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ADHD: a real disease? or social construct designed to profit big pharma

5/12/2014

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(this blog post is a copy of the interesting article in Natural News. Link below) 
Before his death, father of ADHD admitted it was a fictitious disease
Tuesday, June 25, 2013 by: Ethan A. Huff, staff writer


Learn more:http://www.naturalnews.com/040938_ADHD_fictitious_disease_psychiatry.html##ixzz31WqZf0ft
http://www.naturalnews.com/040938_ADHD_fictitious_disease_psychiatry.html#
(NaturalNews) If you or someone you know has a child that has been diagnosed with attention deficit hyperactivity disorder (ADHD), chances are the child is actually just fine. At least this is what the "father" of ADHD, Leon Eisenberg, would presumably say if he were still alive. On his death bed, this psychiatrist and autism pioneer admitted that ADHD is essentially a "fictitious disease," which means that millions of young children today are being needlessly prescribed severe mind-altering drugs that will set them up for a life of drug addiction and failure.

As explained by The Sons of Liberty host Bradlee Dean, who also writes for The D.C. Clothesline, ADHD was merely a theory developed by Eisenberg. It was never actually proven to exist as a verifiable disease, despite the fact that Eisenberg and many others profited handsomely from its widespread diagnosis. And modern psychiatry continues to profit as well, helping also to fill the coffers of the pharmaceutical industry by getting children addicted early to dangerous psychostimulant drugs like Ritalin (methylphenidate) and Adderall (amphetamine, dextroamphetamine mixed salts).

"ADHD is fraud intended to justify starting children on a life of drug addiction," said Dr. Edward C. Hamlyn, a founding member of the Royal College of General Practitioners, back in 1998 about the phony condition. Adding to this sentiment, psychiatrists Peter Breggin and Sami Timimi, both of whom oppose pathologizing the symptoms of ADHD, say that ADHD is more of a social construct than it is an objective "disorder."

Psychiatric profession all about generating obscene profits for Big Pharma.  The purpose all along for pathologizing ADHD symptoms, of course, was to generate more profits for the drug industry. According to the citizen watchdog group Citizens Commission on Human Rights International (CCHRI), roughly 20 million American children today are taking dangerous, but expensive, psychiatric drugs for made-up behavioral conditions like ADHD. And another one million or so children have been blatantly and admittedly misdiagnosed with phony behavioral conditions for which psychiatric medications are being prescribed.

"Remember, there are two ways drug companies can make money: Invent new drugs, and invent new diseases already invented drugs can treat," writes Dr. Jay Parkinson, M.D., M.P.H., about the fake disease-creation industry. "In the past decade or so, Big Pharma has created no less than 10 new novel drugs per year," he adds, noting that many of the people who have been told they suffer from ADHD actually suffer from "the consequence of bad design," meaning a conventional social and educational system that is unable and unwilling to recognize unique individuality.

This is definitely true for Jacob Barnett, the 14-year-old autistic genius whose mother was told that her son would probably never read or write. Today, Jacob is already working on his Master's Degree in quantum physics while most of his peers are still in junior high. He is also currently developing his own original theory in astrophysics, according to recent reports.

"The psychiatric/pharmaceutical industry spends billions of dollars a year to convince the public, legislators and the press that psychiatric disorders such as Bi-Polar Disorder, Depression, Attention Deficit Disorder (ADD/ADHD), Post Traumatic Stress Disorder, etc. are medical diseases on par with verifiable medical conditions such as cancer, diabetes and heart disease," explains CCHRI. "Yet unlike real medical disease, there are no scientific tests to verify the medical existence of any psychiatric disorder."

Sources for this article include:

http://dcclothesline.com

http://blog.jayparkinsonmd.com

http://www.wnd.com/2012/01/382293/

http://www.currentconcerns.ch/index.php?id=1608

http://www.naturalnews.com/040552_autism_children_genius_IQ.html

http://www.cchrint.org

Learn more: http://www.naturalnews.com/040938_ADHD_fictitious_disease_psychiatry.html##ixzz31Wq0Yxtb
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Time article: ADHD Does Not Exist

4/18/2014

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(This blog post is a copy of the  fascinating opinion of ADHD by Dr. Richard Saul)

Doctor: ADHD Does Not Exist
  • Dr. Richard Saul  http://time.com/25370/doctor-adhd-does-not-exist/ _
  •  
March 14, 2014
    
Over the course of my career, I have found more than 20 conditions that can lead to symptoms of ADHD, each of which requires its own approach to treatment. Raising a generation of children — and now adults — who can't live without stimulants is no solution

This Wednesday, an article in the New York Times reported that from 2008 to 2012 the number of adults taking medications for ADHD increased by 53% and that among young American adults, it nearly doubled. While this is a staggering statistic and points to younger generations becoming frequently reliant on stimulants, frankly, I’m not too surprised. Over my 50-year career in behavioral neurology and treating patients with ADHD, it has been in the past decade that I have seen these diagnoses truly skyrocket. Every day my colleagues and I see more and more people coming in claiming they have trouble paying attention at school or work and diagnosing themselves with ADHD.

