Welcome to Mad in America.txt

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Welcome to the Mad in America podcast. My name is Brooke Siem, and I’m the author of May Cause Side Effects. Today, I’m here with Rick Fee, president of the Richard Fee Foundation.

The transcript below has been edited for length and clarity. Listen to the audio of the interview.

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Brooke Siem: We’re going to get straight into it because neither of us have letters after our names. We don’t need to go into a whole academic bio because that’s not why we’re here, is it?

Rick Fee: No, it’s not. No letters—before or after my name. I’m a parent advocate, sharing my son’s story because he’s not here to tell it himself. I hope that by telling it, I can help others find a better way to manage their own healthcare, diagnoses, and whatever medications they may or may not choose to take.

Siem: Why don’t you introduce us to your son?

Fee: Our son, Richard, was born in 1986—our first child. From the moment he came into our lives, everything changed. Before becoming a father, I knew I wanted to parent differently than my own parents did. I wanted to have kids young so we could experience life together, and we had the best time. It was absolutely awesome.
    He was fun, athletic, and incredibly smart. When his sister came along, it completed our family. Richard was one of those people everyone liked. In high school, college, and beyond, he was everybody’s best friend. It didn’t matter if you were an athlete, a nerd, or the quiet kid in the back of the room—he connected with everyone.
    Baseball was a huge part of his life. He was a talented athlete, and we traveled everywhere for games. He played at the highest level he could, all the way through college. I loved watching him grow. I loved watching him learn things. I was so proud when he went away to school and handled everything on his own. He was an honor graduate in high school and a Presidential Scholar at Greensboro College in North Carolina—the highest academic award—earning a full-ride scholarship based on merit.
    He had clear goals and was incredibly driven, but he never seemed stressed. If he had a tough week at school or a bad game, you couldn’t tell. He was steady. If he aced the hardest exam of his life, he’d just say, “Yeah, I did pretty good.” Not too many ups and downs. I admired that about him.
    We were close. He knew everything about me, and I knew everything about him. It was fantastic—until it wasn’t.

Siem: When did you start noticing that something wasn’t quite right? What did you think was happening versus what was actually happening?

Fee: I’d have to go back to the first time I found out he was taking Adderall, which was probably midway through college. As an athlete, you’re tested for certain drugs, and the coaches know what prescriptions you’re on. If you test positive for something that isn’t allowed, you get suspended—that was the rule.
    Richard mentioned to me that he had taken Adderall because they’d just returned from a long baseball trip, and finals were coming up. He used it to study all night. At the time, I didn’t know much about it, but I knew it wasn’t good. We were coming off the popularity of Ritalin, and now it was Adderall.

Siem: Around 2005 or 2006?

Fee: Yes. He started college in 2004, so this would have been 2005 or 2006. I told Richard, Look, this stuff isn’t good for you. It’s an amphetamine. It’s basically legal speed, and it can have some really bad effects. We had a long conversation but it never came up again. I was confident nothing was going on because he was randomly drug tested multiple times, and nothing ever showed up.
    His goal was to go to medical school. He wanted to help people and change lives. I told him, You’ve got the grades, you can do it. He wanted to stay in Greensboro because he had a great support group and loved the area.
    But then, I started noticing changes in his behavior. Something seemed off, but I couldn’t put my finger on it. It really hit me when he came home in 2009. He’d been on his own in Greensboro for over a year and was still playing baseball in an adult league with former college and pro athletes. I visited him occasionally, and something just wasn’t right.
    When he moved back home, his attitude changed. He wasn’t as goal-oriented or committed anymore. He started working with me at the shop, and I tried to put him on my insurance. That’s when my agent told me, We can’t write your insurance because your son is on Vyvanse.
    I was shocked. Suddenly, things started making sense—his lack of motivation, his shift in direction, his reluctance to be around people like he used to. His irregular sleep patterns, staying up all night—it all started coming into focus.
    I confronted him about it, and that was the start of the slide. Our once-great relationship became strained. Arguments started—verbal confrontations that escalated over time. Eventually, they turned physical. It just kept going downhill. But through it all, we held on to hope that we could turn things around somehow.

Siem: I want to jump ahead to the end of Richard’s story because I think it’s important for the audience to understand what happened to him. How did this end for Richard?

Fee: Richard had a moment of clarity where he sat in front of me and said, “Dad, something’s not right. I need help.” We had been trying for months to get him help, so I already knew what to do. We took him to the emergency room and tried to get him into a facility for detox, rehab—whatever was necessary.
    They made him wait for hours. He got antsy. Eventually, they referred him to the rapid response team that specifically dealt with addiction.

