The Kaiser Daily Health Policy Report today summarizes two new studies from the journal Health Affairs, documenting the explosion in the use–and cost–of psychotropic drugs over the last decade. One study found that between 1996 and 2006, “prescriptions for mental health medications increased by 73% among U.S. adults and by 50% among children.”  As of 2006, one in 10 U.S. adults takes at least one prescription for this purpose.

I’ve written before about the growth of antidepressant use among the over-65 crowd (myself included), which seems to be the new way to deal with what a drag it is getting old. But the new study also finds dramatic growth in the use of other medications: ”The study found that the number of U.S. seniors receiving psychotropic medications, including dementia and antipsychotic drugs, doubled during that time period.”

This points, in particular, to the increasing treatment of older people with cognitive loss, and any kind of agitated or unruly behavior, as “psychotic.” It’s impossible to know for sure, but I suspect this has something to do with the fact that the drug companies have been pushing their lucrative psychiatric medications on this vulnerable population–the most notorious (and illegal) example being Lilly’s campaign to urge doctors to prescribe the antipsychotic drug Zyprexa for off-label use on elderly patients with dementia.

Unsurprisingly, the second study published in Health Affairs documents a steep rise in spending for mental health care during the same ten-year period–more than 30%, with ”nearly all of the increase caused by psychiatric drug costs.” Big Pharma reaps even more rewards from mental health than from other medical fields: “Drugs accounted for 51% of mental health care costs in 2006, while drugs accounted for 26% of spending for all other health care costs, according to national data.” The Kaiser article makes note of the trend toward ”greater reliance of the use of psychiatric drugs compared with other forms of psychosocial treatments such as therapist visits.”

Defending the Defenders

From the Washington Post:

Ex-Bush Officials Launch Bid to Soften Interrogation Report

Former Bush administration officials are lobbying behind the scenes to push Justice Department leaders to water down an ethics report criticizing lawyers who blessed harsh detainee interrogation tactics, according to two sources familiar with the efforts.

In recent days, attorneys for the subjects of the ethics probe have encouraged senior Bush administration appointees to write and phone Justice Department officials, said the sources, who spoke on condition of anonymity because the process is not complete.

Can't say as I blame them, I guess.  But surely they realized that someone at DOJ would rat them out, didn't they?

Civic Order

David Brooks says that if Republicans had learned the right lessons from watching Westerns, they'd be a little less interested in rugged individualism and a little more interested in community and civic order:

They would begin every day by reminding themselves of the concrete ways people build orderly neighborhoods, and how those neighborhoods bind a nation. They would ask: What threatens Americans’ efforts to build orderly places to raise their kids? The answers would produce an agenda: the disruption caused by a boom and bust economy; the fragility of the American family; the explosion of public and private debt; the wild swings in energy costs; the fraying of the health care system; the segmentation of society and the way the ladders of social mobility seem to be dissolving.

But the Republican Party has mis-learned that history. The party sometimes seems cut off from the concrete relationships of neighborhood life. Republicans are so much the party of individualism and freedom these days that they are no longer the party of community and order. This puts them out of touch with the young, who are exceptionally community-oriented. It gives them nothing to say to the lower middle class, who fear that capitalism has gone haywire. It gives them little to say to the upper middle class, who are interested in the environment and other common concerns.

I think this column suffers from Brooks' usual weakness for extending metaphors beyond their useful life, but his central point is a pretty good one.  The American public is obviously in the mood for a little less cowboy capitalism and a little more stability, and there are both liberal and conservative ways of getting there.  Democrats obviously support the liberal path, and to compete the GOP needs to stop offering up its usual menu of non-answers and instead figure out a conservative way to tell the business community to behave itself, a conservative way to produce more clean energy, and a conservative way to genuinely address everyday healthcare concerns.  It's not impossible, but the true-believer rump of the party wants nothing to do with it — and they're suffering the consequences.  They could do a lot worse than to spend a little less time listening to Rush Limbaugh and a little more time listening to Brooks.

Murtha: Keeping it in the Family

Ready for your daily dose of Murtha scandal news? Turns out a company belonging to the Pennsylvania Democrat's nephew, Robert Murtha Jr., has received millions in non-compete contracts from the Pentagon. Could this work have resulted from his uncle's position as chairman of the defense appropriations subcommittee or the congressman's self-styled role as the Hill's undisputed—and unapologetic—earmarker extraordinaire? Robert Murtha insists his company, Murtech, won the work on its merits, and the Pentagon contracting officer who handled one $1.4 million award says the contract was handed out on a no-bid basis because the Army "had a lot of things going on at the time." What's Murtha say? Nothing. His office didn't respond to questions from the Washington Post—hardly surprising given that the paper's Carol Leonnig has been doing some unflattering reporting on Murtha recently. A couple weeks ago, she explored the massive amounts of taxpayer money Murtha has directed to the small airport that bears his name—it's not hard to imagine why—in Johnstown, Pennsylvania. According to the Post, Murtha has steered as much as $150 million to this regional airport with a comically small clientele.

