children “happy drugs” and by denying them an opportunity to find personal solutions to stress and problems expect them to become better.
Currently, the drug usage tendency shows that children become the fastest growing group of drug users, surpassed by the growth figures of senior citizen and baby boomers, the two groups that historically used the most drugs in the USA (Breggin, 36).
The statistics of drug usage are rather scary. The number of users of prescription drugs aged under 20 years of age, grew by 30% in 2002. At the same time the number of users of prescription drugs aged 35% to 49% grew by only 24%. The number of senior US citizen (aged 65+ years) had an increase of only 12% for the year 2002. The same statistics show that children would be spending over 35% more on drugs this year as compared to 5 years ago.
The overall spending on the prescription drugs in the United States grew by 17% in 2002 to the total of $148 Billion. The majority of drugs that were prescribed in 2002 were children drugs to fight allergies, asthma and various infections. The money spent on these drugs surpasses the spending on Ritalin and other drugs that deal with various psychological and neurological mental disorders (Murray, 140).
Another alarming issue that makes many Americans think about the over-prescription issues are the drugs that are used to treat heartburn and gastrointestinal disorders. The amount of money Americans spent on these drugs grew by more than seven times over the past five years (Ludington-hoe, 102).
One should also not forget that the amount spent on adults’ antibiotics grew by 42% over the past three years despite the notion that there develops antibiotic resistance.
I will also add that currently over 8% of adults in the USA have asthma and over 26% have allergies, which is twice the number of allergies that adults had in 1975. There are some speculations that the frequent usage of prescription drugs can be responsible for the increased amount of adults with allergies.
One should also remember that the majority of the prescription drugs in the USA are initially created for adults, and hardly any tests were made on children. In 1997, the US Congress would stimulate the pharmaceutical companies to test the drugs in kids by allowing them to extend the patent protection for additional half a year (Kepler, 47). Despite the ethical issues associated with the testing of drugs on kids, there is a question of whether or not children should be given the drugs that originally were designed for adults. A great number of drugs that children still take have not been approved to children (Zimmerman, 130).
Another drug that is also considered as over prescribed for the US children is the mood-altering benzodiazepine group. The main use of these drugs is attributable to the various social problems, like the inability to find friends, or existing family and school difficulties. As noted earlier, many adults and children get these mood-altering substances without proper medical examination (Breggin, 40).
Benzodiazepines, when used as sedative drugs, are used about 4 times as often in Europe as they are used in the USA, yet benzodiazepine derivates used to fight anxiety and obesity in adults and children are used ten times more often as they are used in Europe. It is believed that loose prescription and aggressive marketing from the pharmaceutical companies are the primary causes of over-prescription of benzodiazepine in the USA (Ludington-hoe, 107).
One of the reasons why there is over-prescription of drugs in adults and children is the existing oversupply of these drugs in the USA which pushes these companies into active promotion of their medicine through the general practitioners
In the past, the majority of Adult Americans thought that all substances that alter mood are not good for children and did whatever they could to prevent their children from taking these drugs. The “say no to drugs” was the slogan of the 70s, simply because it was very rarely advised to have children take any psychiatric drugs (Packer, 69).
At present, one can see the situation is changing drastically as both adults and kids turn to drugs to find the working solution to personal and societal problems. Currently, over 10% of the school population would take one or more prescription drugs this year including the Ritalin, Adderall (noted above) as well as Prozac and Zoloft (Kepler, 51). The rates are higher for children who study in special classes, mental hospitals, juvenile detention centers, probation and foster care centers (Murray, 142).
There is a growing number of children aged only from six to ten years who are put on several prescription drugs at the same time. The reason why they are on drugs is that their parents and educators have not found a way yet to provide them with enough attention, love, care, discipline and relationship, things they lacked and the things that caused these children to have numerous problems. Current US society fails to properly support children in case of family breakdowns or child abuse, issues of discrimination and sexism and rather prefer to use a more economically justified way-put them on drugs (Golden, 112).Speaking about what kind of children are put on overprescribed medicine that deals with mental health, I would like to note that any child who has not have an American smile on their face at all times and who do not conform to the society and parents (Cohen, 90):
- Sad, anxious kids-anti anxiety drugs.
