March 28, 2025 • 50 mins
On this episode of The Middle, we ask if America is overmedicated, something Health and Human Services Secretary Robert F. Kennedy Jr. has claimed. Jeremy is joined by KFF Health News Chief Washington Correspondent Julie Rovner and Daniel Grossman, an emergency medicine physician at the Mayo Clinic. DJ Tolliver joins as well, plus callers from around the country. #RFK #HHS #overmedicated #SSRI #ADHD #Ozempic #GLP1
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Episode Transcript
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Speaker 1 (00:05):
Welcome to the Middle. I'm Jeremy Hobson along with our
house DJ Tolliver and Tolliver have you been watching The
White Lotus?
Speaker 2 (00:12):
I think we both know. I've been watching The White
Lotus and I'm waiting for us to do a show
on it.
Speaker 1 (00:17):
Well, I don't think that's gonna happen, But for people
who have not been watching it. Parker Posey's character has
had some moments that have gone viral online, including this
one that sets us up perfectly for today's show.
Speaker 3 (00:28):
Are when if you take him on the recipams, No, ma'am, No,
I just have my prescription field and I could tell
someone are missing.
Speaker 2 (00:35):
You don't have enough lurazapam to get through one week
at a wellness ball.
Speaker 4 (00:40):
Okay.
Speaker 1 (00:40):
So, Lurazapam is an anti anxiety medication. Along with brand
names like Xanax and Volume. It's part of a class
of drugs called benzo diazepines or benzo's for short, and
those are on Health Secretary Robert F. Kennedy Junior's list
of drugs he thinks Americans are taking too many of.
Speaker 5 (00:59):
Percent of American youth are now on adderall or some
other ADHD medication. Even higher percentages or on SSRIs and benzos.
We are not just over medicating our children, We're over
medicating our entiled population.
Speaker 1 (01:16):
So that's what we're going to be asking you about
this hour. Do you think America is over medicated? And
just to be clear, we are not talking about vaccines here.
We're talking about prescription drugs for conditions including anxiety, depression,
weight loss, and ADHD. And we're going to get to
that in a moment in your calls. But first, last
week on the show, we talked about what the future
of American energy should look like. We got a lot
(01:37):
of calls, a lot of nuance from our listeners. Here
are some of the voicemails that came in after the show.
Speaker 6 (01:42):
Hey, my name is Bill from Chicago. I'm solidly in
the middle. I voted for Democrats and Republicans if we're
going to be real and not disingenuous. Suggesting that the
middle so embraces wind and solar given the actual underlying
statistics is ridiculous.
Speaker 7 (02:01):
This is Tina Brazil calling from Slide to Colorado. I
consider myself a pretty progressive person in support of clean energy,
but there's not really a switch that we can turn
on to go all renewable. It's going to happen over time,
and it's better to have that diversity until we can
go completely clean.
Speaker 8 (02:21):
Douglas Sharnberg calling for muro Linguid Texas. The bottom line
is Americans need to stop being spoon fed their energy
like babies. Where you plug in, you get carte blanche
as much electricity as you could possibly use. There's absolutely
no incentive for conservation with this model.
Speaker 1 (02:43):
Well, thanks to everyone who called in. You can hear
that entire episode on our podcast in partnership with iHeart Podcasts,
on the iHeart app or wherever you listen to podcasts.
So now to our topic this hour is America over medicated.
Tolliver the phone number please.
Speaker 2 (02:56):
Yeah, it's eight four four four Middle. That's eight four
four four six four three three. You can also write
to us at Listen to the Middle dot com and
you can also comment on our live stream on YouTube, TikTok, Facebook, Instagram,
and Twitch.
Speaker 1 (03:08):
Joining us on the panel this hour, KFF Health News
Chief Washington correspondent Julie Robner, Julie, great to have you
on the Middle.
Speaker 3 (03:15):
Great to be here.
Speaker 1 (03:16):
Jeremy and Daniel Grossman joins US as well. He's an
emergency medicine physician at the Mayo Clinic in Rochester, Minnesota,
and has held a number of business leadership roles in
the healthcare industry. Daniel, welcome to you.
Speaker 9 (03:27):
Thanks great to be here.
Speaker 1 (03:28):
So before we get to the phones, Julie, I want
to be clear, as I said, we are talking about
prescription drugs and not vaccines. RFK Junior, the Health Secretary,
has been skeptical of both.
Speaker 4 (03:38):
But on the.
Speaker 1 (03:38):
Issue of prescription drugs, there is a Penn State study
that found in the mid nineties, most Americans were on
one prescription drug. Now people taking prescription meds are just
as likely to be on five or more. How do
you explain.
Speaker 3 (03:54):
That there are more drugs for more things. I mean,
that's not necessarily a bad There are a lot of
things that we can control now using prescription drugs that
we couldn't in the nineties, and some of them are
just or we could but now we have better drugs.
You know, people have high blood pressure and diabetes and
all the chronic diseases that RFK Junior says he is
(04:16):
so concerned about. So I think that's kind of not
a fair way to decide whether Americans are over medicated
by the fact that they're simply taking more prescription drugs.
Speaker 1 (04:28):
Daniel, what do you think? And I'll throw in another
stat The Congressional Budget off has found that nationwide spending
on prescription drugs jump tenfold from nineteen eighty to twenty eighteen.
That's adjusted for inflation. What is your experience as a doctor.
Are people taking more medications now? And if so, why?
Speaker 4 (04:45):
Yeah?
Speaker 9 (04:45):
I think you have to go back a level and say,
are there more diseases do people have?
Speaker 10 (04:50):
You know?
Speaker 9 (04:51):
Is the prevalence of disease greater?
Speaker 4 (04:53):
Yes?
Speaker 9 (04:54):
Is the incidents? Are we seeing more and more new
types of diseases? Yes, because we can diagnose things, and honestly,
the rate of discovery of new drugs has accelerated greatly,
and so all those things combined tell us that there
are going to be more people taking more medications.
Speaker 1 (05:10):
You're saying that we can diagnose more diseases and that's
why it's not that we're becoming sicker.
Speaker 9 (05:16):
That's true. Well, I would say we are becoming sicker
and we can diagnose diseases that we couldn't diagnose before.
They can both be true.
Speaker 1 (05:25):
Do you feel pressure from patients or from pharmaceutical companies
for that matter, to prescribe medications.
Speaker 9 (05:32):
Definitely from patients. I'm held outside of sort of influence
of pharmaceutical companies in our practice environment. But patients when
they come to our emergency department or sea physicians, they
expect something to be done, and so you have to
figure out what that something is going to be, and
that can be a difficult conversation with patients.
Speaker 1 (05:53):
It's hard to say no to the patients.
Speaker 9 (05:55):
It's hard to say no. It's hard to meet expectations.
You have to suss out what the expectations are, and
many of them come with a goal that they would
like met and that may be a medication prescription.
Speaker 1 (06:08):
Julie Robinner, what would the what could the Trump administration
do if they wanted to get people to be taking
less prescription medications? What kind of tools do they have?
Speaker 3 (06:18):
Well, of course, again the biggest tool is obviously the
bully pull pit, and we do you know know that
there is a lot people do listen to federal health officials.
They may not trust them as much as they used
to before the pandemic, but they do listen to them.
We have a brand new head of the FDA, Marty McCarey,
who with the Senate just confirmed this week a fairly
(06:39):
prominent surgeon from John Hopkins, who's written several books and
is good on TV, as as most of the people
in the Trump administration are. He's been he's been trying
to walk kind of a fine line between what our
f kjunior wants but you know, and what he believes.
And he hasn't really said, but he could, obviously, you know,
(07:03):
provide a lot of sway if he wanted to. We'll
see whether he does or not.
Speaker 1 (07:07):
The phone lines are lighting up, so let's get to
a caller. Magdalena is calling from Grand Rapids, Michigan. Magdalena,
what do you think is America over medicated?
Speaker 11 (07:17):
I absolutely don't think so. I think that we as
Americans are lucky enough to have access to these kinds
of medications that really, for me personally, have enabled me
to have a better quality of life. I have been
diagnosed with dystymaic disorder, which is basically a chronic depression
(07:41):
where I have always had a low level of depression
because my brain just doesn't produce enough serotonin or dopamine.
And now at fifty years old. I've learned the symptoms
that I am familiar with the symptoms that I experienced
because of my disorder, and if I didn't have medication
(08:04):
access to the medications that I have access to, I
don't think that I would have been as successful in
my life and been able to be as productive in
my life because I didn't have access to them.
Speaker 1 (08:17):
Do you worry, Magdalena that some of the rhetoric coming
out of the Trump administration that you may not have
access to that, or you just think that they're sort
of talking about a big picture thing but it won't
have an effect on you.
Speaker 11 (08:30):
I'm worried that it's that it's rhetoric and that people
people already have a hard time understanding how depressed medications work,
whether they're medications for depression or anti psychotic medications or
anti anxiety medications. I'm personally as social worker, so I've
(08:51):
seen this throughout my career, and I think that this
will just continue to add to the confusion to people,
and you know, make it difficult for people to understand
how medications work, and you know that you have to
take them a certain way and one thing isn't going
(09:12):
to work for everybody. So when I hear you know,
you know this, this rhetoric that we're over medicated, it's
only because we're in the richest country in the world
and we have access to them.
Speaker 1 (09:28):
Yeah, Magdalena, thank you, thank you so much for that.
Called Daniel Grossman, what do you think of that? And
I wonder also if people are taking off medications they
decide not to take the medications because of what's being
talked about in Washington, could it lead to a mental
health crisis in this country.
Speaker 9 (09:43):
Well, well, let's start with we already have a mental
health crisis in this country. We have a significant challenge
with mental health. There are not enough mental health providers,
there are deserts where people don't have access to it.
What Magdalena described is is essentially what a lot of
people have discovered, which is their bodies might not quite
work correctly, and one person's not correctly is different than
(10:07):
another person's not correctly. And our ability to provide medications
and increasingly to use science to figure out the nuances
of what will work for one person versus another person
is pretty remarkable. So what she's describing, we have the
ability in this country to offer and to help as
(10:29):
she said, lead a more productive life.
Speaker 1 (10:32):
Speaking of Julia Robner, there's news just today about ten
thousand job cuts at the Department of Health and Human Services.
Would that affect the Department's ability to do anything about
over medication if they believe that that's a priority.
Speaker 3 (10:47):
Well, this is an enormous restructuring basically of the entire
Department of Health and Human Services and includes cuts of
thirty five hundred people to the FDA. The fact cheat
that the Department distributed says that it won't affect the
people who are actually reviewing drugs. Those are mostly not
paid for with federal funds anyway. They're paid for with
(11:08):
user fees that are provided by the drug companies themselves.
But you know, it's hard to know exactly how this
worry or you know, how they would try to operationalize
getting people off of too many drugs, you.
Speaker 1 (11:25):
Know, Tolliver, we can't have this discussion without mentioning the
tens of billions of dollars that pharmaceutical companies and retailers
have had to pay to settle lawsuits related to prescription
opioids like oxy contin. Yeah.
Speaker 2 (11:37):
Actually, just this year, a bipartisan coalition of states re
state seven point four billion dollars settlement settlement with oxyconton
maker Purdue Pharma and the Sackler family for their role
in the opioid epidemic. Here's one of the Attorneys General
involved in the settlement, New York's Letitia James.
Speaker 5 (11:54):
The Sackler family, and they're a company, Purdue, who helped
spark the opioid crisis decades ago.
