Over-Prescription as Normalcy

The Attorney General’s I-STOP bill, proposing the institution of a computer system that would track the medical history of patients to prevent against drug abuse, is facing backlash from some members of the medical community. As the article notes, New York “ranks 11th in the nation for admissions to chemical dependence programs for abuse of opioids other than heroin”.

The article’s discussion of the dangers inherent in over-prescription retains a focus on “crooked doctors, street-level drug dealers, and doctor-shopping addicts”. Little attention is paid to the addiction that rages within the employed upper-middle class. This focus perpetuates the stereotype that drug problems are confined to a particular subset of society that doesn’t include ‘us’.

This drug problem extends to law school; indeed, it often starts there. The use of caffeine and alcohol for coping with work and social situations is normalized and embraced. After all, who would knock a good cup of joe and rum and coke? A person who does that would be stigmatized as a radical for not self-medicating daily.

Self-medication – through prescription drugs, alcohol and caffeine – is pervasive in the legal profession. It is used to disassociate from the ‘soul splitting’ to cope with the times when a lawyer is working on a deal that will ruin the lives of thousands of people. Dependency on these substances to cope with moral compromise and cognitive dissonance is accepted by the profession, not rejected as an addiction.

The lack of resources to truly address soul-splitting further drives the problem of self-medication and over-prescription. You will be hard-pressed to find a psychologist or therapist who is not a psychiatrist, and if you do, it won't be long before you are refered to a psychiatrist for medication. It's cheaper for the insurance company to give you pills instead of treating the problem.

A separate but related problem is the prescription of drugs based on ties with pharmaceutical companies. It is unsettling to watch a doctor prescribe a drug while writing on a clipboard that bears the logo of that drug. There is no good reason why prescriptions for OxyContin? have gone up 82% in 3 years. The drug is notoriously abused, and according to the article, has "contributed to more deaths than any other prescription opioid there since 2006". If reform is to come, changes to the marketing practices of pharmaceutical companies are necessary.

There is a stigma in the United States that you're a weakling if you can't function due to internal strife; it's your own fault not to be able to deal with your issues. That in part leads to the normalization of self-medication. After all, our society wouldn't function with lawyers and other professionals being unable or unwilling to do their job due to internal conflicts or strife.

Still, a morning cup of coffee or evening cocktail may not be a manifestation of a subconscious attempt to cope with soul-splitting. It may instead be the result of social conditioning to use. But if all you’re selling is time, not judgment, who cares? If we dismiss the econodwarf and start measuring our worth by judgment proffered instead of time spent, society might take notice of our profound substance dependence instead of the tacit endorsement of whatever it takes to pawn our license and bill our hours.

-- MeaganBurrows, PrashantRai, AgnesPetrucione, and HarryKhanna 03 April 2012