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Comment by notadoc | Hacker News Reader

Compared to other nations, is the US overmedicated in general?

Don't know how it compares to other countries, but the US is definitely overmedicated in general. Not really my place, since at least with prescriptions they are being distributed by people who are by definition more qualified than me, but it's widely known that doctors will often prescribe antibiotics "just in case", even though tests for specific bacteria have all come back negative, and the use in livestock adds to that. The opioid epidemic is another clear sign that it's being prescribed more than is warranted.

Far more subjective and anecdotal, but the number of people I know who take prescriptions for anxiety or other ongoing mental health concerns but who have never tried therapy is scary. Treating with drugs is clearly solution #1 for a lot of our culture.

Therapy is a complicated beast. Not everyone can afford it (generic prozac is fairly inexpensive per month, a therapist is usually more than $20 per month). Even if the insurance is good, not everyone can get off work to go - which is a real issue if you work "doctor hours". And to make it all worse, so many therapists have a waiting list and patients are queued depending on need.

And some folks need the drugs just to talk to someone!

So yeah, drugs is often the go-to. A family doctor is a lot more available than a therapist.

Yeah, I've tried to get a therapist here in SoCal and it is an absolute nightmare. Its one of those things where clearly I don't _need_ it, but I'd probably be a lot healthier and happier with it. But even thought I have good insurance and could definitely afford it, there just isn't availability at all. I've called around and no one is taking new patients.

Saying 'therapy not drugs' is all fine and dandy until you consider that for probably 99% of people therapy just isn't an option and may never be.

> But even thought I have good insurance ... there just isn't availability at all.

Were you only asking therapists who would accept your insurance, or did the lack of availability also apply to "out of network" providers?

You could do tele therapy via Skype for example. Your insurance company should have a program for it.

Fair enough, but I live in a very wealthy area and most of the examples I'm thinking of are stay-at-home moms whose kids are now old enough to be in school most of the day. But they're still at anti-depressants like they're poisoned and it's the antidote. Not saying everyone should be seeing a therapist, these aren't the only 2 possible solutions to whatever they're suffering, but it looks to me like overmedication is for sure happening in a lot of cases.

Once you pop, you can't stop. Washing out anti-depressants and allowing your body to return to a natural homeostasis is frequently a massive ordeal entailing physical fatigue, wild mood swings, serious hopelessness and despair, among other things. Adults can be quite dangerous to themselves and others during that process and it's important to have a patient and disciplined caretaker around to babysit for the duration of the weeks-long washout.

Most people are not apprised of this when they start a medication -- they're just naively following doctor's orders. Consider that psychiatry is a racket where the conventional understanding is that any psych willing to mess with insurance companies is a hack, that every cash-only doc within 50 miles of a significant population has a 3-month waiting list and is generally choosy about their patient base anyway, and that family practitioners aren't willing to do anything slightly unconventional because the DEA will start breathing down their necks, and we have quite the mess on our hands.

I'd suggest that you don't judge those SAHMs too harshly. It's a tough gig on its own, and throwing in "risk becoming totally non-functional" is usually not something that people can just pencil into their schedule.

I would say yes. I am in my 50s and it seems pretty unusual for people of my age not to have a long list of prescriptions they take. But other countries seem to be catching up.

Australia recently had a Royal Commission into the Aged Care sector:

https://agedcare.royalcommission.gov.au/Pages/default.aspx

One of the 3 major issues identified in the interim report is:

to respond to the significant over-reliance on chemical restraint in aged care,including through the seventh Community Pharmacy Agreement

Considering the amount of people that end up with medical issues because they can't afford basic medication, I'd say no.

We're overmedicated in opiates because of the corrupt drug industry and corporations pushing pills for profit (see: the various articles and stories detailing the rampant corruption behind Purdue) and likely undermedicated in everything else.

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