# Why do doctors over prescribe drugs? **URL:** \ **Category:** Great Debates\ **Created:** [March 23, 2012, 3:22am UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575 "2012-03-23T03:22:14Z")\ **Posts on this page:** 20\ **Page:** 3
**Author:** ![thelabdude](https://avatars.discourse-cdn.com/v4/letter/t/dc4da7/32.png) [@thelabdude](https://boards.straightdope.com/u/thelabdude)\ **Post date:** [March 23, 2012, 8:16pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/41 "2012-03-23T20:16:44Z")
> [@Anne\_Neville](#): > > You have to take into account whether most people will be willing to comply with a treatment, as well. If people can’t or won’t do what they need for a treatment to work, it’s not doing them much good. We might need an alternative that people would be more likely to comply with. That might mean drugs over lifestyle changes. People aren’t always willing or able to comply with lifestyle changes that their doctors tell them to make. That doesn’t mean those people don’t need or deserve to have their medical conditions treated. This is true. doctors used to push low salt diets. I have never had a doctor tell me to use less salt. Instead, I am taking this statin and that statin and something else too. ---
**Author:** ![Marley23](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@Marley23](https://boards.straightdope.com/u/Marley23)\ **Post date:** [March 23, 2012, 8:20pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/42 "2012-03-23T20:20:23Z")
> [@thelabdude](#): > > This is true. doctors used to push low salt diets. I have never had a doctor tell me to use less salt. Instead, I am taking this statin and that statin and something else too. Statins lower cholesterol. What’s that have to do with salt? ---
**Author:** ![Kolga](https://avatars.discourse-cdn.com/v4/letter/k/e56c9b/32.png) [@Kolga](https://boards.straightdope.com/u/Kolga)\ **Post date:** [March 23, 2012, 8:28pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/43 "2012-03-23T20:28:20Z")
> [@GreenElf](#): > > It wasn’t an exhaustive list. There’s a million causes of depression, certainly not just self-pity, including mourning someone after death. A percentage of depression has a clinical source, but the TV ads shoehorn the general public into doctor’s offices to get pills rather than just dealing with the external source of depression, which may be as simple as letting a period of mourning, or period of grief after being rejected or divorced (these are just a couple examples, not intended to be an exhaustive list), take its course. Most people should be going to a psychologist first, and only to a doctor if referred by the psychologist. It may be best to first try a placebo and see if the patient recovers from their depression before prescribing meds with potentially harmful side effects. Powerful things, those ads, making people visit doctors’ offices against their will and demand drugs that they don’t need for conditions they don’t have. While I do agree with you that a lot (not most) of people would benefit from seeing a therapist before or in addition to seeing a doctor, that still does not support your belief that people are claiming (or being diagnosed with) depression because they are in mourning, or upset that they aren’t beautiful, or going through a divorce. Prescribing placebos is unethical. Again, for those who believe that drugs are “overprescribed” - how many drugs should be prescribed? What’s the ‘right’ level of prescriptions for our society? And are untrained non-medical people the right ones to determine that? ---
**Author:** ![Hentor\_the\_Barbarian](https://avatars.discourse-cdn.com/v4/letter/h/8edcca/32.png) [@Hentor\_the\_Barbarian](https://boards.straightdope.com/u/Hentor_the_Barbarian)\ **Post date:** [March 23, 2012, 8:28pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/44 "2012-03-23T20:28:20Z")
> [@GreenElf](#): > > It wasn’t an exhaustive list. There’s a million causes of depression, certainly not just self-pity, including mourning someone after death. A percentage of depression has a clinical source, but the TV ads shoehorn the general public into doctor’s offices to get pills rather than just dealing with the external source of depression, which may be as simple as letting a period of mourning, or period of grief after being rejected or divorced (these are just a couple examples, not intended to be an exhaustive list), take its course. Most people should be going to a psychologist first, and only to a doctor if referred by the psychologist. It may be best to first try a placebo and see if the patient recovers from their depression before prescribing meds with potentially harmful side effects. You may be confusing dysphoric mood (sadness), which is a symptom of depression, with major depressive disorder, a diagnosis. To meet criteria you have to have two weeks during which nearly every day you experience dysphoria or anhedonia, along with four or more additional symptoms, such as disruptions in sleep, appetite changes, confusion, psychomotor agitation or retardation, excessive guilt, suicidal ideation, and hopelessness. People constantly misunderstand the criteria for diagnosis of psychiatric disorders, generally towarda the assumption of pathologizing normal experiences. I can assure you that there are no disorders that are shown by 50% of the population. ---