- Angry, aggressive kids-sedative drugs.
- Disobedient kids-sedative drugs.
- Shy and dreamy kids-stimulant drugs.
The parents and society that are all emerged in personal problems and duties fail to consider individual differences in children and prefer to pay a fortune on some magic drug that would work to make a child a good American. Such attempt to make a child fit into the society with the help of numerous drugs is but an effort to prevent child’s individuality and to support conformity in the society (Golant, 16).
Instead of buying drugs against any ‘abnormal’ behavior of their child, the adults should identify and fight the true causes of child’s difficulties that are seen in (Lawrence, 227):
- Parental neglect.
- Family/school conflict.
- Mental Trauma that often is a result of the conflict.
Instead, the parents, doctors and the pharmaceutical companies blame the children for their problems and call them strange names like (Golden, 120):
- Attention Deficit (Hyperactivity) Disorder, i.e., ADD and ADHD.
- Oppositional Defiant Disorder.
- Clinical Depression.
The problem with such imaginary diseases and drugging attempts to make children conform can be seen in the future as the USA will start to lack people who can think critically, stand up against everyone and fight, or dare to ask some painful questions that no one wants to hear.
The fact that more and more millions of children nowadays grow up on prescription mood altering drugs develops less and less personal responsibility in children. Instead of growing up with personal responsibility and ability to change the world for the better, children grow up with the understanding that they are somewhat mentally disadvantaged and should rely on the happy drugs to become able to lead a normal life they deserve.
The growing number of users of Prozac, Ritalin, Paxil and Dexedrine among young kids on the other hand has a plus other than the increased revenues of pharmaceutical companies. The use of illegal drugs among the youth has steadily declined with the figures being the lowest among the teenage users of anti depressant and anti-anxiety drugs who chose to obey the society and not try bad drugs. These children express some patterns of unconditional submission and respect to the governing authorities in school, family, university or elsewhere, without ever questioning their policies, practices or ethics. Such behavior of the young people who are on prescription drugs teamed up with the absence of data on the long-term effects of these prescription drugs on children and adults make us worry about the future of these children who oftentimes act like zombies, i.e. without showing any personal initiative and desire to succeed, while relying on the magic pill in all cases (Packer, 72).
Another issue that currently should make the whole US society worrisome is the over-prescription of more than one drug to a child, namely Ritalin and Prozac. The children are thus exposed to two different types of drugs, with Ritalin being stimulant and Prozac-antidepressant.
The issue of these two different drugs certainly has to deal with the way the physicians diagnose the children’s existing mental disorders. A great number of kids also take the new antidepressant, called SSRI together with the stimulants.
Historically all new drugs in the USA have experienced a drastic rise in prescription over the first several years after their introduction to the market, yet the fact that they are currently mixed with other drugs is very surprising. Currently, there has been hardly any research on how these drugs would work if mixed with each other as it happens in the child’s body (Lawrence, 230).
Speaking about some statistics, I would like to note that in 2000, only about 2% of all children would take antidepressants while about 10% of them would take different stimulants. The average age of kids who take stimulates is nine years, while the age of kids who take anti depressant is about thirteen years (Murray, 145).
Boys who take stimulants in their teens make up 2/3 of the total stimulant users among kids, while about 65% of those who take antidepressant drugs would be girls (Kepler, 55).
As it has been previously noted Ritalin and Dexedrine are the most common stimulants used by kids across the country to fight their ADD and ADHD. Prozac, Zoloft, and Paxil are the most common antidepressants that are used by kids across the land and are aimed to cure child’s phobia, depression, sadness, fatigues, anxiety, and bulimia. Children, thus get these different drugs at the same time with hopes of overcoming their problems while not making any active steps to overcome them on their own. One should make a quick note here that children who get both types of drugs at the same time oftentimes would be required to take higher doses of these drugs (who probably cancel the effects of each other at some point) and are prescribed a longer duration compared to those who take only one of the two drugs (Papolos, 81).
