Tequila

February 26, 2011, 9:30 a.m.

Putting Side Effects in Context
(bought to you by FromDC2Iowa.blogspot.com*)
Have you ever listened carefully to the lists of side effects included in the drug commercials on TV?

The horrible possible consequences from the use of these products seem to go on forever. It makes you wonder why anyone watching the ad would ever follow the suggestion that they ask their doctor if the pharmaceutical is right for them.

Yet the ads must work, or presumably the drug companies wouldn't continue spending billions of dollars showing them to us. See, Julie M. Donohue, Marisa Cevasco, and Meredith B. Rosenthal, "A Decade of Direct-to-Consumer Advertising of Prescription Drugs," New England Journal of Medicine, 2007; 357:673-681, August 16, 2007.

I suspect the reason the ads work is that most of us are sufficiently distracted by the commercials' pretty pictures of happy people that we never really focus on the warnings.

If these side effects weren't so serious their itemization would be hilarious. But they are serious.

So to lighten our load a bit, I'm going to close out this blog entry with one set of warnings that is intended to be hilarious but is actually also quite serious.

But first, give these possible side effects for Pfizer's Chantix a slow and focused read:

CHANTIX is a prescription medicine to help adults 18 and over stop smoking. You may benefit from quit-smoking support programs and/or counseling during your quit attempt. It's possible that you might slip up and smoke while taking CHANTIX. If you do, you can stay on CHANTIX and keep trying to quit.

Important Safety Information

Some people have had changes in behavior, hostility, agitation, depressed mood, suicidal thoughts or actions while using CHANTIX to help them quit smoking. Some people had these symptoms when they began taking CHANTIX, and others developed them after several weeks of treatment or after stopping CHANTIX. If you, your family, or caregiver notice agitation, hostility, depression, or changes in behavior, thinking, or mood that are not typical for you, or you develop suicidal thoughts or actions, anxiety, panic, aggression, anger, mania, abnormal sensations, hallucinations, paranoia, or confusion, stop taking CHANTIX and call your doctor right away. Also tell your doctor about any history of depression or other mental health problems before taking CHANTIX, as these symptoms may worsen while taking CHANTIX.

Do not take CHANTIX if you have had a serious allergic or skin reaction to CHANTIX. Some people can have serious skin reactions while taking CHANTIX, some of which can become life-threatening. These can include rash, swelling, redness, and peeling of the skin. Some people can have allergic reactions to CHANTIX, some of which can be life-threatening and include: swelling of the face, mouth, and throat that can cause trouble breathing. If you have these symptoms or have a rash with peeling skin or blisters in your mouth, stop taking CHANTIX and get medical attention right away.

The most common side effects include nausea (30%), sleep problems, constipation, gas and/or vomiting. If you have side effects that bother you or don't go away, tell your doctor. You may have trouble sleeping, vivid, unusual or strange dreams while taking CHANTIX. Use caution driving or operating machinery until you know how CHANTIX may affect you.

CHANTIX should not be taken with other quit-smoking products. You may need a lower dose of CHANTIX if you have kidney problems or get dialysis.

Before starting CHANTIX, tell your doctor if you are pregnant, plan to become pregnant, or if you take insulin, asthma medicines, or blood thinners. Medicines like these may work differently when you quit smoking.

So now let me make sure I understand. If I buy and use this product in accordance with the manufacturer's and my doctor's directions, I may experience the symptoms of serious mental illness (paranoia or hallucinations), an inclination to commit suicide, outbursts of hostility and anger, panic attacks, and a life-threatening swelling of my throat that prevents breathing. My skin may start peeling off my body, while I'm suffering constipation, vomiting, and an inability to sleep (understandable given those other symptoms), plus a three-in-ten chance of serious nausea. I'm sure I missed some of the warnings, but that at least touches on the highlights, right?

Have you seen Norman Lear's 1971 film, Cold Turkey? Put it on your Netflix' list.

And then tell me, why is it the Chantix symptoms are an improvement over the crankiness that giving up smoking cold turkey seems to produce in some smokers?

(Cold turkey was my father's approach to kicking the habit. He just woke up one morning not wanting another cigarette -- and wasn't even cranky about it as I recall. Unfortunately, it was a decision made too late in what turned out to be a 59-year life. But the lesson was not lost on me. I have never smoked a single cigarette -- although years ago I had occasional, brief encounters with other forms of tobacco use.)

Tobacco contributes to the causes of death for some 400,000 Americans a year. Clearly it contains dangerous drugs. But is it really any more risky than using Chantix? Yes -- given the probable percentages of people using Chantix who suffer from one or more of those side effects -- there's little doubt that the odds of serious, ultimately fatal consequences of using tobacco are greater than the odds of serious consequences from Chantix.

So consider . . . "Tequila."



