Medicalisation
September 2, 2008 3:45 PM   Subscribe

The Medicalisation of Everyday Life. "As the pace of medical innovation slows to a crawl, how do drug companies stay in profit? By 'discovering' new illnesses to fit existing products." An extract from Ben Goldacre's new book, Bad Science. [Via]
posted by homunculus (60 comments total) 14 users marked this as a favorite
 
I am not a doctor, but I think Goldacre sounds slightly bitter and I fear he might be suffering from DSACDAD. He should ask his doctor about HAVIDOL.
posted by homunculus at 3:59 PM on September 2, 2008


1. Take pill.
2. Rinse.
3. Repeat.
posted by infinitewindow at 4:04 PM on September 2, 2008


"My disease may not be fatal, but I can cure my fears /
By taking two twelve-dollar pills each day for fifty years /
They've spent millions to convince me, and now I realize /
Progenitorivox beats diet and exercise"

(from)
posted by athenian at 4:11 PM on September 2, 2008


TV invents a disease you think you have
So you buy our drugs, and soon you depend on them
Pain in your mind got you comin' back for more
Again and again and again and again
Gonna rip you off, rip you off
posted by DecemberBoy at 4:17 PM on September 2, 2008


This is not news.
posted by Sam.Burdick at 4:20 PM on September 2, 2008


Ben Goldacre is awesome, always happy to see him linked here.
posted by Artw at 4:28 PM on September 2, 2008 [1 favorite]


When you're taking every kind of pill
(Ho! The bigger the headache, the bigger the pill)
Nothing seems to ever cure your ill

When you're taking every kind of pill
(You deserve a break today)
Nothing seems to ever cure your ill
(Have it your way)

Where'd you get that funk from?

posted by palidor at 4:29 PM on September 2, 2008


I came to quote the Dead Kennedys, I stay for the soma.
posted by Marisa Stole the Precious Thing at 4:33 PM on September 2, 2008


Before 1935 doctors were basically useless. We had insulin, morphine for pain relief - a drug with superficial charm, at least - and we could do operations fairly cleanly, although with huge doses of anaesthetics, because we hadn’t yet sorted out well-targeted muscle-relaxant drugs. Then suddenly, between the 1930s and the 1970s, science poured out an almost constant stream of miracle cures.

Everything we associate with modern medicine happened in that time: antibiotics, dialysis, transplants, intensive-care units, heart surgery, every drug you’ve ever heard of, and more. For people who were ill, the difference was spectacular. If you got TB in the 1920s you died, pale and emaciated, in the style of a romantic poet. If you got TB in the 1970s, then in all likelihood you would live to a ripe old age. You might have to take rifampicin and isoniazid for months on end - they’re not nice drugs, and the side-effects make your eyeballs and urine turn pink - but if all goes well you will live to see inventions unimaginable in your childhood.


How annoying that he wraps up what could've been a good point in such ridiculous hyperbole like "before 1935 doctors were basically useless." Based on this exerpt, he also seems to think that the whole of the massive amount of progress in medicine from the 1930s-70s happened in a series of unprecedented eureka! moments completely separate from any prior contributing research.
posted by desuetude at 4:33 PM on September 2, 2008 [5 favorites]


The side effects are often worse than the actual ailment itself. Nice article at any rate, but it's preaching to the converted...
posted by Alexandra Kitty at 4:34 PM on September 2, 2008


Based on this exerpt, he also seems to think that the whole of the massive amount of progress in medicine from the 1930s-70s happened in a series of unprecedented eureka! moments completely separate from any prior contributing research.

It would probably be more accurate to say that medical progress consists of one or more S curves, with the steep bit focused on the 1970s.
posted by Artw at 4:36 PM on September 2, 2008


This is not news.

This is true.
posted by homunculus at 4:40 PM on September 2, 2008


This is not news.

And?
posted by Pope Guilty at 4:46 PM on September 2, 2008


This is almost totally misguided set of rambles.

