Overdo$ed America

When I was first diagnosed with sciatica at age 21, I was prescribed Flexoril, Feldene, Percocet and a bunch of other drugs. I remember spending 12-14 and even 20 hours a day in bed, reading like mad, sleeping like the dead and having crazy, crazy dreams (when I could remember them).

Not coincidentally, it turns out, this was also the time when depression descended over my life, as my classmates moved on from college and I remained in place, hobbled by pain but more so by the absolute fear that it would never go away – debilitated for life at age 22.

Over the next 20 years, I went through many more prescriptions, including new anti-inflammatories like Vioxx and Celebrex – more varieties of muscle relaxants than I can name and even, after my second back surgery, Dilantin, which is typically prescribed to those suffering from epilepsy.

Eventually I learned that drugs didn’t help my pain in the long run. Still, I came to rely on them to sleep or travel – the times I had come to expect that my back would hurt. Finally I gave them up completely, convinced that exercise, weight loss and stress reduction were the keys to overcoming pain.

While researching back surgery hardware lawsuits, I came across Overdosed America: The Broken Promise of American Medicine, by Dr. John Abramson, last week.

Although I had some vague idea of the influence of the drug industry on American medicine, this book blew me away. Abramson painstakingly, in scientific detail, describes the hijacking of our healthcare system by  corporations that are allowed to put profits over our health, literally killing people in the process and ballooning the cost of treatment.

They do this by routinely suppressing drug studies that show their products do more harm than good and undermining the credibility of medical journals by paying doctors who research and write articles, Abramson reports. They do it through misleading direct consumer marketing that encourages doctors to write “off-label” prescriptions to treat conditions that drugs were not approved by the FDA to treat (this also enables a skewed public opinion on the viability of drugs compared to safer, less expensive and more effective treatments). Finally, the drug industry, with the help of politicians bought off by huge campaign contributions, orchestrated takeovers of medical research and doctor training that used to be conducted by independent research hospitals.

Despite my negative experiments with pain killers, certainly I realize that some drugs, such as cisplatin, which has revolutionized the treatment of testicular cancer and saved countless lives, are incredible boons to society.

But for every success story there is a debacle, like the saga of Hormone Replacement Therapy described by Abramson. According to his book,  HRTs caused more than 100,000 cancers in American women after they were overprescribed in the wake of flawed studies that mistakenly showed they benefited women in ways they actually didn’t –  specifically that they helped prevent heart disease.

As I reflected on the role of drugs in my 20-year fight against back pain, one fact in Abramson’s book really hit home. The U.S. is the only industrialized country besides New Zealand that allows direct-to-consumer marketing by the pharmaceutical industry (this practice was authorized in 1997). The predictable result of this decision, according to Abramson, has been an  overemphasis on the efficacy of drug therapy when compared to proven, infinitely cheaper, less invasive treatments for disease such as weight loss and changes in diet and exercise.

As a result, we’ve got guys in their 50’s eating red meat five times a week and not exercising because they think their statin prescription will counteract any damage they’re doing to their arteries. Or overweight weekend warriors who think they can play softball into their 60s thanks to lifetime prescriptions to organ-damaging COX-2 inhibitors.

Hopefully the debate over medical insurance reform will draw attention to our failed system of new drug and technology oversight. Clearly we must continue to strive for medical breakthroughs, but it’s just as apparent that the unchecked free market enriches a few and harms the health of the rest of us.

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2 responses to “Overdo$ed America

  1. Chris! I wonder what Dr. Abramson would think about healthcare lobbyists literally writing speeches in Congress?

    • I hope he’s disgusted, but not surprised. Of course, for the benefit of other readers, you are talking about the recent NY Times story that caught a bunch of lawmakers red-handed, in unison, spewing anti-health care reform rhetoric that had been cooked up in some lobbyist’s marketing shop. What’s surprising to me isn’t that elected officials are speaking with the voice of their moneyed masters, it’s how careless they were in covering their tracks!

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