‘American Addict’ Film Explores America’s Prescription Pill Popping Habit

Pill organizer with pillsAn ongoing issue faced by many in the mental health field is the over-diagnosis of conditions like bipolar, depression, and attention deficit or hyperactivity (ADHD), as well as the over-prescribing of psychotropic medications—and consequent addiction—that goes along with the pressure to dole out diagnostic labels to people seeking therapeutic help.

Several organizations and individual practitioners have chosen to resist this tendency through the years, choosing instead to focus on the healing and recovery that comes from the tried and true methods of psychotherapy and counseling. Belief in the power of talking and working with a therapist to move through the various ups and downs experienced while walking in this world is a large part of what fueled Noah Rubinstein’s desire to launch GoodTherapy.org in February of 2007.

Now  Dr. Gregory A. Smith, a medical doctor based in Los Angeles, CA, with co-writer and director Sasha Knezev, brings  a new documentary that explores the issue of prescription drug abuse and addiction and reveals some of the reasons behind the pharmaceutical industry’s heavy influence on the field of medicine.

The film, called American Addict, exposes how the Food and Drug Administration (FDA), Big Pharma, physicians, and the media are tied together “to ensure that medical problems are treated primarily with pills.” It also explores the unfortunate side effects of widespread overprescribing of psychotropic medications in matters of physical and mental health, which often leads to “overuse, abuse, and unnecessary deaths.”

Though there are certain conditions that respond well to pharmaceutical treatment, as well as medical professionals and individual users who claim that the benefits outweigh the side effects, the fact remains that the rate at which diagnoses are handed out and drugs are prescribed is becoming more problematic.

“What was once a diagnostic manual that was paper thin is now a huge book with hundreds of diagnoses in it,” says Dr. Peter Breggin, the psychiatrist and activist who founded the Center for the Study of Empathic Therapy, Education, and Living in Ithaca, New York, and who is interviewed in the film along with several other medical professionals. The author of Talking Back to Prozac, Toxic Psychiatry, Medication Madness, and other related titles, Dr. Breggin is one of many who have devoted their time, energy, and expertise to raising awareness regarding the very serious issues associated with widespread labeling and pharmaceutical drug use.

As Breggin reveals in his research and publications, there are numerous negative side effects associated with short- and long-term pharmaceutical drug use: chronic brain impairment (CBI), which presents with symptoms similar to those of dementia and Alzheimer’s; medication spellbinding, or intoxication agnosognosia, which causes users to underestimate the damaging effects of prescription drugs on their brains and bodies; suicidal ideation and violent behavior, especially in military veterans, are a few examples of these (Breggin, 2006; 2010; 2011).

In its Research Report Series on prescription drug abuse and addiction, the National Institute on Drug Abuse (NIDA) states that approximately 52 million people in the United States have used prescription drugs nonmedically at least once in their lifetimes, with young people, the elderly, and women the most likely to develop an addiction (2011). According to a 2013 NIDA report, “[P]rescription and over-the-counter (OTC) drugs are, after marijuana (and alcohol), the most commonly abused substances by Americans 14 and older.” Opioid pain relievers, stimulants, and anti-anxiety medications are the ones most often associated with addictive behavior, with Adderall and Vicodin accounting for the bulk of pharmaceutical drug abuse, and OxyContin, Ritalin, Valium, and Xanax, as well.

Not only are prescription drugs potentially addictive; they can also be deadly. In the director’s message that appears on the first page of NIDA’s Prescription Drugs: Abuse and Addiction report (2011), Nora D. Volkow writes that since 1999, accidental deaths by prescription drug overdose have quadrupled, and as of 2007, they surpassed the number of deaths tied to heroin and cocaine.

So, what gives pharmaceutical companies such significant sway over practitioners and treatment facilities when their products are known to lead to abuse and addiction, not to mention devastating side effects and even death in some instances?

As one woman interviewed in American Addict shares, it’s partially because these companies are very strategic in their ways of pushing their products on people; the representatives hired to sell prescription drugs are often recruited based on appearance and marketing skills, and prescribing doctors are often offered huge incentives such as fancy vacations and financial perks. And then there are, of course, the myriad advertisements that feature glowing, happy people attesting to the life-changing, health-boosting benefits of said medications.