**Author:** ![erislover](https://avatars.discourse-cdn.com/v4/letter/e/71e660/32.png) [@erislover](https://boards.straightdope.com/u/erislover)\ **Post date:** [March 23, 2012, 8:28pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/45 "2012-03-23T20:28:48Z")
Since we have, for some reason, invested the authority of dispensing drugs in the hands of doctors, it is logically impossible for doctors to over prescribe. ---
**Author:** ![ralph124c](https://avatars.discourse-cdn.com/v4/letter/r/8797f3/32.png) [@ralph124c](https://boards.straightdope.com/u/ralph124c)\ **Post date:** [March 23, 2012, 8:30pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/46 "2012-03-23T20:30:14Z")
An Indian friend once told me that Indian doctors are willing to prescribe antibiotics for colds-even though these drugs are useless to treat colds. Such overuse sounds like it would contribute to the antibiotic-resistant diseases-is this true? ---
**Author:** ![Ann\_Hedonia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ann_hedonia/32/319_2.png) [@Ann\_Hedonia](https://boards.straightdope.com/u/Ann_Hedonia)\ **Post date:** [March 23, 2012, 8:30pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/47 "2012-03-23T20:30:46Z")
> [@GreenElf](#): > > It wasn’t an exhaustive list. There’s a million causes of depression, certainly not just self-pity, including mourning someone after death. A percentage of depression has a clinical source, but the TV ads shoehorn the general public into doctor’s offices to get pills rather than just dealing with the external source of depression, which may be as simple as letting a period of mourning, or period of grief after being rejected or divorced (these are just a couple examples, not intended to be an exhaustive list), take its course. Most people should be going to a psychologist first, and only to a doctor if referred by the psychologist. It may be best to first try a placebo and see if the patient recovers from their depression before prescribing meds with potentially harmful side effects. It’s normal to be sad when the situation warrants sadness and it’s normal to feel anxious and overwhelmed when faced with an anxious and overwhelming situation. I knew I had a problem when these negative feelings were occuring outside of the context of the real world situations that would warrant them…specifically when I woke up in my luxury resort suite the first morning of my dream vacation and felt anxious, overwhelmed and wanted to do nothing more than pull the covers back over my head and go to sleep…that’s when I got help. ---
**Author:** ![Silver\_Jan](https://avatars.discourse-cdn.com/v4/letter/s/90ced4/32.png) [@Silver\_Jan](https://boards.straightdope.com/u/Silver_Jan)\ **Post date:** [March 23, 2012, 8:47pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/48 "2012-03-23T20:47:55Z")
> [@Buck\_Godot](#): > > Speaking as a federal employee involved in cancer research I can state without equivocation that we are all working our collective buts off to try to find a cure. If fresh vegetables actually worked we would gladly close up shop and work on something else. The claim that we are all just sitting here cackling evilly pretending to do research is highly offensive. Given that many of these researchers also have relatives who have died of cancer saying that they are actively holding up the cure is a monstrous accusation. > > Cancer is a very difficult disease to treat because cancer cells are just like other cells in the body so its hard to kill them without killing the patient. Some types of cancer we can handle well. Breast cancer caught early has a greater than 90% cure rate. Others are more difficult, but we are working tirelessly to try to treat them. If you don’t believe us just open up a medical journal or visit the NIH. you will see people working hard to make the world a better place. Thank you! ---
**Author:** ![Tim\_T-Bonham.net](https://avatars.discourse-cdn.com/v4/letter/t/46a35a/32.png) [@Tim\_T-Bonham.net](https://boards.straightdope.com/u/Tim_T-Bonham.net)\ **Post date:** [March 23, 2012, 10:23pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/49 "2012-03-23T22:23:36Z")
> [@Hentor\_the\_Barbarian](#): > > What’s the evidence supporting the claim that medications are overprescribed? Well, the development of drug-resistant strains of bacteria could be considered evidence of this. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [March 23, 2012, 11:04pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/50 "2012-03-23T23:04:52Z")
> [@t-bonham@scc.net](#): > > Well, the development of drug-resistant strains of bacteria could be considered evidence of this. Frankly, even the most appropriate prescribing of antibiotics will inevitably lead to some resistance. But at least in that circumstance, said resistance should develop and spread much slower, and proper use of other antibiotics against the resistant strains should be able to contain the problem. ---
