Woman; 009; The Medicine Cabinet Addict

And in. The ration of women to be with the man not we're going to be talking about medicine cupboard addicts all pill poppers as they're often referred to two billion prescriptions are written every year for the 35 million Americans who take pills to pep themselves up slow themselves down go to sleep lose weight relieve stress and a variety of other reasons. The family medicine chest is also becoming the spawning ground for young children. As far as drug abuse is concerned. With us this evening to discuss some of these problems are Dr. Christopher demanda be the director of the emergency drug abuse services E.J. mile Memorial Hospital in Buffalo New York. Mr. Richard Mehta director of the Westside drug sevice counseling center a division of the Legal Aid incorporated a Buffalo New York. And Miss Gianna Henderson who was a dependent at one time in her life on drugs and has been drug free now for the past six yes.

She is now counsellor of the Westside drug center at Buffalo New York. Doctor demand that all of these 35 million Americans who take pills. What percentage go on subsequently to become addicts. It's really difficult to speak about what percentage of those 35 million because there are many other people who take pills and are addicted besides just the ones who get their drugs legally. The Food and Drug Administration that estimated in 1970 that some eight million doses of amphetamines alone were available or produced in this country. They estimated some 50 percent were in fact diverted to illegal channels. But anyway that production level would supply approximately 30 to 50 capsules of amphetamines for every man woman and child living in the country. Now you mentioned that a men's room Richard could you explain the difference between an atom and barbiturates and no cutting. Surely.

And settlements are your uppers your stimulant drugs. A generic example would be unethical a lewd often women will take and that it means in the form of diet pills or pep pills downers or depressants or barbiturates or another classification of drugs. They are usually central nervous system depressants they slow you down. They are sometimes used in psychiatric cases to tranquilize a person or to slow their respiratory or their actions now. And the last. Cl. you asked about was narcotics. That's generally a that's a legal term actually and it includes a lot of drugs both illicit and and legal. Most people however think of narcotics as illegal drugs but that's a misconception. What cocaine for instance would these things be included under no. Yes legally. Gordon to New York. And federal law as they see just how easy is it to become addicted to a pill such as a diet pill for instance. Well each pill has its own

potential if you will for for addiction but addiction should be understood as a as I think best defined by Dr. Jaffe director of the Special Action Office for drug abuse programs in Washington. And his concept of addiction is the compulsive use of a drug with a strong tendency to relapse. If for any reason the drug is interrupted in other words the the addiction state is something that any person can develop if they have certain kinds of needs which are met by the drug. Amphetamines particularly have this very strong abuse potential and addiction potential because they provide so many nice feelings for people who are looking for feelings of relief and some degree of euphoria a feeling of well-being. A number of things that they believe will help them solve their problems or perhaps at least be able to help them cope with their problems better. What would be the difference for

instance between a not an addiction and addiction to a barbiturate such as fien above or to an addiction to heroin in intensity and withdrawal problems and so on. Well the. One can be addicted to either of those drugs without being physically dependent. The withdrawal syndrome that is associated with certain groups of drugs only is present if those drugs produce changes within the body metabolism after continued use. At a certain dose in a certain frequency certain drugs for instance such as marijuana or LSD have no dependency potential that is if they do not produce physical changes in the body. They obviously are drugs to which people can become addicted but in relation to the sanction of the withdrawal syndrome from barbiturates as distinct from heroin. I think it's very very clear that the withdrawal syndrome barbiturates is a life threatening. Problem and as much as if a person is stopped

cold turkey so to speak on the bar from barbiturate used and has been maintained have been using a lot of these drugs they can have a seizure as a part of their withdrawal syndrome and that seizure can cause death. How about a baby born of a woman who's been taking barbiturates during her pregnancy. What's the situation here. The Chronic the Perth with a baby can be born either chronically or acutely addicted or dependent if you will very much as an infant could be born to a mother using heroin on a chronic or acute basis. The difficulty with a newborn infant is to understand what the problem is most mothers do not indicate their drug abuse history at the time of delivery. So if the baby is chronically exposed to the drug while in the uterus. The infant will not begin to show the withdrawal syndrome until 2 or 3 days after delivery. And this is poorly perceived and understood perhaps by the pretty attrition who is caring for this infant who suddenly became ill with no apparent reason.