Speaker 12 (12:01):
Half for years avoided accountability for the immense.
Speaker 5 (12:04):
Cause that they have caused. All of the victims, all
of the loved ones who have died, all of those
who are in.
Speaker 9 (12:13):
The throes of addiction right now.
Speaker 13 (12:15):
But that ends today.
Speaker 1 (12:18):
This latest settlement, by the way, replaces one that the
Supreme Court rejected last year. And we'll be right back
with more of the Middle. This is the Middle. I'm
Jeremy Hobson. If you're just tuning in the Middle as
a national call in show, we're focused on elevating voices
from the middle geographically, politically and philosophically, or maybe you
just want to meet in the middle. This hour, we're
(12:39):
asking you, is America over medicated? Tolliver? What is the
number to call in?
Speaker 2 (12:43):
It's eight four four four Middle that's eight four four
four six four three three five three. You can also
write to us a listen to the middle dot com
or on social media.
Speaker 1 (12:51):
I'm joined by Daniel Grossmann, emergency medicine physician at the
Mayo Clinic, and KFF Health News Chief Washington correspondent Julie Robner.
And before we go back to the phones, Julie, we
heard a moment ago about the settlements against big Pharma.
How much pushback are you seeing or would you expect
from the pharmaceutical companies when it comes to reducing the
amount of prescription drugs that Americans are on.
Speaker 3 (13:12):
Well, obviously pharma has a you know, financial interest in
Americans getting and continuing to take prescription drugs. The opioid
epidemic was kind of separate and from for many of them.
But there, I mean, there is a problem with drug
companies being incentivized to make not necessarily the drugs that
(13:33):
people most need, but the drugs that they're going to
make the most money from. I mean, we have a
huge shortage now of antibiotics, of new antibiotics coming into
the pipeline because people don't have to take antibiotics for
the rest of their lives. The way they take you know,
statins for cholesterol or drugs for blood pressure. So there's
it's much It does better if you're a drug company
(13:53):
to make something that people are going to take forever.
Speaker 1 (13:56):
It's like a wedding planner. You don't really go back
for don't go back for seconds that they don't need
to repeat business.
Speaker 3 (14:01):
Hopefully on an antibiotic, you hope not. But I mean
we also, I mean you could argue that we have
an under that we're under drugged in some ways because
people often can't afford drugs that they need so they're there.
You know, it does cut both ways.
Speaker 1 (14:18):
Daniel. How do you balance the incredible advances that we've
made in medicine that you talked about, uh, that allow
us to treat so many things with prescription drugs with
not wanting to overprescribe and get people addicted as they
did during the opioid crisis.
Speaker 9 (14:35):
The idea that a prescription from an emergency department or
from a single physician is going to be addictive has
been debunked. But the challenge is that there's a there's
a thought from the general population that if you take
a medication, you will get addicted.
Speaker 14 (14:50):
To it.
Speaker 9 (14:51):
So so it actually has removed some tools because patients
are reluctant to use the medications that we have available
because they are afraid because you know, they have become
afraid over time of becoming addicted. So, you know, our advancements,
our advancements are really in these some of the larger
disease populations that don't have risk for addiction or new
(15:17):
discoveries like Alzheimer's disease medications are coming out. You know,
there's not a risk of addiction there. We have a
new tool to help people that we didn't have before.
We need to find ways to take advantage of those
as opposed to saying that we are over medicated.
Speaker 1 (15:33):
Let's go to Connor, who's in Chapel Hill, North Carolina.
Speaker 15 (15:35):
Hi.
Speaker 1 (15:36):
Connor, welcome to the middle.
Speaker 16 (15:37):
Go ahead, Hi, it's great to be on.
Speaker 7 (15:41):
So.
Speaker 16 (15:41):
I've been taking basically a ad medication for about twenty years.
They diagnosed with ADHD when I was about nine. I've
had to be off of it for periods just due
to insurance and it has a negative all my life
when I'm not on the prescription and is really deeply
worried by the discourse on RFK Junior kind of what
(16:02):
that will do for me being a student and being
a professional.
Speaker 4 (16:07):
So that's kind of nice. Yeah, idea.
Speaker 1 (16:09):
Do you think that RFK Junior will make it impossible
for you to get your ADHD medication? Or why does
the rhetoric worry you specifically?
Speaker 17 (16:20):
I have heard just the way that he talks about
ADHD medications and SSRIs. I don't know exactly what I
am in public house side. I don't really know exactly
what will happen, but as we've seen with this administration,
things can kind of change, you know, in a second.
So I just kind of worried about the discourse around that.
(16:40):
Not exactly sure how it would happen, but just kind of,
you know, a little worried.
Speaker 1 (16:45):
Yeah, Connor, thank you for that call. Let me go
to another. Brent is calling from Jackson, Wyoming. Hi, Brent,
welcome to the middle. Go ahead with your thoughts.
Speaker 10 (16:54):
Hi, thank you for having me. I'm a senior aviation
medical examiner, and I think that people forget that when
children are put on ADHD medication, especially inappropriately, or other
psychotropic medicines, whether they're antidepressants or or tranquilizers, and they
really don't need them, but that can affect their careers
(17:16):
and they can't become a pilot. Many times, they can't
get into the military academies. And with the electronic medical record,
this stuff stays with somebody their entire life, so it's
hard to undo a misdiagnosis or inappropriately treated child. So
I think that's an important thing to remember.
Speaker 1 (17:35):
So what do you say to our previous caller, Connor,
who said, you know that when he has to go
off of his ADHD medication, it has a really negative
impact on his life.
Speaker 10 (17:45):
Well, I think people who are properly diagnosed, they do
definitely need medications like the ADHD medications, but those people
go through an extensive evaluation. It's not thirty men in appointment,
but a primary care doctor or primary care it's a
full day of examination, usually with a neuropsychologist are a
(18:06):
psychiatrist to really make a definitive diagnosis, you can't just
these medicines get thrown around so much that there are
a lot of people on these medications that really don't
need to be on them and never should have been
on them.
Speaker 1 (18:20):
Brent, thank you for that call. Julie Robner, two very
different views there on that issue just of ADHD medications.
Speaker 3 (18:28):
Yeah, absolutely, you know, and I think the same is true.
Most medications can be used properly and can be used improperly.
I mean, people are not out there, I don't think
abusing their blood pressure drugs for the most part. You know,
there's a lot of drugs that are not really subject
to abuse, and that's a whole different discussion, but of
the ones that can be or that somebody can make
(18:48):
money from basically, you know, pressing people to take although
generally doctors don't make money when people take prescriptions, but
there are a lot of people who you know, we'll
we'll try to sort of keep keep patients coming back
by giving them drugs. And obviously, you know, I think
the opioids were a little bit of a one off.
(19:09):
But I think one of the problems, one of the
big problems that we had with the opioids is that
the drug company lied about how addictive they were, and
I think that legitimately now has people kind of freaked
out about drugs, particularly about pain killers.
Speaker 2 (19:23):
Yeah, yeah, we'll have a personal one if that's okay.
So I saw an ad today for are you familiar
with hers dot com? Or hymns dot com. These apps
basically where you can order your you know, your prescriptions
after just like a virtual appointment or someone just text.
Do you what do you think about this? Are they
harmful or not? What do you think?
Speaker 3 (19:40):
I think they are lightly regulated, let's put it that way.
I think I think I would like to know what
the doctor thinks about that, Daniel.
Speaker 9 (19:47):
For while they are lightly regulated and they they have yeah,
you know, these are these are companies that have often
venture backed financial models and need to show growth, and
they've pivoted to sort of meet some of the emerging
areas where there are prescription opportunities. They have also expanded
(20:08):
access to people who might not have access for things
because of the virtual models. Because of the decentralization, you
can actually get more patients into the system and that's
a really good thing. So I would look at it
that way.
Speaker 1 (20:22):
Matthew is calling from mine, not North Dakota. Matthew, welcome
to the middle. Do you think America is over medicated?
Speaker 4 (20:30):
All right, guys, I just want to kind of synthesize
what your last two college said. I've been on these
medications benzos and amphetamines for about twenty years and I
think there's a whole generation of us now, people my age,
who were put on them early when they were in
the school by their parents or psychologists or whatever. We
grow up taking them and now we're dependent on them,
(20:54):
and I'm worried that this will kind of demonize those medications.
For those of us who have this point can't function
without them, and we just need them for maintenance. I
recently came to North Dakota from a different state and
to get a prescription up here, they asked me to
redo add testing. But the fact is, whether I actually
have it or not, now it's irrelevant. I need the
(21:17):
medication of functioning just because some of us have been
on it so long, whether we choose that or not.
Speaker 1 (21:23):
Do you feel like you wish you had not been
put it on it in the first place, or do
you think about that.
Speaker 4 (21:30):
I consistently think it was the worst thing that ever
happened to me.
Speaker 1 (21:34):
Wow, what do you think your life would be like
if you had not been Obviously a doctor at some
point decided that that was a good idea.
Speaker 4 (21:43):
Sure, And I mean I can't speculate, but I do
know it's not as simple as well, why don't you
just stop taking it after you've been on them for
thirty years. Just because of the nature of the drugs life,
it really is necessary to function after a certain point.
And that's hard to articulate in a way to newer
medical professionals because they don't understand the history. You know
(22:06):
what it was like twenty years ago when doctors first
started giving riddle into everybody.
Speaker 1 (22:12):
Matthew, thank you for that call. Daniel Grossman, your thoughts
on that very interesting.
Speaker 9 (22:16):
Yeah, that's a you know, very compelling personal story. I
would have to agree with his perspective on what's been
happening for many, many years. Our prior caller who talked
about the impact on getting jobs. You know, the larger
issue there might actually be the stigma that's attached to
these medications and that it impacts employment in some areas
(22:41):
and some it might, but we could destigmatize these The
other thing to keep in mind is that the robustness
of the diagnostic process that leads to people being taking
anti depressants or on ADHD medications, the robustness of that
process has increased dramatically. Our ability to accurately need to
diagnose patients is significantly better today than it was before.
(23:05):
And so this idea that that caller said that people
are inappropriately put on them, I don't think that's the
vast majority of patients now, and we should flip the
script a little bit on why patients are taking them,
how they got there, and what that means for them professionally.
Speaker 2 (23:20):
Julie Rogers, Yeah, go ahead tell her so sorry, We're
gonna get this together one day. I've got a bunch
of comments coming in online, about ninety percent of them
about ADHD, but I want to get some in Luke
and Milwaukee says the MAGA movement is very harmful to
ADHD and autistic people, and I myself am both an
adhder and autistic. It's important for those with ADHD to
be able to have our medications, as well as people
(23:42):
with depression like myself who need SSRIs. And then let's see.
Speaker 18 (23:47):
Sorry.
Speaker 2 (23:47):
Captain in Kansas City says, is America over medicated? Yes,
American medical care is more algorithmic, business based, consumer satisfaction based,
and less patient centered and health promoting. This is slowly changing,
but we are still decade behind where we could be
in Decades of life and health have been lost because
of it. That was a very precient comment.
Speaker 1 (24:05):
Julie Rober interesting there. Just comparing the American medical system
to other countries, Robert F. Kennedy would say, we spend
and rightfully so, we spend way more money on healthcare,
and part of that is prescription drugs. A big part
of that is prescription drugs than many other countries do.