1) Fish oil isn't pushed by pharma companies, because it's a nutritional supplement. It's not their business model.
2) Certain supplements had astonishing effects in trials for heart disease. That's nothing to sneeze at.
3) SSRIs and SNRIs are genuine innovation that help some very sick people. Even if you think that they're "pushed" on a larger market than absolutely needs them (which is true), they are unambiguously useful for otherwise miserable people.
4) There is no reason to think that all the "low hanging fruit" has been had. None. Our current business models and markets don't support the search for basic innovation (which was behind much of the "low hanging fruit"), that doesn't mean it's impossible.
5) His own arguments rebut his later tale of expansive restless leg syndrome. If previously there was no treatment for something that bothered people, diagnosing it is lower priority. If there are people with nighttime leg jerks, and fluoxetine helps good for them. Whether or not it helps, and how many of them exist are questions that we answer with science and data.
5) The dismissal of diet as relevant to disease is astonishing in its stupidity.
6) The idea that attention is not paid to the social determinants of health is bizarre. Data please, because I observe people talking about diet, exercise, and active lifestyle all the time.
posted by a robot made out of meat at 4:47 PM on September 2, 2008 [10 favorites]




Pill-Popping Culture
posted by homunculus at 4:58 PM on September 2, 2008


Work is over but I can’t stay to work late
Got to leave and get ready for my second date
With a pretty girl that I met at the pharmacy
Right in the prescription line
I take a pill for my social anxiety
I get a table and a nice bottle of chablis
Now it’s getting late and there’s still no sign of her
I have another glass of wine

All I know is the wine lasts longer when you don’t gotta share it with someone
All I know is my steak tastes better when I take my steak tastes better pill

And I feel fantastic
And I never felt as good as how I do right now
Except for maybe when I think of how I felt that day
When I felt the way that I do right now, right now, right now.
And I feel fantastic.
posted by l33tpolicywonk at 5:15 PM on September 2, 2008 [1 favorite]


Yeah, the excerpt seems to mix some rather important points with some questionable ones.

And having talked to people with restless leg syndrome for this article on disease-mongering, let me tell you, it's not something to laugh at.
posted by Maias at 5:16 PM on September 2, 2008


That "pill popping culture" blog item was truly awful, I have to add. Long ago, I began to suspect that the illegal drug problem would ultimately be solved by better drugs. The fact that we are taking loads of drugs to deal with our problems isn't new-- it's the substances and rationalizations. And why can't we ever recognize that there are no good drugs or bad drugs, just good and bad drugs in particular sets and settings?

Of course, now drug warriors are moaning on about how while illegal drug use is down, prescription drug misuse is up. The fact that this surprises them--and that the shift actually could increase harm because marijuana is a lot less harmful than prescription painkillers and stimulants-- just shows how divorced our ideas about the problem are from realistic solutions.
posted by Maias at 5:22 PM on September 2, 2008 [3 favorites]


It would probably be more accurate to say that medical progress consists of one or more S curves, with the steep bit focused on the 1970s.

Well, except for the polio vaccine in the 1950s. And the first vaccine for smallpox at the end of the eighteenth century. And cholera, outbreaks of which have been prevented in developed countries by sanitation for a hundred years now. Quinine was used to treat malaria in the 1600s, and was in wide use as a prophalatic by the mid-1800s. Penicillin wasn't successfully used in patients until the 1940s, but the first published reference was prior to the turn of the century -- while Fleming did have a eureka moment, it wasn't that no-one was aware of the potential of the mold prior to 1928.
posted by desuetude at 5:30 PM on September 2, 2008


I don't think anyone has put it up yet.... Frank Zappa's take on the subject....

Out through the night
An the whisperin breezes
To the place where they keep
The imaginary diseases

posted by Kronos_to_Earth at 5:31 PM on September 2, 2008


More than the pharmaceutical industry, the nutritional supplement people are the ones who piss me off. No regulation, no checks, minimal safety controls. The people pushing fish oil are worse than the ones pushing SSRIs. At least we know what SSRIs do, their side effects, etc.

Beyond that, I think the big thing is the direct to consumer marketing. I don't know how that got started, but it worries me. The medications need to be developed, yes, but trying to sell them to people who don't need them pisses me off.

I have ADD. I'm on ritalin (well, concerta, a ritalin in a neat capsule that has a slow release). Almost all of the people I know with ADD have responded well to the traditional stimulant medications. The few that didn't did ok with stratera. Yet, for some reason, there seems to be a new stimulant medication out every other year for AD(H)D. Why? If it does something different, ok. But more stimulants? Way to get people to think that ADD is overdiagnosed, assholes.