Siem: At this point, he was only addicted to Adderall?

Fee: Adderall. There was a period when he was prescribed Seroquel and Wellbutrin, but he didn’t stay on them long—he didn’t like them. So, by the end, it was Adderall.
    The rapid response team, which was supposed to specialize in addiction, not only didn’t stop his Adderall—they increased it. They prescribed him more: Take Adderall in the morning, take Adderall at night. He was taking 90 milligrams a day—far above the recommended dosage. And then he started abusing it, taking more and more. The hallucinations, the mood swings—it all escalated.
    Eventually, he was placed in a psychiatric hospital and deemed suicidal. But no one told us. After that, the rapid response team cut him off completely. They stopped treating him. So he went back to his original doctor—the one he hadn’t seen in four months—who gave him another prescription for Adderall. He abused that too. As that ran out, he hanged himself.

Siem: I’m so sorry.

Fee: It was a complete shock. He had stopped answering phone calls. My wife called him constantly. When we went to his house, I was the one who found him. It was the absolute worst experience of my life.

Siem: How long was the period between when you first found out he was on Adderall and when he died?

Fee: He started working with me at the store in the fall of 2009. He died in November 2011. So, two years. Two years where Richard wasn’t the same person at 24 and 25 as he was for the first 23 years. He was totally different.

Siem: The New York Times published a major article on February 2, 2013, detailing Richard’s story. I encourage everyone to read it—it gives a powerful overview of how quickly things spiraled out of control.
    One of the things that struck me, partly because it was similar to my own experience, was how many different doctors Richard saw. Based on the article, it doesn’t seem like any of them ever questioned what was happening. This wasn’t the fault of just one prescriber—there were multiple.

Fee: There were definitely multiple. And each one would say Richard was articulate and intelligent—he didn’t present as someone struggling. And he was all of those things.
But by that point, he also knew how to manipulate the system. He wanted Adderall as a study drug—that’s how it started. He used what he knew to get what he wanted, and he became addicted. Even when I confronted doctors, they still wouldn’t help him.

Siem: They wouldn’t tell you what was going on either, which, on the one hand, you understand because of HIPAA, but at the same time, this was all happening under your insurance. That’s a blurry line.

Fee: Extremely blurry. The main doctor in Virginia Beach that I confronted wouldn’t talk to me. I went back and forth with him numerous times. He knew my concerns, but he refused to engage. He told me outright that he wouldn’t speak to me because he had been sued before.
    During one of our arguments in his lobby, with a room full of patients, I was so frustrated that as I was leaving, I said, “If you keep giving my son Adderall, you’re going to kill him.” At the time, he didn’t seem to care. In another conversation, he straight-up told me that he knew my son better than I did. He was not one of my favorite people, but unfortunately, he was typical of a lot of doctors who prescribe medication without deeper consideration.
    HIPAA became my first target for change after what happened to Richard. Parents can keep their children on their health insurance until they’re 26, but in life-or-death situations, we should be able to get critical information. We contacted our state representative and U.S. Congressman, and we were working toward bringing this issue before Congress to push for an informed consent exception in emergencies. But then some global crisis happened, and it got pushed to the back burner. I still hope something can change, but given the current climate, I don’t see it happening.

Siem: What was the prescriber’s reaction when he found out Richard had taken his own life? Is he still practicing? What happened?

Fee: This psychiatry practice was right across the street from the entrance to our neighborhood. We saw it every single day for years after Richard died. Less than a week after his death, I went in unannounced—like I always did—and demanded to see the doctor.
    He brought in one of his colleagues to witness the conversation. I asked him, “Why did you keep giving my son Adderall?” We had the same back-and-forth, but he could tell something was different. I wasn’t yelling. I wasn’t as intense. I was more subdued, but I needed to face him. I wanted to be face-to-face with him. I didn’t want him to read about it in the newspaper or see an obituary. I wanted him to look me in the eye and tell me why he did what he did.
    At some point in the conversation, he asked, “How is your son?”
    I said, “My son is dead and you killed him.”
    Absolute silence.
    His colleague turned and looked at him. They just stared at each other. Then suddenly, the doctor became oh-so-compassionate, but he was only trying to cover his ass.
    I could tell by his voice and his colleague’s reaction that they were concerned. But my wife and I were exhausted. We had lost the fight. We had fought for our son’s life, and we didn’t have the energy to fight anymore. We were lost for a long time—until The New York Times article came out. That changed everything.

