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Follow the Money

Addiction in America is set to increase massively in the next year or so.  A new recreational drug epidemic?  No.  They’re just getting ready to change the definition of “addiction” in the new DSM (V, I think).  The new definition makes diagnosing someone as an addict much easier.

The DSM (Diagnistic and Statistical Manual of Mental Disorders) is produced by the American Psychiatric Association.  If you’re a psychiatrist, you can’t bill an insurance company for treatment of something that doesn’t have a DSM code.  Frankly, I don’t give a rat’s ass how addiction is defined.  What I do care about is that insurance companies mostly only pay for mental health services that have a DSM designation.  Once there is a designation, there is pressure to pay for it.  Look forward to your insurance premiums going up to pay for treatment for Internet addiction:

In addition, the manual for the first time would include gambling as an addiction, and it might introduce a catchall category — “behavioral addiction — not otherwise specified” — that some public health experts warn would be too readily used by doctors, despite a dearth of research, to diagnose addictions to shopping, sex, using the Internet or playing video games.

So who benefits from an expanded definition of “addiction?”  The DSM folks say

The broader language involving addiction, which was debated this week at the association’s annual conference, is intended to promote more accurate diagnoses, earlier intervention and better outcomes

Really?  The official position is that earlier treatment will save millions of dollars and won’t lead to significant increases in the number of patients because they will fix people faster (OK, that’s a paraphrase on my part, but I think it’s accurate).  So the APA is gifting itself a huge number of new potential patients, but it will save money, is all for the public good, and won’t be a significant windfall for psychiatrists.  Wow.  I almost believe that.

The doctor who lead the group writing the addiction diagnosis standards lobbied to have “craving” inserted as a recognized diagnostic symptom.  This is the same doctor who has consulted for several major drug companies and

worked extensively as a paid consultant for Alkermes, a pharmaceutical company, studying a drug, Vivitrol, that combats alcohol and heroin addiction by preventing craving.

Like I said, follow the money.

(via The Agitator)


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