Thinking about all these drugs is giving me a headache

September 2005
       

There used to be a retired Scotsman that lived down the street from me. He came to Logan from Glasgow, where he had been a plumber. He said he wanted to try being an American for a while and liked the looks of Cache Valley.

        I once asked him what was one of the most obvious differences between everyday culture and life in Logan from that he had left in Scotland. "Everyone here has a headache," he said. "Huh," said I, and asked for further explanation.

  "Everyone must have a headache because there are so many headache remedies being peddled on the telly. I never imagined there were so many ways to fix aches and pains."

        He makes a point. It's a point that I have been milling around in my empty head for several months. It's a point that I feel a bit hypocritical about but feel the need to discuss anyway.

        After his suggestion that we have more aches and pains that the rest of the world, I began noticing the number and type of pharmaceutical advertising, specifically on the telly. Have you counted how many personal health, pharmaceutical and "remedy" commercials there are? During three recent days of NBC's "Evening News," shown locally at 5:30 p.m., eight of every 10 paid advertisements were for personal health aids and remedies. Asthma, reflux, diabetes testing troubles, and arthritis pain were all attacked with slogans and pretty people telling me I need to get better. Eighty percent. I dare you to watch the evening news and CNN (mid-day and evening) with a notepad sometime, as the number and overwhelming percentage of drug ads will astound you.

        Now, I have some theories as to why pharmaceutical companies pinpoint news channels for their promotions: News is painful and causes many a thinking American to run for the Tums; and the only ones who care about news anymore are those old enough to feel aches and pains. (We could examine the long-term problems inherent with Theory 2, but we'll save that for another time, deal?)

    A Berkely study confirms that the United States, with only 5 percent of the world's population, is paying close to 55 percent of all the world's money spent on pharmaceuticals. My neighbor was right -- we do have more headaches, or we spend more on them. Which?

   Interwoven in this discussion is the very recent trend of direct-to-consumer drug advertising. This is now so commonplace and so confusing to the issue that it has its own acronym in the medical world (DTC) and a bag-full of opponents. DTC drug advertising is banned in many Western countries and is allowed only with specific restrictions in Canada. We have become far too accustomed to adverts that suggest viewers should "ask your doctor if you need" Pill X or Elixir Y. Drug companies no longer just send salesmen with briefcases to sneak in the private doors at the back of the clinic in order to promote new drugs to physicians. The new tactic is to force patients to force doctors to prescribe. Physicians are reluctant to tell patients no. Study after study shows physicians are influenced by patients dropping brand name requests on them. The new DTC drugs are high-end in cost, with catchy brand names, and they make piles and piles of money for drug companies.

    DTC drug ads are also challenged because of their misleading nature, that is, that their benefit is overstated. A Paxil ad shows a housewife so lonely and depressed we are heartbroken. One pill and 20 seconds later she is as happy as a pig in mud. And we are then told to make sure our doctor knows we want a Paxil.

     While I rail against drugs being pushed on us, I will go home tonight and take two little pills and one big one before hitting the sack. But I can sleep peacefully and without hypocrisy knowing the doctor made the decision to try them independent of my insistence or an actor's portrayal of a better life. I believe it would be in all of our best interests if that were universally the case.

My friend the Scot also used to have a favorite saying that popped to mind this past week: "There's no such thing as a small leak."

     As I watched -- as you did -- pictures originating in New Orleans, I heard a CNN talking head suggest, in his words, that it was OK for a family "to take food and bottled water from a 7-11 because of the horrendous nature of the tragedy." In his next breath he reported that thousands of National Guard troops were on their way to the city in an  attempt to control the lawlessness and looting.

      Yup. My friend was right again. There is no such thing as a small leak.