That’s fair.
Don’t see a difference.
A doctor normally prescribes. Even if a med is OTC, a doctor can recommend, or design a plan of care for a chronic condition that includes both OTC and prescription medications.
But you administer your own medications, unless you are a child, or live in an institution, or something. You take the medications at your disposal, the prescription and the OTC, and maybe even supplements (some doctors may recommend vitamins, or melatonin, or Omega-3 supplements, even if 98% of what are called “supplements” are crap), and medicate yourself according to the instructions you have-- which might include the words “as needed.”
People who bypass the doctor altogether to use alcohol, street drugs, or prescription drugs without a prescription, are “self-prescribing.” They are also self-medicating, but it’s not unique to them.
Again, losing battle.
I think when most people hear the term self medicate, they understand it mean the same thing you refer to as self prescribe.
I would agree.
I’m also not sure what the exact definition of “over-medicated” is. Is it “redundantly medicated”? You are taking three different kinds of antidepressants, because when one doesn’t work, the doctor adds another without removing the previous one? or is it “unnecessarily medicated,” because some great arbiter decides whose problems are med-worthy, and has decreed that a large number of unmed-worthy people are nonetheless receiving meds? or are people just taking high doses when lower doses would work? That happens. A med does work right away, so the dose is raised, and when a person’s blood-level has a change to stabilize, the dose isn’t lowered. The gold-standard is the lowest effective dose, but sometimes that’s hard to find, and even “effective” is hard to define.
Obviously, someone perceives “over-medication,” whatever it means as a problem. What is the problem? that is, what is the result of a large block of over-medicated people that is detrimental to society?
Or our lawmakers want to let drug companies make money by marketing prescription drugs directly to consumers. That isn’t allowed to the same degree in a lot of other countries.
What if the father can’t or won’t stop drinking too much? Do we just tell the kid “too bad, it’s your dad’s fault”? There really is no effective way to force an alcoholic to quit drinking if he or she doesn’t want to. We know a lot of them won’t quit or cut down even if their drinking is causing problems for themselves and their families (that’s kind of the definition of an alcoholic).
I’m a little alarmed by the rise in medicating kids for issues like ADHD and other disorders based on school “diagnoses.” Part of it is related to better recognition, but I think part of it is the expectations placed on kids earlier and earlier and a cirriculum that requires young children to sit for long periods of time.
Anecdote warning: My son’s counselor encouraged us to have him tested for Aspberger’s syndrome even after we permitted the school to evaluate him and their own testing and observation yielded no results. We were seeing a family therapist at the time (my husband was frustrated with his relationship with my son) and were also in contact with our pediatrician. Both diagnosed our son as being a six year old boy. It turns out that nearly 50% of my son’s first grade class had been recommended for evaluation through our special school district and the counselor and teachers were really influencing diagnoses. It was horrifying and I haven’t trusted the counselor since. Shockingly, the next year after my son had matured and was put in a class with a teacher he really trusted, his behavior issues melted away to zero and he has been an A or B student ever since.
It’s hard to tell with adults, too. I agree with the above commentary that more healthy lifestyles would probably solve a lot of our problems. More sleep, more movement, less crap food, fewer electronics, etc. I have no doubt that a lot of the issues adults face require medications, but it seems like a lot of them might also be managed otherwise.
Part of the “problem” is that a kid can fall behind and never be able to catch up if a diagnosis is missed early. Schools have been screened every single child for hearing and vision problems since I was in school in the early 1970s, and probably for a while before that. Granted, minor vision problems that can easily be corrected with glasses are pretty common, but hearing problem that need, or can use intervention are more unusual (and were even more unusual when I was in school, and hearing aids were all that good).
Starting in the 80s or 90s, all elementary school children were screened for scoliosis, and now a lot of milder cases are caught early-- the kinds of cases that wouldn’t be corrected, and would cause problems for adults when corrected was much more complicated, or even impossible (it was ironic-- serious cases got caught and corrected, and those people were more likely to avoid problems later, if they were in fact correctable, while minor cases were the ones who had more problems as adults).
I wouldn’t be surprised in, within the next 10 years, someone designs a 15-minute screening for autism spectrum disorder for kindergarteners or first graders, to try to catch the milder cases who wouldn’t be identified until they had serious social problems in later grades. It will be administered to ALL children, and then maybe 15% will be referred for further testing, but of those, only about 1% will get any kind of diagnosis. Just like all kids get hearing screenings, and a small number are referred for more extensive testing, and a small percentage of those actually end up with a hearing aid, or some kind of therapy.
