The United States makes up 5% of the world’s population and is responsible for 75% of the prescription drugs consumed annually. This is according to the United Nations Office on Drugs and Crime annual World Drug Report published in 2011. Stop and think about that statistic. These aren’t street drugs. Most of these drugs are legally obtained through doctor’s prescription. So what’s the big deal? Accidental overdose of prescription medications is the leading cause of accidental death in America. 78 Americans die every day from opioid abuse. This doesn’t just include opiates, though they are by far the most abused drug. It is what led to the demise of our beloved Prince and Michael Jackson. This includes anti-depressants, antibiotics, statins, and whole host of other overly prescribed medications.
Before we get started I will disclose two facts. I don’t believe these bias me in either direction, this is for the sake of transparency and a reminder as it’s contained in my bio. I worked at the largest pure play medical device company in the world for nearly 13 years and did a summer internship at one of the largest pharmaceutical companies in the world. I believe in quality health care and in the advances in these industries that save lives. As with anything there are cautions and as informed consumers, we need to know what we are doing to our bodies, even if it’s something that helps and heals.
Big Pharma’s Influence Is Unmatched
When Barack Obama was first elected President his hallmark legislation, the Affordable Care Act (Obamacare) levied a tax against medical device companies. The 2.3% tax threatened jobs and the ability to innovate. How much was the tax on pharmaceuticals you ask? The government’s official answer, “it’s complicated”. The medical device industry, which includes everything from pacemakers to eye glasses, is expected to reach $155 billion by 2017. By 2020 pharmaceuticals, only drugs, is expected to reach $548 billion. It was an estimated $395 billion in 2014 according to GlobalData. Pharmaceutical growth is expected to continue to outpace medical device sales growth into the foreseeable future. Biotechnology which can include a mix of drugs and medical devices tends to fall into the medical device space, including drug delivery devices.
The largest pharmaceutical companies, aka Big Pharma, have two things, money and influence. These companies contribute to political campaigns and have an army of lobbyists. The second thing they do is influence, not just the government, but also the American people. Would you agree that when it comes to diagnosing and treating your condition or illness you are a unique human with unique needs? Then ask yourself, why are pharma companies broadly advertising prescription drugs on television and in magazines? There are very few regulations preventing big pharma companies from engaging in direct-to-consumer (DTC) advertising. As long as they tell you that long list of side effects they’re good. Pharmaceutical companies spend more than any other industry on advertising to push their agendas. While their visible agenda is to get physicians to prescribe medications, their primary objective is to convince the American people they need them. What’s the saying, the greatest trick the Devil ever played was convincing the world he didn’t exist.
This is not to compare Pharma companies to the Devil. There are many lifesaving drug breakthroughs that have brought about miracles such antibiotics, Alzheimer’s drugs, and so on. It’s an entire system and pharmaceutical companies are only one cog in the machine. Government, the health care industry itself and consumers all play their parts. This perfect storm has led to the over-medication of America through various methods.
Method 1: Demand And Supply
The class I did the worst in was Economics. As a finance major, though, you can’t escape it. The first lesson we learned however is incredibly simple and everyone gets it – supply and demand. It takes millions and billions of dollars to develop drugs. What good is it to develop a drug if no one asks for it. Pharmaceutical companies created a system of demand and supply. They create the demand through influence (DTC advertising) and then supply the cure. Let’s take clinical depression as an example. Clinical depression is a real condition brought about by an imbalance of biochemicals. However, it is often confused with emotional depression brought about by life events. While the two can cross, emotional depression can’t be treated by drugs. Pharmaceutical companies however rarely make such an important distinction in their advertising. According to the National Center for Health Statistics the use of anti-depressants by people 12 years of age and older increased by 400% between 1988-1994 and 2005-2008. Guess what? Prozac was approved by the FDA in December, 1987. Lilly was the first big Pharma company to speak of depression in DTC advertising. Whites are far more likely to be on antidepressants than blacks or Hispanics. This may be attributable to several factors such as access to prescription drug insurance coverage and increased access to and belief in mental health care professionals. Women in their 40’s and 50’s are more likely than any other gender or age group to be on anti-depressants. The jury is still on out the effectiveness of anti-depressants.