Obama and the Business Community

I nominate this for the least surprising news of the year:

President Obama's plan to crack down on what he called abuse of overseas tax loopholes was met Monday with quick and unusually sharp opposition from big business, threatening to produce the administration's first major confrontation with a broad segment of corporate America.

The fiercely negative reaction to the plan, much of which requires congressional approval, contrasted strongly with the business community's muted criticism, at most, of the president's sweeping government intervention in the banking and automobile industries.

Imagine!  The business community was OK with the government shoveling hundreds of billions of dollars into the business community, but is unhappy when the government wants to take away their PO boxes in the Cayman Islands.  Who could have guessed?

Obama's Weird Choice for CSPC

President Obama has made it clear he wants the Consumer Products Safety Commission to do a better job protecting the public from killer baby cribs and asbestos-tainted CSI toys. He's proposed doubling the commission's budget and expanding the commission from three to five members. All of which makes his naming today of Inez Moore Tenenbaum as the commission chair seem even weirder.

Tenenbaum is a South Carolina politico who did two terms as the state's elected schools superintendent. Her resume is heavy on education and politics. She ran for the Senate in 2004, but aside from a stint doing public interest law in the 1980s, she's not a big name in the consumer protection world. She was on the short list, in fact, for secretary of education. The CSPC post seems like a consolation prize. Apparently Obama owes Tenenbaum big time for helping him win the South Carolina primary. She and her husband are heavy democratic donors (nearly $27,000 in federal contributions in the 2008 election cycle) and she endorsed Obama early, when it was still the "risky" vote. On stage after winning the South Carolina primary, Obama hugged first his wife and then Tenenbaum.

While she's probably not an ideal choice for the job, Tenenbaum is still likely to be an improvement over the current chair, Nancy Nord, whose corporate ties have been well documented and whose attempt to fight a budget increase for her own agency didn't go over too well with Congress. Tenenbaum's eight years of fighting public school bureaucracy might even be good training for her assignment to clean house at the beleagured CSPC.

Racism as Ghost Story

Ta-Nehisi Coates has some interesting thoughts on how racism cosmetically updates itself to accomodate modernity but remains the same at its core. He's riffing on the whole tea party phenomenon; here's the (longish) setup for the thought I found most interesting:

No Progress? No Nookie!

Now there's a slogan!

The women of Kenya have gone Lysistrata on their do-nothing political husbands. Spurred on by Kenya's Federation of Women Lawyers, the Kenyan leaders' wives are being encouraged to cut their husbands off until a weeks-long political stalemate gets resolved:  "The boycott has been sparked by a feud between Mwai Kibaki, the president, and Raila Odinga, the prime minister, over who runs the government agenda in parliament."

So far, the Prime Minister's wife has joined the boycott. No word yet on whether Mrs. Kibaki will develop a blinding headache, but here's hoping.

Whatever works, right?

Bad as all the talk is of Michelle Obama's clothes, hair and arms, at least we don't have to deal with this.

Credit Report

The latest on credit conditions:

Although credit conditions remain strained, an April survey of loan officers by the Federal Reserve found a smaller number of banks were tightening loan standards compared with a few months ago.

Glimmers of improvement were most notable in commercial lending. The Fed said 40% of the 53 domestic banks it surveyed between March 31 and April 14 said they tightened standards on commercial and industrial loans, a smaller percentage than the 65% that said in January that they tightened standards.

Other metrics apparently show the same thing: banks are still cutting back on lending, but they aren't cutting back quite as much as before.  In other words, the economy is still getting worse, but not quite as fast as it was earlier this year.  These days, that counts as good news.

Note to Self: Avoid Surgery in Georgia

Doesn't "wrong-site" surgery sound oh so much friendlier than "Oops, we removed the wrong breast?"

From the AJC:

A surgical team at Northside Hospital was supposed to remove one of the patient’s breasts — but performed a double mastectomy because of a mistake, state records show. At Atlanta Medical Center, a surgeon drilled into the wrong side of a patient’s head before discovering the error. At several Georgia hospitals, doctors circumcised the wrong babies, performing the procedure against their parents’ wishes in cases at Wellstar Kennestone Hospital and Cartersville Medical Center. At others, doctors mistakenly operated on the wrong hand, knee, hip, leg, hernia and other body parts.

In Georgia, wrong site surgeries apparently get reported once a month. And it's not just a problem in the South: Pennsylvania's even worse.

I wonder how many of these mistakes are related to sleep deprivation in doctors, don't you?

[H/T ProPublica.]