At a meeting of the Royal College of Psychiatrists in Brighton in June 2011, Dave Nutt, a professor of psychiatry at Imperial College London issued a call to arms to his audience at a plenary lecture to defend psychiatry which in Dave’s view meant defending psychopharmacology. On a slide entitled ‘No Psychiatry Without Psychopharmacology’ he outlined the threats from treatment deniers like Irving Kirsch and Joanna Moncrieff whom he claimed argued drugs don’t work. Psychiatry is also apparently threatened by illness deniers who claim that addiction or shyness are just lifestyle options.
Then labeling and libeling me a Scaremongerer, he claimed psychiatry was threatened by me. The first point to note is that I was not held to deny the reality of illness nor held to say that treatments don’t work.
The only risks of an on-patent drug that can be mongered are ones that are real
As regards the risks of drugs, pharmaceutical companies are quick to sue people who claim that treatments have risks if they cannot back up their claims with evidence. As we have seen in the first post in this series almost everything I write or say at meetings is scrutinized with a view to suing me. Calling someone a Scaremongerer, as a matter of logic, should be all but an oxymoron – such a beast cannot exist. The only risks that can be mongered are one’s that are real. If these risks are real, should they be regarded as scares?
If the argument is that it is fear that is being mongered, pharmaceutical companies monger fear the whole time. Leave your child’s depression untreated and she will grow up to be alcoholic, drug abuser, will have a failed career and marriage and ultimately commit suicide. Leaving your anxiety or depression untreated while pregnant and your child is likely to be born with a birth defect.
Doctors are there to quarry information out of pharmaceutical companies
If medicine is going to save itself, if it is going to remain a profession, it is time to embrace the duties given it in 1951 and again in 1962 when drugs were made available on prescription-only (See Pharmageddon). Doctors warn people about the risks of over-the-counter products – like patent medicines or tobacco. Prescription-only medicines are prescription only precisely because they are riskier than over-the-counter drugs. If they are no riskier than alcohol or nicotine, which people can manage on their own, why have them on prescription-only. Doctors are there to quarry information out of pharmaceutical companies about these risks – not to be a risk-denying conduit for drugs.
Dave, who I used to think of as a friend or at least a colleague, has form in this area. He has instigated investigations of me by the General Medical Council (see Academic Stalking), aimed it would seem at getting me debarred from practice.
After this lecture, I sent an email asking for the slide branding me a scaremonger – it’s one to treasure – but he didn’t respond.
Dave has another role which is agitating on behalf of the pharmaceutical industry – making regulations less onerous and the environment more company friendly so companies don’t move jobs elsewhere. Mickey Nardo has commented on this http://1boringoldman.com/
Should doctors be scaremongerers?
But if Dave as a spokesperson for Pharma has taken one line, the question is has he inadvertently crystallized what doctors should be doing? The thrust of a series of recent posts here (Pills and the Man, If Pharma made cars, We need to talk about doctors, Professional suicide) is that if doctors cannot be identified as the people who know about the risks of drugs, they are likely to go out of business. They should be scaremongerers in other words.
It’s time to come out of the closet
Now is the time for doctors to come out of the closet. We urgently need to develop Scaremonger Pride to match Black, Gay and Mad Pride.
I’m open to nominations for a Dave Nutt Prize for most effective Scaremongering of the Year for 2011 and would urge everyone to keep track of possible nominees for 2012. You can nominate the person who in your opinion did the most to alert others to a hitherto unknown or poorly recognized substantial risk from some treatment. Anne-Marie or Rosie Meysenburg would be good candidates for 2011.
(also see DN slide).
Congratulations. The APA calls Allen Frances a “dangerous man” http://www.huffingtonpost.com/allen-frances/dangerous-man_b_1347521.html
You’re a “scaremonger.” This must mean criticisms are being heard, if not heeded.
Allen Frances who was chairman of DSM 1V and critic of DSM V should be commended for speaking out about his concerns about the power to harm as ‘Not doing Harm’ is overlooked in the creation of new diseases and ‘false epidemics’. Selling diagnosis sells drugs he says. I heard Allen Frances speak at the ‘Selling Sickness’ conference, organised by Gezonde scepsis in Amsterdam. He spoke about the harm from psychotropic medicines and referred to psychiatric hospital as ‘prison’. The amazing talk can be heard, with other speakers at the conference, on this video. Allen Frances begins speaking at 57.04 on the video:
http://vimeo.com/16696039
Another favorite is to label critics as Scientologists. I’ve been labelled one many times. Thing is, I’m an atheist, I follow no religion. Having said that, I have nothing against anyone who wishes to follow any type of religion – whatever brings them comfort is a good thing. My comfort comes from my writing…and looking at Shania Twain CD covers 🙂
I would like to nominate Maria Bradshaw of http://www.casper.org.nz/ who lost her son Toran due to a Prozac induced suicide.