If someone finds it difficult to pay attention or feels somewhat hyperactive, attention-deficit/hyperactivity disorder has those symptoms right there in its name. It’s an easy catchall phrase that saves time for doctors to boot. But can we really lump all these people together? What if there are other things causing people to feel distracted? I don’t deny that we, as a population, are more distracted today than we ever were before. And I don’t deny that some of these patients who are distracted and impulsive need help. What I do deny is the generally accepted definition of ADHD, which is long overdue for an update. In short, I’ve come to believe based on decades of treating patients that ADHD — as currently defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM) and as understood in the public imagination — does not exist.

Allow me to explain what I mean.

Ever since 1937, when Dr. Charles Bradley discovered that children who displayed symptoms of attention deficit and hyperactivity responded well to Benzedrine, a stimulant, we have been thinking about this “disorder” in almost the same way. Soon after Bradley’s discovery, the medical community began labeling children with these symptoms as having minimal brain dysfunction, or MBD, and treating them with the stimulants Ritalin and Cylert. In the intervening years, the DSM changed the label numerous times, from hyperkinetic reaction of childhood (it wasn’t until 1980 that the DSM-III introduced a classification for adults with the condition) to the current label, ADHD. But regardless of the label, we have been giving patients different variants of stimulant medication to cover up the symptoms. You’d think that after decades of advancements in neuroscience, we would shift our thinking.

Today, the fifth edition of the DSM only requires one to exhibit five of 18 possible symptoms to qualify for an ADHD diagnosis. If you haven’t seen the list, look it up. It will probably bother you. How many of us can claim that we have difficulty with organization or a tendency to lose things; that we are frequently forgetful or distracted or fail to pay close attention to details? Under these subjective criteria, the entire U.S. population could potentially qualify. We’ve all had these moments, and in moderate amounts they’re a normal part of the human condition.

However, there are some instances in which attention symptoms are severe enough that patients truly need help. Over the course of my career, I have found more than 20 conditions that can lead to symptoms of ADHD, each of which requires its own approach to treatment. Among these are sleep disorders, undiagnosed vision and hearing problems, substance abuse (marijuana and alcohol in particular), iron deficiency, allergies (especially airborne and gluten intolerance), bipolar and major depressive disorder, obsessive-compulsive disorder and even learning disabilities like dyslexia, to name a few. Anyone with these issues will fit the ADHD criteria outlined by the DSM, but stimulants are not the way to treat them.

What’s so bad about stimulants? you might wonder. They seem to help a lot of people, don’t they? The article in the Times mentions that the “drugs can temper hallmark symptoms like severe inattention and hyperactivity but also carry risks like sleep deprivation, appetite suppression and, more rarely, addiction and hallucinations.” But this is only part of the picture.

First, addiction to stimulant medication is not rare; it is common.The drugs’ addictive qualities are obvious. We only need to observe the many patients who are forced to periodically increase their dosage if they want to concentrate. This is because the body stops producing the appropriate levels of neurotransmitters that ADHD meds replace — a trademark of addictive substances. I worry that a generation of Americans won’t be able to concentrate without this medication; Big Pharma is understandably not as concerned.

Second, there are many side effects to ADHD medication that most people are not aware of: increased anxiety, irritable or depressed mood, severe weight loss due to appetite suppression, and even potential for suicide. But there are also consequences that are even less well known. For example, many patients on stimulants report having erectile dysfunction when they are on the medication.

Third, stimulants work for many people in the short term, but for those with an underlying condition causing them to feel distracted, the drugs serve as Band-Aids at best, masking and sometimes exacerbating the source of the problem.

In my view, there are two types of people who are diagnosed with ADHD: those who exhibit a normal level of distraction and impulsiveness, and those who have another condition or disorder that requires individual treatment.

For my patients who are in the first category, I recommend that they eat right, exercise more often, get eight hours of quality sleep a night, minimize caffeine intake in the afternoon, monitor their cell-phone use while they’re working and, most important, do something they’re passionate about. Like many children who act out because they are not challenged enough in the classroom, adults whose jobs or class work are not personally fulfilling or who don’t engage in a meaningful hobby will understandably become bored, depressed and distracted. In addition, today’s rising standards are pressuring children and adults to perform better and longer at school and at work. I too often see patients who hope to excel on four hours of sleep a night with help from stimulants, but this is a dangerous, unhealthy and unsustainable way of living over the long term.

For my second group of patients with severe attention issues, I require a full evaluation to find the source of the problem. Usually, once the original condition is found and treated, the ADHD symptoms go away.

It’s time to rethink our understanding of this condition, offer more thorough diagnostic work and help people get the right treatment for attention deficit and hyperactivity.


Dr. Richard Saul is a behavioral neurologist practicing in the Chicago area. His book, ADHD Does Not Exist, is published by HarperCollins.

