There was a big flap over the weekend when, during the Super Bowl, AstraZeneca and Daiichi Sankyo spent five  million dollars on an ad which didn't actually list the name of the drug they were selling. The name of the drug is Movantik, and the fact that they didn't even mention the name of the drug is interesting and fuels the belief that the commercial was as much to sell a new drug as to make it okay to keep taking highly addictive substances.

As a psychologist, I don't prescribe medication. If I feel a client could benefit from a psychotropic medication, I refer them to a psychiatrist to evaluate them. The psychiatrist determines whether the client is appropriate for medication and, if so, what medication would be best. This is not a simple process and I have great esteem for my colleagues that are prescribers. It has long been "best practice," if taking psychotropic medication, to also be in therapy at the same time.

So why am I, a non-prescribing professional, talking about an ad for a medication that has nothing to do with the field of psychology? I see this ad as an example of how the pharmaceutical industry is not always looking out for the best interests of their customers. I won't even bring up as an example Martin Shkreli. I don't really need to, because the ad I mentioned at the outset, I believe, is a wonderful example of this.

The ad talks about opioid induced consipation in very familiar terms. It makes it seem like this is such a natural thing, plaguing so many people. I'm not going to talk about numbers right now but the point is, in doing this, the industry is minimizing or at least normalizing the issue of using opioids--never mind the side effects that occur from their use.

The opioids that they seem to be talking about are among the Schedule II drugs. These are "substances [that] have a high potential for abuse which may lead to severe psychological or physical dependence" but they are allowed to be prescribed because"they have a currently accepted medical use in treatment in the United States." ( These include such substances as OxyContin®, Percocet®, and morphine. These are some serious, heavy duty narcotics. People are usually prescribed these because of extreme pain. The goal, at least from the prescriber's point of view I believe, is to either provide relief for situations where there is nothing they can do medically to help, or provide short-term symptom relief until natural healing has occurred (like after a surgical procedure).

The problem is that so many people have been prescribed these and take them for years and years, becoming addicted to them, increasing their doses as their body becomes habituated to them and, additionally, dealing with other complications (like constipation) that are side-effects of the medication. To the pharmaceutical company, its simple supply and demand and there is a huge demand.

The White House was apparently outraged at the ad (you can read about it here) but are they going to do anything about it? I doubt it. I'm not trying to be political at all, please don't misunderstand me, but because pharmaceuticals are so huge and powerful, the White House, regardless of who currently sits in it, is going to have a tough time making any real changes to how things are done. The pharmaceutical industry can plop down five million dollars for an ad without batting an eye.

Back to why I'm talking about this today. I merely wish to point out that as long as drug companies are making money on these highly addictive substances and even more money on remedies for dealing with the side-effects of them, nothing will change dramatically. I would love to see alternative methods (whether it be some natural substance or advances in therapy) that are healthier than our current methods of dealing with pain, anxiety, depression, ADHD... today's society seems to be one where "there's a pill for that" and we never have to feel a moment of discomfort.

As a psychologist, I look at medication referrals as a "last resort" because I would rather try to offer my clients "non-substance" solutions to their anxiety and depression. For mild cases, it is really not necessary to take medication and although this undoubtedly is different for everyone, I take a very conservative approach. Unless my client is having thoughts of suicide, I'm going to put off talking about medication until I've tried a bunch of other options first. This is bad news to pharmaceuticals. I am sad to say, the impression I have is that they would rather I be a prescriber and pass out their pills than try to help people with therapy and behavioral changes. It's not profitable to them if I'm providing my clients with alternatives to dealing with their discomforts. It's not profitable, but I believe it is the ethical and moral thing to do.