MEDICATION RISKS TO CONSUMERS

Consumerism, a characteristic feature of contemporary society, is generally regarded as an advantage from industrial and economic growth. It tends to be equated with "life, liberty and the pursuit of happiness." Unfortunately, risks are incurred when the search for greater comfort, health and longevity is promoted by misleading hype, greed, and peer pressure. Insofar as the potential dangers are largely ignored or unrecognized, they threaten mankind. This (article) deals with topics that remain highly controversial but have profound public health consequences:

• The prodigious and unrestrained consumption of Vitamin E

• The widespread use of statin drugs to lower cholesterol levels

• The ravages of "fear of fat," particularly among young women

• The lack of awareness of light and radiation stress

The feats of pharmaceutical research and development admittedly have been remarkable. They must be tempered, however, by the adverse effects of potent drugs -- whether through use, abuse or negligence on the part of the prescribing doctors.

• Revelations about articles published in major medical journals, pertaining to cross conflicts of interest and ghostwriting have been disturbing.

• Richard Horton, a respected editor of "The Lancet, commented in 2004 that such contributions "have developed into information laundering operations" for this industry. * The pharmaceutical industry funds an estimated 60 percent of all continuing medical education in the United States.1

The safety of new drugs should require close postmarketing surveillance, limited direct-to-consumer advertising, a special symbol on packaging (as a black triangle), a database on all clinical trials and mandatory review after five years by the FDA's Center for Drug Evaluation and Research. A major problem heretofore has been the setting up of studies to showcase a drug's benefits while obscuring side effects -- as "non-serious events" with the statins.

Some pharmaceutical companies are now advertising medical conditions directly to the public as diseases that require drug treatment. This state of affairs has been termed "selling sickness"3 Examples are Attention Deficit Disorder, premenstrual tension, osteoporosis, slight arthritis pain and isolated elevated cholesterol levels. But the enticing pitch usually glosses over potentially serious side effects. In fact, the withdrawal of Vioxx (rofecoxib) came as an embarrassment when it was learned that severe cardiovascular reactions noted in clinical trials had been overlooked and understated. There also must be extreme doubt about the safety of pharmacologic innovations when the line between drugs and foods/additives is blurred. An illustration is the introduction of chemicals that block receptors in the mouth to enhance taste.

References

1. Elliott, C. Should journals publish industry-funded bioethics articles? The Lancet, 2005,366:422-424
   
2. Dial, S., et al. Use of gastric acid suppressive agents and the risk of community-acquired Clostridium-difficile associated disease. Journal of the American Medical Association, 2005;294:2989-2995.
   
3. Moynihan, R., and Cassels, A Selling Sickness: How the World's Pharmaceutical Companies Are Turning Us All Into Patients. New York: Nation Books; 2005