**Author:** ![Toucanna](https://avatars.discourse-cdn.com/v4/letter/t/3bc359/32.png) [@Toucanna](https://boards.straightdope.com/u/Toucanna)\ **Post date:** [March 23, 2012, 11:34pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/51 "2012-03-23T23:34:56Z")
> [@ralph124c](#): > > An Indian friend once told me that Indian doctors are willing to prescribe antibiotics for colds-even though these drugs are useless to treat colds. Such overuse sounds like it would contribute to the antibiotic-resistant diseases-is this true? FWIW: [http://www.wired.com/wiredscience/2012/01/tdr-india-denies/](http://www.wired.com/wiredscience/2012/01/tdr-india-denies/) ---
**Author:** ![GreenElf](https://avatars.discourse-cdn.com/v4/letter/g/9de053/32.png) [@GreenElf](https://boards.straightdope.com/u/GreenElf)\ **Post date:** [March 24, 2012, 1:11am UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/52 "2012-03-24T01:11:39Z")
> [@Hentor\_the\_Barbarian](#): > > You may be confusing dysphoric mood (sadness), which is a symptom of depression, with major depressive disorder, a diagnosis. > > To meet criteria you have to have two weeks during which nearly every day you experience dysphoria or anhedonia, along with four or more additional symptoms, such as disruptions in sleep, appetite changes, confusion, psychomotor agitation or retardation, excessive guilt, suicidal ideation, and hopelessness. > > People constantly misunderstand the criteria for diagnosis of psychiatric disorders, generally towarda the assumption of pathologizing normal experiences. I can assure you that there are no disorders that are shown by 50% of the population. My view is that a lot of depressed people watch TV, and _TV tells them to talk to their DOCTOR about depression_, so he can give them meds, but they should be either taking active measures themselves to alleviate it, go for a walk every day and the like, or talk to a PSYCHOLOGIST about their depression. Most don’t need to risk taking meds, only those with a clinical rather than environmental or psychological source of depression, but those who actually need meds would be referred by a psychologist. ---
**Author:** ![Guinastasia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/guinastasia/32/5751_2.png) [@Guinastasia](https://boards.straightdope.com/u/Guinastasia)\ **Post date:** [March 24, 2012, 2:19am UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/53 "2012-03-24T02:19:10Z")
> [@GreenElf](#): > > My view is that a lot of depressed people watch TV, and _TV tells them to talk to their DOCTOR about depression_, so he can give them meds, but they should be either taking active measures themselves to alleviate it, go for a walk every day and the like, or talk to a PSYCHOLOGIST about their depression. Most don’t need to risk taking meds, only those with a clinical rather than environmental or psychological source of depression, but those who actually need meds would be referred by a psychologist. Are you getting this info from viewing TV commercials, or from, you know, actual evidence, like reading studies? Do you honestly know someone who’s depressed because they aren’t pretty or rich enough? Because I can assure you, that wasn’t my situation. ---
**Author:** ![Marley23](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@Marley23](https://boards.straightdope.com/u/Marley23)\ **Post date:** [March 24, 2012, 2:23am UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/54 "2012-03-24T02:23:00Z")
> [@GreenElf](#): > > My view is that a lot of depressed people watch TV, and _TV tells them to talk to their DOCTOR about depression_, so he can give them meds, but they should be either taking active measures themselves to alleviate it, go for a walk every day and the like, or talk to a PSYCHOLOGIST about their depression. Most don’t need to risk taking meds, only those with a clinical rather than environmental or psychological source of depression, but those who actually need meds would be referred by a psychologist. How many people get antidepressants from their personal/family doctor instead of getting them from a psychiatrist? ---
**Author:** ![XT](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/xt/32/456_2.png) [@XT](https://boards.straightdope.com/u/XT)\ **Post date:** [March 24, 2012, 2:26am UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/55 "2012-03-24T02:26:14Z")
Well, I got a paxil prescription from my regular doctor years ago after a death in the family. He put me on it for maybe 6 months before I was…well, better I guess. So you can get one, though maybe paxil isn’t very strong. No idea but my guess is it’s not. -XT ---
**Author:** ![Marley23](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@Marley23](https://boards.straightdope.com/u/Marley23)\ **Post date:** [March 24, 2012, 2:40am UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/56 "2012-03-24T02:40:39Z")
That _sounds_ medically appropriate, but I wouldn’t know. I’m sorry for your loss- I’m not sure I knew about that. ---
