http://www.thirdworldtraveler.com/Political_Reform/CaseStudyCorruption_HTO
TG.html
A Case Study in Corruption
excerpted from the book
How to Overthrow the Government
by Arianna Huffington
ReganBooks, 2000, paper
p149
THE WAR ON DRUGS AND THE DRUG INDUSTRY'S WAR ON US
For an object lesson in how money has corrupted the political process-changing
and even endangering our lives-just look in your medicine cabinet.
The tentacles of the pharmaceutical industry have nearly every aspect of our
public policy in their vice grip: from the health care choices we are offered
to the way we treat the troubled souls among us; from the government's much
publicized war on illegal drugs to the shadowy battle the legal drug giants are
waging to make their moodaltering products an integral part of American life;
from the public leaders they pay for endorsements to the public policy they pay
to influence.
MONEY > PUBLIC POLICY
Let's start with the money that drug companies are pouring into both political
parties. In the last election cycle, according to the Center for Responsive
Politics, pharmaceutical manufacturers and wholesalers ponied up to candidates,
PACs, and party committees over $9.5 million (that includes soft and hard
money-it doesn't matter to the drug makers, just as long as it's absorbed into
the system). On top of this, the entire pharmaceutical and health products
industry spent nearly $150 million on lobbying in 1997 and 1998, the highest
total of any interest group and more than was spent on lobbying by the defense
industry and labor unions combined. They know that contributing to politicians
is simply a good business investment. Which is why they are investing so much
more. Prozac's manufacturer, Eli Lilly, went from zero dollars in 1992 to over
$787,000 in the last election cycle. "We do it because we think we have to
participate in the political process," says Lilly spokesmanJeffNewton. "They
are important institutions, basically, and that's why we do it."
ANTIDEPRESSANTS > CHILDREN
What kind of return are the drug companies getting on their investment? Let's
just say they're beating the Dow. First of all, they've bought the benign
neglect of our political leaders over the legal drugging of America, starting
with our children, who were prescribed antidepressants 1,664,000 times in 1998.
This is despite the fact that no antidepressant-Prozac, Zoloft, Paxil, or
Luvox-has been approved by the Food and Drug Administration for pediatric use.
Luvox was approved by the FDA in 1997 for the treatment of obsessivecompulsive
disorders (OCD) in children, but not for the treatment of depression.
So the question is, why are we trusting the drugmakers? The manufacturer of
Luvox, Solvay, declares it "safe and effective." Yet the Physicians' Desk
Reference reports that during controlled clinical trials 4 percent of children
on the drug developed manic reactions. Another clinical trial found that
Prozac, America's most popular antidepressant, caused mania in 6 percent of the
children studied. "I have no doubt that Prozac can cause or contribute to
violence and suicide," Dr. Peter Breggin, the author of Reclaiming Our Children
and Talking Back to Prozac, told me. "And manic psychosis can lead to
violence."
Another example: Even though the National Institutes of Health reported that
"there is no current, validated diagnostic test" for Attention Deficit
Hyperactivity Disorder, that has not stopped the makers of Ritalin from pushing
the drug to three-quarters of the children diagnosed with ADHD in 1996, up 20
percent since 1989. At the same time, the percentage of those receiving
psychotherapy dropped from 40 percent to 2 5 percent.
"The age range for being treated for ADHD has gone down as people think these
medications are relatively safe and effective," says Richard Todd, psychiatrist
at Washington University in St. Louis. "This is a very important developmental
period. The effects of medications on these processes are not well understood."
Such is the crass, bottom-line approach of most health care providers, who
prefer relatively cheap drugs to costly therapy. But they also speak to our
lazy culture's inclination to medicate problems rather than confront them.
"Settling for Ritalin says we prefer to locate our children's problems in their
brains rather than in their lives," says Dr. Lawrence Diller, author of Running
on Ritalin.
Dr. Leon Eisenberg of the Harvard Medical School described the Prozac/Luvox
family of antidepressants as "potent medications that change nerve
transmission." "What happens," he asks, "after two to three years of that?" No
one knows. But even mildly skeptical voices from within the medical community
are routinely ignored as if they were attacks on scientific progress itself.
