Parents Against Psych Abuse
The event was sponsored by the local chapter of Children and Adults with Attention Deficit Disorder (Chadd), the nation’s primary advocacy group for A.D.H.D. patients... The evening opened with the local Chadd coordinator thanking the drug company Shire — the manufacturer of several A.D.H.D. drugs, including Vyvanse and extended-release Adderall — for partly underwriting the event. An hourlong film directed and narrated by two men with A.D.H.D. closed by examining some “myths” about stimulant medications, with several doctors praising their efficacy and safety. One said they were “safer than aspirin,” while another added, “It’s O.K. — there’s nothing that’s going to happen.”
Sitting in the fourth row, Mr. Fee [whose son took his own life while strung out from Adderall addiction] raised his hand to pose a question to the panel, which was moderated by Jeffrey Katz, a local clinical psychologist and a national board member of Chadd. “What are some of the drawbacks or some of the dangers of a misdiagnosis in somebody,” Mr. Fee asked, “and then the subsequent medication that goes along with that?”
Dr. Katz looked straight at the Fees as he answered, “Not much.” Adding that “the medication itself is pretty innocuous,” Dr. Katz continued that someone without A.D.H.D. might feel more awake with stimulants but would not consider it “something that they need.” “If you misdiagnose it and you give somebody medication, it’s not going to do anything for them,” Dr. Katz concluded. “Why would they continue to take it?”
Excerpts from Drowned in a Stream of Prescriptions,
New York Times, Feb. 2, 2013
Alan Schwarz's poignant New York Times article about the heart-breaking tragedy of a young man's promising life ended prematurely by an addiction to ADHD medication, and his parents' anguish as they tried in vain to stop professionals from prescribing more medication while their son continued to spiral downward, raises important questions about the role of so-called patient/parent associations in promoting controlled stimulants and other ADHD drugs to the general public.
That the risks of ADHD medications would be minimized at a Shire-sponsored event is not exactly ground-breaking news. Shire's advertising and marketing of its ADHD medications has a long history of running afoul of the U.S. Food and Drug Administration (FDA) Division of Drug Marketing, Advertising and Communications (DDMAC). The FDA has sent warning letter (Nov. 9, 2000), after warning letter (Sept. 25, 2008), after warning letter (June 22, 2010), after warning letter (May 6, 2011) to Shire for its false advertising and marketing of its ADHD drugs Adderall, Adderall XR, Intuniv and Vyvanse respectively.
A day before Schwarz's article appeared in the New York Times, Business Week reported that Shire "agreed to pay about $57.5 million to resolve a federal investigation into the marketing of its drugs for treating attention deficit hyperactivity disorder." Shire's 10-K filed with the SEC states, "On September 23, 2009 the Company received a civil subpoena from the US Department of Health and Human Services Office of Inspector General in coordination with the US Attorney for the Eastern District of Pennsylvania seeking production of documents related to the sales and marketing of ADDERALL XR, DAYTRANA and VYVANSE. The investigation covered whether Shire engaged in off-label promotion and other conduct that may implicate the civil False Claims Act. On February 1, 2013 the Company announced it had reached an agreement in principle to resolve this matter. The Company has recorded a $57.5 million charge comprised of the agreement in principle amount, interest and costs... Discussions between the Company and the US Government are ongoing to establish a final resolution to the investigation."
In fairness to Shire, though, they are not the only
greedy lying pusher pharmaceutical company to engage in false advertising and marketing of ADHD medications. The FDA has also sent a warning letter or notice of violation to Strattera manufacturer Eli Lilly & Company, Methylin manufacturer Mallinckrodt Inc., Focalin XR manufacturer Novartis, and
Concerta manufacturer Johnson & Johnson.
The FDA's repeated false advertising and marketing complaints against ADHD drug manufacturers often involve the following misleading practices: overstatement of efficacy, broadening of indication, unapproved uses, ommission or minimization of risk information, omission of material fact, unsubstantiated claims and unsubstantiated comparative claims.
While pharmaceutical companies misleading consumers is not exactly news making, what is revelatory and indeed troublesome about Schwarz's article is that a so-called patient or parent association, through its Board member who is also a licensed psychologist, is reported to have engaged in similar misleading practices, ie. downplaying the risks of ADHD medications.
This is not the first time concerns have been raised about so-called "parent associations" advocating the use of stimulant medications. As early as 1995, in their annual report, the United Nations (UN) International Narcotics Control Board (INCB) asked U.S. authorities to investigate "whether article 10, paragraph 2, of the 1971 Convention [on Psychotropic Substances], prohibiting the advertisement of controlled substances to the general public, is not being undermined by the activities of 'parent associations' advocating the use of methylphenidate [the active ingredient in the ADHD drugs Ritalin, Concerta, Daytrana, Quillivant XR, etc.]."
