Death by Medicine

From the Introduction

Something is wrong when regulatory agencies pretend that vitamins and nutritional supplements are dangerous. They are not, but some may become so if taken in renegade doses (too high or too low), or if they are contraindicated for your condition, or when taken with certain pharmaceuticals. So always ask your holistic doctor before taking vitamins, minerals, herbs, or other supplements, particularly if you are taking medications. Many in the media, without scientific basis, denigrate the use of supplements, yet these “vitamin critics” ignore published statistics showing that the real hazard is government-sanctioned medicine.

In many respects, however, these regulatory agencies act as their own critics. The government is not blind to its own deficiencies in healthcare delivery. The Institute of Medicine, a part of the United States National Academy of Sciences, states:

Healthcare in the United States is not as safe as it should be. . . . Among the problems that commonly occur during the course of providing healthcare are adverse drug events and improper transfusions, surgical injuries and wrong-site surgery, suicides, restraint-related injuries or death, falls, burns, pressure ulcers, and mistaken patient identities [all of which exact] their cost in human lives.

The Institute of Medicine even refers to “the nation’s epidemic of medical errors,” many of which involve adverse drug reactions (ADRs). The US Food and Drug Administration (FDA) says that “ADRs are one of the leading causes of morbidity and mortality in healthcare.” . . .

The irony is that safer (and less expensive) preventive alternatives are often attacked or strategically ridiculed by regulatory powers, even—or perhaps especially—when proven effective. This condescending stance toward alternatives may be fueled by their relative lack of side effects in a competitive marketplace.

From Chapter 2: Medically Induced Death

As little as 5% and no more than 20% of iatrogenic events [doctor-induced illnesses or complications] are ever reported. This implies that if medical errors were completely and accurately reported, we would have an annual iatrogenic death toll much higher than 794,936. [This] figure is equivalent to six jumbo jets falling out of the sky each day.

What we must deduce from this report is that medicine is in need of complete and total reform—from the curriculum in medical schools to protecting patients from excessive medical intervention. It is obvious that we cannot change anything if we are not honest about what needs to be changed. This report simply shows the degree to which change is required.

We are fully aware of what stands in the way of change: powerful pharmaceutical and medical technology companies, along with other powerful groups with enormous vested interests in the business of medicine. They fund medical research, support medical schools and hospitals, and advertise in medical journals. With deep pockets, they entice scientists and academics to support their efforts. Such funding can sway the balance of opinion from professional caution to uncritical acceptance of new therapies and drugs. You have only to look at the people who make up the hospital, medical, and government health advisory boards to see conflicts of interest. . . .

To reach the widest audience possible, drug companies no longer simply target medical doctors with their marketing of antidepressants. By 1995, drug companies had tripled the amount of money allotted to direct advertising of prescription drugs to consumers. The majority of this money is spent on seductive television ads. From 1996 to 2000, spending rose from $791 million to nearly $2.5 billion. This $2.5 billion represents only 15% of the total pharmaceutical advertising budget.

While the drug companies maintain that direct-to-consumer advertising is educational, Dr. Sidney M. Wolfe of the Public Citizen Health Research Group in Washington, DC, argues that the public often is misinformed about these ads.179 People want what they see on television and are told to go to their doctors for a prescription. Doctors in private practice either acquiesce to their patients’ demands for these drugs or spend valuable time trying to talk patients out of unnecessary drugs. . . .

Dr. David Graham of the FDA’s Center for Drug Evaluation and Research warns:

Direct-to-consumer advertising in general is a great disservice to the American people. We see wonderful ads of people demonstrating their health, whether they’re skating across the ice or doing their Tai Chi. Madison Avenue knows that a picture is worth a thousand words, so they convey an image, a message, and it makes an impression on patients and on physicians. It creates needs or desires where there really isn’t a need or a desire.

There was a recent study in the Journal of The American Medical Association that showed that if patients mentioned a drug that they’ve seen on television to their physician they were much more likely to be prescribed that drug by the doctor. Drug companies know this. That’s why they do it. . . . Clearly, direct-to-consumer advertising does not serve the American people well.

From Chapter 7: Poor Care of the Elderly

Dr. Robert Epstein, chief medical officer of Medco Health Solutions Inc. (a unit of Merck & Co.), conducted a study in 2003 of drug trends among the elderly. He found that seniors are going to multiple physicians, getting multiple prescriptions, and using multiple pharmacies. Medco oversees drug-benefit plans for more than 60 million Americans, including 6.3 million seniors who received more than 160 million prescriptions.

According to the study, the average senior receives 25 prescriptions each year. Among those 6.3 million seniors, a total of 7.9 million medication alerts were triggered: less than half that number, 3.4 million, were detected in 1999. About 2.2 million of those alerts indicated excessive dosages unsuitable for seniors, and about 2.4 million alerts indicated clinically inappropriate drugs for the elderly.

Reuters interviewed Kasey Thompson, director of the Center on Patient Safety at the American Society of Health System Pharmacists, who noted: “There are serious and systemic problems with poor continuity of care in the United States.” He says this study represents “the tip of the iceberg” of a national problem.

According to Drug Benefit Trends, the average number of prescriptions dispensed per non-Medicare HMO member per year rose 5.6% from 1999 to 2000, from 7.1 to 7.5 prescriptions. The average number dispensed for Medicare members increased 5.5%, from 18.1 to 19.1 prescriptions. The total number of prescriptions written in the US in 2000 was 2.98 billion, or 10.4 prescriptions for every man, woman, and child.

In a study of 818 residents of residential care facilities for the elderly, 94% were receiving at least one medication at the time of the interview. The average intake of medications was five per resident; the authors noted that many of these drugs were given without a documented diagnosis justifying their use.

Seniors and groups like the American Association of Retired Persons (AARP) have accepted allopathic medicine’s overriding assumption that aging and dying in America must be accompanied by drugs in nursing homes and eventual hospitalization. Seniors are given the choice of either high-cost patented drugs or low-cost generic drugs. Drug companies attempt to keep the most expensive drugs on the shelves and suppress access to generic drugs, despite facing stiff fines of hundreds of millions of dollars levied by the federal government. In 2001, some of the world’s largest drug companies were fined a record $871 million for conspiring to increase the price of vitamins.

What if some of these chronic diseases are really lifestyle diseases caused by deficiency of essential nutrients, lack of care, inappropriate medication, overmedication, and isolation? This question is extremely important to consider, yet current AARP recommendations for diet and nutrition assume that seniors are getting all the nutrition they need in an average diet. At most, AARP suggests adding extra calcium and a multivitamin and mineral supplement. We would urge AARP to become more involved in prevention of disease, and not to rely so heavily on drugs. We would like to send the same message to the Hemlock Society, which offers euthanasia options to chronically ill people, especially those in severe pain, who may have become depressed. We must look to healing, lifting pain, releasing depression, instead of cashing in granny’s chips. Let’s also look at the irony of underuse of proper pain medication for patients who really need it.

Ironically, studies do indicate underuse of appropriate pain medication for patients who need it. One study evaluated pain management in a group of 13,625 cancer patients, aged 65 and over, living in nursing homes. While almost 30% of the patients reported pain, more than 25% received no pain-relief medication, 16% received a mild analgesic drug, 32% received a moderate analgesic drug, and 26% received adequate pain-relieving morphine. The authors concluded that older patients and minority patients were more likely to have their pain untreated.

The time has come to set a standard for caring for the vulnerable among us—a standard that goes beyond making sure they are housed and fed, and not openly abused. We must stop looking the other way and we, as a society, must take responsibility for the way in which we deal with those who are unable to care for themselves.