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Volume 16, Issue 3
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Spring 2004 |
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| published quarterly by: The New Hampshire Challenge, Inc. P.O. Box 579, Dover, NH 03821-0579 |
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| In This Issue |
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Preferred drug list not good for people with mental illness
To the editor:
Commissioner John Stephen's support of a preferred drug list for psychiatric patients (SB 383) overlooks some serious difficulties with such a program.
If enacted, the program would allow the state, in consultation with doctors, to create a list of psychiatric drugs doctors must use for their patients unless the doctors can offer an acceptable medical justification for using some other drug that is not on the preferred list.
The main problem is that, in psychiatry, there are no therapeutic equivalents. The same drugs will not have the same effects on two people, even if they have exactly the same symptoms.
In my own history, Zyprexa helped, Risperdal did nothing; Ativan helped, Klonopin did nothing; Depakote helped, and lithium caused serious side effects. Any of these pairs could be considered therapeutic equivalents. In practice, I would have to get sick before my doctor felt justified in asking the state's permission to write me a brand-name-only prescription.
Another problem is that changing medicines can cause a person with severe mental illness to go through a serious recurrence of symptoms that could lead to loss of a job, a hospitalization or even worse.
So if there must be a preferred drug list, it must also provide that people now taking something successfully will not be forced to change. State employees, who have had a preferred drug list for a couple of years now, have gotten sick when forced to switch to cheaper anti-depressants. Sick days, overtime to cover sick days, and lost productivity make this a questionable way to save money, and the suffering makes it an inhumane way to try to save money.
And these people's conditions are relatively mild compared to a disabled Medicaid recipient with severe persistent mental illness. There is another way to save money on psychiatric prescriptions that would help patients, not endanger them. The state could monitor and question doctors who prescribe higher than average doses for conditions other doctors manage with lower doses. The state could also question doctors who prescribe a lot of different drugs for a single patient.
In addition to saving money, this approach would help patients by cutting down on over-medicating and poly-pharmacy, both of which put patients at risk or force them to function below their potential.
Ken Braiterman
Plaistow, NH
Public transportation is critical for people with disabilities
To the editor:
I live a trailer park and vote in Salem. I am a board member of the Greater Derry/Salem Regional transportation Council. I am advocating for Public Transportation Services in the Southern New Hampshire Region on the Massachusetts Border.
There are no such resources in this community at this time. Derry, Salem, Windham, Pelham, Hampstead, Atkinson, Sandown, Chester, Londonderry, Plaistow are part of the Boston Metropolitan Area, yet have no public transportation. This is a serious problem in the 21st Century.
If the Bush Administration restricts funding for public transportation (especially the federal match rate) in the re-authorization of the Transportation Equity Act, President Bush dose not understand people like myself who cannot drive.
I am no different from anyone else. Anyone could become disabled in a car accident at any time or have a serious illness which can cause one to lose the ability to drive. Then they would find out what life is like for me. I live it day-to-day.
I am very worried that the Bush Administration wants to cut The TEA-21, when we have a growing population of elders. We have to move out of the 20th century and into the 21st. We cannot depend on relatives, friends, coworkers, or our neighbors for a ride.
Public Transportation is the best solution for those of us who do not drive. Those who do drive would also benefit especially when they are stuck in traffic for hours which makes it difficult to get to work.
There are serious needs for public transportation for the 21st Century. Just try to put your car away for one week or two to see what life is like when you can't drive. Americans greatly need better access to Public Transportation in all 50 states, including New Hampshire.
Respectfully,
Jocelyn Gallant
Salem, New Hampshire |
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