“Poisons and medicines are often the same substances given with different intents”
Peter Mere Latham
It is always a toss up. Whenever you put a pill in your month, be at a medicine or even certain supplements, you must weigh potential risks with reward. Withdrawal of the NSAID Vioxx from the marketplace a few years back underscores this and provides a good lesson.
Vioxx was Merck’s $2.5 billion blockbuster anti-inflammatory medication taken by more than 80 million patients for the treatment of arthritis, and also as a pain reliever. This was the largest prescription drug withdrawal in USA history. It was one of the new Cox-2 NSAID class of drugs, along with Bextra (also since withdrawn for health reasons) and Celebrex, that was great for arthritis and pain, easy on the stomach (moreso than traditional NSAID’s) and easy to take (one small pill once a day). The perfect potion-or so we thought.
Sales were driven by a direct-to-consumer marketing campaign that resulted in unprecedented demand by patients for this prescription. In my many years in practice, I never saw more patients request (and even sometimes demand) a particular medication. At the time, this was also true of Bextra and Celebrex as well because of similar marketing efforts. In fact, if I did not suggests these meds initially, many patients would look at me as being not “up to date” in my treatment plans. Pretty amazing since there are so many tried and true alternatives with longstanding research and safety data available and more importantly, equally effective as the newer ones.
Vioxx was great, I even occasionally took it myself when old sports injuries would flare up. But within a few years of its release, it became obvious that it probably significantly increased the risk of serious heart problems and stroke, especially when taken chronically (i.e. months). Some individuals with cardiac risk factors could get into trouble even with shorter use. Also, it’s unfortunate, but the lawsuits that predictably followed will not only cloud this issue, but will ultimately discourage the development and refinement of safer, more dependable drug alternatives.
Bottom line, when it comes to soothing bones, muscles and joints, be careful not to be popping any NSAID’s (Advil, Motrin, Aleve etc.) like they are M & M’s. Although they can make you feel better, there can be side effects involving gastrointestinal, kidney, or liver systems. They also more recently have been implicated in potentially causing heart problems. Also there is some research suggesting that NSAID’s may interfere with your body’s own musculoskeletal related healing response for fractures as well as tendon or joint injuries. As always, ask your doctor to help you weigh the pros and cons. Don’t just do what the latest commercial or ad suggests.
According to the New York Times and Philadelphia Inquirer, between 1996 and 2003, direct-to-consumer (DTC) advertising by pharmaceutical companies increased from $791 million to $3.2 billion, with industry promotional spending totaling $25 billion. I believe it has increased even more since then as it is hard to watch a TV show without seeing one. It is clear that the DTC approach has significantly expanded, and involve many different drugs for many conditions. Some skeptics believe that new conditions and diagnoses (with brand new names or acronyms) are even “created” from marketing experts, to create the need for newly developed medications. I do believe in the power of the media, even through advertising, to educate people about important health issues and treatment options but information needs to be presented in a fair manner and must balance the pros of the desired effects with the potential unwanted, undesirable side effects so that consumers, along with their health professionals, can make wise informed choices. Recently I’ve noticed that direct-to-consumer (DTC) drug/pharma TV ads ALL have major distractions during the (required) “potential complications” portion of the ad. Watch carefully next time you see one, it may forever change the way you view them in the future. Or watch John Oliver‘s very humorous (but lengthy) take on pharmaceutical companies and their possible influence on physicians. (PS- I would love to see him do the same type of analysis on our politicians and lawmakers, and their daily and woefully underreported conflicts of interest.)
Don’t get me wrong, I do, when needed and indicated (and without financial incentive), prescribe medications. Also, I certainly would not go so far as Oliver Wendell Holmes who in 1860 suggested that if all medications could be sunk to the bottom of the sea, it would be all the better for mankind and all the worse for the fishes.
When it comes to our health, we are often an inpatient nation- usually willing to pop a pill for a hopeful quick fix rather than make long-term lifestyle changes for a more certain, and safer resolution of many of our health problems.
FitTip
Follow Alexander Pope’s wise words that have stood the test of time-“be not the first by whom the new are tried, nor yet the last to lay the old aside”.
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