The pill pandemic
The sheer size of the global pharmaceutical industry is terrifying. The numbers are simply too big, and they are also rising too fast. A closer look at some figures that will help put things in perspective.
In 2014 global pharmaceutical sales crossed the $1 trillion mark for the first time. And by 2018 those figures are expected to rise to $1.3 trillion.That’s certainly big business, and great for those executives and investors. But a closer look shows that it is anything but great for the consumer.
Behind these huge numbers lies a truly alarming story concerning the amount of these drugs that are not only damaging to our health, but may also be completely unnecessary.
And while there are so many potential pharmaceuticals to single out, in this article I am going to focus on two categories that I – and many other physicians – feel very strongly about: painkillers and statins.
The painkiller addiction
No doubt the extent of the painkiller problem varies per country, but to get an idea of just how serious this issue can become it’s worth looking at the figures out of the United States. While there are so many mindboggling stats to present, we only need to look at a few to start to see the story come together.
Let’s begin with the sheer numbers of these things being prescribed: According to the US Centers for Disease Control and Prevention, in 2010 enough prescription painkillers were doled out to medicate every single American adult every four hours for a month.
We are of course here mainly talking about opioid-based painkillers – which are incredibly addictive and as such are abused in the United States and around the world to a frightening extent. Some of the more common names that many of you will have heard include the drugs Vicodin, OxyContin, Tylenol 3, Percocet, and tramadol.
Tramadol is worth a special mention in that it is very commonly abused in the UAE. So much so, in fact, that the Director of Public Health and Research at the National Rehabilitation Centre in Abu Dhabi reported that of the more than 400 patients who were registered at the facility in June of last year, well over half (240) were there due to tramadol abuse.
Why are opioids so powerful in this respect? It’s certainly not possible to explain in brief, and so for reasons of space I will keep it very high level and not go into the science of it all. In a nutshell, the process is a result of brain abnormalities that result from the chronic use of morphine-derived drugs. In many people dependence (which is that need to keep taking the drugs so as to avoid withdrawal) and addiction (the drug cravings that are a result of the intense feelings of pleasure that opioids are able to provide) can form very quickly.
Which is why roughly one in 20 people in the United States use prescription painkillers for non-medical reasons (that is, they use these drugs just for the “high”); hundreds of thousands of people visit US emergency rooms for complications due to non-medical use of opioids every year; and overdose rates from these painkillers have tripled in the past 20 years.
And whether due to recreational abuse of these drugs or a legitimate medical condition, the dangers of long-term use and abuse of opioids must be clearly understood. Let us examine a few.
For starters, because opioids slow down the breathing function, long-term use is linked to an increase in the risk of lung-related issues such as pneumonia.
Bowel function can also be slowed by regular use of opioids, leading to a number of potentially serious gastrointestinal conditions.
And of course because all drugs are broken down and processed by the liver, heavy long-term opioid use will cause a tremendous wear and tear on this vital organ. At the extreme end, liver failure can occur due to the high doses of acetaminophen that some of these medicines contain.
Now before moving on to those statins, let me drop in one last statistic: Today in the United States far more people die each year from prescription painkiller overdoses than they do from cocaine and heroine overdoses combined.
Those unnecessary statins
I’ll now turn to what is one of my biggest frustrations as a physician – the over-prescription of statins. To keep things simple we will stick to those numbers out of America, once again looking at figures provided by the US Centers for Disease Control and Prevention. What do they tell us? That just under 30% of Americans over 40 are taking statins.
Statin medications are indeed among the best-selling drugs in the world – a veritable goldmine for drug companies, bringing in billions of revenue every single year. And while that would all be well and good if they actually worked, the simple fact is this: statins do not work (what's more, they come with about 130 side effects).
But surely I must be mistaken that statins do not work, right? Not at all. Statins have been shown time and again to be largely ineffective, with studies repeatedly confirming this. And when I say ineffective, I mean it: Research by the Expert Review of Clinical Pharmacology clarifies that statin drugs benefit as little as 1% of the population in terms of ultimate risk. In other words, these drugs are all but useless, folks.