Siem: This level of media coverage—I mean, honestly, I don’t even know if it would happen today. Do you think The New York Times would write that same article now?

Fee: No, they wouldn’t. When we worked with Alan Schwarz on that article, it took months. I first saw Alan on MSNBC or CNN—one of those networks—during an ADHD and Adderall segment. At the time, he was doing a series of articles on ADHD for The New York Times.
    A joke was made during the segment, saying, I better keep my Adderall locked up so my dog doesn’t get it. I was in my store, walking past the TV, and when I heard that, I stopped dead in my tracks. The audacity of that joke—almost two years after Richard’s death—infuriated me. I found a way to contact Alan, and that’s how the article came to be.
    It took months to write. Alan told me that this was one of the biggest articles they had ever published in terms of content length. I’ll never forget when he called me and said, “I’ve never done this with anyone I’ve written about, but I have to tell you—your son’s story is being released tomorrow, February 2, 2013. It’s front page, above the fold, with Richard’s graduation photo front and center on The New York Times.”
    I was at a trade show, standing outside in the freezing cold, having this surreal conversation. I still couldn’t quite grasp what it meant. The next morning, I checked out of my hotel at 4:30 AM, and there, on the front counter, was the newspaper. And staring back at me was my son.
    That day, I traveled through multiple airports, and at every newsstand I passed, I saw my son’s face following me home. It felt like we were walking through the airport together like all the times we had returned from ski trips. It was overwhelming. By the time I got home, I was wrecked.
    I walked in the door, and my wife said, “You won’t believe what’s been happening.” That is when we realized the impact of what happened to Richard and how it could help other people. We had never been outspoken before. I had never been a public speaker. Getting up in front of a crowd of five people scared the living bejesus out of me. But Richard always said he wanted to help people. He’s doing it through us now, telling his story.
    Beyond the national media and TV shows that reached out—which we were very selective about—we received personal calls and emails.
    One woman emailed me, saying her daughter was going through the same thing. She saw the article and asked if we could help. After numerous conversations, we got her daughter the help she needed. To this day, she credits Richard’s story with saving her daughter’s life.
Three months after the article, a man called me and said, “I was traveling with my daughter through a remote area in the Northeast. We stopped at a gas station, and I saw The New York Times on the counter. That article saved my daughter.”
    And those are just two examples. Brooke, there are hundreds of stories like that.
    But you asked me if the prescriber is still practicing. That’s another life-changing result of The New York Times article.
    After it was published, the Virginia State Medical Board got involved. We didn’t pursue legal action against any of the doctors—we just didn’t have the fight left in us. But the Medical Board came to us. They interviewed us for four hours and brought the two main doctors up on charges.
    The doctor I confronted—the one who refused to listen to me—had his license revoked. He never practiced again. The 10 to 15 other doctors who worked there abandoned the practice because the name was tainted. Nobody wanted to be associated with it. He’s in his late 70s now, and a few years ago, they tore that building down.

Siem: Oh, thank God.

Fee: I love seeing that empty lot because that building was an absolute house of horrors. That doctor didn’t present himself well in his defense before the State Medical Board. I testified at that hearing, and two other people testified against him as well.
    The second doctor—the rapid response team doctor—was very smooth, and very articulate. He claimed it was Richard’s fault, that Richard was so intelligent he had fooled him. He was given a slap on the wrist—just had to take some continuing education courses—and he’s still practicing today. His therapist, the one who had been seeing both Richard and my wife, Kathy, ended up resigning from his practice. She was actually a customer at our store, so we knew her personally. She left because of what had happened.
    So one practice was completely shut down, and the building torn down. And the other guy? Just a slap on the wrist—he kept doing what he was doing.

Siem: The New York Times article lays out the progression so clearly. When people push back against concerns about Adderall, they say, Oh, this is rare. Most people are fine. Most people don’t go into psychosis from ADHD drugs.
    But this article is so detailed in its timeline. It shows exactly how things escalated for Richard. It doesn’t matter if someone is just occasionally taking Adderall to study or if they’re already deep in addiction—the article maps out the entire process. That’s why people say it saved lives. They saw themselves or their loved ones in Richard’s story before things got really bad.