It is understandable why the U.S. government might not want to seriously look into these allegations, as they would in effect be investigating themselves. What Schwarz doesn't tell you in the article is that the part of the CHADD meeting not underwritten by Big Pharma, was underwritten by - wait for it - you. That's right, CHADD has received $12,412,919 of your tax money in grants from the U.S. Department of Health and Human Services (HHS) to reportedly facilitate the promotion of controlled stimulants to the general public, while simultaneously downplaying their risks, in seeming violation of the 1971 Convention on Psychotropic Substances, which the U.S. signed on February 21, 1971 and ratified on April 16, 1980, and the False Claims Act.
Quite the self-sustaining eco-system: Shire pays HHS $57.5M to end a federal investigation into alleged false claims about their ADHD medication, and meanwhile HHS pays out $12.4M to CHADD, which reportedly makes false claims about Shire's ADHD medications at patient/parent meetings. However, the pharmaceutical industry's financial support of CHADD goes far beyond the apparent indirect conduit via HHS, and includes direct contributions to CHADD as an organization, as well as personal payments to individual members of CHADD's Board of Directors and CHADD's Professional Advisory Board.
From 2006 through 2009, ADHD drug manufacturers contributed $7,078,050 to CHADD as an organization. Pharmaceutical companies have also personally paid current CHADD Board of Directors member Anthony Rostain, current CHADD Professional Advisory Board Member Craig Surman, and past CHADD Professional Advisory Board members Rahn Bailey, Marcus Griffith, Patricia Quinn, Adelaide Robb and Timothy Wilens to the tune of $743,646 collectively. (Source: ProPublica.org Dollars for Docs).
The cited figures are by no means exhaustive, and merely represent the contribution and personal payment amounts that the pharmaceutical companies and CHADD have chosen to report thus far. While the full scope of the payola from Big Pharma to CHADD may not be ascertainable at this time, the data that is available attests irrefutably to Big Pharma's significant financial support of CHADD as an organization, as well as its considerable financial support of individuals with authority and influence inside CHADD.
With so much Big Pharma money ending up in CHADD's bank account and in the pockets of CHADD leaders, it really begs the question as to whether patient or parent association is even an accurate description of the true nature of the organization. Remember, Schwarz refers to CHADD as "the nation's largest advocacy group for A.D.H.D. patients." CHADD is an advocacy group alright, but for whom exactly?
A review of CHADD's tax documents dispels any remaining illusion that it is an advocacy group for, by or of ADHD patients or their parents. CHADD's tax returns tell the real story: "THE ORGANIZATION'S MEMBERS DO NOT HAVE POWER TO VOTE. THEY PAY DUES THAT ENTITLE THEM TO... CHADD UNA DISCOUNT PRESCRIPTION CARD..."
So if ADHD patients and their parents are not calling the shots inside CHADD, who is? A review of CHADD's income and expenditures from 2001 to 2009 (the only years available) reveals that Celltech (UCB Pharma), Cephalon, Eli Lilly, Janssen (Johnson & Johnson), McNeil (Johnson & Johnson), Novartis, Pfizer, Shire and UCB Pharma have contributed to CHADD over the years, though CHADD won't say exactly how much.
What does all that Big Pharma money buy? If we take Shwarz's account of one CHADD event as an example, apparently it buys plenty - a poorly disguised direct promotional pitch of ADHD drugs to patients and parents, where even CHADD Board of Directors member Jeffrey Katz gets in on the act, throwing the weight of his psychology license behind a campaign to promote ADHD drugs that minimizes their risks to both patients and parents alike in the audience.
This type of apparently false direct-to-patient and direct-to-parent advertising campaign cloaked as grassroots "Parent-to-Parent: Family Training on AD/HD" sponsored by Big Pharma (see, for example, CHADD's income and expenditures reports and Big Pharma's donations to "CHADD Public Education and Outreach," "Parent to Parent: Family Training on AD/HD," "CHADD Education Initiative on AD/HD," etc.) appears to be a clever attempt to circumvent the jurisdiction of the FDA's DDMAC, which according to its own literature is limited to reviewing labeling and advertising distributed by the manufacturer.
The tight alignment of finances and mutual interests between Big Pharma and CHADD seems to be paying dividends for the ADHD drug manufacturers. In the two plus decades since CHADD's inception, prescriptions for stimulant medications used to treat ADHD have increased more than ten-fold, from 4 million per year in 1990 to 45 million per year in 2010 (Source: National Institute on Drug Abuse, Prescription Drugs: Abuse and Addiction).
Sounds like a reason to celebrate. So it shouldn't be a surprise that Big Pharma footed the $114,950 bill for CHADD's 20th Anniversary Gala.