Speaker 3 (24:22):
That's because our healthcare system is much more expensive than
most other countries. That it's not that we take more
that we're sicker, it's that we pay more for what
it is that we get. This is obviously a very
difficult and sensitive issue for an awful lot of people.
And as I say, there's a lot of people who
could be taking prescription drugs, who should be taking prescription
(24:43):
drugs and who aren't because they can't afford them, because
we pay more for our prescription drugs in the United
States than any other country in the world, even though
most of the drug companies are US companies.
Speaker 1 (24:54):
Megan is calling from Minneapolis, Minnesota. Hi, Meghan, welcome to
the middle Go ahead with your thought.
Speaker 19 (25:01):
Hi, welcome and our Thanks for having me and thanks
for having this discussion. I think it's a really important one.
And I'm the mother of My son is now twenty two,
but he had been medicated starting at a really young age.
It was like third grade where they wanted to introduce
ADHD meds. And so I've seen the effects of these
psychotropic and sort of met them betamin drug use on
(25:24):
a young child's brain, and I have a lot of
concerns about it. I was a young mother at the
time when I sort of took the lead of the experts,
and now looking back on it, I wish I would
have maybe tried some other things before. But I see
it's a pretty big trend where these young children are
put on these heavy, heavy medications, and then now we
have this mental health crisis and we have a lot
(25:45):
of addiction issues running wild in our country, and I
think it can stem back to having been overly medicated
at young ages and those little brains just can't handle
all that stuff. You know, it seems like it might
help solve things, but there's other ways to do it,
and that should be the first thought for young.
Speaker 1 (26:04):
How does your child feel about it?
Speaker 8 (26:06):
Now?
Speaker 1 (26:06):
Now that your child is an.
Speaker 19 (26:07):
Adult, he's actually really angry and has a lot of
thoughts about having not given consent to this, and you know,
he struggles with addiction now, and so he feels kind
of like he had no choice and now he's kind
of like one of the one of the last colors.
Like you know, when you've been on these things for
your life, then suddenly you're stuck on it, right. You
have no other way to do things, and you're used
(26:29):
to functioning with these medications, and so life about them
is challenging. And I know there's a lot of times
issues with shortages, and so one of the meds my
son takes is off and not even available, so he's
forced them to sort of self medicate and do other things.
Speaker 1 (26:45):
So yeah, great points, Megan, Thank you very much. Daniel Grossman, Well,
actually there are two things in there, but one of
them is she just said, he self medicates because he
can't get what he needs. Are we are you seeing
shortages of medications because of overuse in some cases?
Speaker 9 (27:04):
I don't think you know, I don't know a specific
answer to that, whether it's from overuse or because we
consolidate the number of manufacturers. There are plants that have problems.
There's a natural disaster that takes out a major manufacturer
of things like ivy fluid that happens now, and so
(27:25):
that is probably a larger contributor to shortages of medications
than an overuse problem.
Speaker 3 (27:33):
We have supply chain issues with medications. That's mostly what's
causing shortages.
Speaker 1 (27:38):
Yeah, let me sneak in one more call here before
we have to take a quick break. Stephanie's in Longmont, Colorado. Hi, Stephanie, go.
Speaker 20 (27:45):
Ahead, Hi guys. Absolutely, I do agree that the opioid
crisis was definitely a problem. Agree, But I kind of
wanted to just get the opinion on do we think
that currently the state the state of being over medicated
is really and truly being over medicated or do you
think it's potentially a product of the poor health of Americans,
(28:09):
the bad diets and things like that, and then also
a mix of you know, the just acceptance of mental health,
like and people being more willing to seek out treatment,
being more willing to kind of go seek those medications,
and that kind of stigma going down and just the
combination of those things making it seem like we're overly medicated.
Speaker 1 (28:30):
Stephanie, I'll take that to Julie Robner.
Speaker 3 (28:34):
Well, I think doctor Grisam said it early on. It's
you know, it's a combination of there's more things we
can do and more things that we can diagnose, and yes,
are there people who are inappropriately getting medication, clearly? Are
there people who should who are not getting medication who
should also, clearly. I mean it's a really hard problem.
You know, we don't have our you know, it goes
(28:56):
back to sort of the mess that our nation's healthcare
system is in which we don't really have a health
care system. So some people have better access to care
than others. Some people have access to care that maybe
not with the best providers, and so we end up
with people in different situations.
Speaker 1 (29:13):
And Julie, you know the Trump administration, there was a
first Trump administration and they did not focus on this
issue really at all.
Speaker 3 (29:22):
Well, they focused on Trump was actually very much into
drug prices in the first administration and very much trying
to get drug prices down, including by some some ways.
That court said no, you can't like trying to you know,
price drugs the way the same as they are in Europe,
which obviously the drug makers all suit. And you know,
(29:42):
now there's still the question is whether we're even going
to continue this very small program that we have to
negotiate drug prices for Medicare. It does look like that's
going to continue. But you know this has been hand
to hand combat with the drug industry over a lot
of years.
Speaker 1 (29:59):
Well, Tolliver, Long before Parker Posey in The White Lotus,
there was a character played by Cherry O Terry on
Saturday Night Live.
Speaker 2 (30:05):
Uh yeah, her name was Collette Reardon. And in addition
to uneven lipstick and eyeshadow, we've all been there, she
had no shortage of prescription drugs. Here's a clip from
nineteen ninety nine.
Speaker 6 (30:16):
Oh seriously, I'm legitimately troubled by the amount of medication
on this table.
Speaker 12 (30:20):
Me too.
Speaker 13 (30:22):
Well, the second all here is for the night sweats
and hot flashes. I get what with being preman a Pauls.
Speaker 1 (30:28):
Listen, I better fix your phone here right well.
Speaker 13 (30:30):
Mexic quick branch, I got sta call doctor Doug bevlockwam
E n T And sometimes why why Well, because I
need a refill on the delatta to take from a
carpal tunnel syndrome.
Speaker 1 (30:45):
Uh, doc, how do you pronounce balloqua beva lockwa? And
she has different names for all the doctors. By the way,
I had a lot of fun going through all the
clips that we could have used for that with Serio Terry,
the problem is that most of them ended up having
her swearing at some point. Well well, on the podcast
we wouldn't have to, but on the radio show we do.
(31:06):
We'll be right back with more of your calls on
the Middle. This is the Middle. I'm Jeremy Hobson. In
this hour, we're asking you is America over medicated? You
can call us at eight four four four Middle. That's
eight four four four six four three three five three,
or you can reach out at Listen to the Middle
dot com. My guests are KFF Health News Chief Washington
correspondent Julie Robner and Daniel Grossman, an emergency medicine physician
(31:28):
at the Mayo Clinic. And before we go back to
the phones, Julie, even if Americans on different sides of
the political spectrum, we don't know the political views of
the callers that have called in so far, but even
if people on both sides were to agree that we
are over medicated, the messenger here is Robert F. Kennedy Junior, who,
as we mentioned, is also skeptical of vaccines, even in
(31:50):
the face of a deadly measles outbreaks that is being
fueled by unvaccinated children. Does he have credibility with the
people that you speak with in the world of healthcare?
Speaker 3 (32:01):
Not really. I mean the MAHA movement, the Make America
Healthy Again movement consists of people who are legitimately skeptical of,
you know, some things, of people being over medicated. But
there it's also made up of people who are selling
supplements that have not been you know, the quote unquote
natural things that have not been evaluated and approved by
the FDA, and then in some cases have been shown
(32:23):
to be dangerous. So there's an awful lot of uh,
you know. I will resist the urge to say snake
oil salesman, but there's an awful lot that's out there
on the market that's not quote unquote a drug that's
also not very good for you.
Speaker 1 (32:39):
Daniel. I'm not going to ask you that question because
you're a doctor the Mayo Clinic, and Julie can say
things like that because she is a correspondent at KFF
Health News. But I will ask you this. If you,
as a doctor, were to snap your finger and say
I want to make America healthier, what would you do
and would fewer medications be anywhere on your list.
Speaker 9 (32:59):
No, your medications wouldn't. It would be more providers, more physicians,
it would be more mental health experts. It would be
better access to medical care for our Native American populations.
It would be better access to healthy foods and medical
care for our Black and Hispanic populations. It would be
infrastructural and systems issues. It's not a medication problem.
Speaker 1 (33:23):
Let's go to Eli, who's calling from West Hartford, Connecticut. Hi, Eli,
welcome to the middle and go ahead, all right.
Speaker 14 (33:30):
Thank you for taking the call. Yeah, you know, I
just wanted to hold on. I apologize. I'm over here.
I'm on a bluecer ally, So I just wanted to
mention I actually went through a very part of this
process for a very long period of time. I was
taking high doses of xanax for years and years and years,
having been prescribed it in my teens, and I went
(33:51):
through a highly difficult process of having to stop, and
all of that was all like there's I just wanted
to mention, like the kind of the confluence of all
of this. I was stuck in very like dictam mentality.
Everything is somebody else's fault, you know, uh, you know
the anxiety is you know, I'm not supposed to be
experiencing it. Kind of like a cliche millennial male in that,
(34:12):
you know, just the world is supposed to be softened
my footsteps and sorry, I'll super quick and finished, really quickly.
Is that having stopped all that and you know been
you know, a responsible member of society like I've been
able to you know, triple my income, find my fiance
buy a house in just two or three years of
just experiencing life as it's supposed to be. Difficult. People
(34:33):
experience depression, You experienced anxiety. Get the hell over it.
That's the way that life is supposed to be. And
I'm for any type of movement that that is supposed
to perpetuate that, especially with young men. You know, that
is the way that things are supposed to be. It's
supposed to be difficult. Get over yourselves.
Speaker 3 (34:51):
Can I present aunt ad I've had anxiety, serious anxiety
since I was eleven. I'm now in my sixties. I
would I, by the way, is one of the people
who did with part of the clinical trial for xanax,
which did not work very well for me. But I
will say I am now on an SSRI and it
has changed my life for the better. And I know
a lot of people who are that way because as
(35:12):
the first caller, I think it was said, when you
have a chemical imbalance and you take something that balances
your chemical imbalance, you feel like a normal person. So
I think, yes, there's a lot of people who are
on drugs who shouldn't be. These drugs are not all
the same. You can be inappropriately, you know, put on
a drug that either does not work for you or
that's not appropriate for you. But I think to make
(35:33):
some of these blanket statements like Robert F. Kennedy Junior
is making that people are over drugged. It's doing a
serious disservice to people who take medications that they need.
Speaker 1 (35:44):
You know, one class of drugs we haven't talked about
this hour surprisingly that Robert F. Kennedy Junior has gone after,
is the GLP one drugs, o zepic, wigo, v et cetera.
Daniel Grossman, do you have any different thoughts about those
than you do about other medications.
Speaker 9 (36:02):
I mean, isn't science amazing? We have been able to
create a synthetic version of a natural peptide in the
body that tells our body to eat less or help
with insulin regulation and sugar regulation and also so you know,
diabetes control weight loss as a result also and also
(36:25):
will help with things like substance use disorder and alcohol
use disorder. Like this is phenomenal. We should avail ourselves
of the resources that happen. We should avail ourselves of
our mental health providers SSRIs, GLP one. Access like this
is amazing and we have access to these things to
make us healthier as a result.
Speaker 1 (36:45):
Bill is calling from Chelmsford, Massachusetts. Hi, Bill, Welcome to
the middle What are your thoughts?