Diller described three candidates for ADHD diagnosis: four-year-old Stevie and
his two younger sisters, all of whom get dropped off for preschool at 7 A.M. by
their dad and are picked up at 5:30 P.M. by their mom "if she isn't running
late." Stevie is overly aggressive, and his parents, whose own marriage is
troubled, are desperate, demanding a fix: prescription drugs. Is there really a
consensus that this is a medical problem?
DRUGS > SHOOTINGS
On April 20, 1999, Dylan Klebold and his friend Eric Harris walked into their
high school in Littleton, Colorado, and opened fire on their classmates,
killing twelve students and a teacher before turning their guns on themselves.
Buried in the saturation coverage of the Littleton massacre was the finding
that traces of Luvox were found in Harris's bloodstream. The presence of Luvox,
the coroner said, "does not change the cause and manner of death." Well, of
course not-he died of a selfinflicted gunshot wound. But did the presence of
Luvox change the cause and manner of Eric's life?
Mania is defined as "a form of psychosis characterized by exalted feelings,
delusions of grandeur . . . and overproduction of ideas." That pretty much
describes Harris's Web site. "My belief," he wrote, "is that if I say
something, it goes. I am the law. If you don't like it, you die." This should
have troubled any doctor who was following Harris after he was put on Luvox. Or
was Harris one of the tens of thousands of children cavalierly put on
antidepressants without either a proper psychiatric evaluation or any ongoing
monitoring of side effects?
The news that Harris had been on Luvox came on the heels of the revelation the
previous summer that Kip Kinkel, the Oregon school shooter, had been on Prozac.
Later, Anthony "T. J." Solomon, the Conyers, Georgia, school shooter, took
Ritalin the morning of the shooting. Solomon is facing trial for wounding six
students just weeks after the Columbine killings; Kinkel was sentenced to 111
years in prison after killing his parents and two schoolchildren and wounding
twenty-two others. Kinkel and Solomon were only fifteen at the time. The
antidepressants clearly did not exorcise these teenagers' demons. The question
is, did they embolden them?
"I have testified as a medical expert," Dr. Breggin says, "in three teenage
cases of murder and attempted murder in which antidepressants were implicated
in playing a role.
In one case a sixteen-year-old committed murder and tried to set off multiple
bombs at the same time. The comparisons with Littleton are obvious and
ominous."
At a congressional hearing on media violence last spring, we were reminded that
95 percent of children are never involved in a violent crime. Most children
whose parents own guns do not steal them; most children who watch Natural Born
Killers do not go on shooting rampages; and most children on antidepressants do
not kill their schoolmates. But while there is constant coverage about the
dangers of guns and media violence, there is no debate about the dangers of
antidepressants to the brains of our most vulnerable children, no campaign to
examine kids for mood-altering legal drugs in their bloodstream the same way as
they are examined for illegal drugs and alcohol.
In the aftermath of the Littleton massacre, President Clinton proposed new laws
to restrict the marketing of guns to children, and hosted a conference to
examine the entertainment industry's marketing of violence to children. But no
one planned a conference or introduced laws to deal with the third problem-the
marketing of moodaltering prescription drugs for children.
DRUG MONEY > PRESIDENTIAL SEAL OF APPROVAL
Quite the opposite. Weeks after Littleton, a high-profile White House
conference on mental health was held, presided over by the vice president and
Mrs. Gore. The conference was hyped as "historic" but turned out to be mostly a
cheerleading session for drug manufacturers, with Tipper pumping her fists and
giving the thumbs-up from the stage.
It was striking that at a time when, following the rash of school shooting
tragedies, parents and communities were being called upon to get more involved
in the lives of their children, the conference managed to trace all behavioral
and emotional problems to the biochemistry of the brain. Dr. Harold Koplewicz,
director of New York University's Child Studies Center, went so far as to say
that it was an "antiquated way of thinking" to blame "inadequate parenting and
bad childhood traumas" for depression. And the First Lady, who not long ago
told the world that it takes a village to properly raise children, backed him
up, as if a well-stocked drugstore in the village center was good enough.
Even after Koplewicz blamed the wave of school violence on "depression or other
mental health problems" that had been left untreated, no one at the conference
challenged the good doctor by reminding him of Harris, Kinkel, or Solomon, who
had all been treated. "Both plenar,v sessions," said Sally Zinman, director of
the California Network of Mental Health Clients, "were an infomercial for
drugs. There was absolutely no mention of the potential risks."