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Looking at number needed to treat: flu shots

11/22/2013

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The number 'needed to treat' is how many people have to be treated before one person is saved from dying.  It shows how many people take the treatment and it doesn't save them from death because statistically they wouldn't have died anyway.   Only one person out of their particular population group is saved.  It only saves the one out of whatever-the-number-is.  

A study in the Journal of Epidemiology was funded by four drug companies who sell flu shots: Sanofi Pasteur, Novartis, GlaxoSmithKline, and MedImmune.  The study gave a number to treat for flu vaccinations in the elderly.

http://aje.oxfordjournals.org/content/170/5/650.full

"The corresponding “number needed to treat” was 4,000; in other words, 1 death was prevented for every 4,000 elderly people vaccinated."

So those stats say that 3,999 out of those 4,000 elderly patients who got a flu shot would not have died anyway if they didn't get the vaccine.  It doesn't help the 3,999; it only saved the one. 

 It's a gamble. 
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Hpv vaccine scam

11/11/2013

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http://www.feelguide.com/2013/07/16/lead-developer-of-hpv-vaccines-comes-clean-warns-parents-young-girls-its-all-a-giant-deadly-scam/
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Drug companies hide "rare side effects" and hide responsibility

2/3/2013

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    This is copied from an excellent article written by DAVID KUPELIAN
    Read more at _http://www.wnd.com/2013/01/the-giant-gaping-hole-in-sandy-hook-reporting/#zwWz7AWuhvhJw0qv.99_


Indeed, pharmaceutical manufacturers are nervous about lawsuits over the “rare adverse effects” of their mood-altering medications. 

To avoid costly settlements and public relations catastrophes – such as when GlaxoSmithKline was ordered to pay $6.4 million to the family of 60-year-old Donald Schnell who murdered his wife, daughter and granddaughter in a fit of rage shortly after starting on Paxil – drug companies’ legal teams have quietly and skillfully settled hundreds of cases out-of-court, shelling out hundreds of millions of dollars to plaintiffs. 

Pharmaceutical giant Eli Lilly fought scores of legal claims against Prozac in this way, settling for cash before the complaint could go to court while stipulating that the settlement remain secret – and then claiming it had never lost a Prozac lawsuit.


_Read more at http://www.wnd.com/2013/01/the-giant-gaping-hole-in-sandy-hook-reporting/#KwdMrBVZzb5VLsUM.99 
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Keeping us safe, it's an overwhelming task

10/19/2012

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Picture
the logo of the FDA
Few employees, many drugs and OTC products
It may seem like 2,889 employees[1] in the drug department of the FDA is sufficient to regulate all prescription drugs on the market. 

But there are 17,143 drugs listed in the Orange Book, the FDA’s publication formally called Approved Drug Products with Therapeutic Equivalence Evaluations.[2] 

The Orange Book has 16,609 drugs in the prescription category and 534 drugs in the over-the-counter (OTC) category.[3]

The FDA drug department supervises OTC drugs, like pain relievers and cold medicines.  The website gives examples of other products it regulates that are not normally considered to be OTC drugs, such as fluoride toothpaste, antipersperspirants, dandruff shampoo and sunscreens.  Think of all the differents brands of these over the counter products on the market they have to monitor. 

The FDA drug department monitors a large amount of different products when OTC drugs are included in their jurisdiction.

Not only do the 2,889 employees perform drug evaluation and research on 17,143 drugs, they regulate marketing claims in all magazines, TV, pamphlets, physician seminars and luncheons sponsored by drug companies. 

If a company claims a drug is effective for a condition it was not approved for, the drug company is in violation and receives a carefully detailed warning letter and follow-up from the FDA.  It takes time to draft a legal warning letter and follow up letters to the thousands of companies that violate marketing laws and warning labels..

The FDA also monitors all drug-warning labels to ensure the right information is given to consumers.  Consumers have a right to know if their medication has a risk for liver toxicity or gastrointestinal bleeding. 

In summary:
Evaluation and research, regulating marketing claims, monitoring warning labels on all products and drugs, and taking legal actions...it's an overwhelming task!

Do we trust that only 2,889 employees in the FDA can protect us from the adverse reactions of 17,143 drugs?


   
[1]FDA  www.fda.gov/AboutFDA/Transparency/Basics/ucm213161.htm
[2]
FDA www.fda.gov/Drugs/DevelopmentApprovalProcess/ucm079068.htm Orange Book Preface 32nd Edition,  FDA Center for Drug Evaluation and Research Approved Drug Products with Therapeutic Equivalence Evaluations
[3]FDA www.fda.gov/ohrms/dockets/ac/99/slides/3506s2/sld008.htm
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Your Medical Mind

10/3/2012

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Picture
"Making the right medical decisions is harder than ever. We are overwhelmed by information from all sides—whether our doctors’ recommendations, dissenting experts, confusing statistics, or testimonials on the Internet. Now Doctors Groopman and Hartzband reveal that each of us has a “medical mind,” a highly individual approach to weighing the risks and benefits of treatments.  Are you a minimalist or a maximalist, a believer or a doubter, do you look for natural healing or the latest technology?  The authors weave vivid narratives of real patients with insights from recent research to demonstrate the power of the medical mind. After reading this groundbreaking book, you will know how to arrive at choices that serve you best."  ~ author description.