The fact is, like much humor, many of these enumerated tequila side effects hit very close to the truth. Over consumption of alcohol, what is sometimes called binge drinking (especially by teenagers and college students), is no more a laughing matter than the consequences of tobacco use.

With proper care -- diet, exercise, stress reduction, weight control -- our bodies can serve us well for many years. Avoiding things that impede normal functioning, such as tobacco and excessive alcohol (as well as highly advertised, often unnecessary, high-cost designer pharmaceuticals with serious side effects) can provide a big assist. If a little humor can help us see that, it can be a positive public health contribution.

[Notes: (1) Thanks to Sherman Johnson for bringing the tequila "commercial" to my attention. (2) Unfortunately (as he agrees), the video includes one use of an insensitive and politically incorrect reference to those persons professionals currently describe as people with "intellectual and developmental disabilities." See discussion in "Mental Retardation," wikipedia.org.]
_______________

* Why do I put this blog ID at the top of the entry, when you know full well what blog you're reading? Because there are a number of Internet sites that, for whatever reason, simply take the blog entries of others and reproduce them as their own without crediting the source. I don't mind the flattering attention, but would appreciate acknowledgment as the source -- even if I have to embed it myself.
-- Nicholas Johnson
# # #

Big Pharma Makes Me Sick

July 12, 2009, 8:30a.m.

Big Pharma is a Carcinogen
(brought to you by FromDC2Iowa.blogspot.com*)
The pharmaceutical industry is deliberately causing and spreading cancer -- and very successfully so.

It is the cancer of corruption spreading from our body politic throughout the major institutions of our medical profession, research, and regulation.

I'm indebted to Holly Mosher (a successful, self-described "independent filmmaker - producing and directing independent media with an eye towards positive change") for bringing the film "Money Talks: Profits Before Public Safety" to my attention -- and especially for making the entire film available for viewing, for free!

In this film those from inside pharma, academic medicine, medical research, and practicing physicians who are willing to talk, describe in horrifying detail in this film how the pharmaceutical industry's money and influence has infected institutions well beyond those with which we're familiar: the Congress (campaign contributions and the $1.3-million-a-day lobbying expenses we're now experiencing)and the White House (e.g., although not in the film, the recent revelations of the President's agreement to oppose a legislative provision permitting government to negotiate for lower drug prices -- as a result of s secret, closed door meeting with pharma's top lobbyist).

According to those in the film, pharma's carcinogenic infestation of American institutions now includes relationships, financial and otherwise, with practicing physicians, medical schools, research institutions, government regulators, mass media and the academic journals. Pharma is designing, paying for, controlling, manipulating and withholding the data from clinical trials.

It is a credit to the participants in this film, and the producer, that the film is not a reenactment of the shouting matches on cable television; those interviewed are relatively calm and more straightforward in providing mere description rather than judgmental conclusions.

But with the facts they reveal there's no need to shout. The facts shout for them.

There's not room in a single blog entry to provide you a transcript of the additional litany of shocking practices -- and their consequences, up to and including unnecessary deaths (and obviously wildly overinflated prices for drugs that are sometimes less effective than the cheaper generics).

According to the Web page, the American Library Association has called "Money Talks" one of the most important films of 2008. I agree.

As the bumper sticker has it, "If you're not outraged you haven't been paying attention." In either case you need to watch this film. If you're already outraged you'll be much better informed as to why. If you're not yet outraged you will be after you've watched it.

Obviously, it couldn't be more timely than now, while our nation confronts its last best hope for meaningful health care reform.

But for public policy wonks, social studies teachers, and others interested in politics and our legal system, it contains more general lessons as well. They will, sadly, undoubtedly be as usefully insightful ten years from now in other contexts as they are today for health care.

This film portrays a classic case study of how we get ourselves in the fix we're so often in when obviously necessary reforms seem beyond our legislative grasp. How do industries, sometimes individual companies, spread their influence throughout not just our political institutions, but many to all of the powerful institutions in our society -- universities, organized religion, labor unions, the mass media? There is far more involved in this process than spreading around a few hundred million dollars on elected officials and mass media advertising.

So when you watch this film don't just learn how and why the drug industry makes us sick, as important and timely as that is. Think about the analogies: the power that AT&T once had over America (before its breakup), how Wall Street was able to get trillions of taxpayer dollars, why the auto industry was able to be the favored recipient of government largess when dollars elsewhere might have produced more and faster meaningful recovery -- and the examples of other companies and industries that seem to have what would otherwise be inexplicable power.

This film explains how they do it.
____________

* Why do I put this blog ID at the top of the entry, when you know full well what blog you're reading? Because there are a number of Internet sites that, for whatever reason, simply take the blog entries of others and reproduce them as their own without crediting the source. I don't mind the flattering attention, but would appreciate acknowledgment as the source, even if I have to embed it myself. -- Nicholas Johnson

# # #