American Addict Page #8

THE SIZE OF THE PEOPLE WHO ARE

WORKING IN THE FDA ON MOVING THE

APPROVAL OF DRUGS FORWARD.

THERE ARE MORE PEOPLE DOING

THAT. AND YOU HAVE LESS PEOPLE

WHO ARE INVOLVED MONITORING

MARKETING PRACTICES OF DRUG

COMPANIES. WHO ARE MONITORING

DRUG SAFETY.

BASICALLY. COMPANIES. THROUGH

THEIR LOBBYING. GOT CONGRESS TO

AGREE THAT THEY WOULD PAY FOR

THE FDA.

THEY GET QUICKER APPROVALS.

THAT MEANS THEY MAKE BILLIONS

MORE IN REVENUES AND PROFITS.

AND IN RETURN. MORE PEOPLE GE SERIOUSLY ILL. HOSPITALIZED.

AND DIE.

BECAUSE WE'VE INCREASED THE

NUMBER OF DRUGS. WE'VE INCREASED

THE ADVERSE EVENT RATES FROM

DRUGS FOUR TIMES THAN WE'VE

INCREASED THE PRESCRIPTION RATE.

SO THAT THE ADVERSE EVENT RATE--

EVENT RATES FOR MEDICATIONS ARE

GETTING BIGGER AND NOT SMALLER.

AND FOR SOME MEDICATIONS.

WE'VE INCREASED THE ADVERSE

EVENT RATES 16 TIMES WHAT IT WAS

TEN YEARS AGO.

SO THERE'S NO QUESTION IN MY

MIND THAT THE EVIDENCE SHOWS--

STRONG EVIDENCE--THAT ADVERSE

EVENTS FROM MEDICATIONS ARE THE

FOURTH LEADING CAUSE OF DEATH.

I WROTE AN ARTICLE IN THE

JOURNAL OF THE AMERICAN MEDICAL

ASSOCIATION TEN YEARS AGO.

INTERESTINGLY ENOUGH. THE

ARTICLE WAS ORIGINALLY SUBMITTED

TO ANOTHER JOURNAL--A VERY

HIGH-LEVEL. PREMIER JOURNAL.

WHICH REJECTED IT ON THE GROUNDS

THAT NOBODY WOULD BE INTERESTED

IN IT.

IT WAS AN ARTICLE THA DOCUMENTED THE FACT THAT THE

UNITED STATES RANKED VERY POORLY

ON HEALTH LEVELS WITH REGARD TO

OTHER COMPARABLE COUNTRIES--

INDUSTRIALIZED COUNTRIES IN THE

WORLD.

AND IT ALSO DOCUMENTED THE FAC THAT WE HAD A VERY HIGH RATE OF

ADVERSE EVENTS FROM THE USE OF

VARIOUS INTERVENTIONS IN THE

HEALTH CARE FIELD.

AND SINCE THAT ARTICLE WAS

PUBLISHED 11 YEARS AGO. I HAVE

CONTINUED TO GET REQUESTS FOR

REPRINTS.

I STILL GET ABOUT FIVE REQUESTS

FOR REPRINTS EVERY WEEK.

THE ARTICLE HAS GOTTEN A LOT OF

ATTENTION. MOSTLY. I THINK,

FROM LAYPEOPLE. ALMOST NO

ATTENTION FROM GOVERNMENT.

I HAVE NEVER BEEN CONTACTED BY

THE FDA TO EXPLAIN WHAT I'VE

DONE OR TO EXPLORE THE

RAMIFICATIONS.

AND I THINK THAT'S BECAUSE

PEOPLE DON'T LIKE TO KNOW THA MEDICATIONS CAN BE HARMFUL AND

THAT THEY. IN FACT. MAY ACCOUN AT LEAST IN PART FOR THE FAC THAT WE DON'T DO VERY WELL

INTERNATIONALLY IN OUR HEALTH

LEVELS.

SO HOW IS THE CARTEL GOING TO

PRESENT ITSELF AS. REALLY.