My Review:

The most important thing I learned from this book is that everyone has a preset approach to modern medicine.  Some people try to avoid medical interventions and and sort of 'go back to nature'.  Some people rely on the latest technology and want to maximize every scientific treatment available for their health. 

Neither extreme approach is wrong!  Our unique approach to medicine is highly individual.  Our level of trust in the medical system is based on how we were raised and what we learned about modern medicine as we grew up.

Trying to convert you to my personal approach may go against your intrinsic beliefs.  'Going back to nature' may be what is right for me, but it may scare the heck out of you!   If you adopt any extreme approach without complete belief in it, you might have a bad outcome and suffer intense regret.

My takeaway:   Be forgiving of other people's approach to modern medicine. 
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Treating Symptoms With Drugs Comes With A Price

9/29/2012

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Adverse Drug Reactions
While modern medicine intends to fight disease, the quest to treat illness by prescription drugs comes with a price. 

It is generally accepted that prescription drugs carry unwanted side effects.  Hidden in the well-known category of annoying side effects are serious events known as ‘adverse drug reactions’. 

Less is understood about the frequency and severity of adverse drug reactions.  “Unintended, harmful reactions to medicines (known as adverse drug reactions) are among the leading causes of death in many countries,” according to the World Health Organization. (http://www.who.int/mediacentre/factsheet/fs293/en/   Last update

Only One Study
In the United States, the most quoted and best estimate of the incidence of adverse drug reactions comes from a meta-analysis published in the Journal of American Medicine in 1989.  (Lazarou.J. (1989). The Journal of the American Medical Association, JAMA 1989;279 (15):1200-1205. doi:10.1001/jama.279.15.1200)  Searching a database of 39 different studies, the research team’s stated goal: to estimate the injuries incurred by drugs that were properly prescribed and administered. 

Especially since the study excluded therapeutic failures, errors in prescribing and administering, noncompliance, overdose and drug abuse, the numbers are astounding.  In the year they focused on they found that 2,216,000 hospitalized patients had serious adverse drug reactions and 106,000 patients had fatal adverse drug reactions.  That means that if you added in therapeutic failures, errors in prescribing and administering, noncompliance, overdose and drug abuse, the numbers would be astronomically higher.  A very low number of adverse drugs reactions are reported to hospitals.  When someone already has a condition that requires drug treatment, it is difficult to blame death on the drug.  

This article claimed adverse drug reactions from properly prescribed and administered drugs appeared to be the fourth leading cause of death behind heart disease, cancer and stroke.  While the numbers are impossible to adequately verify, the fact is, legal drugs that are considered ‘safe’ are killing Americans in large numbers.  We are not fully aware of the extent of adverse drug reactions because there are many, many, many, many flaws in the system.  

Why Not More Studies?
We will never see a better estimate of fatal adverse drug reactions because the drug companies control what gets published in the leading medical journals.  Funding for research comes from the drug companies.  Doctors must sign elaborate non-disclosure agreements before beginning drug research.  If the research results are less than complimentary to the drug companies, the projects get shut down and doctors are not allowed to discuss the results with anyone or they will be sued for everything they have by the drug companies for violating the non-disclosure agreements.   

Marcia Angell M.D. was the first woman editor-in-chief of the distinguished New England Journal of Medicine.  In the 20 years she worked there, she witnessed so many atrocities, she has written a book called "The Truth About Drug Companies"
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320 Billion Dollars!!

9/27/2012

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Last year Americans spent 320 billion dollars on prescription drugs, according to the best estimates. No one really knows for sure; the drug companies don't release that info.

320 Billion Dollars!! In twelve months!!
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Legal Drugs Considered 'Safe' Are Killing Americans

9/26/2012

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 I am proud to present my Bachelor Research Paper!  

I wrote it to show how messed up the pharmaceutical process is from the government, to the drug companies to the doctors.  The system is loaded with problems that threaten our safety.

Are you ready?  Here we go!

Legal Drugs Considered ‘Safe’ Are Killing Americans

     While modern medicine intends to fight disease, the quest to treat illness by prescription drugs comes with a price.  It is generally accepted that prescription drugs carry unwanted side effects.  Hidden in the well-known category of annoying side effects are events known as ‘adverse drug reactions’.  Less is understood about the frequency and severity of adverse drug reactions.  “Unintended, harmful reactions to medicines (known as adverse drug reactions) are among the leading causes of death in many countries,” according to the World Health Organization.[1] 

     In the United States, the most quoted and best estimate of the incidence of adverse drug reactions comes from a meta-analysis published in the Journal of American Medicine in 1989.[2]  Searching a database of 39 different studies, the research team’s stated goal was to estimate the injuries incurred by drugs that were properly prescribed and administered.  Especially since the study excluded therapeutic failures, errors in prescribing and administering, noncompliance, overdose and drug abuse, the numbers are astounding.  In the year they focused on they found that 2,216,000 hospitalized patients had serious adverse drug reactions and 106,000 patients had fatal adverse drug reactions.  This article claimed adverse drug reactions from properly prescribed and administered drugs appeared to be the fourth leading cause of death behind heart disease, cancer and stroke.  While the numbers are impossible to adequately verify, the fact is, legal drugs that are considered ‘safe’ are killing Americans in large numbers.  We are not fully aware of the extent of adverse drug reactions because there are many flaws in the system.  