Speaker 21 (36:50):
Hey everyone, thank you for taking MC call. I don't
think we're over medicated. I think we're undersupported. I think
that you see the doctor initially and they give you
a doctor to help. There's no follow up as much
as there should be. But here's my question. Also, there's
an awful lot of stress and concern with the administration
and our government today, and there's an awful lot of
people who are in need, who don't have the resources.
(37:13):
And if RFK is successful in denying even more support
to them in the way of whatever, whether it be
medication or doctors or social work, what happens to these
people who turn from that support or even the medication
they need or find help with and turn to things
like alcohol or marijuana or other sources where you can't
(37:35):
even track it. And at least with medication. Hopefully there's
some kind of system that follow with doctors. And I
know that the general question we over medicated so broad.
There's so many different areas that maybe we're over medicated
in one, but we're not in others, and maybe we
need more medication than even others. But I think unfortunately
(37:56):
that people are going to suffer. The ones that need
the support from the government and the fire of case
there this way, they're not going to get it, And
I'm concerned about that. I'm wonder what you've bandled things.
Speaker 1 (38:05):
Yeah, thank you, Bill, Either of you want to get
into that about whether if people don't get the medication
they need for things like stress and depression, they may
turn to other drugs, including alcohol.
Speaker 3 (38:16):
People have been self medicating since there were people. I mean,
we know this from you know, anthropological digs. We see
it in you know, in sort of tribes that are
in the in the middle of the Amazon. The things
that people have availed themselves of to deal with stress
and anxiety, and yes, it is part of the human condition,
but it's also trying to deal with it is something
(38:39):
that humans have always done and I suspect will always do.
It's a lot safer, I think, to take drugs in
most cases than it is to do some of these
other things.
Speaker 1 (38:48):
Let's get to Gretchen, who's in beautiful Myrtle Beach, South
Carolina High Gretchen, welcome to the middle What do you.
Speaker 12 (38:54):
Think, Well, I think we're very, very over medicated in
this kind. I've been told that only in the US
and New Zealand is it legal for drugs to be
advertised on TV. And many of the drugs advertised say
(39:16):
ask your doctor about this, that or the other drug.
And I think it's such a big business that it's
really running our country in several ways, as is the
automotive industry. But if you watch TV for just a
few hours, every other ad on TV is about pharmaceuticals
(39:38):
with multiple deadly side effects. I think it's a big
business that's running our country in many many ways.
Speaker 2 (39:47):
Yeah.
Speaker 1 (39:50):
Yeah, Actually, I had a former colleague who didn't want
her kid to be marketed to and so she only
let him watch p and the Food Channel because the
Food Channel she thought would only market to adults. And
one night he said to her, Mommy, I can't sleep.
Can I have a lunesta? Like six years old? But
(40:11):
what about that, Daniel Grossman, just the advertising on television
for all these drugs, and just the big business that
it is.
Speaker 9 (40:18):
It's a big business. This is it both helps feed
discovery of these and is a marketing machine, right, And
so patients do come into physicians and ask for medications
by name. That is how marketing works. And the only
way to stop that is, of course, is to remove
all pharmaceutical marketing, which is not going to happen. So
it becomes inherent to the physicians and the patients and
(40:42):
develop a relationship of trust to guide for or a
way for those medications.
Speaker 3 (40:47):
And the caller is exactly correct that the US and
New Zealand are the only countries that allow the kinds
of drug advertising that we have.
Speaker 1 (40:55):
That you know, funny, for a long time, I wouldn't have.
Speaker 3 (40:57):
For advertised in medical journals, and you know there were
advertised to doctors, but not directly to patients. And I
think I think that is one of the things that
RFK Junior talks about trying to scale back that. I
think there is bipartisan support for hm HM.
Speaker 1 (41:12):
Cole is calling from Salt Lake City. Hi, Cole, Welcome
to the middle your thoughts.
Speaker 18 (41:19):
Hey, how's it going? I first off want to thank
the doctor in.
Speaker 1 (41:24):
The room, what's his name, Daniel Grossman, Daniel.
Speaker 18 (41:29):
For his views and you know, I wish there was
someone like him, uh, you know, leading leading the healthcare
in our country and not you know, not not someone
who maybe doesn't have as much scientific background and training.
I think we really owe a lot to the centuries
(41:52):
of science and research that's taken place in this country
and you know, all over the world. It's just amazing.
As a little kid, I was diagnosed very quickly, I think,
in about a thirty minute session with my school counselor.
(42:13):
She was pretty sure I had ADHD. And I went
through some diagnostic testing, you know, for that whatever, the
thirty question test on a sheet of paper, and I
did a trial of adderall and I had horrendous restless
legs and night terrors and I was hyper vigilant, couldn't sleep,
(42:37):
And twenty years later, I was still struggling with ADHD
and tried to, you know, become medicated again as an adult.
And I actually had a manic break that time around.
And you know, it's speculated now that I have bipolar
(42:58):
two disorder, which is kind of a murky uh diagnosis.
But you know, I wouldn't ever criticize the doctors for
trying to help me. I think that's what they were
trying to do. I wasn't, however, warned of the potential
(43:21):
psychotic effects of of.
Speaker 1 (43:24):
Oh I think we lost I think we lost Cole there.
Speaker 2 (43:27):
Jeremy.
Speaker 1 (43:28):
Yeah.
Speaker 2 (43:28):
I had actually a couple comments related to that also,
first one to say, Julie, we love you too, Okay.
Speaker 1 (43:33):
Julie could eily that.
Speaker 9 (43:36):
Juliet charge?
Speaker 14 (43:38):
Okay.
Speaker 2 (43:38):
So someone says, it seems that a record number of
people that I know are on antidepressant medications, yet the
suicide rate of skyrocketing. I personally known the three people
who have had their medications adjusted and then took their
own life. People seemed to take these meds very lightly.
John and Michigan says, are we over medicated or are
we just aware of the world around us? People have
always had depression anxiety, but for twenty years now we've
been facing down flat wage's, ridiculous house rental prices, a
(44:01):
work life with little to no time off, toxic work culture,
people can't afford kids healthier out of reach, an inverse
relationship between voter support and policies, past environmental recage, coming infrastructure.
I think you guys get the point.
Speaker 1 (44:11):
Yeah, yeah, Well, and Julie, this gets to something that
we've that has come up a little bit in this hour,
which is, you know, the idea that we're that we're
we're sicker and because and therefore we're dealing with more medications.
Is it just that people now are you know, being
able to be diagnosed, as doctor Grossman said earlier, with
these things, and we're remembering a time that didn't really
(44:32):
exist before.
Speaker 3 (44:34):
Yeah, I mean it's a combination. And absolutely, you know, yes,
we have a huge we have huge mental health problems
right now, but partly it's because we're aware of them.
We obviously had huge mental health problems throughout time immemorial,
but we weren't. We didn't know it as much as
we do now. I think that's part of it, is
that we can we're able to see things and you know,
(44:55):
and realize things and plus we have remarkable drugs that
can help. I mean, there's all kinds of you know,
science marches on and we discover new things. So but
you're right, I think we're thinking. You know, one of
the reasons we have so much chronic diseases that people
aren't dying of acute diseases anymore, is that things like
vaccines have you know, stop people mostly from dying from
(45:19):
measles and mumps and chicken pox and other kinds of
communicable diseases because we figured out how to not have
them spread, and therefore they're living to be older and
ending up with some of the chronic elements that you
get as you age.
Speaker 1 (45:33):
I mean, and yeah, go ahead, Daniel.
Speaker 9 (45:35):
Only today people are more willing to say out loud
that they're seeking therapy, they're seeing therapists, and that didn't
used to happen. And so when more people say that,
more people end up on medications or it just destigmatizes
getting help. And that's a great thing.
Speaker 1 (45:51):
I'm going to seek in one more call. Adam is
in Houston, Texas. Hi, Adam, what do you think?
Speaker 15 (45:58):
Great points all everything you guys are talking about tonight.
I grew up kind of underprivileged schizophrenic mom, never had
any psychiatric help, always felt the press. Finally got on
an SSRI when I was like twenty seven, so I
dealt with self medication as a teenager doing the opiate
(46:18):
crisis thing. One of our friends' moms used to give
us oxy cotton when we were like thirteen. So I
was always adverse to medication after I got off the opiates,
so I didn't want to go on one, but I
really needed it. It's really helped me out since then,
and I'm in therapy now as well. So I just
wanted to speak about that side.
Speaker 1 (46:40):
Of the coin and how old are you now people.
Speaker 14 (46:42):
They helped forty two forty.
Speaker 1 (46:45):
Two Okay, Adam, thank you, thank you so much for
that call. Really amazing calls this hour, so many people
with very personal stories, and I before we go, I
do want to bring it to a personal story of
one of our guests, Daniel Grossman, who many years ago, Daniel,
I came to you in Rochester, Minnesota to do a
story about you because you had been in an accident.
(47:07):
You suffered a spinal cord injury. Our listeners can't see you,
but you are in a wheelchair now. And you had
gone back to work months after that spinal cord injury
as an er doctor at the Mayo Clinic helping patients
once again. It was just an amazing thing to see,
and I wonder how that experience informs your views on
(47:29):
what we've been talking about this hour.
Speaker 9 (47:32):
Yeah, well, Jeremy, thanks for bringing that up. And our
story then has continued to bring people forward, and you know,
I get emails from folks who have found that and
some of the videos from it and helps them get
back to work. You know, Listen, I take a bunch
of medications. I am medicated because of my chronic illness.
(47:53):
That is the reality of it. My life would be
more difficult without those medications. I would be less well
off and less able to function. And they're not the
medications we're talking about today. But we're not just talking
about those medications. We're talking about the five or ten
medications that many Americans are on and that help them.
And so, you know, I both have empathy as a patient.
(48:14):
I have empathy for my patients. As a physician. I
look at their medication lists and I think about what
the ramifications of some of those medications are. Are they safe?
Are they dangerous. Could we change some things? I as
an emergency room doctor, I am not the one to
be changing them, but that's a you know, the healthcare
infrastructure needs to get better at thinking about all of
(48:37):
the medications because they're not going to go away, and
there's the opportunity for improvement is let's embrace the things
we have, get better at optimizing them for people, and
continue to live the best lives we can.
Speaker 1 (48:52):
Well, I want to think my guest so much, Daniel Grossmann,
emergency medicine physician at the Mayo Clinic, and KFF Health
News Chief Washington correspondent Juli Robner, Thanks so much to
both of you.
Speaker 4 (49:02):
Good great thanks.
Speaker 1 (49:04):
And don't forget the Middle is available as a podcast
in partnership with iHeart Podcasts on the iHeart Apple wherever
you listen to podcasts and coming to your feed. Next week.
An episode on our weekly podcast Extra One Thing Trump Did,
featuring the former Attorney General of the United States, Alberto Gonzalez,
talking about Trump's targeting of law firms. And next week
we'll be right back here going to be asking what
can be done to improve legal immigration to this country.
Speaker 2 (49:27):
As always, you can call in at eight four four
four Middle. That's eight four four four six four three
three five three. You can also reach out to Listen
to the Middle dot com, where you can sign up
for our free weekly newsletter and find the Sexiest Middle
t shirts and mugs.
