The wages of sickness

We once knew a fairly incompetent mother whose young children were insufferable. They were insufferable because they were miserable, and they were miserable, it seemed, because their parents provided neither discipline nor routine. The children stayed up late, drank as many soft drinks as they liked, ran about unsupervised, and generally lived one remove from the stranded boys in Lord of the Flies.

This mother was convinced that her daughter was depressed and needed medication. Her evidence for this was the fact that her daughter was unhappy and quarrelsome. I remember praying that she wouldn't find a prescription-happy doctor who casually agreed with her diagnosis.

I thought of this mother, whom we haven't seen in years, after reading that Forest Laboratories Inc. is being prosecuted by the U.S. Justice Department for allegedly marketing antidepressants improperly for children, and paying doctors kickbacks to get more kids on their drugs. The Feds further claim that Forest Labs suppressed research indicating its drugs were not only ineffective for children, but could cause suicidal thoughts.

The company faces financial penalties should the government's allegations prove true. There was a time when people convicted of marketing dangerous potions to unsuspecting children would have received more than financial penalties-the business end of an ax handle, for starters. Perhaps frauds no longer faze us. Or perhaps we have grown accustomed to assuming that problems in our children demand pharmaceutical remedies.

Since the 1990s, U.S. doctors have been increasingly likely to prescribe drugs to combat depression in children, though this practice abated after research, slow to be recognized by the Food and Drug Administration, indicated a link between some of these drugs and suicidal tendencies. Pediatric prescriptions for Ritalin skyrocketed over the same period.

I don't doubt there are children helped by such drugs. Nor do I doubt that some children who would benefit from medication are denied it due to the unwarranted biases of their parents. But I also suspect that what should be a last line of defense is becoming the vanguard. We are forgetting how to parent. You can see this in a good many churches, not to mention public schools and shopping malls. Discipline is discontinuous and ungrounded, religious dogma goes largely untaught, participation in the rituals of the faith are postponed, and talk of values is well-nigh embarrassing.

No wonder so many children are ill-mannered and reclusive, shiftless and aimless. If it depresses me just to write about it, I can only imagine how depressing it must be to live the life of a child amongst too many adults who haven't quite grasped how to stop being children themselves.

Many children of entirely competent and loving parents, of course, still desperately need medical help, which compounds the tragedy, because they run the risk of getting lost in the sea of troubled children who don't need drugs so much as better parents. It's a tragic truth that a society intent on defining wide swaths of its citizens as ill will consequently neglect the ones who most need help. In a village where everyone is sick, where do you send the ambulance?

It's especially troubling to learn that family practitioners may well have been participating in Forest Labs' drug push. I read on the same day that a prominent Emory University psychiatrist is being investigated for inadequately disclosing over $800,000 in payments from drug company Glaxo while he researched the effectiveness of that company's antidepressants. Many other doctors were paid by Glaxo to attend "training seminars" described by the company's own internal documents as a means to "influence clinicians." Worse, the participating doctors signed agreements not to disclose the company's payments.

There are mentally troubled people, including children, who probably need drugs. The problem is, it seems, that drug companies aren't satisfied there are enough of them. So they recruit the doctors we trust to serve as their shills, which only compounds the problem. A great many parents are willing to put their children on drugs, and a great many others of us immediately distrust anyone who suggests such a measure. And the ones who suffer most are our children. Who is looking out for their interests?