Online pill services use the same marketing tactics that fueled the opioid epidemic.
The first Adderall ad appeared on my Instagram feed around the time the outbreak closed. I thought the 30 second video that promised me a "really easy" way to get ADHD medication was just another scam. But I'm curious after the algorithm pushes a few more plugins. To my surprise, the drug was real. Unlike many sketchy ads for black market supplements, then-telehealth startup Cerebral offered a legal route to prescription drugs behind its ads.
It was actually the "super easy" way - way too easy. The process of receiving potentially addictive amphetamines was easier than buying Taylor Swift tickets or seeing a family doctor. Although I doubted that I met clinical criteria for ADHD, I was able to honestly answer a short, vague self-report (eg, “How often do you have trouble paying attention when performing stressful or repetitive tasks?”). Same result as tens of thousands of AI-targeted customers: "You have symptoms consistent with ADHD. We suggest further evaluation." The experience was the same when I spoke with the psychiatric nurse for 13 minutes. He said yes, I was distracted once in a century and gave me an official diagnosis and prescription. Like its other telehealth competitors, Done, Klarity, adhdonline.com, and Circle Medical, Cerebral can sell, order, and order a pack of Adderall for me without leaving the couch.
It uses aggressive advertising to market a new type of drug directly to the consumer. Not only do these companies facilitate recreational drugs, but they are also designed to undermine and intimidate the sober individuals who have returned. Unlike a typical doctor who may need answers to determine genuine need, some of these companies are created to eliminate all possible obstacles.
In short, the artificial intelligence and spy capitalism that drives today's targeted advertising has teamed up with the OxyContin killer playbook. But in the year Unlike the opioid crisis of the early 2000s, advertisers today have more information and more precise tools to change prescriptions, and our privacy laws haven't even tried to keep up. Without intervention, another public health threat looms.
"Drop Antipsychotics Like Candy."
An algorithm may not be dependable, but it can be an important link that allows companies to reach those at risk. Looking back on my mental experience, the parallels with the opioid crisis are clear. After investigating the rise of Purdue Pharma's OxyContin, the most damaging booster was the same thing I saw in Instagram ads: aggressive, data-driven marketing. Like Dr. Art Van Zee wrote in the American Journal of Public Health in 2009, "The cornerstone of Purdue's marketing plan is to use sophisticated marketing data to influence prescriptions." The pharmaceutical giant, owned by the Sackler family, "uses individual physician profiles that list prescriptions nationwide to influence prescribing habits," he wrote.
OxyContin, like countless other opioid drugs on the market for decades, has been medically neglected. But Purdue got a clever and sinister advantage: using the data to target doctors in marketing materials, forcing importers to dispense the drugs freely, and promising grimly that their preparations would be less dependent. It wasn't. OxyContin was patented in 1996 and Purdue's blitzkrieg began soon after, largely fueling the opioid epidemic. In the year From 1999 to 2017, overdose deaths involving prescription opioids rose from 3,000 to 17,000 per year. In 2017, Purdue's annual revenue grew to $35 billion.
Purdue, now bankrupt, serves as a warning to any pharmaceutical company trying to recruit doctors with similar predatory tactics, but they persisted. Similarly, it is hard to believe that a doctor today would trust pharmaceutical agents selling similar claims. But online prescriptions do not need to consult a doctor because they are doctors and they are left alone for the safety of the patients themselves.
Doctors are already warning that the Adderall crisis may repeat history. Dr. David Sack wrote in a 2018 Psychology Today article, "The Prescription Amphetamine Crisis May Overcome the Opioid Epidemic in Scope and Damage," Canadian psychiatrist Anthony Yung examines misinformation in ADHD videos on TikTok. This fraud is widespread. "There's no question that targeted advertising (especially at the height of the epidemic) has had a big impact on Adderall prescription rates," he said, though researchers are still struggling to find advertising data across multiple platforms so an accurate map can be drawn. difficult. effect. Although Adderall has been the primary growth engine for these telehealth companies for the past three years, they also market several addictive drugs. Drugs like Xanax and other addictive drugs are such a ticking time bomb for people addicted to pain relievers.