I don’t find it alarming that 50% of kids are referred for testing, since that’s all a school is really doing. I find it a little overly-cautious, but the school may have been sued once by the parents of a child who was overlooked. I doubt a teacher who refers 50% of a class for testing really thinks that all those kids are autistic-- she just thinks all those kids should be checked out just to be on the safe side. A teacher who notices bruises on a kid frequently may call social services, and probably more often than not, the child isn’t being abused, but it’s still not a bad thing that the teacher made the referral. The kid might take karate, or the kid might have an undiagnosed motor skills deficit.
Now, if the teacher actually said “50% of my kids had autism, and no one would listen to me,” I rescind my defense. That teacher is paranoid.
Honestly, I would be fine with a standard screening; however, I feel that a counselor who has no medical degree should NOT encourage parents to get their kids on medication as the one at my son’s school did. I strongly believe that that is is completely irresponsible and that, while she can recommend an evaluation, recommending prescription drugs to a parent whose kid has been evaluated as within the normal range for behavior, cognitive and social ability using the school’s own tests is inappropriate.
Our pediatrician had us fill out a questionnaire about Lil’ Neville at her 2 year checkup, that seemed to us to be asking about things that might indicate autism.
Exercising (in my case, walking to and from work) has really helped me in a ton of ways. I try not to be preachy about it, but I kinda like thinking that I inspire people when they see me walking every day.
The thing that keeps me from being preachy about it is that I know not everyone can do what I do. I can devote two hours to exercise every day because I don’t have responsibilities outside of myself. I don’t have children to hurry out of the door in the morning. I don’t have to take anyone to soccer practice after work. I don’t have to come home and slave over a hot oven, because I don’t mind leftovers. Hell, I’m even lucky in that I don’t sweat that much. If I were a heavier sweater, I probably wouldn’t be an avid fan of walking anywhere.
It’s also easy for me to manage my diet because I don’t have to cook for anyone else. I don’t have to shop for anyone else. I don’t have to deal with frowny faces sitting across from me at the dinner table. I don’t have a spouse influencing me with his own bad habits.
I used to medicate myself to control my Tourette’s. One day I reaalized that I was enduring painful side effects just so that people wouldn’t laugh and stare at me. And that was ludricrous to me, so I stopped taking them. However, if I were a more sociable person and I had a lot more riding on me presenting as “normal”, I probably would still be taking a pill every day. I don’t think it is fair to expect everyone to be able to endure stares just because I can.
That’s why I’m loathed to get on the “everyone’s over-medicated” bandwagon.
You touched one of my pet peeves related to this topic. My suspicion, based on no scientific evidence whatever, is that most of the kids diagnosed as ADHD are actually suffering what what used to be called “boredom”.
My impression is that modern school environments want a room full of little clones that exhibit identical behavior. That makes them easier to “manage”.
It seems that teachers/school sytems today don’t want to take the trouble to understand students as individual people, and tailor their teaching approach appropriately.
It has even gone so far as to threaten parents with legal action if they refuse to drug their kids. Does this not seem extreme to anyone?
I believe the idea is that people are taking medicine for non-problems or else for problems where behavioral changes would be cheaper and more effective. I know an active lifestyle and healthy diet help my depression far more than any pill did, but I may be a minority.
One example is ADHD meds for kids. According to some (I’m not really sure where I stand on all this, so I’m trying to be an unbiased observer), kids have always been hyper with low attention spans, so Big Brother is just medicating them into institutional compliance instead of letting kids be kids. In fact, I think this is a big part of the “overmedicated” complaints. That we’re medicating people in order to make them conform to society instead of changing society to accept the full variability of personalities that exist.
My girlfriend’s grandma had a miscarriage in the late 1950s. She was born in 1917 so she knew that was probably her last pregnancy, her last chance at having another baby, and she was understandably devastated. She mourned for a long time, and finally was pressured to see a psychiatrist, who promptly put her on some ancient antidepressant. Well she was the compliant type, and stayed on that medicine for another 50 years (she lived to be really old – she just died two years ago). Anyway, my girlfriend complains about overmedicating people for this reason. When some doctor finally got around to reevaluating her when she was put into a nursing home this century, he was appalled that she was allowed to be on this medicine for so long. Then he took her off of it, and of course she was fine. She never needed it in the first place, she was just mourning her last pregnancy.