Speaker 1 (49:40):
The Sexiest Ones. The medal is brought to you by
Longnok Media, distributed by Illinois Public Media and Urbana Illinois,
and produced by Harrison Fatino, Danny Alexander, Sam Burmas, Dawes,
John Barth, Anakadeshler, and Brandon Condritz. Our technical director is
Jason Croft. Thanks to our satellite risk radio listeners, our
podcast audience in the four hundred and thirty public radio
stations man if possible for people across the country to
(50:02):
listen to the Middle. I'm Jeremy Hobson, and I will
talk to you next week.
Welcome to the Middle. I'm Jeremy Hobson along with our
house DJ Tolliver and Tolliver have you been watching The
White Lotus?
Speaker 2 (00:12):
I think we both know. I've been watching The White
Lotus and I'm waiting for us to do a show
on it.
Speaker 1 (00:17):
Well, I don't think that's gonna happen, But for people
who have not been watching it. Parker Posey's character has
had some moments that have gone viral online, including this
one that sets us up perfectly for today's show.
Speaker 3 (00:28):
Are when if you take him on the recipams, No, ma'am, No,
I just have my prescription field and I could tell
someone are missing.
Speaker 2 (00:35):
You don't have enough lurazapam to get through one week
at a wellness ball.
Speaker 4 (00:40):
Okay.
Speaker 1 (00:40):
So, Lurazapam is an anti anxiety medication. Along with brand
names like Xanax and Volume. It's part of a class
of drugs called benzo diazepines or benzo's for short, and
those are on Health Secretary Robert F. Kennedy Junior's list
of drugs he thinks Americans are taking too many of.
Speaker 5 (00:59):
Percent of American youth are now on adderall or some
other ADHD medication. Even higher percentages or on SSRIs and benzos.
We are not just over medicating our children, We're over
medicating our entiled population.
Speaker 1 (01:16):
So that's what we're going to be asking you about
this hour. Do you think America is over medicated? And
just to be clear, we are not talking about vaccines here.
We're talking about prescription drugs for conditions including anxiety, depression,
weight loss, and ADHD. And we're going to get to
that in a moment in your calls. But first, last
week on the show, we talked about what the future
of American energy should look like. We got a lot
(01:37):
of calls, a lot of nuance from our listeners. Here
are some of the voicemails that came in after the show.
Speaker 6 (01:42):
Hey, my name is Bill from Chicago. I'm solidly in
the middle. I voted for Democrats and Republicans if we're
going to be real and not disingenuous. Suggesting that the
middle so embraces wind and solar given the actual underlying
statistics is ridiculous.
Speaker 7 (02:01):
This is Tina Brazil calling from Slide to Colorado. I
consider myself a pretty progressive person in support of clean energy,
but there's not really a switch that we can turn
on to go all renewable. It's going to happen over time,
and it's better to have that diversity until we can
go completely clean.
Speaker 8 (02:21):
Douglas Sharnberg calling for muro Linguid Texas. The bottom line
is Americans need to stop being spoon fed their energy
like babies. Where you plug in, you get carte blanche
as much electricity as you could possibly use. There's absolutely
no incentive for conservation with this model.
Speaker 1 (02:43):
Well, thanks to everyone who called in. You can hear
that entire episode on our podcast in partnership with iHeart Podcasts,
on the iHeart app or wherever you listen to podcasts.
So now to our topic this hour is America over medicated.
Tolliver the phone number please.
Speaker 2 (02:56):
Yeah, it's eight four four four Middle. That's eight four
four four six four three three. You can also write
to us at Listen to the Middle dot com and
you can also comment on our live stream on YouTube, TikTok, Facebook, Instagram,
and Twitch.
Speaker 1 (03:08):
Joining us on the panel this hour, KFF Health News
Chief Washington correspondent Julie Robner, Julie, great to have you
on the Middle.
Speaker 3 (03:15):
Great to be here.
Speaker 1 (03:16):
Jeremy and Daniel Grossman joins US as well. He's an
emergency medicine physician at the Mayo Clinic in Rochester, Minnesota,
and has held a number of business leadership roles in
the healthcare industry. Daniel, welcome to you.
Speaker 9 (03:27):
Thanks great to be here.
Speaker 1 (03:28):
So before we get to the phones, Julie, I want
to be clear, as I said, we are talking about
prescription drugs and not vaccines. RFK Junior, the Health Secretary,
has been skeptical of both.
Speaker 4 (03:38):
But on the.
Speaker 1 (03:38):
Issue of prescription drugs, there is a Penn State study
that found in the mid nineties, most Americans were on
one prescription drug. Now people taking prescription meds are just
as likely to be on five or more. How do
you explain.
Speaker 3 (03:54):
That there are more drugs for more things. I mean,
that's not necessarily a bad There are a lot of
things that we can control now using prescription drugs that
we couldn't in the nineties, and some of them are
just or we could but now we have better drugs.
You know, people have high blood pressure and diabetes and
all the chronic diseases that RFK Junior says he is
(04:16):
so concerned about. So I think that's kind of not
a fair way to decide whether Americans are over medicated
by the fact that they're simply taking more prescription drugs.
Speaker 1 (04:28):
Daniel, what do you think? And I'll throw in another
stat The Congressional Budget off has found that nationwide spending
on prescription drugs jump tenfold from nineteen eighty to twenty eighteen.
That's adjusted for inflation. What is your experience as a doctor.
Are people taking more medications now? And if so, why?
Speaker 4 (04:45):
Yeah?
Speaker 9 (04:45):
I think you have to go back a level and say,
are there more diseases do people have?
Speaker 10 (04:50):
You know?
Speaker 9 (04:51):
Is the prevalence of disease greater?
Speaker 4 (04:53):
Yes?
Speaker 9 (04:54):
Is the incidents? Are we seeing more and more new
types of diseases? Yes, because we can diagnose things, and honestly,
the rate of discovery of new drugs has accelerated greatly,
and so all those things combined tell us that there
are going to be more people taking more medications.
Speaker 1 (05:10):
You're saying that we can diagnose more diseases and that's
why it's not that we're becoming sicker.
Speaker 9 (05:16):
That's true. Well, I would say we are becoming sicker
and we can diagnose diseases that we couldn't diagnose before.
They can both be true.
Speaker 1 (05:25):
Do you feel pressure from patients or from pharmaceutical companies
for that matter, to prescribe medications.
Speaker 9 (05:32):
Definitely from patients. I'm held outside of sort of influence
of pharmaceutical companies in our practice environment. But patients when
they come to our emergency department or sea physicians, they
expect something to be done, and so you have to
figure out what that something is going to be, and
that can be a difficult conversation with patients.
Speaker 1 (05:53):
It's hard to say no to the patients.
Speaker 9 (05:55):
It's hard to say no. It's hard to meet expectations.
You have to suss out what the expectations are, and
many of them come with a goal that they would
like met and that may be a medication prescription.
Speaker 1 (06:08):
Julie Robinner, what would the what could the Trump administration
do if they wanted to get people to be taking
less prescription medications? What kind of tools do they have?
Speaker 3 (06:18):
Well, of course, again the biggest tool is obviously the
bully pull pit, and we do you know know that
there is a lot people do listen to federal health officials.
They may not trust them as much as they used
to before the pandemic, but they do listen to them.
We have a brand new head of the FDA, Marty McCarey,
who with the Senate just confirmed this week a fairly
(06:39):
prominent surgeon from John Hopkins, who's written several books and
is good on TV, as as most of the people
in the Trump administration are. He's been he's been trying
to walk kind of a fine line between what our
f kjunior wants but you know, and what he believes.
And he hasn't really said, but he could, obviously, you know,
(07:03):
provide a lot of sway if he wanted to. We'll
see whether he does or not.
Speaker 1 (07:07):
The phone lines are lighting up, so let's get to
a caller. Magdalena is calling from Grand Rapids, Michigan. Magdalena,
what do you think is America over medicated?
Speaker 11 (07:17):
I absolutely don't think so. I think that we as
Americans are lucky enough to have access to these kinds
of medications that really, for me personally, have enabled me
to have a better quality of life. I have been
diagnosed with dystymaic disorder, which is basically a chronic depression
(07:41):
where I have always had a low level of depression
because my brain just doesn't produce enough serotonin or dopamine.
And now at fifty years old. I've learned the symptoms
that I am familiar with the symptoms that I experienced
because of my disorder, and if I didn't have medication
(08:04):
access to the medications that I have access to, I
don't think that I would have been as successful in
my life and been able to be as productive in
my life because I didn't have access to them.
Speaker 1 (08:17):
Do you worry, Magdalena that some of the rhetoric coming
out of the Trump administration that you may not have
access to that, or you just think that they're sort
of talking about a big picture thing but it won't
have an effect on you.
Speaker 11 (08:30):
I'm worried that it's that it's rhetoric and that people
people already have a hard time understanding how depressed medications work,
whether they're medications for depression or anti psychotic medications or
anti anxiety medications. I'm personally as social worker, so I've
(08:51):
seen this throughout my career, and I think that this
will just continue to add to the confusion to people,
and you know, make it difficult for people to understand
how medications work, and you know that you have to
take them a certain way and one thing isn't going
(09:12):
to work for everybody. So when I hear you know,
you know this, this rhetoric that we're over medicated, it's
only because we're in the richest country in the world
and we have access to them.
Speaker 1 (09:28):
Yeah, Magdalena, thank you, thank you so much for that.
Called Daniel Grossman, what do you think of that? And
I wonder also if people are taking off medications they
decide not to take the medications because of what's being
talked about in Washington, could it lead to a mental
health crisis in this country.
Speaker 9 (09:43):
Well, well, let's start with we already have a mental
health crisis in this country. We have a significant challenge
with mental health. There are not enough mental health providers,
there are deserts where people don't have access to it.
What Magdalena described is is essentially what a lot of
people have discovered, which is their bodies might not quite
work correctly, and one person's not correctly is different than
(10:07):
another person's not correctly. And our ability to provide medications
and increasingly to use science to figure out the nuances
of what will work for one person versus another person
is pretty remarkable. So what she's describing, we have the
ability in this country to offer and to help as
(10:29):
she said, lead a more productive life.
Speaker 1 (10:32):
Speaking of Julia Robner, there's news just today about ten
thousand job cuts at the Department of Health and Human Services.
Would that affect the Department's ability to do anything about
over medication if they believe that that's a priority.
Speaker 3 (10:47):
Well, this is an enormous restructuring basically of the entire
Department of Health and Human Services and includes cuts of
thirty five hundred people to the FDA. The fact cheat
that the Department distributed says that it won't affect the
people who are actually reviewing drugs. Those are mostly not
paid for with federal funds anyway. They're paid for with
(11:08):
user fees that are provided by the drug companies themselves.
But you know, it's hard to know exactly how this
worry or you know, how they would try to operationalize
getting people off of too many drugs, you.
Speaker 1 (11:25):
Know, Tolliver, we can't have this discussion without mentioning the
tens of billions of dollars that pharmaceutical companies and retailers
have had to pay to settle lawsuits related to prescription
opioids like oxy contin. Yeah.
Speaker 2 (11:37):
Actually, just this year, a bipartisan coalition of states re
state seven point four billion dollars settlement settlement with oxyconton
maker Purdue Pharma and the Sackler family for their role
in the opioid epidemic. Here's one of the Attorneys General
involved in the settlement, New York's Letitia James.
Speaker 5 (11:54):
The Sackler family, and they're a company, Purdue, who helped
spark the opioid crisis decades ago.
Speaker 12 (12:01):
Half for years avoided accountability for the immense.
Speaker 5 (12:04):
Cause that they have caused. All of the victims, all
of the loved ones who have died, all of those
who are in.