One place you will find them is in the complaint filed in the Superior Court of
California by the estate of Brynn Hartman, wife of comedian Phil Hartman, who
killed her husband and herself while on Zoloft. "Although none of the drug
manufacturers will admit it," read the complaint,
"these drugs pose an unreasonable risk of violent and suicidal behavior for a
small percentage of patients. They can also cause a condition known as
'emotional blunting,' or disinhibition." Hartman's estate sued Zoloft's
manufacturer, Pfizer, as well as the doctor who allegedly gave her a sample
package of the drug without a proper diagnosis. To settle the case, Pfizer
agreed to provide a $100,000 college fund for the Hartmans' children, Sean and
Birgen. "Our principal goal in pursuing the case," said plaintiffs' attorney
Andy Vickery, "was to let them know this wasn't really their mom that did
this." Pfizer is also being sued in Kansas by the family of a thirteen-year-old
boy who hanged himself while on Zoloft. The trial is set to start inJuly.
But the White House conference organizers seemed intent on avoiding all the
tough questions while engaging in insidious hyperbole. The promotional
literature stated that "13.7 million of the nation's children have a
diagnosable mental illness." When I asked Mrs. Gore's press secretary how the
conference came up with this number, she referred me to the White House press
offfice, which in turn referred me to the Health and Human Services Department,
which sent me to the American Psychiatric Association and its director of
research, Dr. Harold Pincus. The problem is that Dr. Pincus had never heard of
this number. It turns out that it is based on a Florida Mental Health Institute
study that states that the upper limit of an estimate of "youth with any
diagnosable disorder" is 20 percent. Yet despite repeated warnings in the study
that we don't have the ability to project national rates, this number was
quickly and conveniently treated as gospel by conference organizers and by
members of Congress, who set national health policy and readily cash drug
industry checks.
If one in five children in this country is mentally ill, it is time to declare
a national emergency. But this is true only in the addled brains of those who
lump serious mental illnesses like schizophrenia with the garden-variety
depression that comes with being awkward and fourteen.
It is particularly disturbing when drugs are used to keep so-called mentally
ill children docile, as occurred in California's foster care and group home
system, where children were given antidepressants in dosages that psychiatric
experts said could cause irreversible harm. Or in Michigan's Medicaid system,
where 57 percent of children aged three or younger diagnosed with attention
deficit disorder were taking drugs for it, while only 27 percent were being
treated with therapy.
How come no one at the conference mentioned that these little panaceas might
actually cause harm? Because, as Dr. Breggin put it, "The drug companies call
the tune. The problem with this biochemical model is that by blaming the brain
of the child, even for commonplace sadness and anxiety, we take parents,
teachers, politicians, and all of society off the hook for the widespread
suffering of our children."
Some politicians, including Rep. Sheila Jackson Lee (D-Tex.), who led the
Children's Mental Health breakout session at the conference, did not let
themselves off the hook. "My focus," she told me, "has been not on drug therapy
but on how children can be made whole. I've seen the changes that happen when
you put your hands around a troubled child by providing a nurturing
environment. In our session we talked about mentoring, and about not coming in
and telling parents what to do, but engaging them in a plan for their child."
But the overwhelming impression the White House conference left was that of the
Clintons and the Gores endorsing a purely pharmacological view of humanity. The
conference was supposed to "burst myths" about mental illness, but it never got
to the truth behind the myths: that human beings consist of a soul as well as a
brain. And there will never be a drug to cure a troubled soul.
DRUG COMPANIES > DAMAGE CONTROL
Buying politicians' silence and seal of approval is one thing. But sometimes
it's not enough-not with a world of potential new customers out there.
So when President Clinton called on pharmaceutical companies in 1997 to test
all drugs likely to be prescribed for children, Lilly signed up Leo Burnett of
Chicago, the ad agency handling Reebok and McDonald's, to target consumers
directly. The company sent its spokespeople out to radio shows to debate its
critics (myself included) with measured talk of Lilly's "partnership with the
academic community," "peer review medical journals," and the need to establish
"whether the benefits outweigh the risks." Guess which side they came down on.
