Why a simple misdiagnosis can turn deadly

>>> here with us the e medical correspondent for pbs's need to know , dr. emily sinae, and pulitzer prize winning journalist allen schwartz who wrote a piece about richard mcphee who died after an addiction of adde of this. richard fee's experience included it all. conversations with friends and family members and a review of detailed medical records depict an intelligent and articulate young man lying to doctor after doctor, and physicians continuing with a hasty diagnosis and psychiatrists continuing to prescrip medication even increasing dosages despite evidence of his growing addiction and psychiatric breakdown. any step along the way, someone could have helped him, but they were just handing him out drugs says richard 's father, and these people know there are kids out there getting these drugs and getting addicted to them. and doctors are helping them do it.

>> i have seen it with my son's friends and friends of friends and the part of the problem is, doctor, that psychiatrists now, they get reimbursed not for sitting and counseling, but reimbursed for getting people in and out of the office as quickly as possible and prescribing medication, and a lot of times they have prescribed it on a whim and i have heard the story hundreds of times.

>> i can't say that is not true, because it happens for sure, and certainly in the terrible tragic story that alan describes in a heart-breaking way, this is a disaster and fail on every level. particularly, since the information got back to the doctors that were prescribing that this is a kid who was really in the throes of a terrible addiction, so there were problems down the line and not just the initial diagnosis and the prescription, but repeated failures to catch this kid who was so terribly addicted.

>> alan , this is a growing epidemic, and college campuses, prescription abuse is rampant and kids are dying. kids are dying. it would shock americans to know how many kids are overdosing whether it is adderall , oxycontent, and some kids do a combination of it and they are on the adderall and then going on theoxycontin to come out of the adderall and then it stops working and they are falling off of a clip and they stop breathing in their sleep, and it is happening all over america.

>> and there are other cases who are prescribed adderall and for kids who do not have the disorder for which it is prescribed. one thing that is important, doctor, i think that you would agree, that adderall and other medications when prescribed appropriately, they can be safe and effective and lifesavers and not life takers, but the problem is when that process is misused either by the doctor not paying attention or by the patient who is lying in order to get the equivalent of free cocaine, then you have problems. so it is important to make a distinction between those who have the disorder legitimately and shouldn't be demonize and those who don't.

>> and then you have kids who start to popping the adderall close to finals.

>> yes.

>> or studying for the big exams, and it is happening.

>> and i think that another part of this is that just so that we are, these kids are not junkies, and these kids are not caught in the back alleys.

>> and a different type of junk junkie.

>> and it is a different type of junkie.

>> and the stereotype is that these are good kids and in this example the parents brought them up as well as they could, but my point is that when you are addicted to something, you will say anything and you can be the nicest and the sweet eest and the most well educated and well brought up person, but if you are addicted to one of these drugs, you will do what it takes to get them.

>> and make no mistake, they are polite, and well behaved and they come from the right families, and they are junkies. and we live in a culture where --

>> i should have put it in quotes.

>> and mike barnicle said this and i remember reading this back in the 1980s when tom wolf said that we have the most affluent generation of all time and the most medicated generation at the same time. and kids are dying. left and right.

>> well, as alan points out, for the right people n is a terrific drug. i can't imagine that there is another drug though that is more overprescribed and more easily prescribed than adderall and i worry about the parental addiction to adderall in the sense that your kid is trying to get into high school and testing high school or trying to get into college and didn't do that well on the s.a.t.s and someone says he does not concentrate well, and get him some adderall .

>> and this did not start in 20 12 or 2013 and you remember, because you have kids.

>> and mother's little helper. that is what it was.

>> and mike, you have kids and you have like zen khave like seven kids, b ut in the 1990s any problems, they would say, the attention deficit and give them ritalin .

>> and one of the things that we must acknowledge is that for a certain percentage of american children, whether it is 3, 5, 7 and it works on anybody, and it is saying hey, put on the platform shoes and see fit makes you taller, but it is 3 or 5 or 7% of kids with a legitimate disorder of dopamine transfer, and when handled by an appropriate physician and/or parent.

>> and there are a certain of spern t percentage of kids who need it and they are not getting it. so problems on both ends of the spectrum.

>> so i'm not a mathematician, but that means that half of the kids are not meeting the dsm-iv level.

>> well, i want to confirm and then we will do a statement from the drug companies , but did you get that from your kids growing up, too? it was constant and not just a doctors, but it was the teachers and the principals and the counselors and you heard ritalin , ritalin , ritalin , and now are hearing adderall , adderall , and adderall , and mee car, the -- mika, where a small percentage it works, but it is causing damage, because it is overprescribed and the culture now.

>> and adderall is a schedule ii controlled substance and the package insert clearly states the risks and abuses, and this medication is not recommended for people with a history of drug abuse , and it is one of the drugs subject to abuse.

>> well, it comes under the info moder of how dangerous this can be and that is what the kid kept saying, the doctor wrote me the prescription, and it must be okay.

>> that is correct.

>> and it gives you a certain sense of security if it is coming through a physician, but somewhere it has been lost that these can be dangerously addictive and, you know, although his case is rare, and we would agree with that.

>> yes, but the reason it is instructive is not in how it ended, but how it evolved.

>> yes.

>> and not the fact that he killed himself tragic as that is, but what led him to the point to consider something like this.

>> and let me say, again, having kids and i have a 25-year-old, a 22-year-old, and a lot of friends and friends of friends of friends and maybe the ending is rare, but the story is being played out on every single college campus , and it is so widespread.

>> and in high school now.

>> and in high school now. and the abuse of prescription medications, and it seems safer, because it comes from mom and dad 's cabinet or mom and dad saying, you go to this doctor and if you are having a problem and they can handle it. you rush into the psychiatrist office and he is not being paid for listening for 20 or 30 minutes , but give them this, and this is a crack judgment, and here you go.

>> and some handle it that way, and some are very good, but most do not.

>> and the pay structure does not reward doctors for sitting in an office to talk to a kid for 30 or 40 minutes and then having these callbacks.

>> and so great to see you dr. emily senay, and alan schwartz , thank you as well, incredible piece. and coming