Speaking about some working solution to remedy the existing over prescription problem in the USA, I would like to note that there can’t be only one. Certainly, it is apparent that the majority of the problems that the children have are caused by the societal and parental faults, such as the lack of communication among the family members, friends and colleagues. One of the steps to reduce the number of kids with
Attention Deficit (Hyperactivity) Disorder, ADHD, Oppositional Defiant Disorder, and Clinical Depression is to contribute to the strong family interaction, healthy adult relationships, inspiring and motivational education in schools and universities as well as equal opportunity for people of both sexes and all races and ages. Apparently it is almost impossible to somehow influence the private lives of individuals and not violate the US constitution, yet much efforts could be done to educate the parents about the causes of the Attention Deficit (Hyperactivity) Disorder, ADHD, Oppositional Defiant Disorder, and Clinical Depression. Much can be done to improve communication and motivation between students and teachers (Murray, 149).
The kids and parents should understand that the drugs that they take have not research properly and certainly there is no certainty about their effects on these children in the future. Thus, they should do as much as possible to reduce the intake of different drugs or their combinations to reduce the possible risks associated with the side effects of such drugs.
Group therapies have proven to be effective in treating different types of mental sicknesses in the USA and abroad, and the group therapy does not fight the consequences of the disease (depression, anxiety) but rather fights the causes of it which lie in the lack of communication, and understanding. Group therapies allow a person to make more new friends and thus possibly reduce the stress or other cause of his/her sickness (Cohen, 94).
Another thing that should be done is the general promotion of the healthy lifestyle that would eliminate the extra stress and problems among kids. Just like the US government-sponsored “Milk, does your body good,” so it could sponsor things like “Exercise does you body and mental health good” (Kepler, 59).
It is common knowledge that those who are engaged in various sports and athletics activities suffer less often from depression, ADD, ADHD and other mental sicknesses. Although there is hardly any scientific proof that guarantees that all those who suffer some mental disorder would be healed by exercise alone, it would certainly not harm them. The following things can be said about the exercise (Packer, 77):
- Exercise reduces anxiety. Those who exercise regularly show less hyperactivity.
- Exercises relax us. Such relaxation usually benefits our mood and reduces depression.
- Exercises increase our alertness.
- Exercises improve self-esteem and self-worth and thus reduce phobias.
- Exercise can have the antidepressant effects on those who exercise regularly (Golant, 20).
- Exercise gives us better sleep, and thus more energy and better mood.
- Exercises help people to overcome stress. Just like in the movie “Forest Gump,” it is
- believed that whenever you run, you manage to lower your stress.
- Exercise reduces adrenaline and other stress acts in the body.
- Exercises help you eat more healthy food which in fact will also contribute to one’s better
- shape and improvement of self-respect (Papolos, 84).
The reason why I believe that exercise, group therapy and government promotion of healthy lifestyles would help kids to get off the hook of the drugs promoted by the pharmaceutical companies is because these means are rather natural and have been already proven to work without causing future problems which is still a question of drugs (Murray, 150).
Kids rather than medicine should also use the personal work and self-inquiry. Kids should learn how to prioritize, how to plan their time effectively, how to forget their mistakes and failures. Benjamin Franklin said, “It is the lot of men to suffer. It is also his fortune to forget.” After all, if our past problems still cause us stress, it would be more effective to learn how to forget about these problems and failures rather than to take a pill every time we think of the problem.
Depression luckily can be easily treated. One can take certain drugs to fight depression, and some of them will be presented below. Antidepressants will efficiently work when combined with counseling as visiting a psychiatrist, psychologist, social workers and other professionals in that field. One should remember that people who are on anti-depressants should not take other medication and the anti-depressants need to be taken daily regardless of how a person feels during the day.
The drugs directly affect the special chemicals called neurotransmitters such as serotonin and norepinephrine. There is a correlation between the amount of these chemicals in the body and the person’s mood. If the level of chemicals is high the person’s mood will be high, if the level of these chemicals is low, than the person will feel depressed.