Lobbying is another way the pharmaceutical industry has established authority and control at the political level. “If you look at the amount of money they spend on lobbying, they have more lobbyists active than there are members of Congress,” says one of the interviewees featured in the film’s trailer. “Right now, pharmaceutical companies are in control,” he adds.

Additional issues, such as accessibility and affordability, are also explored, as well as a glimpse into the “underground” prescription drug trade. The hope of the film’s creators is that American Addict will spark increased awareness and dialogue on the subject, thereby inspiring change.

References:

  1. Breggin, P. (2006). Intoxication Anosognosia: the spellbinding effect of psychiatric drugs. Ethical Human Psychology and Psychiatry, 8, 201-215. Retrieved from http://breggin.com/index.php?option=com_docman&task=cat_view&gid=53
  2. Breggin, P. (2010). Antidepressant-induced suicide, violence, and mania: risks for military personnel. Ethical Human Psychology and Psychiatry, vol. 12, no. 2. Retrieved from http://breggin.com/index.php?option=com_docman&task=cat_view&gid=53
  3. Breggin, P. (2011). Psychiatric drug-induced Chronic Brain Impairment (CBI): implications of long-term treatment with psychiatric medication. International Journal of Risk & Safety in Medicine, 23, 193-200. doi: 10.3233/JRS-2011-0542. Retrieved from http://breggin.com/index.php?option=com_docman&task=cat_view&gid=53
  4. National Institute on Drug Abuse. (2011). Research report series: Prescription drugs: abuse and addiction. National Institutes of Health. Retrieved from http://www.drugabuse.gov/sites/default/files/rrprescription.pdf
  5. National Institute on Drug Abuse. (May 2013). DrugFacts: prescription and over-the-counter medications. Retrieved from http://www.drugabuse.gov/publications/drugfacts/prescription-over-counter-medications

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  • Keith

    Keith

    March 18th, 2014 at 3:52 PM

    And what about the doctors who are more than willing to keep writing the prescriptions for these drugs? Aren’t they in many ways just as responsible, maybe in many ways even more so, for these growing habits? And yet no one is pointing the finger at them and blaming them and holding them accountable for their actions.

  • Bryan

    Bryan

    April 5th, 2017 at 5:40 AM

    Keith, they actually address this in the documentary. They say if your doctor is prescribing you pills for every little problem its time to get a new doctor. It is also hard because the pharm companies have roots in many universities where a lot of these doctor went to school.

  • Iris

    Iris

    March 19th, 2014 at 3:37 AM

    Addiction is the biggest problem nowadays. People should be well educated about consequences of drug use. Special institutes should provide all necessary information concerning substance use and its after-effects. Special reality show “Doctor Life” produced by doctor Nazaraliev shows which problems and consequences has drug addiction. It would be great if people have started to watch such kind of programms.

  • blake

    blake

    March 19th, 2014 at 4:05 AM

    I work in a doctor’s office, and let me tell you, there are pill seekers out there every day, and they are Soooo creative with the stories that they can tell you! The doctors that I work for are only trying to do what they can to help these people but you are dealing with people who are addicts, sneaky and manipulative, and as much as you try to have them on your radar, there are always those who are going to get through the cracks and get more meds than they need, just through doctor shopping and being cunning.

  • Keller

    Keller

    March 19th, 2014 at 11:51 AM

    Know what I am most curious about and I am not sure if this is brought up in this film or not, but I would like to know if this is purely an American problem or are there other first world countries that are seeing the same sorts of issues with painkillers?
    I would be willing to say that this is something that is pretty unique to the American health care system, that the abuse has been put into play by the incestuous relationship that has been created via the insurance and pharmaceutical companies and the patients have been caught in the middle.
    That does not excuse the fact that there are many that are profiting from it, but I feel that the patients have gotten the raw end of the deal by being told that these pills were harmless and that many are now battling addictions that can’t be beaten.