Speaker 9 (12:13):
The throes of addiction right now.
Speaker 13 (12:15):
But that ends today.
Speaker 1 (12:18):
This latest settlement, by the way, replaces one that the
Supreme Court rejected last year. And we'll be right back
with more of the Middle. This is the Middle. I'm
Jeremy Hobson. If you're just tuning in the Middle as
a national call in show, we're focused on elevating voices
from the middle geographically, politically and philosophically, or maybe you
just want to meet in the middle. This hour, we're
(12:39):
asking you, is America over medicated? Tolliver? What is the
number to call in?
Speaker 2 (12:43):
It's eight four four four Middle that's eight four four
four six four three three five three. You can also
write to us a listen to the middle dot com
or on social media.
Speaker 1 (12:51):
I'm joined by Daniel Grossmann, emergency medicine physician at the
Mayo Clinic, and KFF Health News Chief Washington correspondent Julie Robner.
And before we go back to the phones, Julie, we
heard a moment ago about the settlements against big Pharma.
How much pushback are you seeing or would you expect
from the pharmaceutical companies when it comes to reducing the
amount of prescription drugs that Americans are on.
Speaker 3 (13:12):
Well, obviously pharma has a you know, financial interest in
Americans getting and continuing to take prescription drugs. The opioid
epidemic was kind of separate and from for many of them.
But there, I mean, there is a problem with drug
companies being incentivized to make not necessarily the drugs that
(13:33):
people most need, but the drugs that they're going to
make the most money from. I mean, we have a
huge shortage now of antibiotics, of new antibiotics coming into
the pipeline because people don't have to take antibiotics for
the rest of their lives. The way they take you know,
statins for cholesterol or drugs for blood pressure. So there's
it's much It does better if you're a drug company
(13:53):
to make something that people are going to take forever.
Speaker 1 (13:56):
It's like a wedding planner. You don't really go back
for don't go back for seconds that they don't need
to repeat business.
Speaker 3 (14:01):
Hopefully on an antibiotic, you hope not. But I mean
we also, I mean you could argue that we have
an under that we're under drugged in some ways because
people often can't afford drugs that they need so they're there.
You know, it does cut both ways.
Speaker 1 (14:18):
Daniel. How do you balance the incredible advances that we've
made in medicine that you talked about, uh, that allow
us to treat so many things with prescription drugs with
not wanting to overprescribe and get people addicted as they
did during the opioid crisis.
Speaker 9 (14:35):
The idea that a prescription from an emergency department or
from a single physician is going to be addictive has
been debunked. But the challenge is that there's a there's
a thought from the general population that if you take
a medication, you will get addicted.
Speaker 14 (14:50):
To it.
Speaker 9 (14:51):
So so it actually has removed some tools because patients
are reluctant to use the medications that we have available
because they are afraid because you know, they have become
afraid over time of becoming addicted. So, you know, our advancements,
our advancements are really in these some of the larger
disease populations that don't have risk for addiction or new
(15:17):
discoveries like Alzheimer's disease medications are coming out. You know,
there's not a risk of addiction there. We have a
new tool to help people that we didn't have before.
We need to find ways to take advantage of those
as opposed to saying that we are over medicated.
Speaker 1 (15:33):
Let's go to Connor, who's in Chapel Hill, North Carolina.
Speaker 15 (15:35):
Hi.
Speaker 1 (15:36):
Connor, welcome to the middle.
Speaker 16 (15:37):
Go ahead, Hi, it's great to be on.
Speaker 7 (15:41):
So.
Speaker 16 (15:41):
I've been taking basically a ad medication for about twenty years.
They diagnosed with ADHD when I was about nine. I've
had to be off of it for periods just due
to insurance and it has a negative all my life
when I'm not on the prescription and is really deeply
worried by the discourse on RFK Junior kind of what
(16:02):
that will do for me being a student and being
a professional.
Speaker 4 (16:07):
So that's kind of nice. Yeah, idea.
Speaker 1 (16:09):
Do you think that RFK Junior will make it impossible
for you to get your ADHD medication? Or why does
the rhetoric worry you specifically?
Speaker 17 (16:20):
I have heard just the way that he talks about
ADHD medications and SSRIs. I don't know exactly what I
am in public house side. I don't really know exactly
what will happen, but as we've seen with this administration,
things can kind of change, you know, in a second.
So I just kind of worried about the discourse around that.
(16:40):
Not exactly sure how it would happen, but just kind of,
you know, a little worried.
Speaker 1 (16:45):
Yeah, Connor, thank you for that call. Let me go
to another. Brent is calling from Jackson, Wyoming. Hi, Brent,
welcome to the middle. Go ahead with your thoughts.
Speaker 10 (16:54):
Hi, thank you for having me. I'm a senior aviation
medical examiner, and I think that people forget that when
children are put on ADHD medication, especially inappropriately, or other
psychotropic medicines, whether they're antidepressants or or tranquilizers, and they
really don't need them, but that can affect their careers
(17:16):
and they can't become a pilot. Many times, they can't
get into the military academies. And with the electronic medical record,
this stuff stays with somebody their entire life, so it's
hard to undo a misdiagnosis or inappropriately treated child. So
I think that's an important thing to remember.
Speaker 1 (17:35):
So what do you say to our previous caller, Connor,
who said, you know that when he has to go
off of his ADHD medication, it has a really negative
impact on his life.
Speaker 10 (17:45):
Well, I think people who are properly diagnosed, they do
definitely need medications like the ADHD medications, but those people
go through an extensive evaluation. It's not thirty men in appointment,
but a primary care doctor or primary care it's a
full day of examination, usually with a neuropsychologist are a
(18:06):
psychiatrist to really make a definitive diagnosis, you can't just
these medicines get thrown around so much that there are
a lot of people on these medications that really don't
need to be on them and never should have been
on them.
Speaker 1 (18:20):
Brent, thank you for that call. Julie Robner, two very
different views there on that issue just of ADHD medications.
Speaker 3 (18:28):
Yeah, absolutely, you know, and I think the same is true.
Most medications can be used properly and can be used improperly.
I mean, people are not out there, I don't think
abusing their blood pressure drugs for the most part. You know,
there's a lot of drugs that are not really subject
to abuse, and that's a whole different discussion, but of
the ones that can be or that somebody can make
(18:48):
money from basically, you know, pressing people to take although
generally doctors don't make money when people take prescriptions, but
there are a lot of people who you know, we'll
we'll try to sort of keep keep patients coming back
by giving them drugs. And obviously, you know, I think
the opioids were a little bit of a one off.
(19:09):
But I think one of the problems, one of the
big problems that we had with the opioids is that
the drug company lied about how addictive they were, and
I think that legitimately now has people kind of freaked
out about drugs, particularly about pain killers.
Speaker 2 (19:23):
Yeah, yeah, we'll have a personal one if that's okay.
So I saw an ad today for are you familiar
with hers dot com? Or hymns dot com. These apps
basically where you can order your you know, your prescriptions
after just like a virtual appointment or someone just text.
Do you what do you think about this? Are they
harmful or not? What do you think?
Speaker 3 (19:40):
I think they are lightly regulated, let's put it that way.
I think I think I would like to know what
the doctor thinks about that, Daniel.
Speaker 9 (19:47):
For while they are lightly regulated and they they have yeah,
you know, these are these are companies that have often
venture backed financial models and need to show growth, and
they've pivoted to sort of meet some of the emerging
areas where there are prescription opportunities. They have also expanded
(20:08):
access to people who might not have access for things
because of the virtual models. Because of the decentralization, you
can actually get more patients into the system and that's
a really good thing. So I would look at it
that way.
Speaker 1 (20:22):
Matthew is calling from mine, not North Dakota. Matthew, welcome
to the middle. Do you think America is over medicated?
Speaker 4 (20:30):
All right, guys, I just want to kind of synthesize
what your last two college said. I've been on these
medications benzos and amphetamines for about twenty years and I
think there's a whole generation of us now, people my age,
who were put on them early when they were in
the school by their parents or psychologists or whatever. We
grow up taking them and now we're dependent on them,
(20:54):
and I'm worried that this will kind of demonize those medications.
For those of us who have this point can't function
without them, and we just need them for maintenance. I
recently came to North Dakota from a different state and
to get a prescription up here, they asked me to
redo add testing. But the fact is, whether I actually
have it or not, now it's irrelevant. I need the
(21:17):
medication of functioning just because some of us have been
on it so long, whether we choose that or not.
Speaker 1 (21:23):
Do you feel like you wish you had not been
put it on it in the first place, or do
you think about that.
Speaker 4 (21:30):
I consistently think it was the worst thing that ever
happened to me.
Speaker 1 (21:34):
Wow, what do you think your life would be like
if you had not been Obviously a doctor at some
point decided that that was a good idea.
Speaker 4 (21:43):
Sure, And I mean I can't speculate, but I do
know it's not as simple as well, why don't you
just stop taking it after you've been on them for
thirty years. Just because of the nature of the drugs life,
it really is necessary to function after a certain point.
And that's hard to articulate in a way to newer
medical professionals because they don't understand the history. You know
(22:06):
what it was like twenty years ago when doctors first
started giving riddle into everybody.
Speaker 1 (22:12):
Matthew, thank you for that call. Daniel Grossman, your thoughts
on that very interesting.
Speaker 9 (22:16):
Yeah, that's a you know, very compelling personal story. I
would have to agree with his perspective on what's been
happening for many, many years. Our prior caller who talked
about the impact on getting jobs. You know, the larger
issue there might actually be the stigma that's attached to
these medications and that it impacts employment in some areas
(22:41):
and some it might, but we could destigmatize these The
other thing to keep in mind is that the robustness
of the diagnostic process that leads to people being taking
anti depressants or on ADHD medications, the robustness of that
process has increased dramatically. Our ability to accurately need to
diagnose patients is significantly better today than it was before.
(23:05):
And so this idea that that caller said that people
are inappropriately put on them, I don't think that's the
vast majority of patients now, and we should flip the
script a little bit on why patients are taking them,
how they got there, and what that means for them professionally.
Speaker 2 (23:20):
Julie Rogers, Yeah, go ahead tell her so sorry, We're
gonna get this together one day. I've got a bunch
of comments coming in online, about ninety percent of them
about ADHD, but I want to get some in Luke
and Milwaukee says the MAGA movement is very harmful to
ADHD and autistic people, and I myself am both an
adhder and autistic. It's important for those with ADHD to
be able to have our medications, as well as people
(23:42):
with depression like myself who need SSRIs. And then let's see.
Speaker 18 (23:47):
Sorry.
Speaker 2 (23:47):
Captain in Kansas City says, is America over medicated? Yes,
American medical care is more algorithmic, business based, consumer satisfaction based,
and less patient centered and health promoting. This is slowly changing,
but we are still decade behind where we could be
in Decades of life and health have been lost because
of it. That was a very precient comment.
Speaker 1 (24:05):
Julie Rober interesting there. Just comparing the American medical system
to other countries, Robert F. Kennedy would say, we spend
and rightfully so, we spend way more money on healthcare,
and part of that is prescription drugs. A big part
of that is prescription drugs than many other countries do.
Speaker 3 (24:22):
That's because our healthcare system is much more expensive than
most other countries. That it's not that we take more
that we're sicker, it's that we pay more for what
it is that we get. This is obviously a very
difficult and sensitive issue for an awful lot of people.