The baby born to a mother who is acutely just recently used either heroin or the barbiturates that it would be born with a respiratory depression syndrome and there would be immediate kinds of things that would be done for the infant at that point to resuscitate him maintain him in a living state. The difficulty with the with the infant born to a chronically addicted person with either those classes of drugs is that the infant may have a seizure and the infant may die. John I'd like to ask you something. I think you're in a position to answer this this rather well you can either answer it from personal point of view or a general point of view. Do you feel that women are more prone to be addicted to pills of this nature than men. It's kind of hard to say. I don't have a lot of statistics to back me up or anything. It just sort of feelings I have from excuse me from my own personal sort of experiences from people I've met through my

job that I see a lot of women who do have dependency problems. And I think it's possible that there are more women than men involved with the medicine cabinet sort of. Why do you think this is what do you attribute this to this possibly the fact that they're the ones that are at home or they're there with you know just ordinary housekeeping duties and children take care of. And it's sometimes very difficult for a woman to do these sorts of things if you feel she's not achieving her potential. And you know that sort of thing it makes it easier to deal with three three preschool kids. If you can take a tranquilizer and they don't get to you I think you're exceptionally tired. It makes it easy to deal with them if you take a diet pill or take two diet pills and get your housework done twice as fast this sort of thing. I think this is a lot of the

things that I feel would tend to make women more susceptible. And also the fact that we we were talking about it earlier and that that there are more women seeing doctors than men. More women go to doctors for weight loss problems you know for weight problems to get diet pills to lose weight. And they the their reasons for going are good ones. They want to look attractive but they find out that after they've lost their weight it's easy to take one when you need it to get the vacuuming done on time. All right. Well this is one specific problem that people go to doctors with but do you think that there is a sort of proclivity amongst doctors to obscure perhaps the underlying problems by writing prescriptions a little bit too freely. I mean how easy was it for you to get a prescription. Oh extremely easy.

There's a lot of doctors you know across the country that write prescriptions for almost no reason at all and I know of people that came into our center who have had drug problems or who do have drug problems who can go to a doctor and get a prescription for whatever they say they they whatever they tell the doctor they want. What do you think the medical justification for this is. That's not that's not all that all is well I really intended it. I think it's an easy answer to a to a complex problem. And unfortunately doctors don't have the time. In many cases to treat problems like I think they would like to. And of course pills and medication is a quick or quick way to cover up symptoms it's a Band-Aid approach to underlying problems and I think doctors because of their caseload because of their time and the time pressure tend to overprescribe medication in many cases I think a psychiatrist

because they can't spend enough time with patients in a therapeutic setting also tend to overprescribe let's say tranquilizing drugs. I think the time of Zab study doctors asked that in state institutions as a relevant example here you pointed out that in his opinion the precedence and antidepressants are. Use more than they should in state hospitals and institutions more to appease the staff of the hospitals then because of the need of the patients. In other words because they don't have the manpower to help people like they should be through counseling and individual attention they control them easier by drugging them. And this is of course a trend that's changing people and women and men and state institutions are being taken out into the community more now you're finding more of a community mental health approach to problems which is obviously the more appropriate

means of helping solving these problems. And less of the overprescribing syndrome that I was indicating But there's still evidence of this. You're talking though about a particular setting for prescriptions which is within the institution. And I think you were very nice about what the medical professional reasons of the medical profession might have for prescription writing. I think there is no it no ability to excuse the medical profession which has a very real hand in contributing to this problem in terms of Compounding the issue. Of course doctors are overworked course they don't have time to spend all the time they do want to with maybe but you don't compound that problem by giving a pill or a tranquilizer especially with amphetamines which have been known now for the last 10 years. To be totally incorrectly prescribed for the two major uses that people go to doctors for getting them one to lose weight and the other because of a rash. I mean there's two other considerations that should be discussed here. Those are

pharmaceutical houses and mass media. I think there's for example a lot of overprescribing of those two types of drugs and fed amines and downers or barbiturates or whatever type of depressants we're talking about. There's there's enough overprescribing so that drugs like these get out on the black market usually because there's there's more than I really needed for legal medical use of the second. Consideration which I was alluding to was in the mass media. I think let's let's tonight all of us turn on our TVs after the show not on an educational TV station as this is which fortunately doesn't have a lot of advertising or anything but let's turn to another station commercial station Let's count the drug advertisements in a two hour block of time. I'm not of course aspirins or drugs NyQuil and I shouldn't mention products but all these things are drugs. Let's just count how many Let's let's consider the situation let's consider the medical society

