Hopeful news
Homelessness and severe mental illness go hand-in-hand
Nationwide, it's estimated that somewhere between one-quarter and one-third of people who are homeless suffer from schizophrenia. In 2005, a study published in The American Journal of Psychiatry showed that among 10,340 people who had come in contact with San Diego County Adult Mental Health Services during the 1999-2000 fiscal year, 20 percent of those people with schizophrenia were homeless.
Suffice to say, homelessness and severe mental illness go hand-in-hand. It's a reality rife with hopelessness because this country's efforts to help this group of people can be called lackadaisical at best. As such, we welcome any reason at all to be optimistic.
One cause for hope is upon us. On Sunday, the journal Nature Medicine published a paper reporting a successful early clinical trial of a new drug developed by the pharmaceutical company Eli Lilly. The experimental drug, known currently as LY2140023, so far has shown that it can ease symptoms of schizophrenia without the serious side effects associated with Thorazine, a drug that's been around for more than 50 years, and Zyprexa, an Eli Lilly medication that hit the market 11 years ago.
To this point, people who take any available antipsychotic drugs are at high risk for tardive dyskinesia, a neurological disorder that results in tics and other involuntary movements. Additionally, 90 percent of Zyprexa users gain substantial amounts of weight. Such side effects are prohibitive for some sufferers.
Eli Lilly's early trial of the new drug involved just 200 patients, and two more trials involving greater numbers of patients are scheduled. Food and Drug Administration approval is several years away in any case.
It would be nice if the news came without Eli Lilly's baggage. We take anything coming from big pharmaceutical companies with a grain of salt, but this firm's recent history is troubling in particular. Last year, The New York Times published an exposé based on hundreds of e-mails and other internal documents showing that Eli Lilly deliberately kept from doctors information about side effects--namely, the high risk of diabetes associated with dramatic weight gain. Documents show the company was concerned about the impact disclosing such information would have on sales. The Zyprexa controversy is just one example of Eli Lilly's ethical lapses. There are others.
We can only hope that the settlement money Eli Lilly has had to pay out to Zyprexa users--$1.2 billion and counting--will force company officials to think twice about doing something like that again. If this week's news is accurate, perhaps there won't be any serious side effects to conceal. That would certainly be nice.
Maybe as an act of contrition, if this drug pans out, Eli Lilly can make it available free of charge to health clinics that serve indigent clients, including the homeless, whose grim life situations only worsen the effects of schizophrenia. One month's worth of Zyprexa for one patient costs $303, expensive for almost anyone, let alone folks who can't even afford rent.
We realize we're getting a little bit ahead of ourselves here, but if this new drug can be made accessible to people of little means, it would be a huge step toward helping a population known collectively as the "chronically homeless." These are people who are homeless because of serious physical or mental disabilities or debilitating substance-abuse problems. They are the people hardest to reach. They are not the low-hanging fruit. And as we said at the outset, schizophrenia is a major feature of chronic homelessness. Medication and intensive case-management could go a long way toward getting some of these folks on track.
It's also worth noting that researchers are learning more and more about environmental factors that can trigger schizophrenia among people who are genetically predisposed to the disorder. There is evidence that psychosocial stressors like poverty, substandard housing, a dysfunctional family and frequent moving can increase a child's risk of developing schizophrenia. So, too, can exposure to pollution.
Wanting to stop the suffering associated with schizophrenia should be reason enough to do more about those contributing factors, but here's another reason: A study by Boston-based consultancy firm Analysis Group reported that the overall cost of dealing with schizophrenia in the U.S. was estimated at $62.7 billion. An estimated 2.2 million U.S. citizens suffer from it.
Dire stuff, yes--but the news from Eli Lilly leaves us, as they say, cautiously optimistic.
