FIGHTING THE REAL DRUG WAR

Welcome To The Real Drug War. And The Front Line May Be As Near As Your
Medicine Cabinet.

A new study by the National Center on Addiction and Substance Abuse finds
that the number of Americans who abuse prescription drugs nearly doubled in
just over a decade - from 7.8 million in 1992 to 15.1 million in 2003. That
more recent figure exceeds the number of Americans estimated to be abusing
cocaine, hallucinogens, inhalants and heroin - combined.

You might be shocked to hear that. But something tells me that Tom Cruise
isn't so surprised. You'll recall that the movie star recently got into a
rhetorical shoving match with, well, just about everyone over whether
prescription drugs should be used to treat mental illness.

A recent column on the subject brought a tremendous reaction from readers,
including many parents determined to keep their kids off Ritalin and other
medications.

It also brought a gentle scolding from a child psychologist who, in a
lengthy phone conversation, insisted that the media missed the real story.
She said that while the Tom Cruise story was about - or rather had become
about - whether psychiatrists (and these days, increasingly also
psychologists) overprescribe drugs, mental health professionals were
getting a bad rap.

It's not that there isn't prescription abuse going on, she said. It's just
that psychiatrists and psychologists aren't the ones who are doing most of
the abusing.

It is, she said, a well-known fact within the medical profession that
general practitioners, family doctors and pediatricians are really quick on
the draw when it comes to writing prescriptions.

That makes sense. These are the entry points into the health care system,
where people first go when they suspect something is wrong. And, she said,
the problem is that these kinds of doctors usually don't have the training
or expertise to diagnose conditions such as Attention Deficit Disorder. So
you end up with a lot of kids being put on drugs when they may not really
need them.

But even that isn't the real story, she said. The real story is that we
wouldn't have so many prescription drugs if so many people in our society
weren't so darn eager to take them - and, in some cases, even ask for them
by name, often after seeing them advertised in television commercials.

That's the key. Like so many other things that leave Americans feeling
perplexed and helpless - from illegal immigration to our society's
declining moral values to the challenges that come with raising children -
this is one of those areas where Americans could easily find the culprit if
only they would look in the mirror.

For most of the people who wrote me, the easy way out was to blame doctors
or the pharmaceutical companies who reap huge profits from producing the
drugs that wind up in so many American homes.

But let's be honest. A big part of the problem is that too many Americans
want quick and easy solutions to all their problems - and that includes
their health problems and those of their children. And as the National
Center on Addiction and Substance Abuse study points out, sometimes the
pressure that doctors feel to whip out their prescription pads comes not
just from drug companies, but from patients who demand the convenience of
being able to pop a pill and go on their way.

I'll buy that. I've been there. Who hasn't? I remember a former employer
who, after noticing that I had a cold and a cough, urged me to go to the
doctor and specifically ask for a kind of extra-strength antibiotic known
to clear up such things in a few days. My boss wanted me back at work as
soon as possible. So I went to my doctor and did as she suggested.

The convenience factor also shows up with regard to Ritalin. A lot of
parents would simply rather give their kids pills every day than spend the
time and money to schedule therapy sessions with the right specialist who
could accurately diagnose and treat the problem.

And whose fault is that? Not the doctors and the drug companies. Oh, they
may profit - perhaps even to an obscene degree - from a situation like
this. But most of the blame goes to the parents and to other ordinary
Americans with all manner of ailments who, rather than go to the trouble of
getting real help, try to find relief from a little orange bottle.