With RFK Jr's brainworm/roadkill approach to healthcare these days, this article seemed rather relevant once more:
Ninety-two years ago (note: this would have been 1905), the general public had direct access to nearly any drug available on the market. Morphine, cocaine, opium, and strychnine were available by mail from Sears' catalogue; a prescription was often but a formality and "patent medicines" containing unknown and often addictive agents made millionaires of unscrupulous entrepreneurs. Consumers believed the ads, took the "cures," and often died; their memories endured as "unsolicited testimonials" to the treatments that shortened their lives.
When Theodore Roosevelt pushed for the creation of the FDA in 1906, lobbyist pressures saw to it that the agency would begin its life as a toothless child. It took medical disasters and consumer deaths to give it the power to determine which drugs should be available only with a prescription. That scrap of paper became the control valve on potentially harmful medications; products that didn't make the cut were considered generally safe if properly used.
The 1980s, a noteworthy decade for its hands-off approach to governmental regulation, produced an ever increasing collection of drugs entering the marketplace, many representing only variations on existing treatments. The FDA seemed willing to approve anything that might further stimulate the piranha -churned economy; if one of the new entries later proved to be harmful, or perhaps deadly, it could always be removed.
The past few years have seen a less passive FDA, yet, with all the criticism levied upon outgoing chairman David Kessler in his efforts to strengthen the agency, it was under his administration that several drugs were deregulated to nonprescription status. There have been further deregulations on the part of other therapies, most notably of the naturopathic, or herbal variety. With each deregulation came the presumption of safety on the part of the consumer, and with each deregulation the main source of public information came primarily from advertising and mass marketing. Once again, consumers believed the ads and took the "cure." In a sad regression to the turn of the century, some have fallen ill; others have died.
When Theodore Roosevelt pushed for the creation of the FDA in 1906, lobbyist pressures saw to it that the agency would begin its life as a toothless child. It took medical disasters and consumer deaths to give it the power to determine which drugs should be available only with a prescription. That scrap of paper became the control valve on potentially harmful medications; products that didn't make the cut were considered generally safe if properly used.
The 1980s, a noteworthy decade for its hands-off approach to governmental regulation, produced an ever increasing collection of drugs entering the marketplace, many representing only variations on existing treatments. The FDA seemed willing to approve anything that might further stimulate the piranha -churned economy; if one of the new entries later proved to be harmful, or perhaps deadly, it could always be removed.
The past few years have seen a less passive FDA, yet, with all the criticism levied upon outgoing chairman David Kessler in his efforts to strengthen the agency, it was under his administration that several drugs were deregulated to nonprescription status. There have been further deregulations on the part of other therapies, most notably of the naturopathic, or herbal variety. With each deregulation came the presumption of safety on the part of the consumer, and with each deregulation the main source of public information came primarily from advertising and mass marketing. Once again, consumers believed the ads and took the "cure." In a sad regression to the turn of the century, some have fallen ill; others have died.
Consumers saw a commercial announcing that Anacin or Excedrin are now "aspirin free" and some presumed all Anacin and all Excedrin were aspirin free, with disastrous results. The natural products ephedra and golden seal have caused deaths from severe elevations in blood pressure. Both plants were, and are, promoted as "natural" treatments for infections or fatigue. Even the ubiquitous acetaminophen, more commonly known as the heavily advertised Tylenol, can cause severe liver damage in high doses.
Of recent concern has been the deregulation of prescription antacids into "nonprescription strengths," heavily promoted as a casual alternative to previous antacids (one of the disturbing messages of these ad campaigns is that the consumer shouldn’t change his eating habits, he should just take another pill). One of these newer antacids is cimetidine, currently marketed as Tagamet HB. Cimetidine has been shown to interact with other drugs used as blood thinners to treatments for asthma and epilepsy; to reduce the effectiveness of some antibiotics; to increase the toxic effects of strong pain killers. It's now available at your grocery store, next to "aspirin free" Anacin and capsules of golden seal.
Then follow the drugs-du-jour: the melatonins, the DHEAs, the chromium picinolates. At best, they can be harmless (some could say worthless); at worst, can cause side effects that are difficult to predict and won't be listed on the bottle.
Education becomes an issue here, since a nonprescription drug can be safe and useful when properly used. Unfortunately, the primary source of public information is from the companies who are selling the goods. They're businesses, after all, out to make money, and side effects won't sell a product--especially to a consumer looking for a quick fix. If a company is going to point out a flaw, it certainly won't be theirs. We have seen this in campaigns pitting one newly deregulated pain killer against another for its interaction with alcohol; again, it was a case of the pot calling the kettle black.
With more deregulation on the horizon, consumers need to be increasingly wary of overblown claims, especially those made by marketing teams who treat their health as just another commodity
to be packaged and sold. They need to rely more on information from a properly trained, well-informed health care provider instead of hype from a glossy magazine spread.
Of recent concern has been the deregulation of prescription antacids into "nonprescription strengths," heavily promoted as a casual alternative to previous antacids (one of the disturbing messages of these ad campaigns is that the consumer shouldn’t change his eating habits, he should just take another pill). One of these newer antacids is cimetidine, currently marketed as Tagamet HB. Cimetidine has been shown to interact with other drugs used as blood thinners to treatments for asthma and epilepsy; to reduce the effectiveness of some antibiotics; to increase the toxic effects of strong pain killers. It's now available at your grocery store, next to "aspirin free" Anacin and capsules of golden seal.
Then follow the drugs-du-jour: the melatonins, the DHEAs, the chromium picinolates. At best, they can be harmless (some could say worthless); at worst, can cause side effects that are difficult to predict and won't be listed on the bottle.
Education becomes an issue here, since a nonprescription drug can be safe and useful when properly used. Unfortunately, the primary source of public information is from the companies who are selling the goods. They're businesses, after all, out to make money, and side effects won't sell a product--especially to a consumer looking for a quick fix. If a company is going to point out a flaw, it certainly won't be theirs. We have seen this in campaigns pitting one newly deregulated pain killer against another for its interaction with alcohol; again, it was a case of the pot calling the kettle black.
With more deregulation on the horizon, consumers need to be increasingly wary of overblown claims, especially those made by marketing teams who treat their health as just another commodity
to be packaged and sold. They need to rely more on information from a properly trained, well-informed health care provider instead of hype from a glossy magazine spread.
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