THE ONE AND ONLY SOLUTION TO

THE PROBLEM OF ILLNESS?

THROUGH MEDIA.

COULD YOU IMAGINE A SOCIETY

WHERE PEOPLE ADVERTISED.

YOU KNOW. HEROIN ON TELEVISION?

YOU KNOW. "I GOT BLUE MAGIC.

DA DA DA DA DA.

CALL THIS NUMBER OR. YOU KNOW.

THIS WEBSITE."

YOU KNOW. LIKE. THAT'S FUNNY,

BECAUSE YOU COULDN'T IMAGINE

THAT.

BUT YOU NOW HAVE PHARMACEUTICAL

COMPANIES SELLING DRUGS THROUGH

COMMERCIALS ON TELEVISION.

BILLBOARDS. AND SUCH.

THE UNITED STATES IS ONE OF

VERY FEW COUNTRIES IN THE WORLD

IN WHICH DIRECT-TO-CONSUMER

ADVERTISING IS LEGAL. AND IT'S

CONSIDERED A FREE SPEECH RIGH IN THE U.S.. AND IT'S PROTECTED

AS A FREE SPEECH RIGHT HERE.

PROPONENTS OF DIRECT-TO-CONSUMER

ADVERTISING SAY THAT IT HELPS

FACILITATE COMMUNICATION BETWEEN

DOCTORS AND PATIENTS. THAT I INFORMS PATIENTS OF THINGS AND

SORT OF HELPS THEM TO BE ABLE

TO TALK ABOUT THEM WITH THEIR

DOCTORS.

AND THERE ACTUALLY IS SOME

EVIDENCE THAT THAT'S TRUE.

THERE'S ALSO EVIDENCE THAT IT--

IT INCREASES PRESCRIBING OF

ADVERTISED DRUGS. AND.

OBVIOUSLY. YOU KNOW. THE

PHARMACEUTICAL INDUSTRY ARE

PRETTY SMART.

AND THEY WOULDN'T DO IT IF I DIDN'T WORK.

THERE'S NO COUNTERBALANCE TO

THAT.

SO IN OTHER WORDS. WHEN A PERSON

IS WATCHING TELEVISION AND THEY

SEE THIS AD COMES ON. AND THEY

SAY. "ARE YOU NOT GETTING ENOUGH

SLEEP AT NIGHT?

ARE YOU RESTLESS?

ARE YOU ANXIOUS?

YOU HAVING PROBLEMS IN THE

BEDROOM?

ALMOST ANYBODY WATCHING THESE

COMMERCIALS CAN RELATE TO SOME

OF THESE PROBLEMS AT SOME POIN IN TIME. AND THEN ALL THE WHILE.

IT'S JUST BEAUTIFUL COMMERCIALS

ROLLING. PEOPLE IN SLOW MOTION.

FROLICKING THROUGH THE FOREST.

HOLDING HANDS. BEAUTIFUL MUSIC.

YOU HAVE A GUY READING IN A VERY

LOW VOICE OF ALL THE POTENTIAL

SIDE EFFECTS.

BUT OUR VISUAL--THERE'S A VISUAL

DISCONNECT.

WE HAVE THE SIDE EFFECTS BEING

READ REALLY LOW VOLUME AND

FAST. AND YOU HAVE THE PEOPLE

THAT LOOK LIKE THEY'RE JUS ENJOYING THEIR LIFE.

AND YOU HAVE PEOPLE THAT END UP

GOING TO THEIR DOCTOR'S BASED ON

A COMMERCIAL. ASKING FOR A PILL.

HIGH FEVER. STIFF MUSCLES.

AND CONFUSION TO ADDRESS A

POSSIBLE LIFE-THREATENING

CONDITION. OR IF YOU HAVE

UNCONTROLLABLE MUSCLE MOVEMENTS.

AS THESE COULD BECOME PERMANENT.

HIGH BLOOD SUGAR HAS BEEN

REPORTED WITH ABILIFY AND

MEDICINES LIKE IT.