There currently are two different families of anti-depressants available on the market:
- SSRI’s (Selective Serotonin Reuptake Inhibitors). These very drugs will increase the level of serotonin and thus will improve the mood. SSRI’s are effective in treatment of obsessive-compulsive disorder and certain types of shyness. Some of the side effects of SSRI would include heartburn and drowsiness. They oftentimes produce the loss of appetite.
- Tricyclic Antidepressants are also effective in combating depression and associated with powerful side effects such as drowsiness, dry mouth, and constipation. They also have drug interactions so should not be taken together with other drugs.
- Other drug facilities include MAOI (monoamine oxidase Inhibitors). These drugs are very effective yet have powerful side effects and food interactions.
Now let’s take a look at several drugs as depicted below:
- Citalopram, SSRI, a.k.a. Celexa. This drug is currently considered outdated and is available in third world countries. Generic Celexa is still available on the market.
- Lexapro, SSRI is an improved version of Celexa and is moderately expensive. It treats depression and GAD effectively. Lexapro works well with Zoloft and Effexor.
- Luvox, SSRI, a.k.a. Solvay. Luvox is an old name for Fluvoxamine (generic drug). It treats effectively obsessive symptoms.
- Prozac, SSRI, a.k.a. Lilly. Prozac used to be the most popular anti-depressant in the USA. Now there are generic options.
- Zoloft, sertraline, SSRI. Currently, Zoloft is the most sold antidepressant in the USA. It has been on the market for 13 years and only in 2005 generic Zoloft will be sold. Zoloft besides treating depression also treats shyness and post-traumatic distress disorder.
Now let’s refer to another family of drugs, Tricyclics as depicted below:
- Amitriptyline, a.k.a. Tricyclic generic drug. This drug was very popular in the 1980s. The side effects of amitriptyline are the weight gain, sleepiness, and dry mouth.
- Desipramine is similar to amitriptyline. It has similar side effects.
- Nortriptyline is similar to the two drugs depicted above. It has the same side effects as amitriptyline and desipramine.
- Cymbalta, a.k.a. Duloxetine is from the SSNRI, serotonin, and norepinephrine uptake inhibitor family. Besides fighting depression, it treats diabetic nerve pain.
- Effexor, Venlafaxine, serotonin, and norepinephrine uptake inhibitor, works in the same way as Cymbalta.
- Mirtazapine from the tetracyclic family. It effectively fights depression yet has the side effects of increased hunger and weight gain. It also causes drowsiness and should be administered at bedtime.
- Nardil, phenelzine from the MAOI drug family. It is very powerful in fighting mental disorders and depression. It should not be mixed with aged cheeses or alcohol, let alone other foods. It is used as a drug of last resort.
- Parnate, tranylcypromine from the MAOI drug family. It has the same powerful effect as
- Nardil yet the same side effects of not working well when mixed with some foods.
- Wellbutrin from the aminoketone drug family. It is a powerful antidepressant and unlike other drugs does not cause the reduction in sexual drive. Still, its side effects include sweatiness and excessive response to heat.
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Kepler, Ann, Children’s Medicine: A Parent’s Guide to Prescription and Over-The-Counter Drugs, McGraw Hill, 2002.
Murray, Michael, Natural Alternatives (o T C) to Over-The-counter and Prescription Drugs, Prentice Hall, 2001.
Papolos, Demitri, The Bipolar Child: The Definitive and Reassuring Guide to Childhood’s Most Misunderstood Disorder (Revised and Expanded Edition), NY Random House, 2002.
Breggin, Peter, Talking Back to Ritalin: What Doctors Aren’t Telling You About Stimulants and ADHD, Penguin books, 2001.
Zimmerman, Marcia, The A.D.D. Nutrition Solution: A Drug-Free 30 Day Plan, Barons, books, 2003.
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Packer, Lester, The Antioxidant Miracle: Put Lipoic Acid, Pycnogenol, and Vitamins E and C to Work for You, barons books, 2002.
Ludington-hoe, Susan, How to Have a Smarter Baby: The Infant Stimulation Program For Enhancing Your Baby’s Natural Development, NY Random House, 2001.
Cohen, Jay, Over Dose: The Case Against the Drug Companies: Prescription Drugs, Side Effects, and Your Health, Prentice Hall, 2002.
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