The other thing I noticed recently is the fact that almost all of the direct marketed drugs I see on TV carry liver warnings with them. And if not, kidney warnings. Why are all the new drugs out there fucking with crucial internal organs? We already have a perfectly reasonable way of fucking up our livers.

Sorry. I depend on the pharmaceutical industry to function normally, and I was suckered into trying fish oil for a while (no noticeable difference). But I do feel the right to rant about this. My parents tried everything for three years before agreeing to put me on ritalin. I think this would be a better place if people put that much effort (not necessarily that much time) into finding alternatives before assuming that dropping something into the body is worth doing. After all, exercise is as effective as anti-depressants.

I really like the line "all problems, in a very real sense, but perhaps not necessarily the stuff of pills, and perhaps not all best viewed in reductionist biomedical terms." By framing something purely as a disease, you lose sight of it as part of your life. One of the best things I ever did for myself was come to accept ADD as part of me, something that was easier to deal with on medication, but part of who I am, not some foreign invader. I understand that dealing with things like depression (I have read Darkness Visible) may not be the same, but seeing chronic conditions as invaders I think carries many dangers.

Please, if you've read this far and disagree with me about chronic conditions, let me know. I'm writing from personal, subjective experience, and don't have any data beyond that. I'm especially curious about people with bipolar disorder or other more disruptive conditions.
posted by Hactar at 5:41 PM on September 2, 2008 [7 favorites]


(I meant I hope I didn't miss it in an earlier comment.)
posted by Kronos_to_Earth at 5:44 PM on September 2, 2008


Well, except for the polio vaccine in the 1950s. And the first vaccine for smallpox at the end of the eighteenth century. And cholera, outbreaks of which have been prevented in developed countries by sanitation for a hundred years now. Quinine was used to treat malaria in the 1600s, and was in wide use as a prophalatic by the mid-1800s. Penicillin wasn't successfully used in patients until the 1940s, but the first published reference was prior to the turn of the century -- while Fleming did have a eureka moment, it wasn't that no-one was aware of the potential of the mold prior to 1928.

None of which would really be contrary to medical innovation following an s-curve.
posted by Artw at 5:47 PM on September 2, 2008


By framing something purely as a disease, you lose sight of it as part of your life.

Well put.
posted by Ritchie at 6:28 PM on September 2, 2008 [1 favorite]


He forgot to mention fibromyalgia- invented by Pfizer in order to create a market for Lyrica.
posted by Zambrano at 6:33 PM on September 2, 2008


^ Works for me. I've been a chronic asthmatic all my life, and while changes in drugs have made it easier to manage, the best solution was to take complete responsibility for managing my life, and stop expecting the medical system to help. Lately, I've been diagnosed with an "incurable" neurological condition. I don't even know if I can find the energy to blame the asthma medication or anything else - it's just better to get on with it.

I wish I knew more about Ivan Illich's ideas on this subject, but he's the one that got me thinking about resisting medicalization in my own life.
posted by sneebler at 6:41 PM on September 2, 2008


I'm more curious to know how all these chemicals interact, the ones that don't break down easily, the ones that people pass these drugs out of their bodies and into the public water supply we all drink from.
posted by Blazecock Pileon at 6:59 PM on September 2, 2008


Blazecock, these chemicals have conspired to make me chubby! The horror!
posted by Mister_A at 7:14 PM on September 2, 2008


PS Drink vodka, kiddies!

/Ripper
posted by Mister_A at 7:14 PM on September 2, 2008 [1 favorite]


None of which would really be contrary to medical innovation following an s-curve.

I don't understand where your curve starts or how you're qualifying steepness, then.
posted by desuetude at 7:42 PM on September 2, 2008


Yeah, the excerpt seems to mix some rather important points with some questionable ones.

That was my reaction. I like Goldacre's blog and columns, but some parts of this one made do a double take. All the more reason to post it and see what other people think.

That "pill popping culture" blog item was truly awful, I have to add.

Well, it struck me as a very personal piece, and I'm not prepared to dismiss it like that.

now drug warriors are moaning on about how while illegal drug use is down, prescription drug misuse is up.