that were in the drug society rather the medicated society. In view of this problem I think you can avoid those issues and if you put it in terms of the woman sitting at home in the afternoon. Watching television and watching the the afternoon shows in the games and things every five minutes she's got a commercial to sit and watch. That's filling her head with don't feel discomfort. You know this is getting to be almost the national national cry God forbid when any of us should feel any sort of discomfort or not always a non-prescription drugs do you think these are setting the stage now getting a psychological climate that is conducive then to go on other drugs. There are none there are none prescription or over-the-counter drugs. But it makes drug taking. OK. Jeremy was it OK what they're doing then of building the two essential sides of a commercial equation if you will. The media are promoting a large market a large demand if you will. Right. The medical profession has been entirely too permissive

in making the supply all to read it so that they have those two essential factors are operating and have been operating always as country has always been dedicated to quick results quick solutions panaceas for all kinds of ills but you're much too complex to handle will be the one capsule or one visit to a doctor. Don't you think also that the quality of medical practice may be affected because it's far easier to scribble on a pad than it is to go into a long session on reading the psychosomatic causes for this. This type of behavior. And also the doctor perhaps is communicating that this is a perfectly valid and very acceptable way of dealing with a national problem. What what combinations of drugs do you feel taken perhaps by the average person unwittingly perhaps drugs and alcohol or drugs and caffeine might ultimately prove fatal. Drugs now would be to begin any types of drugs. Well let's let's convert any down to right anybody here and I was that I am without some use of alcohol as the major drug of abuse in this country and to begin with

we'll say but combined with a growing use of barbiturates are a growing use of the opiate drugs whether they're listed legally available such as the dialogue in Demerol pills or illegally bought on the street such as heroin that those combinations of drugs which have an initial effect a depressant action. They are for the most part synergistic the act together and producing a total effect on the body which can lead to death rather easily. How about the stimulants just caffeine which is a mild relatively innocuous stimulant if this is combined with any type of drug in a sprint. I don't know of any direct response or use that report the caffeine per se would would produce a fatality. The most frequent combination as I said is alcohol with the other depressant drugs and some a lot of smoking in the room sometimes drives me nuts I would

consider that a phenomenon that smokers and that's us that's considered a stimulant. Going to get back to this over prescribing and perhaps too freely prescribing drugs. What standards the American Medical Association taking on this perhaps to crack down on the advertising of that from the suitable companies or perhaps the FCC would you like to see a ban on television. If you were talking about against the sort of advertising I definitely have their rights. There are movements in Congress to limit drug advertisement. There was an article in our local Buffalo paper recently which suggested a. Building trend in Washington to try to at least limit drug advertising time on television have been recent articles also the one the amount that I was talking about earlier entitled The corporate pushers. One ranked one of the one of the US senators was introduced making an effort in Congress to deal with the amount of con the

contribution and millions of dollars that were being spent yearly on advertisement of drugs and trying to upright have an appraisal of what that meant in terms of creating the climate if you will from creating the market where people would feel that wow I'm hearing about all these things on TV or the radio whatever. Maybe I ought to try I want to really want to help me because I can't tolerate my life at home. And maybe that's just described in billions of dollars millions of dollars a year spent on the media. And there are no easy ways to control that. One of the efforts that was made in the end about the amphetamines just after the Second World War when the major form of amphetamines at that time was within the with the inhalers. And they were inhalers were over-the-counter available they were containing both. Oh either Benzedrine or Dexedrine. The abuse became so glaring and so apparent that fine of the Food and Drug Administration was able to declare a ban

on the over-the-counter sale of those inhalers. But they did say that they could be had by prescription. That did not deter the producing industry Atar the ban was on Benzedrine and Dexedrine. There are many other kinds of amphetamine drugs which have similar kinds of action. And so the switch in production went to the other amphetamines. And so the Food and Drug Administration got some legislation which was passed but it was minimal and had no effect on the total of use or availability really of amphetamines in the country. In fact they've expanded even more now behind these other use for overweight which is really largely a white middle class suburban housewives problem and depression which fits most chronically into that same group of people. Well what do you do you feel the air may uneconomical says you just can't take any stand here. Well I think that a profession our physician or for that matter a

person who does not learn how to control and police his own activities ultimately is going to invite police in from other sources and this is I think what AM A is running the risk of. And of course there is a certain conflict of interests of course because it's the recipient of large sums of money. You know on the grounds isn't it I mean there is some drug company and it's very hard to try and and deal with I presume really generously oriented populations hold unquote positions and tell them that they cannot do certain things. This smacks of all kinds of autocratic control with a professional person generally and specifically is very resentful. But the medical profession have not responded to this challenge. There is one Suffolk County while back made a concerted effort. Between a combination of the pharmacists and the physicians in the community who agreed they would no promises of me they would no longer fill in for them in prescriptions. The physicians said they would not write and that was the only way