**Author:** ![XT](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/xt/32/456_2.png) [@XT](https://boards.straightdope.com/u/XT)\ **Post date:** [March 24, 2012, 2:49am UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/57 "2012-03-24T02:49:09Z")
It was a long time ago, but not something I talk about much. My drinking problem, something else I don’t talk about much, largely stemmed from it. the paxil wasn’t much help…or, it saved my life. Who knows? Anyone who thinks depression is about being sad because of how you look or whatever the OP was on about is a fool. -XT ---
**Author:** ![MsRobyn](https://avatars.discourse-cdn.com/v4/letter/m/90ced4/32.png) [@MsRobyn](https://boards.straightdope.com/u/MsRobyn)\ **Post date:** [March 24, 2012, 3:17am UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/58 "2012-03-24T03:17:34Z")
> [@GreenElf](#): > > It wasn’t an exhaustive list. There’s a million causes of depression, certainly not just self-pity, including mourning someone after death. A percentage of depression has a clinical source, but the TV ads shoehorn the general public into doctor’s offices to get pills rather than just dealing with the external source of depression, which may be as simple as letting a period of mourning, or period of grief after being rejected or divorced (these are just a couple examples, not intended to be an exhaustive list), take its course. Most people should be going to a psychologist first, and only to a doctor if referred by the psychologist. It may be best to first try a placebo and see if the patient recovers from their depression before prescribing meds with potentially harmful side effects. Most of us know the difference between feeling sad after Grandma dies and a serious problem. And even something as mundane as grief can set off a major depression and require medication in addition to counseling. In any event, most primary care doctors deserve more credit than you’re apparently willing to give them. They see a lot of routine problems like depression, they know how to screen for them, and they know what referrals and recommendations to make for treatment. Most also know what their limitations are and won’t attempt to treat you if it’s something that’s outside of their experience and comfort zone; they’ll refer you to a specialist who does know how to evaluate and manage that condition. I’ve yet to go to a primary care doc who gave out psychoactive drugs like candy; they let the psychiatrists do that. 😃 ---
**Author:** ![Kolga](https://avatars.discourse-cdn.com/v4/letter/k/e56c9b/32.png) [@Kolga](https://boards.straightdope.com/u/Kolga)\ **Post date:** [March 24, 2012, 3:29am UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/59 "2012-03-24T03:29:44Z")
> [@Marley23](#): > > How many people get antidepressants from their personal/family doctor instead of getting them from a psychiatrist? Actually, quite a bit. There are lots of studies showing that most people on anti-depressants receive those prescriptions from PCPs and not psychiatrists. Of course, some of them might be receiving maintenance prescriptions after having been originally assessed by a psychiatrist. There are various studies that state that about 10% of Americans have prescriptions for anti-depressants. However, many of those take anti-depressants for other uses, such as pain management, anxiety disorders, sleep problems, etc. Some of the studies I’ve seen say that about half of the prescriptions of anti-depressants are for non-mental health reasons. Which means about 5% of Americans have a prescription for anti-depressants at any given time. That does not mean that they remain on those medications forever - many people with anti-depressant prescriptions only need the medication for limited periods of time. So, again, I ask - if that’s “too many,” then what’s the correct percentage, according to the TOO MANY DRUGS crowd? ---
**Author:** ![monstro](https://avatars.discourse-cdn.com/v4/letter/m/ba9def/32.png) [@monstro](https://boards.straightdope.com/u/monstro)\ **Post date:** [March 24, 2012, 3:40am UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/60 "2012-03-24T03:40:21Z")
Drugs have risks, of course. Anti-depressants can make your depression worse sometimes. Some drugs have such debilitating side-effects that it’s not worth taking them, even if they do work. But every treatment strategy carries risk. Psychotherapists can plant false memories and give you creative diagnoses to justify long-term therapy. Over zealous surgeons can carve you up unnecessarily. Holistic practitioners can throw raw fruits and vegetables at you when what you really need is someone to remove the tumor in your uterus or prescribe B12 supplements. Someone who pushes their doctor to give them the latest drug is no wackier than the person who races to the herbalist for every ailment. Herbs don’t have magical properties. Those that are effective are that way because of the chemicals they produce. Chemicals with potential side-effects. Just like those pill-shaped chemicals we call drugs. [Previous page](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575.md?page=2) [Next page](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575.md?page=4)