And now there's a war on pain killers and the doctors who prescribe them, which I think is a travesty. No argument there.
posted by homunculus at 7:44 PM on September 2, 2008


Chemicals, don't flatten my mind
Chemicals, don't mess me up this time
Know you bait me way more than you should
And it's just like you to hurt me when I'm feeling good

More than the pharmaceutical industry, the nutritional supplement people are the ones who piss me off. No regulation, no checks, minimal safety controls. The people pushing fish oil are worse than the ones pushing SSRIs. At least we know what SSRIs do, their side effects, etc.

Well, we know that they inhibit the reuptake of serotonin, but that's a superficial understanding of "what they do." For example the "chemical imbalance" marketing with "Hey, you get depressed because you don't have enough serotonin, just like you get anemic because you don't have enough iron" is not at all well-supported science.

There's a lot of bullshit and quackery coming from "supplements" but there's definitely also at least some real stuff that can't get sold as a drug due to the structure of the regulatory system. The regulatory system is biased against drugs which cannot be patented, among other things.

Some examples: Sometimes I have an insomnia and I'd like a bit of a sleep aid. To consider some "approved" options, antihistamines (OTC sleeping pills) don't make me drowsy, do make me sleep for a long time when I eventually do fall asleep, but it is an unrestful sleep often marked by unpleasant night terrors and sleep paralysis. Real Nyquil, the kind you can make meth out of, works most of the time, but leaves me groggy. Benzodiazapenes? Ambien? Researched, DO NOT WANT.

So I read up and tried some promising "supplement" options. I found hops tea induces drowsiness, and melatonin, while not inducing drowsiness with any haste, does help ensure a restful night's sleep. So one of the best sleep aids for me is washing down the melatonin pill with a mug of hops tea. (Actually I think the hops are sold as food, not as supplements, but I'm not picky.)

My father, suffering from a painful arthritis, took some glucosamine, another supplement, and reported great efficacy.

Could be placebo effect, but if so, why are other things ineffective in helping me sleep? As for the glucosamine, they use it in horses, where I don't think that effect is an issue.

Yet, for some reason, there seems to be a new stimulant medication out every other year for AD(H)D. Why?

Patents expire, so a lot of the R&D money goes into modifying existing drugs just enough to get a new patent and just enough to have a bullshit reason to market with "New & Improved!"

Here's something I've never seen remarked upon. There are TONS of people out there taking Adderalls, Oxycontins, Xanaxes, etc., etc., for recreational or non-medicinal use. When stolen rather than diverted or script-chased, I don't suspect they are generally stolen right out of the Big Pharma warehouse.

The pharmaceutical companies are making big money off illicit/recreational use.
posted by TheOnlyCoolTim at 7:54 PM on September 2, 2008


Personally, I just take one big FUKITOL every day, and now things are just peachy!
posted by briank at 8:01 PM on September 2, 2008 [1 favorite]


"Sorry. I depend on the pharmaceutical industry to function normally"

no offence Hectar but where would you be if this was 1960? Is it possible you have been sold a line?
posted by Frasermoo at 8:06 PM on September 2, 2008 [2 favorites]


"The pharmaceutical companies are making big money off illicit/recreational use"

that may be an after effect but they make their invesment on traditional sales. and I call full scale bullshit on the actual need for most people's needs for these drugs.

How DO drug companies stay in profit when marketing their wares to punters?

Create demand.

See you at the docks.
posted by Frasermoo at 8:18 PM on September 2, 2008


"Sorry. I depend on the pharmaceutical industry to function normally"

no offence Hectar but where would you be if this was 1960? Is it possible you have been sold a line?


I am in a similar position. Only I depend on the pharmaceutical industry to function *at all*. (I am bipolar). I don't claim to reach the level of normalcy, just a weaker cousin of it. It's enough for me to be able to hold down a job and not be crippled by abject misery and throwing my life into turmoil.

If this were 1960? I'd be long dead.

I realize that there is overmedicalization, but there are so many types of situations a person's use of a drug falls into, such as... (not intended to be an exhaustive list)

- people who need the drug to survive, period
- people who need the drug in order to avoid wanting to die on a daily basis
- people who would be crippled without the drug but not want to die because of it
- people who are improved only marginally and it's worth the side effects
- people who are improved only marginally and it's not worth the side effects
- people who aren't really improved but just made... different
- people who are improved and they would have been just fine or even happier without it
- people who are duped into thinking they need it but really they just want it
- people who think it will make them better than normal (whatever that is defined as)
- people who use the drug recreationally
- people who sell the drug for recreational use

Yeah I kinda confounded a lot of variables in there.