     To avoid the risks of adverse drug reactions and sudden cardiac death, patients can guard themselves with knowledge about flaws in the system and the nature of drugs to make informed and better decisions to avoid regret.  If we look to the system to offer protection from adverse drugs reactions, we will focus on the main characters: the government, the drug companies, and the medical doctors who prescribe drugs. 

     Government- The original Federal Food and Drug Act of 1906 brought drug regulation under federal law and the Food and Drug Administration (FDA) began evaluating new drugs.  Following the 1962 amendment, the FDA requires manufacturers to show that their new drug products are safe and effective before entering the market.  The FDA approves on average, 22 new drugs a year, known as New Molecular Entities (NMEs).[3]   Of the 941 new drug approvals between 1995 and 2004, over six hundred were not NMEs, but slight variations of already existing drugs.[4]  Because the FDA requires drug manufacturers to provide research prior to approval, it is generally assumed that drugs on the market are safe and effective.  Further investigation shows that ensuring drug safety and effectiveness is an astronomical task for the FDA.

     It may seem like 2,889 employees[5] in the drug department of the FDA is sufficient to regulate all prescription drugs on the market.  But there are 17,143 drugs listed in the Orange Book, the FDA’s publication formally called Approved Drug Products with Therapeutic Equivalence Evaluations.[6]  The Orange Book has 16,609 drugs in the prescription category and 534 drugs in the over-the-counter (OTC) category.[7] The FDA drug department also supervises OTC drugs, like pain relievers and cold medicines.  The website gives examples of other products it regulates that are not normally considered to be OTC drugs, such as fluoride toothpaste, antipersperspirants, dandruff shampoo and sunscreens.  The FDA drug department monitors a large amount of different products when OTC drugs are included.

     Not only do the 2,889 employees perform drug evaluation and research on 17,143 drugs, they regulate marketing claims in all magazines, TV, pamphlets, physician seminars and luncheons sponsored by drug companies.  If a company claims a drug is effective for a condition it was not approved for, the drug company is in violation and receives a carefully detailed warning letter and follow-up from the FDA.[8]  The FDA also monitors all drug-warning labels to ensure the right information is given to consumers.  Consumers have a right to know if their medication has a risk for liver toxicity or gastrointestinal bleeding. 

     Not only evaluating pre- and post market drug surveillance, regulating all marketing claims and warning labels, the FDA hosts the Adverse Event Reporting System, a database that contains information submitted about adverse drug events in the population.  Anyone can submit drug information to the AERS; statistics and files are made public on the website.  Data collected through the AERS has limitations, the FDA warns, “First, there is no certainty that the reported event (adverse event or medication error) was actually due to the product.  FDA does not require that a causal relationship between a product and event be proven, and reports do not always contain enough detail to properly evaluate an event…Therefore AERS data cannot be used to calculate the incidence of an adverse event or medication error in the U.S. population.”[9]  The AERS is a step in the right direction for cataloging adverse drug events; but is under-utilized by those who are affected most.  We can’t expect the FDA to protect us from adverse drug events.  Of the 758,890 reports received in 2010, only 28,952 came from consumers or healthcare professionals.[10]  The majority of adverse drug reporting came from drug companies themselves, manifesting a conflict of interest.  

     Drug Companies- ‘Conflict of interest’ seems to be synonymous with pharmaceutical companies.  They market drugs to improve public health, but also to make money.  The healthier the public is, the less profit the drug companies make.  Reliable financial data about the earnings and spending of drug companies is scarce.  The U.S. General Accounting Office refers to IMS,[11] a firm that provides pharmaceutical market research and is largely backed by the pharmaceutical industry.  According to IMS, in 2011, Americans spent $319 billion dollars on prescription drugs.[12] 

     Public concern over the cost of prescription drugs, the slower pace of new-drug development and suspicions that the ‘pharmaceutical industry is highly profitable’ led to a 65-page study by the federal Congressional Budget Office, called Research and Development in the Pharmaceutical Industry.[13]  It was an attempt to explain the mystery of why prescription drugs cost so much.  The average cost for the average brand-name drug in 2010 was $198,[14] which would be about $2300 a year if a person was only taking one drug.  Many senior citizens have more than one prescription, commonly five or more.  The FDA and the drug companies blame high prices on the expensive and tedious research and development process.