The pharmaceutical giant also sent misleading letters to every newspaper in
America that ran my column critical of its practice of pushing Prozac on kids.
Lilly executive Christina Hendricks was upfront at a drug industry conference
in May 1997 about company policy toward anyone who dares be disrespectful of
almighty Prozac: "We go after these people with a very serious intent to get
them to cease and desist from their activities." Any attack on Prozac is
countered as "belittling those suffering from depression."
Lilly's damage-control strategies include settlements that require plaintiff
confidentiality, preventing any adverse Prozac side effects from being aired in
public. One of the largest occurred in Louisville, Kentucky, where Lilly
quietly reached agreement with the families of the victims of a Prozac user who
killed eight and wounded twelve in a printing-plant shooting spree. In the
trial, the plaintiffs claimed that Lilly had failed to report to the FDA
adverse clinical reactions to Prozac. Judge John Potter allowed evidence of a
similar case from Lilly's past, when it pleaded guilty in 1985 to criminal
charges and paid hundreds of thousands of dollars in fines for concealing from
the FDA the fact that patients in Britain had died after taking Oraflex,
another Lilly drug.
Eli Lilly did whatever it could to keep the Louisville jury from hearing those
details-including misleading the judge. On May 23, 1996, the Kentucky Supreme
Court found evidence of bad faith, abuse of process, and possible fraud on the
part of Lilly during the trial. A separate investigation by the Kentucky
attorney general's office uncovered a secret deal wherein Lilly assured the
plaintiffs' silence in exchange for promising to pay them regardless of the
verdict. The plaintiffs' lawyer also agreed to settle a number of other cases
he had pending against Lilly.
FDA > OVERSIGHT?
In 1997, Lilly ran a three-page Prozac ad in major magazines around the
country, from Time to Cosmopolitan. Under a storm cloud that on the second page
is magically transformed into a bright sun, the ad informed us, "When you're
clinically depressed . . . you may have trouble sleeping. Feel unusually sad or
irritable. Find it hard to concentrate. Lose your appetite. Lack energy. Or
have trouble feeling pleasure. These are some of the symptoms that can point to
depression...."
These are also some of the symptoms that can point to life. Is there anybody on
this planet who has never lacked energy, felt sad or irritable, found it hard
to concentrate, or had trouble sleeping? Because if there is, I would sure like
to meet that perfect specimen.
However, the small print of the ad made for much more interesting reading. The
adverse side effects listed under "precautions" range from anxiety (I thought
Prozac cz~red anxiety) to suicide (a fail-safe cure for depression, though
probably not the one Lilly likes to brag about).
Despite a page chock-a-block with small-print warnings and small-print advice
to consult a doctor, the ad is part of Lilly's multimillion-dollar campaign
specifically designed to bypass doctors and target consumers directly. Treating
life as an illness is bad enough. But treating childhood as a disease is
tragic. And what made the timing of the ad campaign so disturbing is that it
coincided with the publication of the only large-scale study on the effects of
antidepressants on kids, which was then used by Lilly to try and get FDA
approval for pediatric use of Prozac. The University of Texas study found that
about half of the eight- to eighteen-year-olds improved. But then, so did one
third of those on a placebo.
We are in desperate need of more information-not just more clinical studies but
more data released to the public about the medical histories of children
charged with acts of violence. Following the news about Eric Harris being on
Luvox, Rep. Dennis Kucinich (D-Ohio) called for "comprehensive clinical trials
by the pharmaceutical companies" to establish "the behavioral effects of
antidepressants on our youth." Kucinich has been waging a lonely battle to get
the FDA and the Drug Enforcement Administration to conduct "deliberate and
thorough" research on Prozac's effects on children before it is approved for
their use. Isn't this, after all, why these agencies exist?
This is especially important given Eli Lilly's dissembling on the issue.
"Prozac is being studied by Eli Lilly and Co.," F-D-C Reports, which covers the
drug industry, disclosed in 1997, "as an antidepressant for use in patients
under 18 years of age.... A pre-N.D.A. [New Drug Application] filing was made."
This directly contradicted the stance Lilly has assumed for public consumption,
denying that it planned an expansion into the children's market.