Method 2: Self Medication
People drink or take drugs to escape the pain of life. The drug of choice are opiates or painkillers such as Vicodin (hydrocodone), OxyContin (oxycodone), and Opana (oxymorphone) and methadone. In 2010 there were enough prescriptions for painkillers issued to medicate every American adult every four hours for one month. That’s a lot of pain, but according to the Center for Disease Control and Prevention, the amount of pain Americans report hasn’t changed since 1999. The World Drugs Report 2011 revealed that 6.1 million people used a prescription drug non-medically in the past month. Two reasons stand out. First, teens try them for recreational purposes. They often steal pills from their parents. Second, people are in emotional pain and perhaps feel they shouldn’t be or they’re stuck. Do Americans feel they are less happy than the rest of the world? Is it the ease of access and the culture of instant gratification? Regardless of the answer, it isn’t very difficult to get your hands on prescription pain meds.
Method 3: Health Care System Enabled Drug Dealing
Because we lack a unified health care system with connected medical records physicians are often made unwitting accomplices in obtaining prescription drugs, mainly painkillers. A patient who knows how to work the system will simply go to different doctors and get prescriptions filled at different pharmacies. But, before we let doctors off the hook, many, not all, are very willing to prescribe drugs as the first line of defense. I once hurt my back and shoulder pretty badly. After taking X-rays and determining no structural damage, i.e. broken bones, was present he whipped out his prescription pad and prescribed painkillers. When I asked for physical therapy instead he gasped and said of course, people usually just want the drugs. I took Advil and did my exercises. I recovered pretty well. It took time and I had to endure the discomfort. Side note, I ended up going to a chiropractic several years after that because I still had some pain. He also took X-rays that did reveal some structural damage. He was able to reduce my pain significantly. No drugs. The point, had I not asked for an alternative, I would have been put on drugs potentially for the rest of my life. I was 35 at the time. I have even been prescribed opiates without being asked if I have an addiction or without checking a single medical record.
The Truth About Prescription Drugs
When your physician takes out the prescription pad there are a few things he or she may not be telling you. I’m not talking about the long list of side effects or possible drug interactions. There’s a business behind those pills.
Prescription drug overdoses kill more people than car crashes and is greater than heroin and cocaine overdoses combined.
According to the CDC nearly half of a million people died from drug overdoses between 2000 and 2014. Since 1999 the sale of opioids in the US has increased by four times. Take a look at beloved mega star Prince. One would argue he had very little to be depressed about. There’s no mention if Prince had been treated for pain and became addicted or if he just started taking them. Regardless, this is another tragic example of how the system enabled this to occur. Though Prince was reportedly very health conscious, addiction doesn’t care. These medications wage biochemical warfare in our bodies that many find very difficult to win.
Drugs are primarily tested on white people, typically white males.
To explain this at a high level, companies select their clinical study sites. While no consideration is supposed to be given for good customers, it can’t be entirely eliminated from the selection process. A majority of the time these studies are conducted in populations that can afford health care because that’s where the physician is. This trends towards majorly white populations. Additionally, given the history of medical abuses against black people in the United States they tend to avoid participation in clinical trials. Therefore most of the time when you’re giving a drug, not only is the physician not exactly sure how it will work on a white person they have even less knowledge about how it would work on a black woman. The same holds true for the medical device industry. This has led to increased focus on pharmacogenetics, prescribing a drug or variation based on a person’s genetics.
Clinical trials aren’t nearly as definitive as they advertise.
Drug companies must submit clinical trial data to the FDA for approval. They must include safety and efficacy data. Meaning, they don’t harm people and they help people. But the amount of harm is a matter of perspective. Chemotherapy for example can kill its patients but maybe not as fast as untreated cancer. And it only has to be more efficacious (better) than the standard of care. It doesn’t have to show a significant amount of improvement over what already exists. Further, they are allowed some literary license with their trial results. For example, if two patients were on a drug over the course of four years and one had better results than the other, the company can legally say the drug improved outcomes by 50%. This is why it’s important to thoroughly look at the study design, the cohort (patient population) and the results.
