The Medication Reflex: Creating a Culture of Substance Dependence
It seems that with increased focus on child and adolescent mental health, medication is becoming a part of growing up and prescribing trends have raised concern about overmedication. It is a legitimate concern that deserves a place at the forefront of our minds as we treat the symptoms that interfere with a child’s true potential. Early intervention and responsible prescribing as part of a comprehensive approach to treating psychiatric disorders in children can be, and very often is effective in alleviating current symptoms and preventing the progression of disorder and also preventing the development of additional conditions such as substance use disorders.
How closely do we, as parents, teachers, healthcare professionals, consider the language we use with our children and each other about psychiatric medications? In my own practice as a child and adolescent psychiatric nurse practitioner working with children and families, I have routinely encountered language use that reflects unrealistic expectations for medications and I believe encourages a culture of seeking a substance for immediate gratification.
“You need to increase something or put him on something else because his attitude is terrible.”
“I need a pill for my anger.”
“The meds aren’t working the school calls me every day.”
“I need a pill to make me go to sleep.”
“I think it needs to be a higher dose because she still won’t follow rules.”
“It’s to make me be good.”
I could continue listing statements like that, but the point is that in addition sending a message that a child cannot function normally (or as desired) without a medication, the language we use may also be suggesting that the medication is responsible for behavior and symptoms indicate the need for a medication change.
Pharmaceutical companies have capitalized, with aggressive marketing strategies, on the broadening of diagnostic criteria for psychiatric disorders. This symbiotic relationship promotes the thinking that every symptom, every behavior, any hint of a disorder requires a drug.
Change the language and change the culture.
In today’s world we must do more than tell our children not to use drugs; we must do more than warn them about the dangers of prescription drug abuse. It is imperative that we are mindful of the language we use, with careful consideration that is has a powerful influence on how our children will respond to their own thoughts and feelings later in life.