Despite the fact that New Zealand were living in the dark ages where suicide was concerned and that she could be fined for even mentioning that Toran died by suicide, she has single-handedly brought NZ into the 21th century.
One NZ minister actually suggested that communities might show their “disgust” about suicide, by not celebrating suicide victim’s lives, instead he thought it would be a good idea to bury them at the entrance of the cemetery. What an idiot.
She is a force to be reckoned with, has helped hundreds of bereaved families (including mine) and has tirelessly publicised the dangers of SSRI’s in NZ.
The NZ Government had no choice but to consider her approach to suicide prevention, the dangerous adverse effects of medicating children and the ‘abusive’ coroner system when she met with the NZ Prime Minister last year.
So I nominate Maria for the Dave Nutt Prize. Sorry I know she’s not a doctor either but it’s extremely hard to find any doctor who will go up against the ‘industry’ or their colleagues.
Leonie
As I said in my other postings, we will never thank enough people like you or Irving Kirsch for exposing these issues. On the legal front, the work of US Senator Chuck Grassley needs also to be commended. What worries me is the lack of effort by the mainstream media to make the larger case. All there is are small pieces here and there but there isn’t a single well publicized effort to connect the dots as the big media usually do when they deal with a scandal of this magnitude. Take somebody like me; I am by all means a news junkie; yet it wasn’t until I was forcibly medicated that I began to search for answers. And even then, it took me sometime of reading things from here and there to reach my current understanding. I find your mention of James Coyne here http://www.healyprozac.com/AcademicStalking/AcademicStalking.htm interesting. He has been one of the fiercest critics of the work by Irving Kirsch on the lack of efficacy of antidepressants, engaging in ad hominem attacks against him http://www.psychologytoday.com/blog/the-skeptical-sleuth/201203/irving-kirsch-d-j-vu-all-over-again/comments . I wonder what’s the real driver of this much hatred against all critics of the status quo.
Scaremongering with respect to the ingestion of many medications is a noble act these days. It is also, as Orwell said: “In a time of universal deceit – telling the truth is a revolutionary act.” I happen to live in a part of Canada that contains an area described as the largest environmental hazard in North America. It makes Love Canal look like a mud puddle. It was created by the disposal, over many, many years, of an incredible number and amount of industrial toxins resulting from steel manufacturing and coal mining. There is, currently, a class action law suit for health and property damages that will probably take years to settle. In 2004, I was asked to gather health data for the courts in order that this might be certified as a class action. What I discovered left me feeling that I should be living in a HazMat suit. The presence of industrial toxins was frightening enough but, in addition, we found in the water table, large amounts of medications and their metabolites due, most likely, to flushing and through urination and feces.
The FDA produces this:
“MEDICINES RECOMMENDED FOR DISPOSAL BY FLUSHING
This list from FDA tells you what expired, unwanted, or unused medicines you should flush down the sink or toilet to help prevent danger to people and pets in the home. Flushing these medicines will get rid of them right away and help keep your family and pets safe.
FDA continually evaluates medicines for safety risks and will update the list as needed.
Included are:
Fentanyl, Morphine Sulfate, Methylphenidate, Demerol, Meperidine Hydrochloride, Diazepam, Dilaudid, Methadone Hydrochloride, Oxycodone Hydrochloride, Percocet, Percodan.
We are aware of recent reports that have noted trace amounts of medicines in the water system. The majority of medicines found in the water system are a result of the body’s natural routes of drug elimination (in urine or feces). Scientists, to date, have found no evidence of harmful effects to human health from medicines in the environment.”
Of course not, because they haven’t really been looking for them.
Treatment involving radioactive materials have equally nonchalant instructions for disposal. For example, HIDA scans.
“In most cases you can go about your day after your HIDA scan. You’ll likely still have some of the radioactive tracer in your body. The substance will leave your body through your urine over the next day or two. For this reason your doctor may ask that you:
Flush the toilet twice after urinating
Wash your hands thoroughly after you urinate
Drink water throughout the day to help flush the radioactive tracer from your body.”
We are not only at risk from prescription medications but from other people’s prescriptions whether we know it or not.
And, to ask the intelligent child’s question, “Where does rain come from?”