Drug use and mental health

A report that more than 20 percent of U.S. adults took at least one prescription drug for anxiety, depression or a similar condition last year is significant for state residents. Tennessee is one of four states in the "diabetes belt," where a higher number than the national average of people are on at least one behavioral disorder or psychiatric drug.

That, experts say, is because diabetes is so widespread in the "belt" -- Tennessee, Alabama, Kentucky and Mississippi. The condition is associated with higher levels of depression and anxiety disorders. Consequently, about 23 percent of "belt" residents take the drugs. By comparison, the states with the lowest rate of prescriptions for behavioral medications and, presumably, a lower incidence of diabetes had rates of less than 15 percent.

The report, issued by a pharmacy benefits management company and based on 2.5 million patients with of continuous prescription drug insurance and eligibility, indicates that use of psychiatric and behavioral drugs increased by about 22 percent from 2001 to 2010. The survey indicated that the drugs are most often prescribed for women 45 and older, but that the use of the medications by men and younger adults had soared during the period.

The numbers are telling. In the period studied, the use of antipsychotic drugs for attention deficit hyperactivity more than tripled in adults 20-44. In the same period, the use of anti-anxiety medications like Xanax, Valium and Ativan increased more than 30 percent. The report showed that women are twice as likely as men to take anti-psychotic medications like Zyprexa, Risperdal and Abilify, though the use of the drugs by men 20-64 has quadrupled over the last 10 years. Not all trends, however, point upward.

The study indicated a decline in prescriptions for psychiatric and behavioral drugs for children. That, the authors say, is related to findings in 2004 that use of such drugs by those under 19 was strongly linked to suicidal thoughts. The resultant decline in prescriptions for kids was the proper and prompt response to that finding.

The reasons for the significant rise in overall prescriptions is not certain. Report authors say it most likely is because the number of useful medications to treat mental health problems has increased significantly. It is likely, too, that more people now seek help for mental disorders because there is less stigma attached to those conditions than in the past. If the latter is the case, that's a positive step for a society that once viewed mental illness as somehow less real than those of the physical variety.

Given their cost and increasing ubiquity, care is needed to make sure that the use of behavioral medications continues to improve the overall health of Americans. Otherwise the drugs are nothing more than a financial windfall for the pharmaceutical companies that manufacture and eagerly market them to the public.

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