Fee: Doctors are supposed to follow a protocol. They’re supposed to involve family and gather medical history. But they don’t do that.
    All they do is push drugs—psychiatric drugs, ADHD meds, everything. Maybe they’re not trained well anymore. They don’t look at lifestyle factors, exercise, sleep patterns, stress levels, diet—all of which contribute to mental health. Instead of addressing the root problem, they jump straight to medication.
    I put a lot of blame on insurance companies, too. The way psychiatrists are paid plays a huge role in this. A med-check appointment is scheduled for 15 minutes because that’s what insurance will reimburse, but these appointments actually last five to seven minutes.
    So instead of seeing four patients an hour, these doctors are cramming in 10 or more.
Richard’s records showed he was in and out of appointments in five minutes—sometimes seven. That means these doctors are maximizing their earnings at the expense of proper care. It’s not about helping patients; it’s about volume.
    That first doctor had a reputation. After Richard died, I found out so many people I knew had gone to him and had similar experiences. In Alan Schwarz’s article, he mentioned that from 2007 to 2011, prescriptions for Adderall increased by 250%—from 14 million prescriptions to significantly more.
    When we did a recent broadcast, we looked at the numbers from 2019: 35.5 million Adderall prescriptions. By 2022, it had jumped to 45 million.
    So just since Richard died, the numbers have skyrocketed. It’s absolutely mind-boggling that this continues.

Siem: Why do you think The New York Times wouldn’t write this article today?

Fee: My gut feeling is Big Pharma and its influence over the entire medical profession. Doctors aren’t in charge anymore. Big Pharma is. They push their drugs because that’s where the money is, and they don’t care who gets hurt. They pull the puppet strings. There’s no way The New York Times would publish that article today. The backlash would be too intense.
    I don’t know this for a fact, but I’d bet a lot of money goes into The New York Times from pharmaceutical advertising. Just turn on your TV—how many prescription drug commercials do you see? That’s most of the ads now. It’s too big of an influence.

Siem: Tell me about the Richard Fee Foundation and what you’ve been doing over the past few years to share Richard’s story and make change.

Fee: Over the years, we’ve done numerous TV appearances—many early on and some more recently. Whether it’s a local news outlet covering Richard’s story or a reputable national broadcast, we’ve taken almost every opportunity that presents his story in a good light.
    There have been plenty of newspaper articles as well, and a lot of media opportunities come to us—we don’t actively pursue most of them.
    The foundation is also trying to get a platform together. A big example of that was the Medicating Normal event in Virginia Beach, where you and I first met.

Siem: I’ve been lucky to participate in two events with you now. The Virginia Beach event was in your hometown, so I think the audience was already familiar with Richard’s story and why we were there.
But at the event we did at the University of Nevada, the room was packed—hundreds of people, standing room only. You were the first person to speak, and you changed the entire energy of that room. Everyone suddenly realized, Oh, we’re about to learn something really important that we didn’t know before.
    That was so powerful to witness. Even though it was uncomfortable—between the screening and Bob Whitaker speaking, the audience was fully engaged.

Fee: My approach is simple: I tell people the way it is. I share my thoughts and my experiences—respectfully—but I don’t hold back. That’s the approach I took in Reno, partly because of the way you spoke in Virginia Beach. I thought, “Yeah, I need to do more of that.” That’s the goal—keep pushing this forward.
    Your format [in Reno] was really effective—more condensed than ours, which I learned a lot from. To have a captive audience made up of psychology students, psychiatry students, faculty, and members of the public—that’s the model we need to replicate.
    If we could get state involvement, we could create a traveling event, moving from one college to the next, from community colleges to state universities. That’s our foundation’s goal—to take what we did in Reno and expand it. That event proved it can be done, and done successfully.
    On a local level, the Richard Fee Foundation also stays true to who Richard really was.
We do fundraisers—typical small-town charity events like golf tournaments—to raise money. Our biggest initiative is funding scholarships. Every year, we award three scholarships at Richard’s high school. Whether students go to a university, trade school, or community college, we give them financial support for their first year.
    We also run baseball camps. We send 10 to 30 underprivileged kids every year to a baseball camp at Old Dominion University in Norfolk. When Richard was 10, he went to a week-long camp there. Now, in his memory, we give kids who have never even seen a baseball field the chance to experience that same joy. It’s one of the most heartwarming things for my wife and me.
    I just know Richard would have loved it. He would have been out there with them, smiling and saying, These kids are great. It makes us happy to know we’re doing something in his memory that he would have been proud of.
    At Richard’s college, Greensboro College, there’s a fully endowed scholarship in his name that will be awarded for as long as the school exists. Greensboro gave Richard so much—a full ride, the opportunity to play baseball, and an environment where he flourished for four years. It’s meaningful to have a scholarship there in his name.
    Those are the smaller things we do, but we have big plans and big goals. Our foundation isn’t just Kathy and me—we couldn’t do this alone. There’s a close group of friends who are deeply involved, and we love all of them.

