What do you take for a headache? What is your favorite medication to help with a cold? How about a fever – what works best for that? Upset stomach? Insomnia? Allergies? When you go to the doctor, do you expect to leave with a prescription? One last question: Have you ever used heroin for a cough?
This last question may seem outrageous, but if you look back at the histories of aspirin and heroin, you’ll find that they were created within one month of each other by the same researchers. Are you ready for the name of that research company? Bayer Corporation. Surprising? Wait, there is more. Hindsight being what it is, many people say that the use and abuse of heroin would have been avoided had the Bayer company not released the drug as a cure for the common cough and a booster to lung function in the year 1898. Within 10 years, Bayer retracted their statements about heroin’s benefits to lung function, but by then the drug had taken on a life of it’s own.
O.K. That is somewhat shocking. And weird. And scary. But that was a long time ago. Drug companies did not know the fire they were playing with and the great potential for abuse and/or addiction to certain substances. Keep in mind that cocaine was first discovered in 1855 and marketed for such ailments as nasal congestion, postnatal depression, and fatigue. In fact, it was the main ingredient “and namesake” for the Coca Cola company until 1904, when Coca Cola was pressured to replace cocaine with caffeine. But this was all in the past – our society has learned so much since then , and today these drugs are much more regulated – right?
Well, yes. And no. In 2007 the pharmaceutical company Perdue Pharma was fined an estimated $900 million after they were charged with giving false information about their new “wonder drug” OxyContin. These charges were filed after it was reported that representatives for Perdu Pharma were marketing OxyContin as a less dangerous type of opiate with a lower abuse/addiction potential. These representatives were making the rounds to doctor’s offices, hospitals, and other health care facilities with wonderful facts, supported by charts, and powerpoints, and pastries, and gifts “pens, notepads, tote bags,” etc… all to convince those with the power to prescribe OxyContin that they should do so – and do so often. The trouble began when it became undeniably true that the drug was, in fact every bit as dangerous as other opiates and that people being prescribed the drug were quickly developing dependence to it. This phenomena seemed to effect poorer parts of our country the most, and the media coined the phrase “Hillbilly Heroin” to describe the drug. The news was bursting with stories of pharmacies and hospitals in depressed areas that were being robbed exclusively for Oxycontin. The point to all this is that yes, we know more about the addictive potential of prescription drugs, but no, that information is not always transferred directly by those with the power to distribute and prescribe it.
Back to the “history blackboard” for a moment. The Food and Drug Administration was established in America in 1906. This was in response to the public’s concern and insistence that more be done to control the use of certain drugs. The F.D.A. insisted that certain chemicals “i.e. opiates, cannabis, and cocaine, along with many others” needed to have labels identifying their presence and relative percentage within the product sold. In 1914, a key piece of legislation was passed in our country that created the term “controlled substance” and required certain drugs to be acquired only with a doctor’s prescription. It was shortly after this that doctor’s began receiving pastries, lunches, free golf invitations and a variety of “chatchkas” with various names of prescription drugs on them. In truth, this last part is not historically accurate, but anyone who has worked in or around the medical field knows the power of the “schmooze” when marketing medications. The name of this legislation was the “Harrison Act,” and it hoped to decrease access to addictive medications while continuing to use them for pain management and other medical purposes.
And that part was a good idea. In fact, in my humble opinion, it is still a good idea today. If I have surgery, or if someone in my family is suffering physically in some way, I want them to receive medicine that will help with the pain. Anyone who has gone through childbirth will attest to the benefits of pain medication. Personally I have not had a child, but I will always remember my pregnant wife and I, naïve and doe-eyed, walking into the maternity ward with our packets of herbs, and peaceful music CD’s, and lavender scented pillows with every intention of having the perfect “natural childbirth experience” – completely drug free. 25 hours later I was ready to administer an epidural into my bride’s spinal column myself, or to pay any price to have someone else do it. She was in pain – real pain – the kind of pain I cannot begin to comprehend, and I took great pleasure in throwing our herbs and c.d.’s and lavender pillows out the maternity ward window in exchange for drugs that worked. Desperation does that.
The point is that most drugs have a purpose, and a use, and when you look at their creation, it was usually an attempt to help people in some way. I am the last one to say that decreasing production or making stricter laws around prescription drugs “or over the counter medications,” is the best answer to stopping the abuses, addictions, and harm caused by these substances. If nothing else, the prohibition of alcohol in our country gave a wonderful example of how making substances illegal does not solve everything, and it can in fact create new problems.
My question for you is this: what examples are you setting when it comes to using medications? Do you take them as prescribed? Do you take them only when needed? Have you ever given a medication that was prescribed to you by a doctor to a friend or family member? To a child? Would it shock you to know that the greatest number of abuses to prescription medications happen in just that way, by a friend or family member “sharing” a drug that was not intended for the recipient? Would you also be surprised to find out that about 70% of Americans go to the doctor’s office with the expectation of leaving with a prescription for a medication? Fortunately for them, most doctors do not disappoint. This means that 7 out of 10 people who visit the doctor are given a prescription for a drug. That is a lot of medication circulating around our bathroom cabinets, next to our bed stands, and hovering around our kitchen sinks. Look around your house – how many prescriptions, new or old, do you have in the house? Remember that young people will begin using and abusing substances that they have access to. Is there availability and access in your house?
Now think about your use of over the counter or “store bought” medications. What remedies do you have around the house for the common cold, or aches and pains, or troubling allergies? Have you read the warning labels on those items? Have you gone on your computer and looked up the possible side effects? Would it surprise you to know that many teenagers have? One in five teenagers reports taking a medication that they did not need. Experimenting with its effects. It is no coincidence that many cough and cold medicines that used to be on the shelves at stores are now locked up and require proper identification to buy. They were being abused, and some were being mixed with illegal drugs so that street dealers could sell an illegal drug that was less “pure,” made the user feel “high,” and created more profits. So tougher laws were made. Did you know any of this? Does it make you nervous? Good. When asked “What age did you first try drugs?” I hear many patients that I work with respond with answers that include an over the counter medication that was administered incorrectly “because it helped him/her sleep” by an adult or taken from the family medicine cabinet by the patient at alarmingly young ages. Is this much different from the practice of rubbing some type of alcohol on a young child’s teeth & gums to alleviate teething pain or as a sleeping agent?
This week I am asking you to take two inventories. I also have an invitation for you. The first inventory involves looking around your house and disposing of all the medications that are expired and/or that you no longer need. The second inventory involves exploring your own thoughts and opinions on this issue. What are your feelings about when a medication should be taken? What alternatives to chemicals will you consider the next time you start to cough, or sniffle, or your head starts to ache? Have you taken medications to lose weight? Or gain weight? Or to stay the same weight? How much do you know about the substances that you are taking, and that you are giving to other members of your family? Have you read the box? Have you researched online? If you haven’t, do.
Now for the invitation. For those of you in and around Saratoga, the Parent University is putting on a free dinner and panel discussion about these issues this Thursday, March 10 at the West Side Community Center. I have included the announcement as an attachment and I hope to see some “or all” of you there. If you are not able to attend, I invite you to leave any comments and/or experiences with these issues – I would love to hear them!
Good column, but on the topic of medication disposal I would add that I attended an entire seminar sponsored by the New York State Dept. of Environmental Protection. To save you several hours sitting in a lecture hall- do not flush them or put anything down a drain (according to ENCON). They get into the water supply and cause major problems. The Dept. of Encon Con. advises dropping off expired or unwanted medications of all types at readily available collection points in your community (drug stores, hospitals, etc).
more info:
http://www.dec.ny.gov/chemical/45083.html