     Forbes magazine estimates that it costs between 4 and 11 billion dollars to bring the average new drug to market.[15]  It explains that included in high cost of development, are drugs that fail; fewer than 1 in 10 medicines that start research in human clinical trials succeed to market.  According to the FDA, the proportion of all new drugs that begin testing in human clinical trials on healthy volunteers (phase 1) and make it through the next two phases of trial to approval is 8%.[16]  It usually takes about 11 years to complete all testing phases and gain FDA approval.[17]

     Critics claim that most of the drug research is not being done by the drug companies, but in universities for little cost to the drug companies.  “As hard as it is to believe, only a handful of truly important drugs have been brought to market in recent years, and they were mostly based on tax-payer-funded research at academic institutions, small biotechnological companies, or the National Institutes of Health.  The majority of “new” drugs are not new at all but merely variations of older drugs already on the market.  These are called “me-too” drugs.  The idea is to grab a share of an established, lucrative, market by producing something very similar to a top-selling drug.  For instance, we now have six statins (Mevacor, Lipitor, Zocor, Pravachol, Lescol, and the newest, Crestor) on the market to lower cholesterol, all variants of the first.”[18]   These six lipid regulating cholesterol-lowering drugs, by themselves brought in 20.1 billion U.S. dollars to the drug companies in 2011.  In the last five years, 95 billion U.S. dollars were spent by Americans on these six drugs alone, according to IMS.[19]  This estimate does not include sales in Europe or any other countries rich enough to afford a cholesterol-lowering drug.  

     Drug companies are not required to divulge how much money they spend in research and development or on marketing.  Finding reliable numbers is difficult. To keep their prices high and their practices hidden and protected, drug companies spend 855 million dollars[20] a year on lobbying in Washington D.C.      

     Drug companies might underestimate the amount they spend on promotion to enhance their public image.  One independent figure based on numbers from two different pharma-backed market research companies, estimates that 57.5 billion dollars are spent each year on various marketing venues, twice as much as on research and development.[21]  It is more lucrative to promote existing drugs than it is to create new ones.  It is cheaper to find off-label uses for existing drugs.  It is cheaper to promote research that shows existing drugs should be taken by more people for life.  It is cheaper to lead the public into believing that the existing drugs will prolong their life and enhance the quality of their life through clever marketing.  Direct to consumer marketing has increased dramatically, but the biggest portion of marketing dollars is spent on physicians.

     Physicians- In the U.S. alone, 3,703,594,389 prescriptions were filled in retail pharmacies [22] in 2010, managed by an estimate of 691,000 physicians.[23]  There are only 314 million people in the U.S.[24] who are filling 3.7 billion prescriptions and only about a half a million doctors to manage those prescriptions. 

     The time limit a physician has to spend with each patient has decreased as managed healthcare began ‘restricting doctors to an average seven-minute “encounter” with each customer.  This apparently kept shareholders happy.  But it reduced the doctor-patient relationship to a financial concept…’[25]

     Dr. Victoria McEvoy describes seeing patients as trying to look for one face in the window on a train as it goes by.  As the train picks up speed, all the faces start to blur.  If you look away, you might miss the one you are seeking.  The faces start to look the same. Looking becomes monotonous.  Doctoring becomes habitual.  As a pediatrician, she sees an endless number of cranky children with a fever.  The diagnosis is almost always a virus or strep throat.  But if she becomes complacent, she might miss the one child who has meningitis.[26]   

     Physicians are human just like anybody else.  Doctors make mistakes.  Misdiagnosis could occur anywhere from 8% - 42% of the time, according to the best estimates of a few studies.[27]  Doctors need sleep to perform at the optimal level.  Pilots are required to log at least 10 hours in between flights.  Doctors are often required to work 24 hours shifts, or take on-call duty that wakes them up throughout the night, impairing judgment.

     Physicians have biases that affect their judgment and the ability to make the right diagnosis.  ‘All new mothers are overprotective and nervous about the health of their babies.’  ‘Kids and a full-time job will cause this kind of fatigue, of course.’ ‘It’s all in your head.’  ‘You need an anti-depressant.’  In seven minutes, it is difficult to get past biases to examine the real issues.  

     One study in California monitored 45 doctors caring for more than 900 patients.[28] Almost half failed to specify the dose of the drug and how often it should be taken. 

Two thirds of the doctors did not tell their patients either how long to take a new medication or what its side effects could be.  Many drugs have so many side effects, doctors cannot keep track of them, especially the little known side effects.