Siem: What’s a good ask here? You’ve got a large audience listening—probably one of the most dedicated and understanding groups of people in Mad in America. I’m sure someone out there has a connection to a college or another opportunity. Is there anything you want to ask of this audience?

Fee: For Richard’s story to keep making an impact, we need opportunities to share it. We want to talk about what he went through, what it cost him, and what it cost our family. The goal is for people to learn from it—so they can make changes in their own lives or help a family member or friend before it’s too late.
    We just need chances to get in front of people and tell the story. We’re open to any opportunity—anywhere, anytime. I’ll go just about anywhere to do this.

Siem: For anyone considering bringing the foundation, Medicating Normal, or another event to their town—when we did it here at the university, we got it fully set up for continuing education credits. This isn’t just an awareness event—it’s valuable for both current practitioners and future doctors.

Fee: That would be amazing. That’s my big ask.

Siem: Unfortunately, you’re not the only parent going through this. What would you say to other parents out there who feel alone?

Fee: I got an email two weeks ago from a woman in Virginia Beach. It was just one line: “My son lost his life to Adderall addiction.”
    I reached out, and we started talking. She’s exactly where Kathy and I were in those first two years—completely lost. Just surviving day to day. Going to work because she has to. Taking care of the kids she still has at home. But there’s no direction, no will to do much beyond existing.
    Her son was 31 years old. He died in her arms from cardiac arrest. That’s actually how I thought Richard would die. From what I was seeing—the physical toll, the exhaustion—I expected his heart to give out. I didn’t know about the suicidal thoughts because no one ever told us. We learned that after he died. Her story is exactly the same. A smart, talented, well-educated young man who started taking Adderall in college, became addicted and lost his life because of it.
    And the worst part? The story doesn’t change. Just the people in it keep changing. And not enough is being done to stop it.
    For parents who are in the middle of this—whether it’s Adderall or any other psychiatric drug—reach out to anybody that they think may help. It may be someone influential in the person’s life who is going through this and might be able to get through to them—perhaps a close friend, mentor, or coach—anyone they believe could help. It could be another doctor, or it might not be. What matters is finding someone who can make headway.
    Families just need to recognize this and reach out to whoever they can. Anyone is welcome to reach out to us at the foundation, and we will do everything in our power to connect them with the right people. We’ve done this countless times before.
    I just wish there were more resources. Some places have a few, but others have none at all. We’ve been referring a lot of people to Dr. Gretchen Watson and a few others, but it’s not enough.
    You have to realize—and I didn’t realize this soon enough—that you’re in a fight just to keep the person you love alive. It doesn’t matter who you reach out to—reach out to anyone and everyone. Bring people in, whether it’s us, doctors, or anyone who can help. Use every possible resource to do that.

Siem: I’ve never really heard anyone frame it that way before. As open as a parent-child relationship can be, there’s always complicated energy there. Sometimes, bringing in someone from the outside—someone the person trusts—can move the needle in a way that a parent can’t.
    At the end of the day, kids still want to please their parents. But if they don’t know how to fix what’s going on, they might pull away instead.

Fee: You’re exactly right. As a parent in this situation, I have deep regrets. I’ve never talked about this before.
    There were two people I almost reached out to for help with Richard. But I didn’t. One was his high school baseball coach. They had a complex relationship, but Richard respected him more than almost anyone. I considered asking him to step in. But I thought, If I do this, Richard will never forgive me. He’ll be embarrassed.
    The other was a mentor to me, someone who had known Richard since he was a baby. Again, I considered reaching out. But I told myself the same thing: If I do this, Richard’s going to be humiliated. I’ll be airing his dirty laundry.
    Now, I live with the what-ifs. I don’t want anyone else to have to sit with what-ifs. That’s why I say—bring in anyone and everyone who might be able to help because you don’t want to sit there at the end with a tragic loss and have a what-if.

Siem: You probably just saved a bunch of lives by saying it out loud.

Fee: I’ve thought about it for years. I’ve never spoken about it to anyone before.

Siem: Thank you. I adore you guys so much, and I can’t wait to see you again. Thank you for sharing all of this—with me and with the audience.

Fee: This is one of those opportunities I really appreciate. I know we’ve talked before about how these big events take a toll on me—I get all worked up, and then I need a couple of days to decompress.
    But no matter how hard it is to talk about this, the impact it has—the possibility that it helps someone—is worth every bit of emotion and discomfort.
    This is Richard’s work. This is what he wanted to do.

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