And as I say, there's a lot of people who
could be taking prescription drugs, who should be taking prescription
(24:43):
drugs and who aren't because they can't afford them, because
we pay more for our prescription drugs in the United
States than any other country in the world, even though
most of the drug companies are US companies.
Speaker 1 (24:54):
Megan is calling from Minneapolis, Minnesota. Hi, Meghan, welcome to
the middle Go ahead with your thought.
Speaker 19 (25:01):
Hi, welcome and our Thanks for having me and thanks
for having this discussion. I think it's a really important one.
And I'm the mother of My son is now twenty two,
but he had been medicated starting at a really young age.
It was like third grade where they wanted to introduce
ADHD meds. And so I've seen the effects of these
psychotropic and sort of met them betamin drug use on
(25:24):
a young child's brain, and I have a lot of
concerns about it. I was a young mother at the
time when I sort of took the lead of the experts,
and now looking back on it, I wish I would
have maybe tried some other things before. But I see
it's a pretty big trend where these young children are
put on these heavy, heavy medications, and then now we
have this mental health crisis and we have a lot
(25:45):
of addiction issues running wild in our country, and I
think it can stem back to having been overly medicated
at young ages and those little brains just can't handle
all that stuff. You know, it seems like it might
help solve things, but there's other ways to do it,
and that should be the first thought for young.
Speaker 1 (26:04):
How does your child feel about it?
Speaker 8 (26:06):
Now?
Speaker 1 (26:06):
Now that your child is an.
Speaker 19 (26:07):
Adult, he's actually really angry and has a lot of
thoughts about having not given consent to this, and you know,
he struggles with addiction now, and so he feels kind
of like he had no choice and now he's kind
of like one of the one of the last colors.
Like you know, when you've been on these things for
your life, then suddenly you're stuck on it, right. You
have no other way to do things, and you're used
(26:29):
to functioning with these medications, and so life about them
is challenging. And I know there's a lot of times
issues with shortages, and so one of the meds my
son takes is off and not even available, so he's
forced them to sort of self medicate and do other things.
Speaker 1 (26:45):
So yeah, great points, Megan, Thank you very much. Daniel Grossman, Well,
actually there are two things in there, but one of
them is she just said, he self medicates because he
can't get what he needs. Are we are you seeing
shortages of medications because of overuse in some cases?
Speaker 9 (27:04):
I don't think you know, I don't know a specific
answer to that, whether it's from overuse or because we
consolidate the number of manufacturers. There are plants that have problems.
There's a natural disaster that takes out a major manufacturer
of things like ivy fluid that happens now, and so
(27:25):
that is probably a larger contributor to shortages of medications
than an overuse problem.
Speaker 3 (27:33):
We have supply chain issues with medications. That's mostly what's
causing shortages.
Speaker 1 (27:38):
Yeah, let me sneak in one more call here before
we have to take a quick break. Stephanie's in Longmont, Colorado. Hi, Stephanie, go.
Speaker 20 (27:45):
Ahead, Hi guys. Absolutely, I do agree that the opioid
crisis was definitely a problem. Agree, But I kind of
wanted to just get the opinion on do we think
that currently the state the state of being over medicated
is really and truly being over medicated or do you
think it's potentially a product of the poor health of Americans,
(28:09):
the bad diets and things like that, and then also
a mix of you know, the just acceptance of mental health,
like and people being more willing to seek out treatment,
being more willing to kind of go seek those medications,
and that kind of stigma going down and just the
combination of those things making it seem like we're overly medicated.
Speaker 1 (28:30):
Stephanie, I'll take that to Julie Robner.
Speaker 3 (28:34):
Well, I think doctor Grisam said it early on. It's
you know, it's a combination of there's more things we
can do and more things that we can diagnose, and yes,
are there people who are inappropriately getting medication, clearly? Are
there people who should who are not getting medication who
should also, clearly. I mean it's a really hard problem.
You know, we don't have our you know, it goes
(28:56):
back to sort of the mess that our nation's healthcare
system is in which we don't really have a health
care system. So some people have better access to care
than others. Some people have access to care that maybe
not with the best providers, and so we end up
with people in different situations.
Speaker 1 (29:13):
And Julie, you know the Trump administration, there was a
first Trump administration and they did not focus on this
issue really at all.
Speaker 3 (29:22):
Well, they focused on Trump was actually very much into
drug prices in the first administration and very much trying
to get drug prices down, including by some some ways.
That court said no, you can't like trying to you know,
price drugs the way the same as they are in Europe,
which obviously the drug makers all suit. And you know,
(29:42):
now there's still the question is whether we're even going
to continue this very small program that we have to
negotiate drug prices for Medicare. It does look like that's
going to continue. But you know this has been hand
to hand combat with the drug industry over a lot
of years.
Speaker 1 (29:59):
Well, Tolliver, Long before Parker Posey in The White Lotus,
there was a character played by Cherry O Terry on
Saturday Night Live.
Speaker 2 (30:05):
Uh yeah, her name was Collette Reardon. And in addition
to uneven lipstick and eyeshadow, we've all been there, she
had no shortage of prescription drugs. Here's a clip from
nineteen ninety nine.
Speaker 6 (30:16):
Oh seriously, I'm legitimately troubled by the amount of medication
on this table.
Speaker 12 (30:20):
Me too.
Speaker 13 (30:22):
Well, the second all here is for the night sweats
and hot flashes. I get what with being preman a Pauls.
Speaker 1 (30:28):
Listen, I better fix your phone here right well.
Speaker 13 (30:30):
Mexic quick branch, I got sta call doctor Doug bevlockwam
E n T And sometimes why why Well, because I
need a refill on the delatta to take from a
carpal tunnel syndrome.
Speaker 1 (30:45):
Uh, doc, how do you pronounce balloqua beva lockwa? And
she has different names for all the doctors. By the way,
I had a lot of fun going through all the
clips that we could have used for that with Serio Terry,
the problem is that most of them ended up having
her swearing at some point. Well well, on the podcast
we wouldn't have to, but on the radio show we do.
(31:06):
We'll be right back with more of your calls on
the Middle. This is the Middle. I'm Jeremy Hobson. In
this hour, we're asking you is America over medicated? You
can call us at eight four four four Middle. That's
eight four four four six four three three five three,
or you can reach out at Listen to the Middle
dot com. My guests are KFF Health News Chief Washington
correspondent Julie Robner and Daniel Grossman, an emergency medicine physician
(31:28):
at the Mayo Clinic. And before we go back to
the phones, Julie, even if Americans on different sides of
the political spectrum, we don't know the political views of
the callers that have called in so far, but even
if people on both sides were to agree that we
are over medicated, the messenger here is Robert F. Kennedy Junior, who,
as we mentioned, is also skeptical of vaccines, even in
(31:50):
the face of a deadly measles outbreaks that is being
fueled by unvaccinated children. Does he have credibility with the
people that you speak with in the world of healthcare?
Speaker 3 (32:01):
Not really. I mean the MAHA movement, the Make America
Healthy Again movement consists of people who are legitimately skeptical of,
you know, some things, of people being over medicated. But
there it's also made up of people who are selling
supplements that have not been you know, the quote unquote
natural things that have not been evaluated and approved by
the FDA, and then in some cases have been shown
(32:23):
to be dangerous. So there's an awful lot of uh,
you know. I will resist the urge to say snake
oil salesman, but there's an awful lot that's out there
on the market that's not quote unquote a drug that's
also not very good for you.
Speaker 1 (32:39):
Daniel. I'm not going to ask you that question because
you're a doctor the Mayo Clinic, and Julie can say
things like that because she is a correspondent at KFF
Health News. But I will ask you this. If you,
as a doctor, were to snap your finger and say
I want to make America healthier, what would you do
and would fewer medications be anywhere on your list.
Speaker 9 (32:59):
No, your medications wouldn't. It would be more providers, more physicians,
it would be more mental health experts. It would be
better access to medical care for our Native American populations.
It would be better access to healthy foods and medical
care for our Black and Hispanic populations. It would be
infrastructural and systems issues. It's not a medication problem.
Speaker 1 (33:23):
Let's go to Eli, who's calling from West Hartford, Connecticut. Hi, Eli,
welcome to the middle and go ahead, all right.
Speaker 14 (33:30):
Thank you for taking the call. Yeah, you know, I
just wanted to hold on. I apologize. I'm over here.
I'm on a bluecer ally, So I just wanted to
mention I actually went through a very part of this
process for a very long period of time. I was
taking high doses of xanax for years and years and years,
having been prescribed it in my teens, and I went
(33:51):
through a highly difficult process of having to stop, and
all of that was all like there's I just wanted
to mention, like the kind of the confluence of all
of this. I was stuck in very like dictam mentality.
Everything is somebody else's fault, you know, uh, you know
the anxiety is you know, I'm not supposed to be
experiencing it. Kind of like a cliche millennial male in that,
(34:12):
you know, just the world is supposed to be softened
my footsteps and sorry, I'll super quick and finished, really quickly.
Is that having stopped all that and you know been
you know, a responsible member of society like I've been
able to you know, triple my income, find my fiance
buy a house in just two or three years of
just experiencing life as it's supposed to be. Difficult. People
(34:33):
experience depression, You experienced anxiety. Get the hell over it.
That's the way that life is supposed to be. And
I'm for any type of movement that that is supposed
to perpetuate that, especially with young men. You know, that
is the way that things are supposed to be. It's
supposed to be difficult. Get over yourselves.
Speaker 3 (34:51):
Can I present aunt ad I've had anxiety, serious anxiety
since I was eleven. I'm now in my sixties. I
would I, by the way, is one of the people
who did with part of the clinical trial for xanax,
which did not work very well for me. But I
will say I am now on an SSRI and it
has changed my life for the better. And I know
a lot of people who are that way because as
(35:12):
the first caller, I think it was said, when you
have a chemical imbalance and you take something that balances
your chemical imbalance, you feel like a normal person. So
I think, yes, there's a lot of people who are
on drugs who shouldn't be. These drugs are not all
the same. You can be inappropriately, you know, put on
a drug that either does not work for you or
that's not appropriate for you. But I think to make
(35:33):
some of these blanket statements like Robert F. Kennedy Junior
is making that people are over drugged. It's doing a
serious disservice to people who take medications that they need.
Speaker 1 (35:44):
You know, one class of drugs we haven't talked about
this hour surprisingly that Robert F. Kennedy Junior has gone after,
is the GLP one drugs, o zepic, wigo, v et cetera.
Daniel Grossman, do you have any different thoughts about those
than you do about other medications.
Speaker 9 (36:02):
I mean, isn't science amazing? We have been able to
create a synthetic version of a natural peptide in the
body that tells our body to eat less or help
with insulin regulation and sugar regulation and also so you know,
diabetes control weight loss as a result also and also
(36:25):
will help with things like substance use disorder and alcohol
use disorder. Like this is phenomenal. We should avail ourselves
of the resources that happen. We should avail ourselves of
our mental health providers SSRIs, GLP one. Access like this
is amazing and we have access to these things to
make us healthier as a result.
Speaker 1 (36:45):
Bill is calling from Chelmsford, Massachusetts. Hi, Bill, Welcome to
the middle What are your thoughts?
Speaker 21 (36:50):
Hey everyone, thank you for taking MC call. I don't
think we're over medicated. I think we're undersupported. I think
that you see the doctor initially and they give you
a doctor to help. There's no follow up as much
as there should be. But here's my question. Also, there's
an awful lot of stress and concern with the administration
and our government today, and there's an awful lot of
people who are in need, who don't have the resources.