In her book, “The Truth About Statins: Risks and Alternatives to Cholesterol-Lowering Drugs”, Dr. Barbara H. Roberts highlights three major studies involving women who had not been diagnosed with heart disease but who were deemed to be at high risk. The studies, which looked at the effects of statins over placebos, found that in the statin group some 40 women out of 4,904 experienced a heart attack or cardiac death. In the placebo group the numbers were just four more, with 44 women out of 4,836 having experienced a heart attack or cardiac death. Again, virtually no statistical difference.
And there is of course a very logical reason we do not see a difference, and it is all tied to the reality that cholesterol is not the culprit here. Plaque that accumulates on the inner walls of your arteries is made from various substances that circulate in the blood, and cholesterol is one of those substances. The thing is, it is not the presence of cholesterol that is the problem, it is your lifestyle – particularly diet – which causes that cholesterol to become a problem.
When we eat those Western-diet foods heavy on the grains and sugars, our insulin levels rise. The insulin response then leads to the oxidization of LDL cholesterol (not actually a cholesterol but rather a low-density lipoprotein that contains cholesterol). And that is what we need to fear, because the process turns the very harmless LDL-C into the very dangerous LDL-P, which then goes to work on the arteries – resulting in that plaque buildup (I will add here that hydrogenated oils, when heated, are a significant contributor to the problem).
Cholesterol is nothing but the innocent bystander caught up at the crime scene. The insulin response caused by the food you eat is making you sick, which is why those cholesterol-reducing statin drugs have virtually no effect on the actual problem.
What’s the answer?
The painkiller and statin issues are just two among many that exist within the pharmaceutical market, but they illustrate perfectly just how rotten to the core many aspects of this industry have become. In fact, it’s fair to say that today’s pharmaceutical industry has completely lost its way. And that’s because it is now entirely profit driven.
Sure, there have been tremendous medicinal breakthroughs over the centuries, and these continue today and will continue into the future. From insulin to the smallpox vaccine to penicillin to cancer therapies to HIV therapies – I could go on and on and on. Such advances and discoveries have helped reduce suffering around the world while saving so many lives, and they are in and of themselves a wonderful testament to the incredible scientific brilliance that humans are capable of displaying.
But all of these achievements from the past and the present are being overshadowed by the ugly world of big business that is the modern day pharmaceutical industry. We can point fingers – and we do – but we also know that this is simply how human nature is. Where the end goal is money, there are far too many people willing to justify the means of getting there – however perverse and corrupt those means are. This is something that will never change. It cannot change. Again, it’s human nature.
On a final note, though, let's at least attempt to offer a solution to this all. While I do believe we are fighting a losing battle if our goal is to change the system, what I know is that you can at least take care of the one person that matters most – you. And the way you do this is to educate yourself, because awareness is critical for longevity and health.
But what about conflicting information? Yes, you will find it. And if you go to different doctors you will get different stories. But if you stick to your “health studies” you will over time start to see the truth from the lies. I promise you it will in most instances become clear.
Just be on guard, because that is what it has come to. Many doctors are profiting big time from keeping their patients on the statins and the painkillers – as well as the thousands of other potentially dangerous pharmaceuticals that cause more harm than good. And many more doctors are in fact simply misinformed themselves – unknowingly caught up in the lies and the corruption and system as much as their patients are.
The bottom line is that you should trust your doctor. You must. But within today’s healthcare system that’s a trust that has to be earned, and one that you must qualify yourself. Ensure you are properly informed through continuous self-education, and use the power of that knowledge to find physicians who know how to work within the system in a way that benefits you instead of big business.
The opinions in the column are by Dr Graham Simpson, the Chief Medical Officer and Founder of Intelligent Health, a preventive medical centre located in Jumeirah, Dubai, and are not necessarily those held by Esquire or Hearst International.