Prescription for Disaster: The Hidden Dangers in Your Medicine Cabinet

Last month, the pharmaceutical industry announced a crossover point in drug promotion expendituremore money is now spent advertising prescription drugs to consumers than to physicians. The ask your doctor and call this 800 hotline theme of these ads is apparently successful in creating a demand for prescription drugs. If youre part of the groundswell, here are some considerations:

Prescription drugs cause about 100,000 deaths every year, one million injuries so severe they require hospitalization, and another two million injuries occurring during hospital care.
In one study, three-quarters of patients were not informed about the known adverse effects of prescribed drugs.
In 1993, Commissioner David Kessler, M.D., wrote, Only about 1% of serious events [due to prescription drugs] are reported to the Food and Drug Administration (FDA).
The only systematic postmarketing study in the scientific literature found that 51% of drugs approved by the FDA between 1976 and 1985 had important risks not detected in the initial testing.
When new warnings are reported to doctors, they seldom pass the information along to their patients taking the drug.
More Federal employees work in the U.S. Naval Academy Laundry (107) than are assigned full time to monitor the safety of all approved drugs (54).
These are just some of the sobering statistics from Prescription for Disaster by Thomas J. Moore, a senior fellow in health policy at the Georgetown University Medical Center. After a thorough assessment of the pharmaceutical industry, physician prescribing practices, and the FDAs regulatory process, Moore found that the system fails to protect the public in two major ways: its lack of long-term testing and its failure to monitor deaths and injuries caused by prescription drugs. Anyone calling for more deregulation should keep this in mind: We would not tolerate this deficiency in other industries where safety is a major public concern, namely the airline, automobile, and nuclear industries. The drug industrys failure to count deaths and injuries means that the most basic preventive steps have not been taken.

Wide Reaching Effects
The author explains why modern medications can be so hazardous. Many of the noxious medicines taken in ancient times probably never even go out of the digestive tract, he writes. But receptor-based drugs, such as oral contraceptives, beta-blockers, calcium channel blockers, and antihistamines, get into the bloodstream and have all kinds of unexpected medical consequences. Receptor-based drugs send their own instructions to the cells or obstruct the bodys own commands, which is why their adverse effects are what Moore describes as inevitable, inherently unpredictable, amazingly varied. Prozac, for example, is associated with 242 different side effects, including 34 different medical problems in the genital and urinary tract alone.

Moore is not advocating that consumers just say no, but that they should develop what he believes is the right attitude toward prescription drugs. Youre the boss, he writes, but follow the instructions. Its up to you, he says, to determine whether the benefits of the drug prescribed by your doctor are outweighed by the risks. Toward that end, Moore shows the reader how to read a drug label; communicate your needs to your doctor; request a review of all current medications; and talk to your doctor about a drug you are taking thats just been found to be useless or dangerous. Many doctors who have been surveyed on the matter say that they write some prescriptions because they thought patients wanted them, not because they would be effective.

Prescription for Disaster: The Hidden Dangers in Your Medicine Cabinet by Thomas J.

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