Your Rants Against ‘Big Pharma’ Are Probably Ableist

flickr/Daniel Go

Recently, I finally bought a pill organizer — two, actually, so I wouldn’t have to sit down and fill them as often. Usually, getting a new organizing tool makes me feel energized. But as I placed them in my cart, I didn’t feel invigorated at all. I felt defeated.

“Am I on too many medications?” I thought, even though I’d purchased the organizers to track my once-a-day pill for attention deficit disorder (ADHD), Strattera. The last time I’d had to pour the bottle out, count the pills that were left, and count backwards to when I filled the prescription to figure out if I had actually taken one, I almost threw the bottle across the room. This purchase was going to make my life easier. The queasiness, then, was unexpected.

I was a sickly kid — annual strep throat, perpetual ear infections, five ear surgeries by the time I was 13, hospitalizations for severe dehydration due to the flu. To say I was usually on antibiotics is just barely an overstatement. So why — after three decades desperate for access to mental health care and decent primary care — was I having a near panic attack buying organizers for my pills?

The answer? Because I live in the land of medication-shaming, where my needing pills for mental-health issues denotes weakness and a desire to check out rather than deal.

The “Big Pharma overmedicates Americans” charge is so pervasive, it’s rarely even challenged at this point. And in some ways, of course, the railing is justified.

But too often, tirades against the pharmaceutical industry stigmatize those battling mental-health issues. If you’re one of the people who runs around railing against Big Pharma, I have news for you: Your ranting is probably ableist.

My quarrel isn’t with all criticism of the pharmaceutical industry. Far from it.

Our medical system’s capitalist incentives are a definite problem; half of all bankruptcies in this country before the Affordable Care Act (ACA) reformed insurance practices were for medical debt. Prescriptions are too expensive. Patents last entirely too long and are too easy to renew, preventing cheaper generics from reducing cost. And companies devote too many resources to developing new ways to ensure an erection, and not enough to developing new antibiotics to tackle the increasing problem of drug-resistant bacteria.

If you want to go at our pharmaceutical industry for these issues, GO FOR IT. I’m here for it. I’ve been upset about the priority problems in the industry since long before it was fashionable.

My problem is specifically with the message that Big Pharma is overmedicating Americans, a tirade that sends a dangerous message to the masses about the needs of those who are mentally ill. Every time you repeat that bullshit, you are shaming those of us who need medication to live by implying that we’re only on medication because of the agenda of a corrupted industry.

If you Google “Big Pharma,” you get 8.34 million hits in half a second. Phrases like “over-medicated” and “drug pusher” pop up next to headlines like “Big Pharma Is America’s New Mafia.” Conspiracy theories about data-tracking pills and the purposeful sedation and control of our population abound on the left. The way prescription medications are discussed in the media, you’d think it was easy to get your hands on drugs when you want them (if only that were the case).

To cite but one example of the dangerous dynamics at play in the media’s treatment of the pharmaceutical industry: A recent Forbes article about unnecessary prescriptions downplayed the nuances of the piece itself with the salacious, fear-stoking headline “The Dark Side Of Big Pharma.” And though the story contained some nuance, it also perpetuated a limited view with lines like, “For years now, drug makers have been operating on the dark side,” invoking Star Wars themes of good and evil.

Frontline did an entire series — “The Business of Adhd [sic]” — that appears, for those who just read the highlights, to confirm our collective fears about how our children are forced to take pills, rather than encouraged to explore their creativity. One of those who Frontline interviewed, Dr. William Dodson, does a great job of explaining the actual problem: Doctors are rushed and must make assessments with too little information — less a pharma-specific issue than it is a medical-field-in-general-meets-capitalism issue:

“Can ADHD be diagnosed in a 15-minute well-baby check-up at the pediatrician? No way. In order to do a good, adequate evaluation, you need several hours: to rule out all the things that might mimic ADHD; to thoroughly evaluate all the things that can co-exist within ADHD; to educate the parents about the use of medication, and about the ancillary treatments that are going to be necessary; to do a quick screening for learning disabilities. A good, thorough evaluation takes time.”

But is that the headline or a pull quote? Of course not. And the next question immediately returns the focus to where the interviewer wants to go: pharmaceutical marketing villianization. These should be equally important topics as BOTH speak to whether or not people are able to access adequate care. When writing and talking about medications, however, writers are purpose-driven and seek to vilify rather than include the complicated, overlapping issues preventing people from receiving the treatment they need. The full picture isn’t as simple or fun as “Big Pharma Bad!”

