Experts warn on health, wealth expense of U.S. drugs

Vance

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PLYMOUTH, Mass. (AP) — About 130 million Americans swallow, inject, inhale, infuse, spray, and pat on prescribed medication every month, the U.S. Centers for Disease Control and Prevention indicates. Americans buy much more medicine per person than any other country.

Over 125,000 Americans die from drug reactions and mistakes each year, making pharmaceuticals the fourth-leading national cause of death.​
The number of prescriptions has swelled by two-thirds over the past decade to 3.5 billion yearly, according to IMS Health, a pharmaceutical consulting company. Americans devour even more nonprescription drugs, polling suggests.

Recently, safety questions have beset some depression and anti-inflammatory drugs, pushing pain relievers Vioxx and — most recently — Bextra from the market. Rising ranks of doctors, researchers and public health experts are saying that America is overmedicating itself. It is buying and taking far too much medicine, too readily and carelessly, for its own health and wealth, they say.

Well over 125,000 Americans die from drug reactions and mistakes each year, according to Associated Press projections from landmark medical studies of the 1990s. That could make pharmaceuticals the fourth-leading national cause of death after heart disease, cancer and stroke.

The pharmaceutical industry served up more than $250 billion worth of sales last year, the vast majority in prescriptions, according to industry consultants. That roughly equaled sales at all the country's gasoline stations put together, or an $850 pharmaceutical fill-up for every American.

Alice and Ken Heckman each begin their morning by cracking open a rattling plastic tray carting scores of pills in a rainbow of pastel colors.

Between the two of them, they gulp 29 pills every day: a regimen of 14 drugs, with a chaser of dietary supplements.

Here's the curious part: They feel pretty hale for people in their early 70s, working around the house and volunteering with several community groups. They each had heart fixes years ago — him a bypass and her a vessel-clearing stent — but fully recovered. She has well-controlled diabetes. He has worked his way through heartburn, arthritis, an enlarged prostate and occasional mild depression.

Do we need all these drugs? A relative handful yank many people away from almost certain death, like some antibiotics and AIDS medicines. Though carrying some risk, other drugs — such as cholesterol-cutting statins — help a considerable minority dodge potential calamities like heart attack or stroke.

The right balance of risk and benefit is still harder to strike for a raft of heavily promoted drugs that treat common, persistent, daily life conditions: like anti-inflammatories, antacids, and pills for allergy, depression, shyness, premenstrual crankiness, waning sexual powers, impulsiveness in children — you name it.

"We are taking way too many drugs for dubious or exaggerated ailments," says Dr. Marcia Angell, former editor of the New England Journal of Medicine and author of "The Truth About the Drug Companies."

"What the drug companies are doing now is promoting drugs for long-term use to essentially healthy people. Why? Because it's the biggest market."

In fact, relatively few pharmaceutical newcomers greatly improve the health of patients over older drugs or advance the march of medicine. Last year, the U.S. Food and Drug Administration classified about three-quarters of newly approved drugs as similar to existing ones.

Confronted with mounting costs, drug makers churn out and promote uninspired sequels like Hollywood: drugs with the same ingredients in a different form for a different disease.

Of course, many pharmaceuticals improve American health. "We now have more medicines and better medicines for more diseases," says Jeff Trewhitt, a spokesman for the Pharmaceutical Research and Manufacturers of America.

However, the nation also overindulges far too often, the critics say, and violates the classic proscription of the ancient Greek physician Hippocrates: "First, do no harm."

Drug safety researcher Dr. James Kaye, of Boston University, remembers a medical school teacher telling the class: "All drugs are poisonous!"

The Heckmans found out on their own. Heckman lost his alertness for several months to a depression medication. His wife has come down with a rash from one heart medicine and muscle aches from a statin. But each time they switched medicines and escaped any lingering harm.

Hospital patients suffer seven hard-to-foresee adverse drug reactions and another three outright drug mistakes for every 100 admissions, estimates Dr. David Bates, a researcher at Boston's Brigham and Women's Hospital. That translates into 3.6 million drug misadventures a year.

The dangers potentially escalate when doctors prescribe drugs, as they often do, for uses not formally approved by the FDA. In a recent report, the Centers for Disease Control voiced concern about huge off-label growth of antidepressants. They have expanded to treat often loosely defined syndromes of compulsion, panic or anxiety and PMS.