"Lilly's proactive approach to media management may be smoothing the way for
antidepressants in children," FD-C Reports concluded. Indeed. Lilly
representative Dr. Gary Tollefson appeared on National Public Radio earlier
that year to tell listeners that adult depression "often begins in children and
adolescents."
According to the FDA's Melinda Plaisier, the "FDA's decision to market a new
drug is based on the answers to two questions: one, do the results of
well-controlled studies provide substantial evidence of effectiveness? and two,
do the results show the product is safe under the conditions of use in the
proposed labeling? Safe, in this context, means that the benefits of the drug
appear to outweigh the risks." If this is the case, shouldn't we demand a much
fuller accounting and understanding?
Shockingly, many drugs regularly prescribed to children have been tested only
on adults. The Pediatric Pharmacy Advocacy Group reports that approximately 70
percent of the drugs used by children have not been tested on them. Even their
labels admit as much: "Safety and effectiveness in pediatric patients have not
been established." Nonetheless, these drugs continue to be given to children,
while unwitting parents and heedless politicians ignore the unknown and
potentially disastrous long-term effects.
The FDA's lax oversight of drug companies has triggered terrible symptoms.
Every year, two million Americans are hospitalized for drug side effects. David
Lawrence, head of Kaiser Permanente, says that approximately 180,000 patients
in hospitals die annually due to errors and complications from using
prescription drugs.
"Most errors are not caused by stupidity, incompetence or neglect, but by
system failures that allow them to occur," Lawrence said, suggesting that the
safety tests done by drug companies are not enough, and that the companies fail
to educate physicians and hospital workers on the proper administration of the
drugs.
Currently, doctors and hospitals are not even legally required to report
patients' drug side effects to the FDA. And even if they were, the agency has
approximately eighty employees to monitor more than three thousand prescription
drugs. In the past two years, the FDA has banned five drugs that it had
previously approved but that it now deems dangerous. Why do we tolerate such
lax oversight of a powerful industry that affects life and death?
DRUG COMPANIES > COLLUSION
Politicians aren't the only recipients of the drug companies' largesse-or its
coercive clout. Doctors, pharmacists, researchers, and consumers are all
targeted for persuasion, both subtle and aggressive. For instance, medical
journals are funded predominantly by ads they carry from pharmaceutical
companies, while much of the research on drugs is paid for by the drug
companies themselves.
And what the pharmaceutical companies can't buy, they manipulate. Amazingly,
present laws allow them to pick and choose among drug studies. "The public
might be shocked to learn," Dr. Breggin told me, "that the vast majority of
studies done for the FDA approval of psychiatric drugs such as Prozac show them
to be of no value whatsoever. But the companies are allowed to pick out two
often marginally or questionably successful studies as 'proof' that the drugs
work." On top of this, there is growing evidence that the drug companies, by
sponsoring their own research-as well as offering grants, trips, and other
perks-are contaminating the conclusions of these vital studies. Examples
abound, such as the three doctors who editorialized in the British Medical
Journal that Prozac is not addictive, after participating in an
all-expenses-paid symposium in Phoenix sponsored by Eli Lilly. So Prozac is
nonaddictive, but desert golf may be.
Some of the legal drug pushers in the employ of Eli Lilly recently found their
way to a suburban Washington high school. "They gave out pens and pads and
little brochures pushing Prozac to these high school kids," Sidney Wolfe,
director of the Public Citizens Health Research Group, said in a groundbreaking
but hardly noticed 1997 Nightline show. Everything from fancy dinners to
first-class vacations to a lifetime supply of ballpoint pens are doled out by
"detail" men and women, as drug sales reps are called, who constitute a
formidable grassroots army traveling around the country, leaving a trail of
judgment-clouding goodies behind. In the other drug industry, such people are
called runners.
Another drug company tactic puts free pens to shame. It's called "drug
switching"-doctors and pharmacists induced into substituting one brand of drugs
for another. Here's how the scheme works: The major pharmaceutical companies
buy up the giant drug management and rating companies, which create preferred
drug lists (formularies) for use by insurers and HMOs. If doctors or
pharmacists don't choose the "preferred" drugs on the ratings list, the HMO
often refuses to reimburse the patient. Moreover, for his refusal to switch to
the drugs on the list, the prescriber risks being ejected from the HMO and
losing a major source of his income. On the other hand, pharmacists are often
given a few dollars as a "bonus"~ynics have another word for it-for choosing
the preferred drug. Is your doctor giving you a drug because that's the best
one for you? You may never know.