I think that in these discussions it is easy to lose sight of the fact that some people really do need these things to survive, or to survive without abject misery, pain, or other suffering.

I understand some of the outrage at the excesses, but frankly I think it's worth the price of getting the drugs to the people who really do need them. Some of the categories are quite fuzzy and it's hard to discern exactly who needed a drug and who really didn't.

Different drugs obviously have different use / abuse / overuse and effectiveness profiles. I'm just saying don't throw the baby out with the bathwater. Sometimes in these discussions I get the sense that some random person wants to tell me that I don't really need what I know I need. Not everyone is an edge case.
posted by marble at 8:30 PM on September 2, 2008 [6 favorites]


Is it possible you have been sold a line?

Well, you can crush it up and do it as a line, but it comes as a pill.
posted by TheOnlyCoolTim at 8:32 PM on September 2, 2008 [5 favorites]


Rush Limbaugh and Ralph Nader make strange bedfellows, but both have expressed skepticism about restless legs syndrome, [...] Some critics go as far as to claim that RLS doesn’t even exist, but was made up by pharmaceutical companies—with the collusion of doctors, patient advocates and the FDA—in order to sell drugs.

RLS is a syndrome - a constellation of symptoms - not a stab at etiology. Claiming that RLS doesn't exist is essentially claiming that patients who report some of the most common lower-limb paresthesias and dyskinesias are making it up. When you consider that the spectrum of bizarre sensation and movement associated with neuropathies goes well beyond what's accounted for in RLS, it's pretty obtuse to call it fake.

Now, as for why there are more Americans with RLS today than 30 years ago? Well, for starters, there are more Americans with neuropathy (diabetic, age-related) today, so why shouldn't they be exhibiting some of the basic signs?
posted by kid ichorous at 8:41 PM on September 2, 2008 [1 favorite]


A friend of mine who visited us recently from Canada expressed genuine concern about the sheer amount of television commercials for perscription medication. I'm embarassed to say I hadn't noticed them or, maybe, had grown to tune them out over time. But like being told not to think of a blue monkey, once he brought it up, I did begin to notice that god damn, we've got a lot of drugs in this country. Leaving the television on for a couple hours while doing other things, there wasn't a half hour that went by without at least one advertisement for a drug. What bothers me as much as the inundation though, was how these ads become a haze of white noise over time. I can't help but think this contributes to, or at least reinforces, the persistant emphasis on corrective, symptom-focused care, instead of prevention. On the other hand, who'd make any money telling people to eat right and exercise?
posted by Marisa Stole the Precious Thing at 8:45 PM on September 2, 2008


There are TONS of people out there taking Adderalls, Oxycontins, Xanaxes, etc., etc., for recreational or non-medicinal use. When stolen rather than diverted or script-chased, I don't suspect they are generally stolen right out of the Big Pharma warehouse.

The pharmaceutical companies are making big money off illicit/recreational use.


Yes, overprescription leads to big profits for drug companies and tons of diversion into the black market that leads to a spike in abuse. It's important to remember that the witch hunts against pain doctors came in reaction to Purdue Pharma's incredibly sales and market tactics that pushed doctors to prescribe nuclear grade opiates for common problems like arthritis and back pain. It's was an unfortunate reaction, and not surprisingly so considering the DEA's track record, but at the same time back around 2001 there were teenagers dropping like flies in certain parts of Philly where the big pill mills were at. Purdue Pharma is not a company you want to align yourself with out of rage for the DEA's drug war tactics, they are scumbag dope pushers whose top brass were successfully prosecuted in criminal court last year.

"The manufacturer of the potent painkiller OxyContin and three current and former executives at the company yesterday pleaded guilty to falsely marketing the drug in a way that played down its addictive properties and led to scores of people becoming addicted, prosecutors said."