Huffington Post has entire pages on the “overmedication” of basically everything. Even Oprah got into the action, exploring whether America is “a pill nation” and, on her Super Soul Sunday show, stating very clearly that “people take pills like candy.”

We’ve all heard the mantras repeated in punchlines and “serious” reporting and political commentary: “Americans are over-medicated! They’re drugging you to pacify you so you won’t demand change!” The saying “I used to care, but I take a pill for that now” is so over-used (oh, the irony) that it’s impossible to source back to a definite original author/speaker. It’s on coffee mugs, t-shirts, internet memes, bumper stickers, and keychains. There’s even a “comedy” film called Happy Pills.

That meme has been around so long that supposedly serious outlets use it in headlines. “South Carolina College Apologizes for Giving ‘Happy Pills’ to Little Kids,” shrieks an NBC News headline on a story from last year about a professor who jokingly “prescribed” M&Ms to little kids. “Why millions of women are hooked on the happy pills,” reported The Guardian in 2004. The author of that piece boils the thesis down to a combo platter of internalized misogyny and mental health shaming, writing, “Is life now so difficult for women that it’s normal to be depressed?” As though the sexism we face wouldn’t be enough to warrant periods of depression for nearly 100% of those who identify and/or present as women.

What’s interesting about all this noise surrounding Big Pharma and pill-peddling is how it directly contradicts my lived experiences as someone on medication for mental-health issues. My experience with doctors, even after the ACA, has been quite the opposite of what these stories imply. Both my psychiatrists over the past 15 months and my current primary care physician are very cost-conscious; their focus is on determining what the best option I can afford will be, not whether they get credit for it from a pharmaceutical rep.

I had been miserable for almost three decades when I finally was able to get my first accurate diagnosis — extreme ADHD — and medication to alleviate it. Halfway to a therapeutic dose of the daily non-stimulant Strattera, and I no longer felt like I was about to come apart at the seams. I wasn’t completely functional, but I could sit down and write or read without literally pulling my hair out. By the time I hit the full 80 mg, my entire life had changed. I could write; I was doing book reviews. I could enjoy a movie or a conversation with a friend.

I didn’t need commercials or a pharmaceutical rep camped out in my doctor’s waiting room to convince me I needed help. I’d been self-medicating for years; it had almost killed me, and it certainly hadn’t made me feel any better. I hadn’t been able to afford quality therapy or a decent psychiatrist. I didn’t want medication to numb me out or make me feel less; I wanted medication so I could engage more fully with my life and the people in it. I wanted to be able to work, to play, to volunteer, to enjoy leisure time. I’m only partway to my first effective medication protocol, but I’m already able to do some of those things.

I am able, really, to participate in my care for the first time in my life.

When I was in middle school, my parents got a letter from the agency that facilitated my adoption. My birth mother wanted them to contact us so that we’d know my birth father had died of a very rare, genetic disease: Wilson’s disease. According to the Mayo Clinic, “Wilson’s disease is a rare inherited disorder that causes too much copper to accumulate in your liver, brain, and other vital organs.” Now there are treatments — a trio of drugs that cause rather unpleasant side effects, and a liver transplant if your symptoms are advanced before you can access treatment. Twenty-five years ago, though, the medications weren’t so widely available. I was told by the specialist who did the battery of tests required in the days before genetic testing (the liver biopsy was especially fun) that a pill a day would control the condition, but pharmaceutical companies couldn’t make money off of it because so few people have it — fewer than 10,000 in the U.S.

While we waited to hear if I might die before my 40th birthday, I developed a healthy dislike for the companies that didn’t think my life was worth spending money on. The profit motive in medicine is despicable, but here’s the crucial point: It’s not why I’m on psych meds.

Railing against The Over-Medication Of The American Population is a lot like railing against The Establishment. You’re not actually yelling at anyone. What you are doing is telling me I was manipulated into the pills in my organizer, that I don’t really need them as a crutch, and that I should be strong enough to do without the treatment that has put me in control of my life for the first time.

You can — I’m just sure of it — refine your railing so those within eye/earshot understand that your beef is with the capitalistic nature of the companies, not with those of us who (until we change our health “care” system) need the medications they manufacture to function fully.