Drug makers, doctors and patients have all been quick to medicate some conditions once accepted simply as part of the human condition.

Many Americans also assume, often with a nod from sellers or doctors, that new drugs inevitably work better than old ones. "Newer isn't always better, and more isn't always better," warns Dr. Donald Berwick, an adviser to the U.S. Agency for Healthcare Research and Quality.

The Heckmans buy both new and old — nearly $9,000 worth of prescriptions a year, plus hundreds of dollars in cheaper over-the-counter medicines. Even with supplemental insurance, their monthly out-of-pocket share of prescriptions alone roughly equals their food bills.

Around the country, prescription drug sales have pushed relentlessly upward by an annual average of 11% over the past five years.

The aging population is partly at fault, with its attendant ailments like cancer, heart attacks, stroke and Alzheimer's disease. Other conditions have mysteriously proliferated, including asthma, diabetes and obesity.

Exercise and better diet ward off heart disease and diabetes just as effectively as drugs do, studies show. However, says Fred Eckel, who teaches pharmacy practice at the University of North Carolina, "There tends to be a reliance on drugs as the first option."

Drug advertising to consumers has also boomed since the late 1990s, thanks largely to relaxed government restrictions on television spots.

For its part, the FDA generally demands only that new drugs work — not that they work better than existing ones. Dr. Janet Woodcock, an FDA deputy commissioner, says off-label prescribing and allowing similar drugs for the same condition present more options — and "choice is important."

Many safety experts say more new drugs should be tested against marketed ones, with more safety data required and stronger control of consumer ads and off-label promotion.

For now, though, most Americans seem to feel like Heckman: "grateful that there's a pill to take for something."

Source: http://www.usatoday.com/news/health/2005-04-17-medication_x.htm


I met few ultra-cool french people in Japan on 4/19 and we had this fascinating discussion about Americans and French people. I started to like non-Anglo-Axis people bit more after that long discussions. Anyway, two of them asked me two good question with pure curiosity: "Why does Americans depends on drugs so much, double - quadruple more than any foreign countries does? Are Americans really sick or weak or what?" It hit me hard. I realized that is indeed true. I mean, most Americans depends on drugs for virtually everything... My uncle once told my mother to take some Antidepression drugs when my mother found out that her old boyfriend broke up with her. My mother was shocked... Use the drugs to resolve the sorrow, 'hurt' feelings, etc is entirely insane. I would think that we need to learn to control our emotions whether it is high or low to tap the natural 'ability' to control our environment as much as we can. Do you agree with me on that one? or? Anyway, in the end, my mother hammered my uncle down for that stupid statement. I also corrected French people's guess about Americans (not all of us depends on drugs, I haven't take any prescription/non-prescripition drugs for long time... not even for headache either).

However, Frenchies and I & Nas compared the notes after that statement. Maybe it is Anglo-Axis culture to take a quick path to solve their dilemma or conditions instead of take a relatively long path to solve their dilemma or conditions which will ensures/guarantee their relatively long-time healthy mind and body? I have been reading few French books concerning about healths, mother-daughter relationship, etc... it was very fascinating about how they resolve their problems. Simple and workable (so far).

I have many things to say about this issue/subject but I have to stop myself from rambling on. Comments of mine may or may not offend some people, well, I am sorry about it but I want to explore in this subject bit more so therefore I 'shutdown' my feelings and think rationally as much as I can. Again I am not intending to offend anyone.
 
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I am not one of them. I take it WHEN neccessary. I don't take it on daily basis because I don't have any sickness or mental illness or anything like that.
 
Reba said:
Who or what is "Anglo-Axis"?
I believe, Anglo-Axis is the United States, the UK (United Kingdom) and Scandanavian nations. France is not Anglo-Axis country. That's why their culture is different from our 'common' (Anglo-Axis) cultures.

Edit: I am going to google to find more defintion about 'Anglo-Axis', I realized that my definition is lame at best. Addition: I may be wrong about that. It has been while... I learned about that in my history class few years ago.
 