So anyway, I think the argument is that drugs are a first resort when it should be the last, and furthermore that drugs are used on things that aren’t really problems. I know I personally am offended that (until a few years ago at least, I don’t know if things have changed) doctors would prescribe antibiotics for viral diseases like the flu or even a cold, so patients would feel like they were “doing something about it”. And now we’ve bred antibiotic resistant bacteria. I don’t know if that counts as “overmedicating”, but certainly it shows how such a thing could be possible. Patients don’t think their doctors provide any service unless they play fast and loose with their prescription pad.
I’m not sure if we should be overly impressed with the results of evolution. Humans are pretty messed up in the head. We’re definitely a fixer upper, whether that means drugs, genetic modification, whatever. But yeah, the whole be a little smiling cog in the machine, Brave New World sort of medication is something to watch out for. Or medicalizing character quirks.
Are you saying it’s ok for the kid to take drugs if we can’t get the father to stop drinking?
I was thinking about maybe teaching the kid some coping skills.
Why not both?
A few reasons:
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The habits a child learns to cope with stress can affect the child for life. Any coping mechanism that resembles avoiding stress can lead to poor lifetime coping skills. A common problem is that some children are forced to learn coping skills that avoid problems because they are powerless as children to deal with certain problems. These children keep using the same methods when they become adults when they are no longer powerless. The concern here is that a child who learns to take drugs every time she gets upset about her father will learn to take drugs with other problems as well when she grows up.
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Drugs can have harmful side-effects and may lead to addiction.
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Drugs are a short-term solution that can make learning a long-term solution more difficult. It’s hard to learn to how to confront your father about his behavior when you can take some pills instead and feel better about whole thing.
All this said, I can still see a case made for drugs that are not dangerous, but can help boost performance. Like drinking caffeine to help study. There might be a similar drug that can help someone confront an abusive relative, I guess.
The problem then becomes telling the difference between drugs that help boost performance and drugs that help avoid performance. I think the medical system right now tends to make the wrong decision when faced with this question, and it’s mostly because there is no accountability. A doctor can say drug X will help this child with his nightmares, and no one will check medical journals to see if he is correct.
What if the doctor gives the child some pills that help the child sleep short term? The child’s father is still drinking, so now that child can sleep with the help of drugs, and she grows up to be an adult who needs drugs to sleep. That’s the big risk I worry about with drugs.
You can also imagine a scenario where the child only takes pills that help him sleep until he moves away from his parents. However, I think this route requires a good amount of self-control that a child dealing with abusive parents just will not have.
To summarize, the people who need drugs to deal with problems are often too vulnerable to take drugs in order to help them resolve problems rather than avoid them altogether.
Dear gods, not THAT! 
That’s where I was going with my remarks. I take 10 to 12 meds daily, all for things that can’t be handled with behavior/diet/exercise. I’ve tried. I’m emphatically not anti-medication. We won’t fix chronic migraine by exercise. I could train for a marathon and still be asthmatic as hell. But it does drive me mental when things like your son’s situation happen, or when I see someone eating crap when decent food is available, then complaining about heartburn an hour later. Yes, there is a place and sometimes need for laxatives. I take opiates, I get it. If I’m not diligent with my diet, I need one. But for regular (hurr, hurr) people, try eating a salad or some beans before reaching for the poop pills.
One’s mileage may vary, of course. Sometimes we do need a faster result.
Yes, we’re overmedicated. Who know what effect this radiation is having on my perfectly healthy body every time I have a mammogram. And folks with high cholesterol readings are automatically prescribed medication without first being counseled about dietary and lifestyle changes that can help naturally.
Statins are way over-prescribed, IMO and doctors aren’t fully divulging possible serious side effects (memory loss, muscle deterioration) before writing that prescription. And the reward system that pharmaceutical companies create for doctors prescribing their drugs represents a huge, and possibly dangerous, conflict of interest.
When I was diagnosed with “situation depression” from not having a job, I was told to get on disability for depression and (supposed) Asperger’s, and take an antidepressant! In other words: Stay in the same situation, and do drugs! Fortunately, I didn’t listen.
This is one of my biggest soap box issues. Big pharma wants everyone to be taking as many drugs as they can sell. And I personally believe the side effects are built-in, to sell more medications. Your anti-depressant gives you heartburn. Take this pill! That pill makes you constipated? Take this pill! Big pharma loves it.
I read a four step “cure” for depression: Socialization, nutrition, exercise and routine. Not as easy as taking drugs, but much safer. And effective for me.