I am puzzled and bothered. I know why I’m puzzled, I’m not entirely sure why I’m bothered.

On the Book of Face a few days ago I saw a post from a mental health advocacy organization. To be perfectly honest, I don’t pay much attention to them, but they stroll through my feed regularly. Overall what I’ve seen from them is positive. No snake-oil remedies advocated, serious issues in the health care system pointed out.

Then comes this: A link to this site called The teaser pic is a clonazepam tablet, the headline is “Benzodiazepines,” and underneath is:

Discover why a class of drugs used to help curb insomnia and anxiety has become an important component of an effective bipolar treatment regimen.

“Important component?” says I. “…for bipolar disorder?” says I, somewhat redundantly.

I click through the looking glass, and at the top of that page I find this:

Content created by Healthline and sponsored by our partners. For more details click here.

“Sponsored?” says I. Dutifully, I click here.

This content is created by the Healthline editorial team and is funded by a third party sponsor. The content is objective, medically accurate, and adheres to Healthline’s editorial standards and policies. The content is not directed, edited, approved, or otherwise influenced by the advertisers represented on this page, with exception of the potential recommendation of the broad topic area.

Curiouser and curiouser. I didn’t say that out loud, since I realized I’m talking loudly to myself yet again, and it gets weird.

So the content is paid for by some unnamed third party sponsor. It is not influenced by the advertisers represented on this page. Now if you were a compulsive freak, a corrosive skeptic, and had a certain well-developed cynicism regarding the mixed motives of our colleagues in the pharmaceutical industry, you might start thinking in funny little Venn diagrams. Like, for example:

Venn Diagram

This might lead you to note that at no time was there a disclaimer that the third party sponsor was also an advertiser represented on the page who therefore not influenced the content.

Someone could, however, recommend a broad topic area. Such as, “reasons the sky is black. ” Pretty broad. No real advocacy for any one reason the sky is black.

At this point, I smell weasel.

A touch paranoid, you say? Well, I am talking to myself a lot, asking questions of inanimate computer screens, and having olfactory hallucinations involving small vicious mammals. So overall, we must acknowledge the signs aren’t good.

Benzodiazepines are an interesting class of drugs. They do work, in that they quickly relieve anxiety. They also do put you to sleep.

There are “buts.”

  1. Behavioral therapies for sleep work at least as well, and are no doubt safer.
  2. They are not first – line treatments for anxiety disorders.
  3. Recently evidence of all kinds of problems has been piling up. Most alarming are  increased risk of dementia and death with longer-term use.
  4. They are addictive, and bipolar disorder is a major-league risk factor for addiction.

So maybe in the short run, they have a role in some aspects of the condition. “Important component of an effective bipolar treatment regimen?” Harrumph.

The article itself says lots of things about how benzodiazepines have problems. It also does say that short term treatment is recommended.

It then goes on to list a whole lot of symptoms of manic depressive illness and say benzodiazepines are useful for them, without any particular evidence cited for those claims.

It is medically reviewed, we are reassured. The doc’s name is right there at the top.

When I took a moment to look into this worthy, I find he is a family practitioner. Also, he is an executive at Healthline. A couple more clicks, and I’m wondering if he’s practiced Medicine any time in the last decade, since he seems to be so busy being a tech executive.

Never mind. He’s wearing a white coat in his thumbnail. Must be legit.

I’ve seen this hustle before. Shill docs giving “educational talks” to other docs, with their meal and his salary paid by the company that makes the drug everybody is getting educated about. Commercials offering “health education materials” to patients, who then get a load of advertising for the newest, latest, and greatest (and most expensive) drug for that condition (not to mention now being on a junk mail direct marketing list patient registry).

So, this is nothing new.

Here’s where my puzzlement comes in.

Who is doing this?

If this were the newest, bestest, and most expensive drug, or one that’s on patent, that would make sense.  It would be the company behind the drug.

This is an entire class of drugs which, though widely prescribed (often inappropriately), are all generic. One would think that there’s not that much money left to be made, and the population prevalence of manic-depressive illness is probably less than the number of people on benzodiazepines. Off the top of my head, a few times more.

I don’t get this play.

Though in terms of marketing, it does make some sense. The advertisers get around all the regulations for direct-to-consumer advertising by putting three layers of “educational intent” between them and the actual content. Perhaps, generic though they be, the various sources of bad news about benzodiazepines have the manufacturers looking for some new, particularly loyal market?

There’s that smell again.

Maybe I need a doctor.

I hear there’s a family practice doc in the Bay Area who’s good with this kind of thing.




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