This pharmaceutical arm-twisting was evident in the case of Prescription Card
Services, the largest and most influential drug rater in the nation, covering
50 million Americans. In its 1993-94 guidelines, PCS informed doctors and
pharmacists that Prozac "is no more effective than other antidepressants and is
much more expensive." But in its 1995-96 guidelines, the company claimed that
Prozac had fewer side effects than the cheaper antidepressants, which were
"more toxic."
Was PCS merely suffering from one of those manic mood swings that Prozac is
supposed to alleviate? Or did the fact that Lilly acquired PCS in 1994 have
something to do with its "objective" medical conclusions? A PCS spokesperson
predictably denied a connection. Still, Prozac sales rose 40 percent-from $1.7
billion in 1994 to $2.4 billion in 1996.
"The takeover of PCS by Lilly converted a powerful opponent of Prozac into an
ally," charged New York City public advocate Mark Green. And after evidently
ingesting some "nonpreferred" FDA truth serum, a former senior official at
Lilly who was reluctant to let me use his name (our own version of The Insider)
said, "The whole point of buying PCS was to influence the formulary lists and
protect Prozac. You make sure your drugs are on the formularies and your
competitors' drugs are not. If Lilly bought PCS, there was no way they were
going to let Zoloft get ahead of Prozac."
Reports that Lilly was using PCS to promote Prozac were made available to the
Federal Trade Commission- which had consent agreements signed by Lilly and PCS
that this would not occur. Last year, Lilly got rid of PCS, selling it to Rite
Aid, a drugstore chain.
A number of states including California, New York, and ~~rgi~ua are t~ging to
address the bad medicine of drug switching. But our well-compensated Congress,
once again, has been virtually silent on the issue. Recent attempts to reform
managed care and health insurance, such as the Patient Access to Responsible
Care Act, the Fair Care for the Uninsured Act, and the Health Care Access and
Equity Act, among others, completelyignored the issue of pill-ola. When it
comes to legal drugs, our representatives in Washington- pacified by dangerous
doses of pharmaceutical cash-would rather switch than fight.
POLITICAL ENDORSEMENTS > PROFITS
One tried-and-true way to influence public of ficials is to buy the services of
one. After nearly becoming president of the United States, Bob Dole became a
paid spokesman for Pfizer, the maker of Viagra. Pfizer was trying to pump up
sales in the wake of flaccid demand (prescriptions falling from one million in
May 1998 to 346,000 in October 1998) and bad publicity (130 men dying from
Viagra-induced side effects).
But such risks can be smoothed over when you have an underemployed former
presidential candidate up your sleeve. To further imply an official endorsement
from the corridors of power, Dole's television ad was filmed in a plush offfice
before imposing white columns. He positioned the ad as a public service
announcement, dismissing concerns over Pfizer's logo appearing on the screen
with the improbable excuse that not "many men know that Pfizer makes Viagra."
He even compared his campaign to Betty Ford's fight for breast cancer
awareness. As far as I know, no drug company ever paid Betty Ford. Pfizer's
chairman, by contrast, not only paid Dole but pompously praised him for making
"men's health issues a priority for 1999" and "advocating for Americans with
disabilities." (So that's why all those handicapped spots are always taken.)
"It may take a little courage," said Dole in his commercial for Pfizer. But the
courage that's needed by our public officials is the courage to turn down
lucrative offers from drug companies with self-serving agendas. Dole's
protestations have a familiar ring in this era of politicians who feel
compelled to comically deny any link between the massive donations they take
and the public decisions they make.
LEGAL DRUGS > ILLEGAL DRUGS
....the major pharmaceutical companies are big backers of the Drug War, helping
fund both the Partnership for a Drug-Free America and the National Center on
Addiction and Substance Abuse, while 17,000 oftheir sales reps distribute
information to health care professionals to help them identify drug abuse.
Isn't it ironic that the same people who are pushing mood-altering legal drugs
should be taking up the challenge of alerting doctors to the dangers of the
illegal competition? It's not that they don't want us on drugs-they just want
us on theirs.
Rest at site.