Healthy Skepticism Library item: 20109

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: Journal Article

Miller AR
Drugs: It's up to the public to complain
CMAJ 2001; 165:(1):153

Abstract:

I congratulate Joel Lexchin on his well-informed and thoughtful analysis of issues relating to lifestyle drugs. Producing a medical definition for “problems for living” and establishing boundaries for treatment represent major challenges. Many conditions uncomfortably straddle the medical-biological and environmental-social domains. Contemporary North American psychiatry, armed with a powerful tool in its Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), presents a number of examples.

Under the banner of attention-deficit/hyperactivity disorder, the medical community has shown an ever-increasing tendency to use medications to “normalize” children whose behavioural and learning difficulties may, in an unknown proportion of cases, have as much to do with prevailing expectations and the resources available to today’s families and schools as to neurobiology. Similarly, we increasingly use selective serotonin re-uptake inhibitors to treat adults whose minor depressions and dysphoric moods may be as attributable to the subtle yet relentless pressures that are part of life in contemporary industrialised societies as to biological dysfunction.

Physicians who unquestionably adhere to models of biological causation and medical treatment may be complicit in suppressing the need to question the effects of social and economic structures and values on people and may unwittingly obstruct needed social change.

Anton R Miller
Department of Paediatrics
University of British Columbia
Vancouver, BC