So while, no, your buddy snatching an old bottle full of Oxys out of mom's medicine cabinet isn't exactly dipping directly into the Purdue warehouse, the question is why is that unused bottle there in the first place, and is it there because it was unnecessarily prescribed? Was it a too potent medication that was left unused because the script holder felt on initial use the side effects of nausea, vomiting, slurred speech, etc. that come with overmedicating on opiates? If that's the case, and Purdue pushed a doctor into knowingly making that unnecessary prescription, and a curious teenager eventually wound up ODing on those pills, isn't Purdue Pharma culpable in that child's death?
posted by The Straightener at 9:04 PM on September 2, 2008


John Stewart finds out that his Jimmy Legs are, indeed, "Restless Leg Syndrome," and that the side effects of the cure may be worse than the 'syndrome'.

"Just out of curiosity, isn't gambling a bigger problem in this country than jimmy legs? Wouldn't you think they would go: 'Hey, we might be on to something here, we might be able to invent something that stops gambling, but maybe occasionally gives you the jimmy legs'?"
posted by paisley henosis at 9:41 PM on September 2, 2008


A big pharma recipe from The Ambien Cookbook (by Paul Simms in The New Yorker, July 31, 2006):
Icebox Melange

Entire contents of refrigerator
1 Diet Snapple
5 mg. Ambien

Take Ambien, fall asleep.
Wait 2-3 hours, then sleepwalk to kitchen.
Devour everything in refrigerator (including all fancy mustards and jellies, iffy takeout leftovers, and plastic dial from thermostat).
Belch loud enough to wake wife or girlfriend. When she enters kitchen, bellow, “Can’t you see I’m working here?”
Fall asleep on kitchen floor.
After 4-5 more hours, wake up on subway, fully dressed from the waist up, drinking a Diet Snapple.
Enjoy!
posted by cenoxo at 9:45 PM on September 2, 2008 [5 favorites]


D'oh! Jon Stewart/t. No "h."
posted by paisley henosis at 9:59 PM on September 2, 2008


I don't understand where your curve starts or how you're qualifying steepness, then.

Like so.

It starts fairly flat, gets steeper, gets really steep for a bit then flattens out.
posted by Artw at 10:11 PM on September 2, 2008


Ask your doctor about the pharmaceutical lobby.
posted by joe lisboa at 10:11 PM on September 2, 2008 [1 favorite]


Frasermoo, none taken.

If this were the sixties, I don't know. Ritalin actually has been around for ages as has "hyperactivity" as it was called back then. Of course, I would have been expected to grow out of it in middle school, so I don't know if I actually would have made it through college. I really doubt I would have become a teacher. Then again, I might have done what a relative of mine with ADD did in college- a lot of speed. Similar stuff, similar effect (see my earlier rant on new stimulants). (I know a bit about the history of this stuff, I helped run the ADD support group at my college.)

Anyway, if we rewind the clock even further back, before "minimal brain dysfunction" was even a diagnosis (how's that for a syndrome name?), I don't know if I would have made it out of high school. I probably would have, but not in a great position to go to college. Ritalin isn't necessary for me to run my life really, I could do what I do without it, although with great difficulty. But in fourth grade, it made it so I could finally stop and think about what I was saying and doing, stop getting into fights I couldn't win on a weekly basis, and actually figure out how to avoid being a horrible human being.

When I was diagnosed at the age of six, the doctor told my parents that I'd be lucky to finish high school and they should work on keeping me out of jail. While I'm not about to attribute the fact that I beat all her assessments to a little pill, I will say that it helped. If nothing else, it gave me the temporary control to figure out how to get my brain working.

So, no I don't think I've bought a line. But I think I'd probably have lived a different life off of it. Who knows, maybe I would have figured out the mental techniques without the space, but I think it would have been a lot longer in development.

The only thing that I wished existed are long-term studies (10+ years) on people taking ritalin. I'm convinced that in the short term, as long as I'm not stupid and try to take an entire months worth, etc. it's safe. But ingesting stimulant medication for 16 years may have had some negative impact on my body, although I'm not sure what. (It didn't stunt my growth- I'm 6'1".)
posted by Hactar at 12:40 AM on September 3, 2008


An earlier related thread.
posted by Gyan at 12:41 AM on September 3, 2008


Ask your doctor about the pharmaceutical lobby.

