POPPING PILLS: Is over-medicating a concern as it relates to mental illness in the United

States?
Abigail Tull
March 18 2015
Nearly one in five Americans are diagnosed with at least one mental illness a year . That
amounts to 42.5 million people in the United States diagnosed with a disease such as depression,
schizophrenia, or other disorders (Bekiempis). Reasonably enough, medications are prescribed to
combat these diseases; but with so many illnesses to treat, is this dangerous? How much is too
much? With more and more Americans taking various prescriptions for mental illnesses, the risk
becomes higher for addiction and, in extreme cases, death . How is mental illness in the United
States related to the consumption of prescription drugs, and what is at risk?
There are a few major categories of drugs prescribed to help those with mental illnesses .
These categories are antidepressants, anti-anxiety drugs, mood stabilizing medications, and
antipsychotics (Dual Diagnosis). Within these categories are a myriad of brand name
medications, and when someone has a severe mental illness, they may end up taking multiple
drugs in one or more of these categories. Most psychoactive medications are not habit-forming;
however, some drugs, like benzodiazepines (used to treat anxiety), can cause chemical
dependence. Drugs in the benzodiazepine family include lorazepam (Ativan), diazepam
(Valium), clonazepam (Klonopin) and alprazolam (Xanax). (Dual Diagnosis). So while not all
prescriptions are addictive, many popularly prescribed drugs can be habit forming . And
naturally, the more potentially addictive drugs one takes, the more likely they are to become

dependant on them or addicted. In 2013, 51.8% of drug-related deaths were credited to

pharmaceutical overdoses, and 30.6% of these pharmaceutical overdose deaths were brought on
by benzodiazepines (CDC). The Center for Disease Control informs that, Benzodiazepines are
frequently found among people treated in EDs [emergency departments] for misusing or abusing
drugs. (CDC), which goes to show that the risk for overdose when using a drug prescribed for
mental illness is very high. But drugs can be abused by those who were not actually written a
prescription, so how do these numbers relate to the actual number of cases of mental illness?
43.7 million or 18.6% of adults in America were diagnosed with a mental illness in 2012
(NIMH). This is nearly one-fifth of the United States population, and this rise could be due to a
number of things. Bruce Levine, Ph.D., a clinical psychologist, concludes that ,Even within
mainstream psychiatry, few continue to argue that the increase in mental illness is due to
previous under-diagnosis of mental disorders. The most common explanations for the mental
illness epidemic include recent over-diagnosis of psychiatric disorders, diagnostic expansionism,
and psychiatrys pathologizing normal behavior. (Levine). In relation to these numbers, More
than 1 in 5 American adults now takes at least one type of medication to treat a psychological or
behavioral disorder, a 22% rise since 2001, according to a new report by Medco Health
Solutions, which monitors drug trends in insurance claims . (Time). This report by Medco not
only verifies that a significant number of Americans is diagnosed with some sort of mental
illness, but is being prescribed at least one medication to help deal with the illness(es) . In
addition to this information, a report by the National Center for Biotechnology Information
stated that all gender, age, and ethnic groups saw a rise in antidepressant use from 1988-2002 .

The age-adjusted prevalence of psychotropic medication use increased from 6 .1% in 1988-1994
to 11.1% in 1999-2002 This was due to more than a three-fold increase in antidepressant use
(2.5%, 1988-1994 vs. 8.1%, 1999-2002) (NCBI). While antidepressants are not addictive to
the point of depending on the drug to function, patients who use antidepressants can still feel
withdrawal symptoms if they discontinue use . These symptoms can consist of anxiety, vivid
dreams, or nightmares to name a few (RC Psych) . This may not necessarily be a form of drug
abuse, but it is definitely an example of a prescribed drug having negative effects on its user.
A multitude of drugs can be prescribed to those struggling with a mental illness, however,
prescriptions are not the only category of drugs that can be abused. Compared to controls [those
without a mental illness], people with severe mental illness were about 4 times more likely to be
heavy alcohol users (four or more drinks per day); 3 .5 times more likely to use marijuana
regularly (21 times per year); and 4 .6 times more likely to use other drugs at least 10 times in
their lives. (NIMH). While this is not a result of over-prescription, this self medication is most
definitely dangerous and potentially fatal. Forms of self medication can include, The depressed
patient who uses marijuana to numb the pain, the patient suffering from social anxiety who
drinks to feel more comfortable in social situations, the patient who struggles with panic attacks
and takes benzodiazepines like Xanax or Valium in order to calm the symptoms or stop the
attacks before they start, the patient with low energy and lack of motivation who takes Adderall,
cocaine, or crystal meth to increase their drive to get things done (Dual Diagnosis) . The
National Bureau of Economic research reported that, There is a definite connection between

mental illness and the use of addictive substances. Individuals with an existing mental illness
consume roughly 38 percent of all alcohol, 44 percent of all cocaine, and 40 percent of all
cigarettes. Furthermore, the people who have ever experienced mental illness consume about 69
percent of all the alcohol, 84 percent of all the cocaine, and 68 percent of all cigarettes .
(Bussing-Birks). While not all cases of drug abuse relate to the medications prescribed in hopes
of helping those with a mental illness, these statistics show that self-medicating with both legal
and illegal substances is a very large and relevant problem concerning mental illness in the
United States.
When the question of over-medication is brought up, the answer really differs on who is
being asked. Dr. Pies, Professor of Psychiatry and Lecturer on Bioethics and Humanities at
SUNY Upstate Medical University in Syracuse, New York and Clinical Professor of Psychiatry
at Tufts University School of Medicine in Boston, recollects, I often answer this by saying that
we have a twin peaks phenomenon in this country, as regards prescription of psychiatric
medications. I mean that there is evidence of both under- and over-prescribing, depending on the
population studied and the clinicians doing the prescribingas well as on some ethnic and
economic factors. The answer also may depend on the particular type of psychotropic
medication we are discussing, and the diagnosis in question . (Borchard). But whether
medications are being over or under prescribed, there is no denying that the number of
Americans with a mental illness is rising, a lot of which is due to a larger amount of diagnoses
(Levine); and with that, so is the usage of prescription drugs. However, perhaps a bigger issue
lies in self-medication, as those with a mental illness have been proven to abuse more substances

such as alcohol, marijuana, and cocaine. With nearly 1 in 5 Americans struggling with a mental
illness and prescription drug use on the rise, it seems safe to say that over-medication may soon
be a concern as it relates to mental health in the United States.

Works Cited
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"Trends in Psychotropic Medication Use among U.S. Adults." National Center for
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Bussing-Birks, Marie. "Mental Illness and Substance Abuse." NBER. National Bureau of
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Borchard, Therese. "Are We Overmedicating With Psychiatric Medications Today? An Interview

With Ronald Pies, M.D." Sanity Break. Everyday Health, 19 Aug. 2013. Web. 25 Feb. 2015.
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Effects, and a Peculiar Rebellion - Mad In America."Mad In America. N.p., 31 July 2013. Web.
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