Number of Kids on Medication Jumps Dramatically
Most related to obesity
See comments by John Cartmell, MS, at end of article.
By Liz Szabo
The number of children who take medication for chronic diseases has jumped dramatically, another troubling sign that many of the youngest Americans are struggling with obesity, doctors say.
The number of children who take pills for type 2 diabetes — the kind that's closely linked to obesity — more than doubled from 2002 to 2005, to a rate of six out of 10,000 children. That suggests that at least 23,000 privately insured children in the USA are now taking diabetes medications, according to authors of the new study in today's Pediatrics.
Doctors also saw big increases in prescriptions for high cholesterol, asthma and attention deficit and hyperactivity. There was smaller growth for drugs for depression and high blood pressure.
"We've got a lot of sick children," says author Emily Cox, senior director of research with Express Scripts, which administers drug benefit programs for private insurance plans. "What we've been seeing in adults, we're also now seeing in kids."
Type 2 diabetes was once known as adult-onset. But Cox says her records show kids as young as 5 being treated with prescription diabetes drugs.
Cox based her study on prescription records of nearly 4 million children a year, ages 5 to 19, covered by Express Scripts. She says her findings may not apply to the 40% of children who are uninsured or covered by government health plans.
Unless these children make major changes — such as eating healthier and exercising more — they could be facing a lifetime of illness, Cox says.
"These are not antibiotics that they take for seven to 10 days," Cox says. "These are drugs that many are taking for the rest of their lives."
Cox couldn't explain one surprising finding: Most of the increase in drugs for diabetes, attention deficit/hyperactivity and depression was seen in girls. The gender gap was most striking in diabetes: While the number of boys taking medication grew by 39%, the number of girls using them climbed by 147%, Cox found.
John Cartmell comments:
Children are prescribed medications for many conditions including obesity, high cholesterol, asthma, attention deficit, hyperactivity, hypertension and depression. But the greater question is why has the number of children taking medications jumped so dramatically in recent years? There are at least a couple of things that might have influenced the increase in medication use by children children.
The knowledge of medicine is not static, nor is the knowledge acquired from research and development of new medications. Increased knowledge of the nature of a disease or medication often leads to revised models for diagnosis and treatment.
Another reason for increased use of medications is the definitions of some disease have been revised over the last 10 years; to redefine previously "normal" as "pre-disease" conditions needing medication to prevent the development of the full blown disease. In the last 10 years, obesity has been defined as a "disease". Since then, the treatment of childhood diabetes and obesity has increased dramatically. The Seattle Time story, "Suddenly Sick", in 2005, reported:
- Pharmaceutical firms have commandeered the process by which diseases are defined. Many decision makers at the World Health Organization, the U.S. National Institutes of Health and some of America's most prestigious medical societies take money from the drug companies and then promote the industry's agenda.
- Some diseases have been radically redefined without a strong basis in medical evidence.The drug industry has bolstered its position by marketing directly to the health-conscious consumer, leading younger and healthier people to consider themselves at risk and to start taking medications.
- Every time the boundary of a disease is expanded — the hypertension threshold is lowered by 10 blood-pressure points, the guideline for obesity is lowered by 5 pounds — the market for drugs expands by millions of consumers and billions of dollars.
- The result? Skyrocketing sales of prescription drugs. Soaring health-care costs. Worst of all, millions of people taking drugs that may carry a greater risk than the underlying condition. The treatment, in fact, may make them sick or even kill them.
- Dartmouth Medical School researchers estimate that during the 1990s, tens of millions more Americans were classified as having hypertension, high cholesterol, diabetes or obesity simply because the definitions of those diseases were changed. Today, three of every four Americans technically have at least one of these diseases. But millions of them are not truly sick and may never be, even without medication.
- The Dartmouth researchers said....it is "an open question" whether branding them diseased and feeding them drugs may be causing significant physical or psychological harm.
Compare these statements with those in a May 2008 Report that observed:
- More than half of all insured Americans are now taking prescription medicines regularly for chronic health problems,
- Experts say the data reflect not just worsening public health but better medicines for chronic conditions and more aggressive treatment by doctors.
- In addition, there is the pharmaceutical industry's relentless advertising.
- Doctors say the proportion of Americans on chronic medications can only grow.
- Medco's data show that last year, 51 percent of American children and adults were taking one or more prescription drugs for a chronic condition, up from 50 percent the previous four years and 47 percent in 2001.
- Antidepressant use in particular jumped among teens and working-age women.
- Dr. Sidney Wolfe of Public Citizen's Health Research Group said the increased use of medications is partly because the most heavily advertised drugs are for chronic conditions, so most patients will take them for a long time. He also blames doctors for not spending the time to help patients lose weight and make other healthy changes before writing a prescription.
- The study highlights a surge in children's use of medicines to treat weight-related problems and other illnesses previously considered adult problems
- "Unless we do things to change the way we're managing health in this country ... things will get worse instead of getting better," predicted Dr. Daniel W. Jones, a heart specialist, president of the American Heart Association and dean of the University of Mississippi's medical school.
This last statement by Dr. Jones is especially relevant in these times when people want the government to address rising health care costs by nationalizing the health care system. But if we don't reform health care to also promote health to prevent disease and restore health in the face of disease, what difference does it make if our health care is privately or publicly funded; it's still bad medicine when the focus is on treatment of symptoms and not on restoring health in general.
Until our philosophy of health care changes to include a focus on the process of disease and restoration of health, a national health care system will not reduce the cost or improve the quality of care.
Nutrition is an essential factor for maintaining health and preventing disease. Any symptom can be made worse or caused if the balance of diet, digestion, absorption and metabolism (the balance of nutrition) is inadequate to support health. This is especially true of chronic disease where nutritional insufficiencies are common. Symptoms off high cholesterol, high blood pressure, high blood sugar, obesity, chronic fatigue and fibromyalgia are associated with specific nutritional concerns. A nutritional assessment should be done to determine whether symptoms might be related to nutritional issues that should be addressed first. Unfortunately, the subject of nutrition rarely comes up in health care because doctors, while trained to think in terms of treating symptoms of disease, often fail to address the most common symptom of disease; the loss of health.
John W. Cartmell, MS
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