News Item: "On August 9, 2001, Bayer, the manufacturer of Baycol, voluntarily stopped the distribution of Baycol in all countries because of reports of deaths..."

For the past several years, we have been assailed by an avalanche of news concerning prescription and even non-prescription drugs: are they safe; are they useful; are they too expensive; should we buy them from Canada; the list goes on. In addition to the Baycol^® recall, noted above, we have seen the withdrawall of one of the more popular "arthritis drugs" VIOXX^® from the market as well as suspicion being cast on another COX-2 inhibitor, Celebrex^®.

Now we are told that Naproxen commonly sold under Aleve^® and several other names should be cause for alarm. This last item is especially troubling since this drug belongs in a group of medicines called NSAID's (non-steroidal-anti-inflammatory-drug) which although not harmless are considered less invasive. All these events have created a furore with many people pointing their finger at an apparently ineffective FDA (Food and Drug Administration) being overly cosy with what is perceived as a greedy unprincipled pharmaceutical industry.

I will leave it up to others to argue over the validity of these claims since I don't have the inside knowledge or expertise to judge. One person who does seem uniquely qualified is Dr. Marcia Angell whose recently published book The Truth About the Drug Companies - How they Deceive us and What to do About it has caused quite a stir. Dr. Angell is the former editor-in-chief of the prestigious New England Journal of Medicine. She is now a senior lecturer at Harvard Medical School.

With a calm but determined sense of mission Dr. Angell systematically refutes many of the assumptions fostered by the industry to justify the stratospheric prices being charged for some of the newer drugs. She covers everything from the perceived benefits of the many "me-too" drugs to all the money that's required for "research". In addition to reading her book, you can hear Dr. Angell being interviewed on National Public Radio here.

Aside from Dr. Angell, many others are weighing in on the issue. What started out as a low rumble of discontent has been growing of late into a mutinous roar. Whether it's the grandmother in Ohio going for an all-day bus excursion to Canada to take advantage of that country's (regulated) lower drug prices or a family doctor in Minnesota taking a good hard look at his prescribing practices, the issue is not going away.

Then there's a more fundamental question. How essential are these drugs? With the pharmaceutical industry constantly emphasizing the benefits of their products you have to wonder how valid are these claims. Is the industry simply a benign giant whose only aim is to improve our lives and heal our afflictions or are there more sinister motives. Not only does the drug industry constantly remind us of their need for ever more money to do the research that must be done, they are also engaged in a well orchestrated effort to talk us into consuming ever more of their products.

Physicians, especially overburdened and overworked family doctors, are being encouraged on a non-stop basis both directly and indirectly, to prescribe more and more of especially the newer more costly drugs. How beneficial is all this? Do we really need all these drugs? This is not an idle question. In addition to the life saving and life enhancing benefits of these products, there is also a darker side.

A recent article in a publication directed at seniors, The AARP Bulletin, deals with the work of a dedicated Georgia pharmacist, Armon Neel. Neel's work especially among seniors has convinced him that not only are many of the patients he sees prescribed the wrong drugs or the right drugs at the wrong dosage, most are taking way more drugs than is warranted.

Granny's on the Pill
In another study it was determined that "on average, individuals 65 to 69 years old take nearly 14 prescriptions [drugs] per year, and individuals aged 80 to 84 take an average of 18 prescriptions per year" (source). Aside from the disturbing trend to adverse drug reactions, there are reports of especially older patients being given an ever-increasing variety of powerful drugs that could in fact be making them more ill if not killing them outright.

Some of the evidence is anecdotal to be sure, but that doesn't make it any less worrisome. Perhaps it's time for all of us, health professionals yes, but especially the clients of the system, patients like you and me, to become a little more pro-active. Have we become so cowardly and so intimidated that we no longer have any control over our own health? That's pretty tragic

In speaking with friends, colleagues and in casual conversations with acquaintances a common theme emerges. People who should know better, people who are very aware in many other aspects of their lives, seem to have completely surrendered their very well-being to others. Doctors and nurses have become the arbitors of our health and of those who are near and dear to us.

The fact that health care in most Western countries has taken on such an enormous importance not too mention consuming inordinate amounts of money is testament to the fact that we as a society have been gripped by a collective paranoia. Very few people among us it seems, have the courage to take back the responsibility for our own health.

Let's talk prevention—and we're not talking about a regimen involving a whole range of prescription drugs. (Do we really need one or more statins to lower our cholesterol; beta blockers and calcium channel blockers to lower our blood pressure; COX-2 inhibitors to reduce our arthritis symptoms; stomach remedies like Nexium^® to control our "acid reflux disease"; to name but a few?)

Good health is all about feeling good, not constant medical intervention to cure real or imaginary ills. Before you decide to load up your bodies with all these potentially poisonous compounds consider loading up on good nutritious foods instead. When it comes to food, common sense goes a long way. Here's a simple rule: eat what makes you feel good and avoid that which makes you feel bad. Why is it we will gladly swallow a whole cocktail of expensive pills yet refuse to eat things like broccoli?

