Children with ADHD are easy targets because they will be lifelong patients and repeat customers.
A report from the Centers for Disease Control and Prevention last week confirmed what many have suspected: more than 10,000 2- and 3-year-olds in the U.S. are being dosed with drugs like Ritalin and Adderall for "attention deficit hyperactivity disorder." You read that right.
There is no medical basis to the dosing. American Academy of Pediatrics' guidelines for ADHD "do not even address the diagnosis in children 3 and younger—let alone the use of such stimulant medications," reported the New York Times, especially because "hyperactivity and impulsivity are developmentally appropriate for toddlers."
Toddlers on Medicaid are especially targeted for ADHD meds, commensurate with Big Pharma's heisting of government funds as its main source of revenue, a marketing plan also seen with Medicare, TRICARE and the VA prescriptions.
Why does the richest nation in the world have so many children afflicted with ADHD, conduct disorders, depression, "spectrum" disorders, oppositional defiant disorder, mixed manias, social phobia and bipolar disorder?
Because children are good customers.
"Children are known to be compliant patients and that makes them a highly desirable market for drugs,” says former Pharma rep Gwen Olsen, author of Confessions of an Rx Drug Pusher. "Children are forced by school personnel to take their drugs, they are forced by their parents to take their drugs, and they are forced by their doctors to take their drugs. So, children are the ideal patient-type because they represent refilled prescription compliance and 'longevity.' In other words, they will be lifelong patients and repeat customers for Pharma."
Pathologizing kids for money is so insidious, psychiatrist Phillip Sinaikin recounts reading a scientific article in which it was debated whether a 3-year-old girl who ran out in traffic had oppositional defiant disorder or bipolar disorder! The latter is marked by the "grandiose delusions" that she was special and cars could not harm her, said the article.
Stimulants for ADHD are not innocuous. They produce sleep, growth and appetite problems in children, hallucinations and other mental problems and set them up for life-long drug use. There is another class of drugs Big Pharma has convinced doctors to prescribe to large swathes of kids, especially Medicaid kids—atypical antipsychotics like Risperal and Zyprexa. Big Pharma even schmoozed doctors on the golf course to get kids hooked on the dubious drugs. Court documents unsealed in South Carolina in 2009 show that Lilly sales reps used golf bets to push Zyprexa, one doctor agreeing to start new patients on Zyprexa "each time a sales representative parred." Nice.
Texas' Medicaid program spent $557,256 for just two months' worth of pediatric Geodon, another atypical antipsychotic, in 2005, according to court documents, and Geodon was not even approved for children at the time.
A National Institute of Mental Health study of children ages 8 to 19 with psychotic symptoms found Risperdal and Zyprexa were no more effective than the older antipsychotic, Moban, but caused such obesity a safety panel ordered the children off the drugs. In just eight weeks, children on Zyprexa gained 13 pounds and kids on Risperdal gained 9 pounds. Kids taking the older drug, Moban, gained less than a pound.
"Kids at school were making fun of me," said study participant Brandon Constantineau, who put on 35 pounds while taking Risperdal. In fact, the atypical antipyschotics cause so much weight gain and diabetes, Alaska won a $15 million settlement from Eli Lilly in a suit to recoup medical costs generated by Medicaid patients who developed diabetes while taking Zyprexa.
(The government also bought a lot of Risperdal for adults. The Department of Veterans Affairs spent $717 million on Risperdal for Afghanistan and Iraq war troops's PTSD over a period of nine years only to discover, after a large-scale study, the drug worked no better than placebo. Oops. VA doctors wrote more than 5 million prescriptions for risperidone/Risperdal from 2000 through June 2010 apparently for naught.)
Pharma ads to get children on the drugs are also unconscionable. The London-based ad agency, Junction 11 (GSW Worldwide) hired noted Welsh oil painter, Mark Moran, to create the award-winning Risperdal "Living Nightmares" campaign. The paintings were designed to "capture physicians' attention and communicate patients' agony and need for treatment" said its originators while helping Janssen to "own the relapse/prevention space." The paintings were called, among other things, "Dog-Woman," "Witches," "Rotting Flesh" and "Boiling Rain."
Another Risperdal campaign, called "Prescribe Early," uses a macabre abandoned wallet, teddy bear and keys on a barren street, "to reposition a drug that was being used too late to achieve its maximum benefits," said its ad agency, Torre Lazur McCann. Get it? You should have prescribed the drug earlier.
Brand managers for the atypical antipsychotic Seroquel also chased children, even considering creating Winnie the Pooh characters like Tigger (bipolar) and Eeyore (depressed) according to published reports, at an AstraZeneca sales meeting. A mother I interviewed said she saw toys emblazened with Seroquel logos in a healthcare setting.
"Disney-fying" psychoactive drugs for children is not just a U.S. phenomenon. A lime-green kids' brochure for Zyprexa, published by Britain's National Health Service shows cartoons of happy children skating, roller blading and playing soccer while telling kids, "Many children, teenagers and young people need to take medicines prescribed by doctors to help them stay well and healthy." Similar NHS brochures exist for Risperdal and Strattera, an ADHD drug.
Pyschoactives are not the only drugs pushed on kids and often prescribed early, as one cynical doctor put it, "before the symptoms go away." Singulair is heavily marketed to kids for allergies and asthma, and even comes in a cherry-flavored chewable formulation. "When your child breathes in an asthma trigger, such as pollen from trees or weeds, the body releases leukotrienes (loo-ko-TRY-eens)" and Singulair blocks the loo-ko-TRY-eens, said marketing materials jointly produced and distributed by Merck and the publisher Scholastic.
Many were offended by the partnership. Marketing included an endorsement from Olympic gold-medalist swimmer Peter Vanderkaay, a basketball "skills challenge" for kids 9 to 14 and materials distributed through the American Academy of Pediatrics, said published reports. The Scholastic sales pieces assure parents that Singulair is "steroid-free" but kids may experience, "hallucinations (seeing things that are not there), irritability, restlessness, sleepwalking, suicidal thoughts and actions (including suicide), trembling, and trouble sleeping." But hey, they won't have sniffles.
One mother I interviewed gave her son Singulair for "hayfever" and he took his own life days later. Soon after, warnings about suicide appeared on the label. In 2010, television news reports investigated Singulair's links to ADHD-like, out-of-control behaviors. Parents on the website askapatient.com recount chilling stories of how Singulair turned their children into people they "didn't even know" and many say the drug should be banned. Many parents were urged by doctors to treat their toddlers' sniffles, asthma or allergy symptoms "early."
Believe it or not, Pharma has even reclassified babies spitting up as "GERD" to make money off kids. Prescriptions for GERD for babies have quadrupled in recent years. Even though babies spit up approximately 70 times a day, it's normal and does not damage the esophagus like reflux disease, writes pediatrician Darshak Sanghavi, author of A Map of the Child. Prescriptions for GERD meds, on the other hand (proton pump inhibitor drugs or PPIs) are damaging, says Sanghavi, and "may increase brain bleeds and gut damage in preterm infants as well as the risk of food allergies in older infants."
The use of GERD meds is up by 147 percent in children and other non-psychiatric meds are also ballooning in use. Since 2001, high blood pressure meds for kids have risen 17 percent, respiratory meds 42 percent and diabetes meds by 150 percent. And 50 percent of pediatricians also prescribe kids insomnia drugs, according to an article in the journal Pediatrics.
Clearly, treating kids for ADHD is only one of Pharma's revenue streams.
Martha Rosenberg is an investigative health reporter and the author of "Born With a Junk Food Deficiency: How Flaks, Quacks and Hacks Pimp the Public Health (Random House)."