they kept legally available info to me is out of the county and it worked. But that kind of coordination and cooperation is a very rare thing. There's something similar going on in Canada isn't there now where if a patient asks and a doctor prescribes an entitlement for under 30 days it has to be registered by the Health Department it's over 30 days. He has to have a consultant physician who will document this confirm his diagnosis do you think this could work here. It would be well I suppose it could it would mean a lot more paperwork a lot more time of people involved and I think it only could be described as a halfway measure. The point is that instead the means are not medically indicated in the two primary conditions where some of those 35 million prescriptions will bring you the best of it and depression. They're just not to be used. John are back to the media for a moment. What do you do you feel that home is being done to children these days by seeing on daytime television children popping pills vitamin pills and subsequently feeling very much better and just generally tremendously

powerful medicine that's offered to children nowadays. Yeah vitamin pills. Stomach pills any kind of pills. Not only if it's directed at children but adults too. But specifically as as you mention the children vitamins and things. Everything tastes good. It's candy. Medicine shouldn't taste good medicine is not it's not that you never know if it tasted bad. They would be less inclined to eat a battle you know about vitamins. Again in relation amphetamines when that when the FDA did that survey there was some 15 vitamin and a hormone preparations available on the market all of which contain them put in other words not only are are these various drugs marketed in isolation there are marketed in combination with other drugs so that a person who may have may be taking vitamin pills and think they're you know read Gee I'm really feeling good those vitamins are doing the job well they're getting a little dose of amphetamine along with it. And no wonder they're getting you know

boosted up. Joseph Stack of the president of the Pharmaceutical Manufacturers Association said that the reason that the public are under using drugs is because they have been scared off by publicity about drug risks and drug abuse. What do you feel about this one. I think it's humorous. I don't believe it. And I think one wants to know what his what his standard of correct usage at the root of the current one is under you. I think his bias is fairly well it's pretty evident. I've never seen him. I've been in the field of drug abuse for five years and I've never seen to such an extent the number of young people specifically taking amphetamines and barbiturates. It's phenomenal the numbers that you know I think it's interesting to note that this is the trend to at least in our community where our center is located where Jan and I work. The trend is away from hallucinogens which used to be the fun drugs for kids and

now they're uppers and downers especially downers. I don't know if this is the new national trend person might be more aware of that but it definitely is the in thing now and least in our area in high schools and colleges to pop it down or to relax and be cool and what do you feel that toward used to be sort of accepted as the trials and tribulations of everyday life is now being sort of redefined as a medical problem. I think not. Not necessarily just a medical problem. Social medical down the line legal. You know there's a whole string of things you can do to find it interesting to note though a lot of the kids who are getting these pills are getting them from their mothers and fathers medicine cabinets. Yes yes they are going to doctors themselves and getting prescriptions that parents already have the prescriptions that a kid this was a point that was made in a really excellent study that Richard made. It's in the book form now called the Horatio Alger is children. And one of his points is that

he has been made an intensive analysis of a number of families in many different socioeconomic groups across the country. It's very clear that children who are. And houses where drugs are used routinely tend to become drug abusers. What are those drugs as far as the parents are concerned I used in a regular way or not but a family where barbiturates a routine they use for sleep. One member is on track the lives of his children in that kind of family setting. I have a much higher risk of becoming drug abusers. I think it's significant enough to repeat the fact that you mentioned Chris that alcohol is still our number one drug problem in this country I think it will be for many years and it's of course mainly abused by the adult community. It's an institutionalized Americanism and it's legal. It's as American as school I guess.

And then 20 minutes did you say the number is the number two you know talking around and the amphetamines of the number two in this country at least while the numbers are perhaps. Not too helpful in terms of trying to evaluate the total numbers of people using drugs or even ranking drugs of abuse. I'm not inclined to get into a numbers discussion primarily because I'm concerned about what the numbers mean not what they really are. The numbers mean that a lot of people choosing solutions to some problems that they have which are which is a totally inappropriate solution. Huxley fantasized about a sort of situation where we've become a nation of robots and any types of feelings particularly strong emotional feelings would just have no place and we'd be trying to pop pills to restore peace of mind to feel that the situation that you fantasized about is about to actually happen.

Well if you look at what is becoming very clear that has been available in the realm of mental health there's no question that we're there and terms of people who are not able to be admitted to routine social kinds of activities such as work home life and so on. Who can be maintained on very strong and potent tranquilizers and survive in other words behavior modification is with us. Thank you very much Dr. Diamond. John and Richard thank you very much for being with us we'll see you again next week. Good night.