     Physicians rely on drug companies to learn about prescription drugs. The American Medical Association requires physicians to complete continuing education.  In Washington D.C. thirteen pharmaceutical companies are approved to provide continuing education to doctors.[29]

     No Free Lunch is a website sponsored by healthcare professionals dedicated to stopping the unethical behavior of  drug company-to-physician marketing and promotion.  They claim that doctors are influenced by promotion, even the pen or mug given by drug reps. Gifts, even small ones create relationships, obligations and the need to reciprocate.  There have been observational studies that show that doctor’s prescribing behavior is influenced by promotions and interactions from drug reps. No Free Lunch claims, “Doctors who practice on the basis of promotion, meet with reps, and use information provided by them are more likely to prescribe more expensive, inappropriate medication.”[30]  Drug companies know this.  That is why they spend 80% [31]of their 57.5 billion[32] dollars a year on marketing to physicians.  Strapped by insurance companies, health maintenance organizations, the overbearing legal system, and other forces, many doctors feel there is nothing they can do to change the system.  Those who fight the system risk losing their licenses to practice.

     Solution- So far, this prescription drug system paints a dismal picture for modern medicine.  As one desperate arthritic blogger commented, “So all the drugs are bad.  What the heck are we supposed to do?!  Rot in our wheelchairs and die?” No, luckily there is good news.  The good news lies in the statistics.  While 106,000 deaths a year seems like a large number, it is insignificant compared to the 3.7 billion prescriptions filled a year.  Compared to 3.7 billion prescriptions, even 2.2 million serious adverse drug reactions are only about 16% of the total number.  

       There is more good news from the World Health Organization,  “At least 60% of ADRs are preventable, and can be due to: wrong diagnosis of the patient’s condition; prescription of the wrong drug or wrong dosage of the right drug; an undetected medical, genetic or allergic condition that might cause a patient reaction; self-medication with prescription medicines; not following the instructions for taking the medication; and reactions with other drugs (including traditional medicines) and certain foods… Vigilant assessment of the risks and benefits of medicines promotes patient safety”

   To avoid ADRs, become familiar with prescription drugs before taking them.  You should know that Ibuprophen, aspirin and most arthritis medications are so highly linked to severe gastrointestinal bleeding that these NSAIDS have their own disease name: NSAID Gastropathy.  Oral contraceptives and Hormone Replacement Therapy are highly linked to blood clots, strokes and heart attacks.  Statins are highly linked to liver problems, severe muscle degeneration and early dementia.  You should know that if 150 people have a cholesterol level of 280, and all are taking a statin drug, only one of them would be ‘saved’ from a heart attack.  The other 149 would not have suffered the heart attack even with a cholesterol level of 280.[33] It’s called the ‘number needed to treat’ and it is very different than the statistics doctors usually give to patients when suggesting medications.  You should know that Erythromycin, an antibiotic is linked to hepatitis (liver disorder) and it is part of a group of antibiotics called macrolides that cause long QT.  Long QTs are highly linked to torsades de pointe, an unsustainable heart rhythm.  Pepcid, Effexor, Zoloft, Paxil, and others are also linked with long QT under certain conditions.[34]  That means in a small way, these medications can be linked to sudden death.  Our own due diligence can save us from regret.  To avoid the risks of adverse drug reactions and sudden cardiac death, patients can guard themselves with knowledge about the flaws in the system and the nature of drugs to make informed and better decisions.      

     Health reporter Kristin Dold suggests, “Before taking any prescription drug, ask your doctor the following three questions: Are there nondrug options I can try first?  Why did you pick this medication over others?  And what are the pros and cons of taking this?  If he or she brushes off your queries, it’s time to find a new MD.”[35]

     As Dr. Peter Salgo suggests, “This leaves the solution to the problem in the hands of our patients.  You, the patient, are the system’s best hope.  In the age of seven-minute health care, you need to realize that you employ doctors.  That is, your doctor works for you…Evaluate what it is you expect from your doctor, then ask for it.  If you are unhappy with your doctor, fire him…the true power in the health care economy rests not with the doctors and certainly not with the backroom business staff [and not with drug companies] it rests with you.  If you insist on being treated with care and respect, you will be.  And the system will improve as a result.” [36]

     The highest health goal to hope for is in the words of Thomas Edison, “The doctor of the future will give no medicine but will interest his patients in the care of the human frame, in diet and in the cause and prevention of disease.”[37]

Footnotes:
[1] World Health Organization. (2008) http://www.who.int/mediacentre/factsheets/fs293/en/   Fact Sheet No 293, Page Last Updated Oct 2008

[2]Lazarou.J. (1989). The Journal of the American Medical Association, JAMA. 1998;279(15):1200-1205. doi:10.1001/jama.279.15.1200

[3]FDA www.fda.gov/downloads/AboutFDA/Transparency/Basics/UCM247465.pdf  includes 2010 information

[4] FDA “CDER 2004 Report to the Nation: Improving Public Health Through Human Drugs” www.fda.gov/downloads/AboutFDA/CentersOffices/CDER/WhatWeDo/ucm078941.pdf

[5] FDA  www.fda.gov/AboutFDA/Transparency/Basics/ucm213161.htm Page last updated 8/19/2010

[6] FDA www.fda.gov/Drugs/DevelopmentApprovalProcess/ucm079068.htm Orange Book Preface 32nd Edition,  FDA Center for Drug Evaluation and Research Approved Drug Products with Therapeutic Equivalence Evaluations