I never heard that term before. I know that "Anglo" refers to English-speaking people, and that the "Axis" during WWII included Germany, Japan, and Italy. I know President Bush refers to "the Axis of evil" as terrorist countries. But I never heard of Anglo and Axis together. I guess I should look it up.
 
Reba said:
I never heard that term before. I know that "Anglo" refers to English-speaking people, and that the "Axis" during WWII included Germany, Japan, and Italy. I know President Bush refers to "the Axis of evil" as terrorist countries. But I never heard of Anglo and Axis together. I guess I should look it up.
Yeah, that's why I refer "Anglo-Axis" to UK, USA and Scandanavian nations because they are able to speak the English while most of the French people aren't and their culture is different from France's either.

Actually, I learned that from my history teacher and I seem unable to find it through the google... I guess I got the wrong term? If it is indeed wrong, I will ask mods to correct my topic. Sorry about confusion.
 
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I just looked it up on the web. It seems to be a phrase used by left-wing writers to describe the anti-terrorism coalition countries. All the references I found were anti-American, anti-British, anti-war editorials. The writers prefer to use the word "axis" rather than "coalition", in order to make a statement of sorts. Kind of like the good old '60's when anti-war activists would refer to "Amerika", to make the name seem more facist.
 
Well, I can argue about that 'fascist' term but that will be totally off topic so let's not.

Reba, it appears that my terms have offended you? (both topics, here and Seven Sins). If I did, just say so and I will ask the mods to alter to your likings. I couldn't care any less.
 
Magatsu said:
Well, I can argue about that 'fascist' term but that will be totally off topic so let's not.

Reba, it appears that my terms have offended you? (both topics, here and Seven Sins). If I did, just say so and I will ask the mods to alter to your likings. I couldn't care any less.
I didn't say they offended me. I just found them confusing. I truly never heard of that phrase "Anglo-Axis" before. So I looked it up. It seems to be a term created to show disdain for the anti-terrorism coalition. Those who use the term in the links that I found were all anti-American, anti-British. That is just what I found.
 
I know you didn't say that these terms offended you, I just ask you if it does or not. As you said, they haven't offended you. However if you prefer me to use the different terms, just say it so :)
 
Magatsu said:
I know you didn't say that these terms offended you, I just ask you if it does or not. As you said, they haven't offended you. However if you prefer me to use the different terms, just say it so :)
Good grief, if I worried about everything that you posted that offended me, I would never get any sleep. Let's just move on and get back on topic. ;)
 
I think Americans are too dependent on medications. I hate to see so many school children on Ritalin and other mood altering drugs. I don't think it is good for patients to request a pill as first solution to a medical problem rather than making life changes, such as in diet and exercise.

Medications can do much good but they are not the solution to every problem.

I think each generation is getting weaker, not stronger (in general; I know there are always exceptions).
 
Reba said:
I think Americans are too dependent on medications. I hate to see so many school children on Ritalin and other mood altering drugs. I don't think it is good for patients to request a pill as first solution to a medical problem rather than making life changes, such as in diet and exercise.

Medications can do much good but they are not the solution to every problem.

I think each generation is getting weaker, not stronger (in general; I know there are always exceptions).

I know what you mean, people does depend on medications far too much. I don't depend on them at all, I've only taken a few headache pills in my entire life along with some prescribed cough syrup when I was a kid. I also was prescribed to take antibiotics at least twice in my life. I just don't believe in medicines as a solution to every problem.
 
Reba said:
I think Americans are too dependent on medications. I hate to see so many school children on Ritalin and other mood altering drugs. I don't think it is good for patients to request a pill as first solution to a medical problem rather than making life changes, such as in diet and exercise.

Medications can do much good but they are not the solution to every problem.

I think each generation is getting weaker, not stronger (in general; I know there are always exceptions).
This is another miracle minute that I agree with you on these points ;)

I would think that you will like this conservative book: Home-Alone America: The Hidden Toll of Day Care, Behavioral Drugs, and Other Parent Substitutes by Mary Eberstadt, a conservative mother. I agree with her at some points about not giving the kids the prescription drugs to solve the behaviour or social problems and other things but I do not agree with her twisted logics about certain things... Like mothering issues. Just pick it up and read if you are interesting to know about these. I get the feeling that you will like this book. It also contains anti-Leftist comments that I think you will find this book appealling ;P
 
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