Also, we must remember that we evolved as omnivores. That means we should eat a wide variety of foods not just all protein or all vegetables or whatever fad anybody else might suggest. Finally we should eat modestly. It's perfectly alright to indulge from time-to-time but by-and-large we should eat no more than what our bodies require.

If we eat well we won't need anywhere near the amount of stomach remedies that are now being consumed in huge quantities. No healthy population should have to rely on that much antacid to live. I think you'll find that popular myths aside most stomach ailments if they're not indicative of a more serious condition, are the result of eating bad food.

I'm not talking all those delicious hot spicy foods that allegedly cause you pain (they rarely do), instead I'm talking food that is either nearly spoiled—happens a lot more than you think—or food that is just plain bad for your system. That can be anything from foods that contain too much sweetener or too much oil, to foods that your particular system simply doesn't tolerate well.

Forcing your body to adapt to these foods using any of the popular stomach remedies as a weapon is about as smart as a middle-aged man or woman "pushing through the pain" to "shape-up". How many of us have to die before our time, before we stop running our lives to conform to someone else's idea of a healthy lifestyle?

Better Health; Fewer Drugs
Many people are convinced that living a healthy life is far more complicated or unpleasant than it really is. That's because they listen to all the experts. You know the ones: nutritionists, coaches, the media, their mother, not to mention a well-meaning friend who read somewhere that... These people will take all the fun out of good living by making it sound like a chore.

There is also a growing body of evidence that much of the paranoia about certain foods may not be justified. Our bodies tend to enjoy a certain amount of sweet foods for example. Using synthetic products to satisfy this appetite may not be all that wise. Natural sweeteners—even sugar—used in moderation may not be all that harmful and in those special cases when it is, the synthetic substitute is probably also best avoided.

One of the more questionable synthetic food products to hit the market in recent years is so-called synthetic fat marketed under such brand-names as Olestra^® and Simplesse^®. This is a natural progression from one of the early "synthetic" fats, Oleo Margarine. Recent studies suggest that abandoning products like butter and cream—used in moderation, of course—in favor of these synthetics, may not be such a healthy choice after all. The same applies to consuming strictly egg-whites in place of whole eggs.

Speaking of which, there is that whole cholesterol thing. Aside from the fact that we are often confused about which is which—HDL, LDL and that other one you hear about, tri-glycerides¹—many folks are not aware that all these components are part of our normal body chemistry. In fact without them, we would die. That is the reason why our body works so hard to produce cholesterol in-house, regardless of what we eat.

In fact, very few of the foods we eat contain enough cholesterol to matter. It is true however that a diet high in fat especially animal fats, tends to increase cholesterol levels. This is partly because these foods increase the build-up of fatty deposits in our body in general. Studies have shown that certain diets (see details here) can influence cholesterol levels which may mean a reduced reliance on the "popular" statin drugs, which is where we began.

We should ask ourselves this simple question: if all these modern drug and "synthetic" food products are such a good idea, why has it become necessary for us to consume an ever-increasing variety and quantity of drugs? Could it be we're all being duped? If you believe the industry's mantra that because of their products, our collective life expectancy has steadily risen to where it is today, perhaps you should consider an alternative explanation.

Long life-expectancy numbers generally occur in countries where the overall standard of living has reached a certain plateau. Among the key factors that have proven helpful are: improved sanitation; a healthy environment; easy access to an adequate supply of nutritious foods and clean drinking water; a general reduction in bad working environments; and a reasonably disciplined population to name but a few.

This doesn't mean that health care has no place. Of course it does. Whether it deals with victims of accidents or violence or such things as heart attack and stroke, having access to good and efficient health care is of great importance. In fact, this scribe wouldn't be here today without it. The question is, how much of it do we need?

When visiting the emergency department of any hospital—not those scenes of pandemonium we see in T V shows—you may find that as much as half the cases don't need to be there. Common sense tells you if you've got the sniffles there is precious little an ER can do for you. "Rest in bed and get plenty of liquids" is still pretty good advice. A scrape or minor cut usually reponds well to decent quality first aid. Fevers of less than 101º F. are not usually a cause for alarm.

Don't Abandon The Ship
We have to remember above all, that good health is a normal state of affairs. Our bodies, given the chance, can deal with most minor medical emergencies just fine. Every blip doesn't require intervention. Eat good wholesome food most of the time, don't abuse your system too much, give it a break when it cries out for one, don't panic with every little glitch that appears.

As we age we may have to slow down a little and we may feel the odd ache here and there, so what. If your lifestyle doesn't agree with your body's wellbeing maybe you ought to change it. A well-known Groucho Marx routine went something like: "Does it hurt when you do that?", "Yes", "Then don't do that". Good advice!

The illicit drug market relies on a steady supply of "clients" to keep their nefarious enterprise going. What about "legal" drugs? Perhaps if we collectively reduced our dependence on prescription drugs we would send a clear message to that industry also that their behavior won't be encouraged. We won't be duped any longer. Perhaps we too can just say "no"!

• The news just doesn't seem to be getting any better, as shown in this Bloomberg.com article.



• A contrarian view about Cholesterol. Read it here.


• Another highly controversial topic, the use or abuse of Ritalin. Read this piece taken from the website drkoop.com. (Dr. Koop is a former U.S. Surgeon General.)

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