A number of months ago we reported that some 45% of Chicago internists (among those who responded to a survey) said they offered placebos to their patients from time to time. The report got people around the country talking – and maybe even wondering about their own prescription history.
Clearly, physicians recognize the impact of placebos, and research has time and again shown their efficacy. So, how does it really work? And who seems to benefit the most from the placebo effect? Is there anyone who can’t be “taken in”? In light of this recent NY Times article about a company that sells cherry-flavored sugar pills to be administered by parents to their unsuspecting children as a placebo we thought we’d investigate.
This morning’s New York Times reports that the FDA is now echoing what many scientists and industry experts have been saying for weeks: the contaminated stores of heparin that have been associated with 81 deaths and 785 severe allergic reactions in the U.S. was likely adulterated on purpose. In March, the FDA issued a major recall of heparin following increasing reports of adverse reactions and deaths connected with the drug.
Tests have shown that heparin components made by a company in China (Changzhou SPL) were contaminated by a manipulated form of a dietary supplement, oversulfated chondroitin sulfate. Because the cheaper additive resembles heparin, routine screening didn’t reveal the contamination. Contaminants comprised up to a third of some heparin samples that were tested. Dr. Janet Woodcock, director of the Food and Drug Administration’s drug center explained, “[I]t does strain one’s credulity to suggest that might have been done accidentally.”
Last week the British science journal Nature reported the results of an online reader poll that sought to measure the number of scientists who used “cognitive enhancing drug” and readers’ attitude to the drugs themselves. The poll, which was supposed to be part of an April Fools’ feature, revealed some unexpected results. Twenty percent of the 1427 responders (most of them Americans) said they used cognitive enhancing drugs for “non-medical purposes.” Of course, an online poll hardly constitutes a reliable scientific study. Nonetheless, we’re not talking about Mad magazine or The Onion here.
Ritalin was by far the most popular drug of choice (at 60% reported use). Responders said they turned to the drug mostly for extra concentration on tasks. The next most commonly used drug (at 50% use) was Provigil, which promotes wakefulness and is commonly prescribed for narcolepsy. Coming in third were beta-blockers (at 15% use), which are prescribed for high blood pressure and cardiac arrhythmia but were used in these cases for anti-anxiety effects.
Were those gasps we just heard? Maybe a few people falling out of their chairs? (Sorry about that, by the way.) No, the sky hasn’t fallen, and (as far as we know) hell hasn’t frozen over.
As many of you know, we offer the occasional critique of Big Pharma – its business model, advertising practices, ethics, etc. (No, really?) Although this post doesn’t negate our previous points, we want to present a side of the MDA philosophy that, admittedly, doesn’t get as much blog time.
No, it’s not our rant this time. Instead, we’re serving up someone else’s argument for your enjoyment and discussion. You’ll find the voices of a whole host of folks closer to the core than we (thankfully) ever get: physicians, a former pharma sales representative, and a former editor of the New England Journal of Medicine.
(And the timing is apt, we thought. Just two weeks ago the British Medical Journal published research that illuminates (too positive a word, yes) the “invisible influence” that the pharmaceutical industry has on physician education. We invite you to read up on the strategy of silent sponsorship of and input into conference sessions that doctors believe are independent presentations.)
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