  • Todd

    Todd

    March 19th, 2014 at 2:38 PM

    Drug addiction is just another form of self-medication in an attempt to control their pain. If this country would ever have an open discussion on mental health we might get some where. And I am not talking serious mental problems like bi-polar and others that require meds. I am talking generations of general dysfunction that started when the first boat of deseperate europeans landed in America. We are a country of alcoholics and drug addicts, codependents and narcissists, obese and anorexic, workaholics and dead beats and why would that be?????? We keep treating the symptoms but never want to get to the core problem. I guess it is easier to sale a pill or pour a beer than treat the immense inner pain Americans have.

  • Donna Bunce

    Donna Bunce

    March 19th, 2014 at 3:23 PM

    I continue to write my story where ever I can on the internet/facebook. I worked in mental health starting at hotlines for crisis/suicide prevention, a state hospital for the criminally insane, private psych units and mostly county mental health units and programs. I was trained to push meds. In fact you are not compliant or a good patient/consumer if you refuse meds. After ten years in the industry I lost my composure over not getting a job promotion. Quite a disappointment at the time which interupted my sleep and self esteem. My favorite gentle seemingly compassionate psychiatrist also had a private practice. He surpisingly diagnosied me at age 40 with a type of bipolar. Away my life went to the merry go round of pharmarcalogy. No MMPI. Several different psychiatrists and follow the blind counselors. My diagnosis after 5 years went to major depression and borderline personality disorder. Along the way I got ADD and ADHD. I stayed controlled and lost in the numbing drugs 11 more years. Needsless to say I lost my career and the 7 years of higher education. My family disowned my mentally ill status and behavior. Because believe me those meds are hell on earth! Finally while my mother was dying I decided my only option in my life time was to listen to my inner voice. My inner Light House/God. It took the guidance of a real person, a counselor who taught mindfulness meditation to help walk me out the chemically induced dark forest. I made it!! So after 16 years I am free of all medications!! No life is not easy but I like having to see and be responsible to deal with the pot holes in this life. Thanks for listening to my story. p.s. I read and liked Toxic Psychiatry in my masters program. Dr. Breggin has got alot of stuff right. Psych meds are a slow but sure murder.

  • Me

    Me

    March 20th, 2014 at 8:32 AM

    My adult step-daughter is an addict. She is 28 years old. Truly a beautiful young woman – model looks- and could do anything in the world she wanted to. She is choosing her addiction. She’s in the arms of a major relapse right now and could easily lose her life this time with the route she is taking. A few years ago she went pill shopping and was able to walk into a doctors office for the first time and she walked out with a prescription for 60 pills of OxyContin. Her dad found them and discarded them and she’s telling him not to and the street value was $85 a pill. Addicts are very clever with their symptoms of back pain, migraines, etc… The kind that have symptoms that you really can’t diagnose fully with test results. My husband and I use to joke that they needed to have a talk show that would educate people on the deception and manipulitive methods used by addicts. It amazed me how she could pass an at home drug test. It amazed me the methods used to deceive and manipulate. And so quick and convincing with the stories and excuses. I think I’m pretty sharp but thus sure caught me off guard. I had never been involved with addiction world until I married my husband. I knew she was an addict when I married him and she was living at home and I had spent plenty if time around her, but talk about a hard learning curve!

    I don’t understand either why doctors keep prescribing even when they know there are addiction issues. I think thru need to somehow be accountable for their prescribing practices. I think all pharmacies should be connected to show records to each other to show the perscriptions a person has.

    I don’t know the answer but I am fully aware of the problem and it is growing. They start on oerscription drugs and then they go to heroin or other street drugs. OxyContin was $85 a pill and heroin was $5 to $10 a balloon at that time. Heroin has all kinds of grades too. They never know how pure or dirty it is. They never know what’s mixed in it. We list the father of our grandson to really dirty heroin a few years back also and at that same time there were multiple overdose deaths in the same community to these young adults who had taken this path.

  • Me

    Me

    March 20th, 2014 at 8:36 AM

    Oh and one more comment.. She lived to watch the show Intervention. She was very aware of it all and still is. Been thru multiple recovery programs, jail time, etc. she can walk the walk.. But it always catches up with her. Burned pretty much every bridge now.

