Monday, September 17, 2007

Overmedicated America And The Grim Reaper

In August I posted a piece about how the U.S. is slipping in life expectancy compared with many other countries. I included comments and data on deaths from adverse reactions to pharmaceutical drugs. There are enough of them that this should be a scandal in the medical community, and for the Food and Drug Administration as well.

There are new data available on this, from last week's issue of Archives of Internal Medicine, as reported by The Associated Press. AP, citing the article, reported:

Reports of dangerous side effects and deaths from widely used medicines almost tripled between 1998 and 2005, an analysis of U.S. drug data found.

The number of deaths and serious injuries from prescription and over-the-counter drugs climbed from 34,966 to 89,842 during the study of reports to the Food and Drug Administration.

Potent narcotic painkillers including Oxycontin, sold generically as oxycodone, were among 15 drugs most often linked with deaths in the study. Drugs frequently linked with serious nonfatal complications included insulin, the arthritis drugs Vioxx and Remicade, and the antidepressant Paxil.

The report adds to recent criticism of FDA oversight on drug safety, including its handling of serious problems connected with Vioxx, which was removed from the market in 2004.

The authors, Thomas Moore and Michael Cohen of the Institute for Safe Medication Practices, and Dr. Curt Furberg of Wake Forest University School of Medicine, urged sweeping legislative and policy reforms.

They reported that the number of deaths from medications nearly tripled in seven years, from 5,519 in 1998 to 15,107 in 2005. The total number of serious complications between January 1998 and December 2005: 467,809.

Not that those statistics are so shocking. A lot more people die in traffic accidents. But when the deaths nearly triple in seven years, this seems a clear indication that there's something awry in the existing system.

And there's an untold part of this story. Within the past three years, I've been hospitalized twice with symptoms that were, in hindsight, clearly medication-induced.

A doctor might accuse me of trying to practice medicine without a license. Well, I certainly want the licensed docs to keep practicing. Maybe someday they'll get it right.

One doesn't have to be very knowledgeable about medicine to see a connection. Both times I was hospitalized, I suspected meds. And lo and behold, when I discontinued the suspected drugs, the symptoms quickly went away! I was exercising regularly and normally again two weeks after each discharge. A connection, ya think?

But in both instances, the only lasting injuries were to my bank balance. In neither case did any doctor so much as acknowledge the relationship of my symptoms to meds, nor did they even try to explore the possibility.

This tells me that data the authors got from the FDA were only the obvious cases of injury and death. There are likely many more cases that go unattributed to drugs, and unreported; and still many more like mine in which the patient, through luck or common sense, escaped permanent harm.

Anyway, the FDA issued the bureaucrat's classic vague response, saying that neither they nor anybody else really knows what is causing the spike in adverse reactions. But if you've been in a doctor's office sometime in the past decade, you've probably been offered a free sample of something. Some are giving them out like Halloween candy. They get these from pharmaceutical salesmen -- who are pushing meds that, because of inadequate FDA scrutiny, have on occasion turned out to be killers.

Fortunately, there's concern about this even on the Republican side of the aisle. The AP report concluded:

Sen. Charles Grassley, an Iowa Republican and frequent FDA critic, said the report is another indication that the FDA's review of drugs already on the market "must be rigorous and timely."

A postscript, somewhat off-subject:
The number of deaths in 2005 attributed to legal medications: 15,107.
The number of deaths in 2005 attributed to illegal use of marijuana: 0

Crossposted at Manifesto Joe.