They can cause more problems than they fix with ruthless side effects.
SSRI (selective serotonin reuptake inhibitors), essentially these are anti-depressants, can lead to psychotic behaviors. In fact many of the mass murders committed in the US, such as Sandy Hook and Columbine, were carried by SSRI users. Because the New Black Chick has a policy of never naming mass murderers, you can see the entire list here. Another example is statin drugs meant to lower cholesterol. One in four Americans over age 45 are prescribed statin drugs as a means to help prevent heart disease as a result of high cholesterol. The reality is these drugs only benefit one percent of the population and chances are as as a black woman, you’re not one of them. In fact, researchers reported that statins increased the rates of cancer, cataracts, diabetes, cognitive impairment, musculoskeletal disorders, and trigger the very heart disease it’s meant to prevent (Expert Review of Clinical Pharmacology report). Drugs treat, they don’t cure.
Pharmaceuticals Drugs Enhance What Nature has provided
Many pharmaceutical drugs are derived from plants. They are enhanced and concentrated to be more effective and mass produced. This comes in very handy for antibiotics such as penicillin. Others drugs come from the offending organisms themselves, such as vaccinations. Some we get from animals as is the case with insulin for diabetics. On the other hand there are many drugs that are prescribed to manage conditions that can be managed through lifestyle changes, such as statins. Cholesterol can be controlled through diet and exercise. Sure, some people are genetically predisposed to high cholesterol. As I like to say, genetics loads the gun, lifestyle pulls the trigger. The best bet is to see a physician who believes in a holistic approach of science and lifestyle.
Pharmaceuticals are poison
This isn’t being dramatic. Poison is defined as a substance that through its chemical action usually kills, injures, or impairs an organism; something destructive or harmful – aka, side effects. This doesn’t mean that the drugs aren’t doing good, but they are also doing harm. Be an informed consumer and weigh the risk of the side effects with the reward of the cure.
What’s Being Done And What We Can Do
In 2012 Kentucky became the first state to pass law requiring doctors to search a database called prescription drug monitoring program (PDMP) prior to prescribing addictive drugs. In the first year of implementation prescription of painkillers dropped significantly as did opioid related deaths by 25%. They went a step further and have reciprocal agreements to allow sharing of drug dispensing data between states. This model has been adopted by other states such as New Jersey, New York, Connecticut, Delaware, Minnesota, Rhode Island, South Carolina and Virginia. The government continues to debate what can be done to change the tide of this epidemic while simultaneously continuing to accept big Pharma political campaign contributions and diverting our attention to illegal drugs coming into the country and opposition to legalizing Marijuana. The real drug war is being fought in homes across America every day.
As citizens of the United States we can first and foremost regulate ourselves. Black women often refuse to get help or even acknowledge mental illness. There are many who suffer through clinical depression who with the right medical professional would find relief. Women who are suffering from emotional depression often seek out self medication as the cure instead of visiting a mental health professional. As black women we are likely to be prescribed statins as we suffer from heart disease the most. Studies have shown statins are worse for women. Further black women are already predisposed to developing type II diabetes, this can be accelerated through the use of statins.
We can also do research on drugs that are being prescribed to us. Know what the clinical evidence data says, the side effects and the efficacy of the drug. You don’t have to take it just because the doctor said so. Understand drug interactions as well. If you’re being treated for pain, research what the alternatives are and if they apply in your case.
This post is not about dismissing your physician, it is about being a good health care consumer. As a black woman the drug that is being prescribed to you may not have been adequately studied in other black women or may not be very effective in the general population. It is ultimately our responsibility to understand what is going in our bodies. If your doctor doesn’t want you as a partner in your care, find a new doctor who does. There are plenty of doctors who I have met and worked with that are anti-prescription and pro lifestyle changes. They are interested in treating the whole person. They exist, I promise you.
Lastly, keep all prescription medications safely locked away from minors in the home, especially painkillers. Do not offer “just one pill” to family members or friends. Besides being a federal offense, you don’t know their medical history, you could end up harming them or worse.
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