  • Padgett

    Padgett

    March 20th, 2014 at 12:04 PM

    look at how early so many people are started on pills, getting on ritalin and stuff real young and then i guess it just progresses from there no wonder we have problems

  • Christa

    Christa

    March 22nd, 2014 at 6:19 AM

    There is certainly enough blame to go around so I don’t know who is the most at fault but I suppose that most of the responsibility lies at the feet of the big drug companies who have put these medications out there making us feel like they are so harmless and then doing nothing to take them off the market even though they have been proven to be a little more dangerous than we once thought. Once the patients are hooked, then of course there is a huge problem, but the companies have already sucked them in by then so they have their money and its’ too late. The FDA will do little to retract what they have already put out there as the end all and be all and the doctors hands are tied because they ahve already given out the prescriptions. Who is going to say no to the patients from there? The pharmacies? Insurance companies? Give them even more power than they already have? All in all a HUGE problem.

  • kenneth G

    kenneth G

    March 24th, 2014 at 5:45 PM

    Is this what we have been relegated to? A society that cares a whole lot more about the drugs we can get versus the good we can do for others? I swear there are definitely times when it feels escactly that way!

  • Cam

    Cam

    March 26th, 2014 at 4:40 PM

    I must be missing something with the whole pain med industry because I just don’t see the appeal of them. Any time I have had to take any of them they just make me itch like mad and really don’t do anything for me at all. What is the appeal? I guess I am not hard wired to be addicted to them because they have done nothing for me. I would much rather sit down with a nice glass of wine and last time I checked this is nto trading on the underground black market. So if anyone could please explain this to me and let me know what I am missing I would really appreciate it not because I wnat to get involved in it but just because I wnt to try to understand it.

  • Sherman T

    Sherman T

    March 27th, 2014 at 5:31 PM

    I think that more and more you see doctors who are feeling the pressure to cave to the wishes and demands of patients who are telling them that if they don’t get their drugs and prescriptions from them then they will got to someone else who will do it for them. And these are pretty hard times you know, with everyone needing as many patients as they can get. Seems kind of crass but I think that a lot of this has to do with a whole lot of competition and the patients knowing that they hold a whole lot of power in this area where they really shouldn’t.

  • James B

    James B

    September 7th, 2014 at 6:22 AM

    Three things that already work for pain: aspirin, THC, opium.

    Two things that already work for depression and anxiety: diet, exercise.

    Problem solved.

  • Maggie

    Maggie

    October 4th, 2014 at 11:29 PM

    I currently work as a psychiatric nurse practitioner. I recently watched this film hoping to learn about ways to help patients overcome problems with prescription drug abuse issues. Instead of considering strategies or ways to help with addictive behaviors though, this film points the finger at mental health professionals by using a lot of poorly researched arguments.

    First, we can all agree that pain medications are addictive. This is a huge issue. The pain medication issue is brought up in the beginning of the film. Yes, hydrocodone, OxyContin, ect. These are very addictive drugs. They should only be used for short term management of pain. Yes. People overdose and die on these medications. I was in full agreement with this. This is a widely accepted fact.

    But then, the film makes a huge leap to compare pain medications with anti-depressant medications. First of all, these drugs are not anywhere on any spectrum or any category classified with the addictive nature as pain medications. Of course, their reasoning for describing Prozac as addictive is never explained. I can only assume that they make this argument at because Prozac is typically given chronically(lifetime) after multiple depressive episodes because the risk of relapsing when off Prozac is near 100% with multiple depressive episodes. Also, though Prozac should not be stopped abruptly, because of withdrawal symptoms, it can be easily tapered off of and people do not crave Prozac or go out of their way to seek it. Why? It just simply isn’t a drug people abuse. Also, when has anyone ever seen someone “high” or experiencing any drug induced euphoria from Prozac? Those are typically why addicts like drugs right? Even on a technical level, the neurotransmitter dopamine, which is associated with addictive cravings, is not at all affected by Prozac. But no reason for describing Prozac as a supposedly highly addictive drug was ever given. It was just assumed Prozac could be grouped with pain meds. I guess the makers of the film just felt they could get away with not explaining any of this by opening the movie with the actually addictive pain killer type medications.

    So the film continues to just attack psychiatrists. How again this started as a film about pain medication addiction and turned into an attack on the psychiatric profession again is beyond me…
    But the comment is made that psychiatrists cannot make proper treatment decisions because they are given too much information from big pharmaceutical companies. This leads to almost justify a need for insurance companies to regulate prescribers because they are unable to properly prescribe with all this supposed misleading information they are given from pharmaceutical companies.