[7] FDA www.fda.gov/ohrms/dockets/ac/99/slides/3506s2/sld008.htm

[8] www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/EandNoticeofViolationLetterstoPharmaceuticalCompanies/default.htm Page Last Updated January 25, 2012

[9]www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/Surveillance/AdverseDrugEffects/default.htm  Page Last Updated April 27, 2012

[10]www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/Surveillance/AdverseDrugEffects/ucm070434.htm Page Last Updated July 15, 2011

[11] Gagnon, M-A; Lexichin, J (2008) The Cost of Publishing Pills: A New Estimate of Pharmaceutical Promotion Expenditures in the United States. PloS Med 5(1): el. Doi:10:1371/journal.pmed.0050001

[12]IMS www.imshealth.com/deployedfiles/ims/Global/Content/Corporate/POTop-line%20Market%20Data/Top_Therapy_Classes_by_Sales.pdf

[13] Congressional Budget Office www.cbo.gov/sites/default/files/cbofiles/ftpdocs/76xx/doc7615/10-02-drugr-d.pdf  October 2006, Research and Development in the Pharmaceutical Industry

[14] Johnson, L, A. (2011) Prescription-drug prices to plunge as patents expire. The Seattle Times, July 24, 2011

[15] Herper, M, (2012) The Truly Staggering Cost Of Inventing New Drugs. Forbes www.forbes.com/sites/matthewherper/2012/02/10/the-truly-staggering-cost-of-inventing-new-drugs/

[16] Congressional Budget Office (2006) Research and Development in the Pharmaceutical Industry, p. 23

[17] Congressional. p. 20

[18] Angell, M.D. M. (2004) The Truth About Drug Companies. New York: Random House. p. 15.

[19] IMS www.imshealth.com/deployedfiles/ims/Global/Content/Corporate/POTop-line%20Market%20Data/Top_Therapy_Classes_by_Sales.pdf

[20] Dilanian, K. (2007, March 10). Senators Who Weakened Drug Bill Got Millions From Industry. USA Today.  www.usatoday.com/news/washington/2007-05-10-senators-drug-bill_N.htm 

[21] Gagnon, M-A; Lexichin, J (2008) The Cost of Publishing Pills: A New Estimate of Pharmaceutical Promotion Expenditures in the United States. PloS Med 5(1): el. Doi:10:1371/journal.pmed.0050001

[22] The Kaiser Family Foundation. www.statehealthfacts.org/profileind.jsp?sub=66&rgn=1&cat=5

[23] Bureau of Labor Statistics. Occupational Outlook Handbook 2012-2013 edition. www.blsgov/ooh/Healthcare/Physicians-and-surgeons.htm

[24] U.S. Department of Commerce. www.census.gov/main/www/popclock.html

[25] Salgo, P, MD. (2006, March 22). The Doctor Will See You for Exactly Seven Minutes. The New York Times. www.nytimes.com/2006/03/22/opinion/22salgo.html 

[26] Groopman, J. (2007).  How Doctors Think. Boston, Houghton Mifflin. p.77

[27] www.rightdiagnosis.com/intro/common.htm

[28] Groopman, J. (2007). How Doctors Think. Boston, Houghton Mifflin. p. 266

[29] Health Professional Licensing Administration. List of Pharmaceutical Companies Approved for Continuing Education. Hpla.doh.doc.gov/hpla/cwp/view,a,1195,q,501203.asp

[30] www.nofreelunch.org/faqs.htm

[31] Rosenthal, M. (2002, February 14) Promotion of Prescription Drugs to Consumers. The New England Journal of Medicine. 346:498-505

[32] Gagnon, M-A; Lexichin, J (2008) The Cost of Publishing Pills: A New Estimate of Pharmaceutical Promotion Expenditures in the United States. PloS Med 5(1): el. Doi:10:1371/journal.pmed.0050001

[33] Groopman, J. (2011). Your Medical Mind, How to Decide What Is Right for You. New York, The Penguin Press. pp. 17, 24.

[34] The Critical Path Institute. Drugs with Conditional Risk of Torsades http://www.azcert.org/medical-pros/drug-lists/list-04.cfm

[35] Dold, K. (2012, June 3). Doctors Behaving Badly: 7 Types to Watch Out For. MSNBC.MSN www.todayhealth.today.msnbc.com/_news/2012/06/03/12034113-doctors-behaving-badly-7-types-to-watch-out-for?lite

[36] Salgo, P, MD. (2006, March 22). The Doctor Will See You for Exactly Seven Minutes. The New York Times. www.nytimes.com/2006/03/22/opinion/22salgo.html 

[37] www.snopes.com/quotes/edison.asp

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    It is appalling what the drug companies get away with.  I don't believe people understand what a massive collection of lies we have been fed about our health.  Pharmaceutical companies have control over the healthcare industry by enforcing the idea that drugs are the answer to any symptom.  I would like to declare war on this evil giant.  Information is power.

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