It only takes a moment of communication to target you with AI-rich ads. After visiting the Cerebral website for the first time, I was quickly confronted with dozens of advertisements. Some days it seemed like most of the ads I saw on many social media platforms. To me the plan was dubious, but to someone struggling with addiction it seemed diabolical. These ads can be overwhelming for people in recovery – imagine trying to fight addiction and get healthy when these companies bombard you with temptation. (Conversely, the growing recreational use of Adderall makes it harder for people with ADHD to obtain the drug. By 2022, telehealth prescriptions will account for 40 percent of all Adderall prescriptions, with vehicle use at an all-time high.)
This is the nature of online advertising. That's why as they follow you from website to website, you see the same pair of shoes or book a trip that's constantly in your feed. Advertisers are constantly targeting potential buyers. A dollar spent on someone who is interested seems to be worth more than a dollar spent on someone who is a good fit for the product. But these companies have no way of knowing who is addicted or in recovery. Last year, a nurse warned that the cerebral approach was dangerous because it needed to understand who was a drug addict and who had ADHD. "When target marketing gets to this point, people have no way of knowing what other people are going through," Ian Ponsin, a clinical child psychiatrist at Yale School of Medicine, told me. As a society we embrace targeted advertising, but when the product itself is dangerous, the consequences are even more severe. It's one thing to be chased by a thousand-tzu chew toy. Abuse of methamphetamine-like drugs is another matter entirely.
And the scale is unbelievable. Last year, The Wall Street Journal listed that Cerebral's ad purchases were once so large that it was the third largest advertiser on TikTok. And as the company grew, the workers revolted. Some feared the platform was addictive. One nurse told Insider that her staff "throws around antipsychotics like candy." As Cerebral stated last year, "clinicians make independent professional decisions in diagnosing and treating their patients," but the same journal article claims that company executives require employees to prescribe 100% of ADHD patients without comorbidities. . The company wasn't the only one flooding the area. In a four-week period last year, 20 telehealth companies ran more than 2,100 ads promoting unauthorized prescription use or failing to list their risks. According to Bloomberg, the approach can speed up crises for people struggling with complex mental health issues.
Stop targeted advertising
The results of his aggressive-aggressive tactics ended up being cerebral. Things happened after the ADHD drug grew 20% of the VC-backed company's business, valuing it at $4.8 billion, the magazine reported. Cerebral's CEO was fired, many employees walked out, federal prosecutors filed a court order, and a growing number of pharmaceutical partners stopped filling the company's prescriptions, forcing the company to stop offering ADHD drugs.
But cerebral collapse is far from the end of this saga. Relaxed rules during the Covid pandemic are a big part of the problem. During the outbreak, the Drug Enforcement Agency and the Department of Health and Human Services suspended the Ryan Haight Act of 2008, a law that would have required telehealth providers to meet with the customer at least once before writing a prescription. OxyContin and Xanax are addictive drugs. The move made sense at the time, but Ryan Haight's defamation law removed the safety rails to prevent the attack that led to the death of a California teenager who overdosed on Vicod prescribed online.
Companies can order Schedule 2 substances without an in-person visit even after the public health emergency of COVID-19 is officially over. The suspension of the Ran Haight Law currently expires on November 11, 2023, but there is no guarantee that its reinstatement will not be delayed.
Meanwhile, many competitors are jumping into the breach. While researching this article, I received an ad for ADHD drugs from rival telehealth startup Klar, and friends sent me examples of targeted ads on Instagram, TikTok, and Twitter from companies that offer ADHD treatment programs to Adderall. Psychedelics such as ketamine.
Unfortunately, it's not as simple as rolling back the laws that allow companies to prescribe these drugs. Telemedicine is not only more convenient, but also a lifeline for millions of people who do not have local care or find it too expensive. Instead, we need a common understanding. Instead of limiting their ability to distribute drugs remotely, we can focus these businesses on promotional and sales methods that differentiate them from a family doctor visiting a patient via video call. We can modify the admission and evaluation criteria. We can perform automated audits for companies with extremely high Annex 2 requirements.
Art Van Zee's 2009 proposal to curb the OxyContin epidemic still holds true today: "The public's health is better protected if the FDA reviews all advertisements ' before publication' for truth, accuracy, balance, and scientific accuracy."
But above all, we need a regulation that stops the promotion of drugs that can mislead patients. The United States and New Zealand are the only countries that allow direct marketing of prescription drugs. No matter what safeguards are in place, once companies combine, addictive drugs and AI ad targeting create a lethal cocktail.
Albert Fox Kahn is the founder and executive director of the Spy Technology Surveillance Project, or STOP, a New York City civil rights and privacy advocacy group.
Read the original article on Business Insider