    Though this film makes it impossible to believe. In order to prescribe these medications, schooling is required which actually teaches us about prescribing. In these psychopharmacology classes we are taught about every medication. So believe it or not, prescribers learn the differences between all of these drugs in school. We are even taught about these supposedly elusive newer medications. Yes, we learn the side effects. We are even taught about the effects on the brain at a chemical level that the movie doesn’t bother to go into. So, the fact that a $5 free sandwhich lunch would actually persuade prescribing is ludicrous. By the way, there are limits on the amount of money these reps can spend on us. We aren’t even given pens anymore because some lawyer thought that was influencing prescribing. Really?! Has a logo on a pen ever been that persuasive?! And it is even funnier that they try to make the argument that pharm industry only employs attractive women. This almost creates a sexist approach to medicine. I am pretty sure everyone is well aware at this point that sometimes, these prescribers are female. Unless they are lesbians I just do not see how these points again are even logical arguments.

    So, it almost leads me to wonder if united health care or another major health insurance company funded this movie. In reality, patients are often quickly denied necessary treatments because people with absolutely no medical knowledge within the insurance companies deny coverage. I will have patients who have been violent in the past who have been stable for years on a medicine. The insurance companies will deny their medications that have kept them stable and then give no valid reasoning for their decision other than that these medications are now not considered as a first-line treatment option. Now, these patients cannot get their medication because some insurance company with (again) no real medical knowledge finds their medication unnecessary. So, when this happens those patients will often start to become symptomatic and if violence was a previous pattern. Guess what? So, this is a situation that leads to events like shootings and then everyone wants to know how this person got taken off of their medication…

    Then, the discussion on zyprexa. The argument is made that because of pharmaceutical representatives that prescribers are giving newer medications like zyprexa, instead of older medications that they say do “exactly the same thing.” This was almost comical. They fail to even name these older medications. Which had to be purposeful. Because if you were to look up these older anti-psychotic medications like haldol or Thorazine, what you would learn is that those medications caused awful side effects that include movement disorders(comparative to Parkinson’s disease) and even blindness. But yes, zyprexa can lead to diabetes. But prescribers are all knowledgable on following lab values of patients on these drugs and can address it if diabetes were to become an issue. But it is never, never recommended to use an older anti-psychotic because their movement disorder side effects are permanent! And if they had again bothered to go into the differences between older anti-psychotic drugs vs newer ones you have all learned that they do not work on the neurotransmitters in the brain in anyway the same way.

    So, this is what happens when the media and documentary films become more accessible than mental health care. Because you get a situation where misinformation like this spreads. All these films accomplish is that they make mental health care less accessible by increasing the stigma of mental health care by pointing fingers at the professionals that are out there helping this population.

    The reality of the situation is this. When diagnosis are made, it is often done in a setting where there is not enough time to adequately assess completely and fully. Sometimes, simple screening tools are used which are never recommended as a replacement for a full psychiatric evaluation. Often, primary care providers are left to treat mental health disorders in which they have never been fully trained because people cannot afford to access psychiatrists due to limitations that insurance companies make on their coverage. Then you have people taking what they are experiencing in these instances and applying them to the entire mental health community in general.

    So, I really hope that awareness of mental health spreads. But it does absolutely no good to start any of these discussions by pointing fingers at the prescribers who are there trying to help these patients.

    ** Not all mental illness can be helped with therapy alone. **
    This is just a fact that needs to be known.

    It is important for therapists within the community to recognize the role of psychotropic medications in mental health care. I recommend therapy to all of my patients and absolutely recognize the need for more therapists to treat these lower income patients. The best treatment incorporates both approaches. There have been numerous studies to support this statement. But honestly, when I go to recommend therapy to them. There aren’t any available. Why? Very few are out there helping these poorer patients and most do not take any insurance.

    So, in order to really help people with mental illness, awareness is needed on all levels. This includes acknowledging the value of medications and incorporating them within a therapeutic model. This is especially crucial for those patients that have major mental illness that absolutely require medications.

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