(37:13):
And if RFK is successful in denying even more support
to them in the way of whatever, whether it be
medication or doctors or social work, what happens to these
people who turn from that support or even the medication
they need or find help with and turn to things
like alcohol or marijuana or other sources where you can't
(37:35):
even track it. And at least with medication. Hopefully there's
some kind of system that follow with doctors. And I
know that the general question we over medicated so broad.
There's so many different areas that maybe we're over medicated
in one, but we're not in others, and maybe we
need more medication than even others. But I think unfortunately
(37:56):
that people are going to suffer. The ones that need
the support from the government and the fire of case
there this way, they're not going to get it, And
I'm concerned about that. I'm wonder what you've bandled things.
Speaker 1 (38:05):
Yeah, thank you, Bill, Either of you want to get
into that about whether if people don't get the medication
they need for things like stress and depression, they may
turn to other drugs, including alcohol.
Speaker 3 (38:16):
People have been self medicating since there were people. I mean,
we know this from you know, anthropological digs. We see
it in you know, in sort of tribes that are
in the in the middle of the Amazon. The things
that people have availed themselves of to deal with stress
and anxiety, and yes, it is part of the human condition,
but it's also trying to deal with it is something
(38:39):
that humans have always done and I suspect will always do.
It's a lot safer, I think, to take drugs in
most cases than it is to do some of these
other things.
Speaker 1 (38:48):
Let's get to Gretchen, who's in beautiful Myrtle Beach, South
Carolina High Gretchen, welcome to the middle What do you.
Speaker 12 (38:54):
Think, Well, I think we're very, very over medicated in
this kind. I've been told that only in the US
and New Zealand is it legal for drugs to be
advertised on TV. And many of the drugs advertised say
(39:16):
ask your doctor about this, that or the other drug.
And I think it's such a big business that it's
really running our country in several ways, as is the
automotive industry. But if you watch TV for just a
few hours, every other ad on TV is about pharmaceuticals
(39:38):
with multiple deadly side effects. I think it's a big
business that's running our country in many many ways.
Speaker 2 (39:47):
Yeah.
Speaker 1 (39:50):
Yeah, Actually, I had a former colleague who didn't want
her kid to be marketed to and so she only
let him watch p and the Food Channel because the
Food Channel she thought would only market to adults. And
one night he said to her, Mommy, I can't sleep.
Can I have a lunesta? Like six years old? But
(40:11):
what about that, Daniel Grossman, just the advertising on television
for all these drugs, and just the big business that
it is.
Speaker 9 (40:18):
It's a big business. This is it both helps feed
discovery of these and is a marketing machine, right, And
so patients do come into physicians and ask for medications
by name. That is how marketing works. And the only
way to stop that is, of course, is to remove
all pharmaceutical marketing, which is not going to happen. So
it becomes inherent to the physicians and the patients and
(40:42):
develop a relationship of trust to guide for or a
way for those medications.
Speaker 3 (40:47):
And the caller is exactly correct that the US and
New Zealand are the only countries that allow the kinds
of drug advertising that we have.
Speaker 1 (40:55):
That you know, funny, for a long time, I wouldn't have.
Speaker 3 (40:57):
For advertised in medical journals, and you know there were
advertised to doctors, but not directly to patients. And I
think I think that is one of the things that
RFK Junior talks about trying to scale back that. I
think there is bipartisan support for hm HM.
Speaker 1 (41:12):
Cole is calling from Salt Lake City. Hi, Cole, Welcome
to the middle your thoughts.
Speaker 18 (41:19):
Hey, how's it going? I first off want to thank
the doctor in.
Speaker 1 (41:24):
The room, what's his name, Daniel Grossman, Daniel.
Speaker 18 (41:29):
For his views and you know, I wish there was
someone like him, uh, you know, leading leading the healthcare
in our country and not you know, not not someone
who maybe doesn't have as much scientific background and training.
I think we really owe a lot to the centuries
(41:52):
of science and research that's taken place in this country
and you know, all over the world. It's just amazing.
As a little kid, I was diagnosed very quickly, I think,
in about a thirty minute session with my school counselor.
(42:13):
She was pretty sure I had ADHD. And I went
through some diagnostic testing, you know, for that whatever, the
thirty question test on a sheet of paper, and I
did a trial of adderall and I had horrendous restless
legs and night terrors and I was hyper vigilant, couldn't sleep,
(42:37):
And twenty years later, I was still struggling with ADHD
and tried to, you know, become medicated again as an adult.
And I actually had a manic break that time around.
And you know, it's speculated now that I have bipolar
(42:58):
two disorder, which is kind of a murky uh diagnosis.
But you know, I wouldn't ever criticize the doctors for
trying to help me. I think that's what they were
trying to do. I wasn't, however, warned of the potential
(43:21):
psychotic effects of of.
Speaker 1 (43:24):
Oh I think we lost I think we lost Cole there.
Speaker 2 (43:27):
Jeremy.
Speaker 1 (43:28):
Yeah.
Speaker 2 (43:28):
I had actually a couple comments related to that also,
first one to say, Julie, we love you too, Okay.
Speaker 1 (43:33):
Julie could eily that.
Speaker 9 (43:36):
Juliet charge?
Speaker 14 (43:38):
Okay.
Speaker 2 (43:38):
So someone says, it seems that a record number of
people that I know are on antidepressant medications, yet the
suicide rate of skyrocketing. I personally known the three people
who have had their medications adjusted and then took their
own life. People seemed to take these meds very lightly.
John and Michigan says, are we over medicated or are
we just aware of the world around us? People have
always had depression anxiety, but for twenty years now we've
been facing down flat wage's, ridiculous house rental prices, a
(44:01):
work life with little to no time off, toxic work culture,
people can't afford kids healthier out of reach, an inverse
relationship between voter support and policies, past environmental recage, coming infrastructure.
I think you guys get the point.
Speaker 1 (44:11):
Yeah, yeah, Well, and Julie, this gets to something that
we've that has come up a little bit in this hour,
which is, you know, the idea that we're that we're
we're sicker and because and therefore we're dealing with more medications.
Is it just that people now are you know, being
able to be diagnosed, as doctor Grossman said earlier, with
these things, and we're remembering a time that didn't really
(44:32):
exist before.
Speaker 3 (44:34):
Yeah, I mean it's a combination. And absolutely, you know, yes,
we have a huge we have huge mental health problems
right now, but partly it's because we're aware of them.
We obviously had huge mental health problems throughout time immemorial,
but we weren't. We didn't know it as much as
we do now. I think that's part of it, is
that we can we're able to see things and you know,
(44:55):
and realize things and plus we have remarkable drugs that
can help. I mean, there's all kinds of you know,
science marches on and we discover new things. So but
you're right, I think we're thinking. You know, one of
the reasons we have so much chronic diseases that people
aren't dying of acute diseases anymore, is that things like
vaccines have you know, stop people mostly from dying from
(45:19):
measles and mumps and chicken pox and other kinds of
communicable diseases because we figured out how to not have
them spread, and therefore they're living to be older and
ending up with some of the chronic elements that you
get as you age.
Speaker 1 (45:33):
I mean, and yeah, go ahead, Daniel.
Speaker 9 (45:35):
Only today people are more willing to say out loud
that they're seeking therapy, they're seeing therapists, and that didn't
used to happen. And so when more people say that,
more people end up on medications or it just destigmatizes
getting help. And that's a great thing.
Speaker 1 (45:51):
I'm going to seek in one more call. Adam is
in Houston, Texas. Hi, Adam, what do you think?
Speaker 15 (45:58):
Great points all everything you guys are talking about tonight.
I grew up kind of underprivileged schizophrenic mom, never had
any psychiatric help, always felt the press. Finally got on
an SSRI when I was like twenty seven, so I
dealt with self medication as a teenager doing the opiate
(46:18):
crisis thing. One of our friends' moms used to give
us oxy cotton when we were like thirteen. So I
was always adverse to medication after I got off the opiates,
so I didn't want to go on one, but I
really needed it. It's really helped me out since then,
and I'm in therapy now as well. So I just
wanted to speak about that side.
Speaker 1 (46:40):
Of the coin and how old are you now people.
Speaker 14 (46:42):
They helped forty two forty.
Speaker 1 (46:45):
Two Okay, Adam, thank you, thank you so much for
that call. Really amazing calls this hour, so many people
with very personal stories, and I before we go, I
do want to bring it to a personal story of
one of our guests, Daniel Grossman, who many years ago, Daniel,
I came to you in Rochester, Minnesota to do a
story about you because you had been in an accident.
(47:07):
You suffered a spinal cord injury. Our listeners can't see you,
but you are in a wheelchair now. And you had
gone back to work months after that spinal cord injury
as an er doctor at the Mayo Clinic helping patients
once again. It was just an amazing thing to see,
and I wonder how that experience informs your views on
(47:29):
what we've been talking about this hour.
Speaker 9 (47:32):
Yeah, well, Jeremy, thanks for bringing that up. And our
story then has continued to bring people forward, and you know,
I get emails from folks who have found that and
some of the videos from it and helps them get
back to work. You know, Listen, I take a bunch
of medications. I am medicated because of my chronic illness.
(47:53):
That is the reality of it. My life would be
more difficult without those medications. I would be less well
off and less able to function. And they're not the
medications we're talking about today. But we're not just talking
about those medications. We're talking about the five or ten
medications that many Americans are on and that help them.
And so, you know, I both have empathy as a patient.
(48:14):
I have empathy for my patients. As a physician. I
look at their medication lists and I think about what
the ramifications of some of those medications are. Are they safe?
Are they dangerous. Could we change some things? I as
an emergency room doctor, I am not the one to
be changing them, but that's a you know, the healthcare
infrastructure needs to get better at thinking about all of
(48:37):
the medications because they're not going to go away, and
there's the opportunity for improvement is let's embrace the things
we have, get better at optimizing them for people, and
continue to live the best lives we can.
Speaker 1 (48:52):
Well, I want to think my guest so much, Daniel Grossmann,
emergency medicine physician at the Mayo Clinic, and KFF Health
News Chief Washington correspondent Juli Robner, Thanks so much to
both of you.
Speaker 4 (49:02):
Good great thanks.
Speaker 1 (49:04):
And don't forget the Middle is available as a podcast
in partnership with iHeart Podcasts on the iHeart Apple wherever
you listen to podcasts and coming to your feed. Next week.
An episode on our weekly podcast Extra One Thing Trump Did,
featuring the former Attorney General of the United States, Alberto Gonzalez,
talking about Trump's targeting of law firms. And next week
we'll be right back here going to be asking what
can be done to improve legal immigration to this country.
Speaker 2 (49:27):
As always, you can call in at eight four four
four Middle. That's eight four four four six four three
three five three. You can also reach out to Listen
to the Middle dot com, where you can sign up
for our free weekly newsletter and find the Sexiest Middle
t shirts and mugs.
Speaker 1 (49:40):
The Sexiest Ones. The medal is brought to you by
Longnok Media, distributed by Illinois Public Media and Urbana Illinois,
and produced by Harrison Fatino, Danny Alexander, Sam Burmas, Dawes,
John Barth, Anakadeshler, and Brandon Condritz. Our technical director is
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(50:02):
listen to the Middle. I'm Jeremy Hobson, and I will
talk to you next week.
Host
Jeremy Hobson
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