IN SOME CASES. EXTREME HIGH

BLOOD SUGAR CAN LEAD TO COMA OR

DEATH.

OTHER RISKS INCLUDE DECREASES...

THE--THE FDA GUIDELINES ARE

KIND OF LEGALISTIC. BUT THEY'RE

ALSO VERY. VERY VAGUE.

SO THEY DON'T PARTICULARLY

MANDATE THE PRESENCE OF

IMPORTANT INFORMATION.

THEY JUST MANDATE THE ABSENCE OF

OVERTLY MISLEADING INFORMATION.

BECAUSE THE FDA IS SO UNABLE TO

LOOK AT ALL OF THE MARKETING

MATERIALS THAT ARE OUT THERE. WE

FELT IT WAS IMPORTANT TO LOOK A THE ADHERENCE OF MATERIALS TO

THEIR GUIDELINES.

SO WHAT WE FOUND IN THE CASE OF

CONSUMER-DIRECTED ADS IS THA RELATIVELY FEW OF THE ADS WERE

CLEARLY ADHERENT.

BUT MOST OF THE TIME. THAT WAS

BECAUSE OF INCOMPLETE

INFORMATION.

THEY'RE JUST WAS NOT THE

INFORMATION PRESENT IN THE AD

FOR US TO EVEN ASSESS THE

ADHERENCE TO THE FDA GUIDELINES.

WE ALSO FOUND THAT OVER 1/4 OF

THE DRUGS THAT WERE ADVERTISED

IN OUR SAMPLE HAD A BLACK BOX

WARNING FROM THE FDA.

SO A BLACK BOX WARNING IS AN

INDICATION FROM THE FDA THAT A

DRUG IS PARTICULARLY DANGEROUS.

IF YOU ARE PRESCRIBED A DRUG.

AND YOU GET THE PACKAGE'S

INSERT. YOU'LL ACTUALLY SEE A

WARNING IN BOLD LETTERS IN A

BLACK RECTANGLE.

WELL. HOW DO I FEEL ABOUT THE

WAY THIS COUNTRY HAS GONE OVER

THE--MY PROFESSIONAL LIFETIME.

THE FACT THAT IT'S FALLING

FURTHER AND FURTHER BEHIND IN

POPULATION HEALTH.

IT'S FALLING FURTHER AND FURTHER

BEHIND IN PEOPLE'S SATISFACTION

WITH THE HEALTH CARE SYSTEM.

IT'S GOING FURTHER AND FURTHER

BEHIND IN TERMS OF COST CONTROL

AND. IN GENERAL. JUST SIMPLY NO KEEPING UP WITH THE NECESSARY

CHANGES.

IT'S VERY DISAPPOINTING. AND I MAKES ME VERY UNHAPPY. BOTH FROM

A PROFESSIONAL POINT OF VIEW AS

WELL AS FROM A PERSONAL POINT OF

VIEW.

I KNOW THAT PROBABLY EVER SINCE

I STARTED WRITING ABOUT PRIMARY

CARE. WHICH WAS IN THE EARLY

1990s. I HAVE BEEN DELIBERATELY

SHUT OUT OF POLICY MAKING GROUPS

AND CONSULTANCIES.

AND BASICALLY THE ONLY THING

THAT KEEPS ME GOING IS THE FAC THAT I AM WELL REGARDED

SCIENTIFICALLY AND

PROFESSIONALLY.

I THINK NO ONE HAS EVER MOUNTED

A CHALLENGE TO MY USE OF

EVIDENCE. AT LEAST I AM NO AWARE OF IT.

THEY CERTAINLY HAVEN'T DONE I IN PROFESSIONAL MEDIA.

SO I REALLY DON'T HAVE MUCH

DISSATISFACTION ABOUT THE

CONTRIBUTIONS I'VE MADE TO

SCHOLARSHIP AND TO KNOWLEDGE

ABOUT THE WAY HEALTH CARE SHOULD

BE PROVIDED. BUT IT HAS BEEN

PERSONALLY DISAPPOINTING THAT MY

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