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November 16, 2005

self-prescription

Amy Harmon has a front-page New York Times article today entitled "Young, Assured and Playing Pharmacist to Friends." All of her sources are youngish adults who obtain mood-altering or performance-enhancing drugs by sharing stockpiles, buying medications online, or lying and exaggerating to their doctors about their symptoms.

On the one hand, the article seems important to me, because it raises significant issues. For instance, is it generally a good idea to self-prescribe, relying on public information, peers, and personal experience for information? Or is it generally better to rely on physicians? When is it right to treat mild depression, undesired weight gain, or insomnia with chemicals? Is that cheating, or is it smart? Why are these young adults unhappy, to start with? Are they just overly sensitive? Or is there something (perhaps consumerism and careerism, or the way dating and courtship are structured today) that is responsible for their discontent? Finally, is the advertising and R&D of pharmaceutical companies responsible for overuse of medications, or should we hold individuals responsible for their own consumption?

On the other hand, I was struck by the difference between Amy Harmon (as a journalist) and any academic researcher. Harmon talked only to young people who self-prescribe pyschotropic medications. She did a great job finding these informants. But she could say nothing about how typical they are in the overall population. Implicitly, the article implies that many--or most--young people obtain mood-altering controlled medications without legitimate prescriptions. Is this true? Or are there many young people who would never do such a thing?

An academic researcher would almost certainly start with some larger, more representative population--not necessarily a sample of all youth, but a sample of some demographic group or community. The researcher would then describe a range of behavior and attitudes. The results would be less compelling, less alarming, less attention-grabbing than this article. They would provide more reliable guidance, however.

Posted by peterlevine at November 16, 2005 03:58 PM

Comments

Point 1: Questions
a. For instance, is it generally a good idea to self-prescribe, relying on public information, peers, and personal experience for information? Or is it generally better to rely on physicians?
This question is put philosophically. Conceivably it could enter into the realm of jurisprudence, but in most cases the legal answer would be that it is negligent to self-prescribe, relying on public information, etc. The legal regime is based on professionally validated evidence. Is this good or bad? I don't know I'd have to think about it more. I'd have to collect data. It might take me so long that I become part of the professional or academic professional class to study it. Meanwhile, the tolerance of inequality one sees in America's inner cities is almost gutwrenching.

The inequality is due in large part to the failed, costly, and oppressive social policy called "The War on Drugs." While it may be negligent to abuse drugs, it should not be criminal. The so-called "negative" right, the right to be left alone by the government, disappears in these arena where conveniently the the most serious "externalities" of this policy inflict themselves on minority and low-income communities.

b. When is it right to treat mild depression, undesired weight gain, or insomnia with chemicals? Is that cheating, or is it smart? Why are these young adults unhappy, to start with? Are they just overly sensitive? Or is there something (perhaps consumerism and careerism, or the way dating and courtship are structured today) that is responsible for their discontent? Finally, is the advertising and R&D of pharmaceutical companies responsible for overuse of medications, or should we hold individuals responsible for their own consumption?
Is it right? If not, who is to blame? Lately I've been in the mood that it just makes no sense in terms of the next logical step in the further development of the western tradition of morality that we continue to honor the freedom of some to have vast excess while many have so little support, whether the latter are partly to blame for their own circumstances or not. Of course, I've been at a predominately liberal law school in a relatively liberal state for three years.

Point 2. Anecdotal vs. statistical or scientific evidence

This reminded me of the flack a while back about Yale women dropping out of professional careers to take care of children. The reporter or columnist talked to a very small sample of Yale women undergraduates, or so I remember. So anecdotal evidence may not be as useful in reading reality than in political mobilization. But then again, on the other hand, wasn't "The Bell Curve" full of good scientific evidence and reasoned inquiry?

Posted by: Carl [TypeKey Profile Page] at November 16, 2005 08:08 PM

That article shocked and interested me as well. However, I think that you judge the media too harshly. It is perfectly fine to present anecdotal evidence as long you represent it as such, since it motivates the questions that you ask. But the existence of even a few people behaving this way is interesting in itself, especially for a journalistic perspective.

Posted by: Michael Weiksner [TypeKey Profile Page] at November 20, 2005 05:39 PM

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