Let's all go to the pharmaceutical lobby
Let's all go to the pharmaceutical lobby
Let's all go to the pharmaceutical lobby
And get ourselves a treat.
posted by Sparx at 3:01 AM on September 3, 2008 [2 favorites]


Other than an aspirin for a specific ache now and then (because I'm getting older and creakier) and a regular supply of tea (ahhh, a nice cuppa), I don't take anything, and I'm beginning to feel as if I'm in a small and shrinking minority. Am I? Or is this perception just another effect of the constant media crap bombardment? What percentage of people in developed countries are on medications all the time, and how has this changed over the years?
posted by pracowity at 3:59 AM on September 3, 2008


You know they started selling fish oil because snakes are too hard to catch.
posted by srboisvert at 4:38 AM on September 3, 2008 [1 favorite]


ArtW, I know what an S curve is. I was calling into question the characterization of the effective treatment and prevention of some of our most debilitating and deadly infectious diseases as being the "flat" part of the curve in regards to medical progress overall.
posted by desuetude at 6:20 AM on September 3, 2008


I have bipolar disorder and the medication I take makes me tired and my brain feel fuzzy. As I've always been sharp - I read three books a week before the breakdown that got me diagnosed - this makes me feel like I'm losing myself. I know the consequences of not taking it, but taking it has its own. However, I've found my concentration levels have gone up since taking fish oils. Maybe it's the pill equivalent of Dumbo's white feather, but I feel the benefit, and that's the important part.

Onme thing, though: contraception, while being important, can have crazy bad side-effects. Depo-Provera made me put two stone on within six months. But if it were 1960, I'd either be popping out a child every month or so or be in an institution. Neither of which options I would fancy, frankly. (Let's put aside for the moment that one of my medications suggests I use contraception as it can cause birth defects - makes me worry..)

If you were a migraine sufferer you'd bloody believe in the powers of pharmaceuticals.
posted by mippy at 6:40 AM on September 3, 2008


My Empire is CRUMBLING!!!!!!!!



(this article was more funny years ago when it was made into a movie- "Kids in the Hall: Brain Candy")
posted by TechnoLustLuddite at 6:42 AM on September 3, 2008 [1 favorite]


Uh, but don't they stay in profit from the millions of continued prescriptions to their pills?
posted by tybeet at 7:27 AM on September 3, 2008


But ingesting stimulant medication for 16 years may have had some negative impact on my body, although I'm not sure what. (It didn't stunt my growth- I'm 6'1".)
posted by Hactar at 3:40 AM on September 3


How's your blood pressure? That's what we're keeping an eye on for my husband, who takes Adderall.
posted by joannemerriam at 8:18 AM on September 3, 2008


I can definitely verify that Restless Leg Syndrome is 100% real. I've never suffered from it directly, but have felt the distinct side-effects of Swollen Danglies after a bout of Girlfriend Kicking Sharply In the Night-itis.
posted by FatherDagon at 9:59 AM on September 3, 2008 [1 favorite]


Regarding Oxycontin, the media sold it as a drug of abuse far more than anything Purdue did. You can actual follow the spikes in use *after* the media reports about it being the best drug ever and here's how to abuse it: grind it up, don't swallow it. And once that was out on the net...

Regarding why drugs always seem to have liver and kidney side effects, this is because those organs metabolize drugs. So, there's always going to be some degree of that, but hopefully, you will soon be able to tailor to the person's individual enzyme profile.
posted by Maias at 12:06 PM on September 3, 2008


The dismissal of diet as relevant to disease is astonishing in its stupidity.

You know who else dismisses diet as relevant to disease.

Yeah, that's right. Patients.

They also dismiss exercise. Then when they get sick they demand a pill to make their years of neglect all better. Drug companies stay in the black thanks to our crappy lifestyles.

And on a related note - a while back we were working on a product that has been likened to "Drano for your arteries". It would be administered over the course of a couple hours via IV. My immediate thought when I heard about this was get treated when I turned 50 and then every 10 years whether I needed it or not. (I figured even if it was 10K a treatment, I'd still have to live to be like 130 for it to cost as much as a bypass. Plus no scars and a contiguous sternum.)

I was kind of surprised when I heard that it was going to be marketed to heart attack survivors rather than as a preventative measure. When I asked someone in the know why this was it was pointed out that it was believed that there was minimal market for that. He then chuckled and said, "Heck, only a third of heart attack survivors stay on their medication for more that a year or so."

Read up on ventricular remodeling if you want to hear about a scary side effect.
posted by Kid Charlemagne at 4:28 PM on September 3, 2008




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