I finished Our Daily Meds, by Melody Peterson, last week. Sometimes, I think I understand the scope of a social problem, until I read a detailed and well-researched account and realize that what I knew was just the tip of the iceberg. Usually, that’s because I just can’t be cynical enough to take in what’s actually happening.
This book is a perfect example: Peterson is writing about how the American pharmaceutical industry has intentionally transformed not just the country’s prescription drug habits, but our national health, our attitudes towards our health, and our real income levels.
Basically, Peterson convinced me that it isn’t possible to be cynical enough. Her basic premise is that, while the benefits of prescription medications are obvious and crucial, the concept of marketing them like toys or candy has done an incomprehensible amount of harm. Drug marketing is not only pretty advertisements in public media, it’s also hundreds of millions of dollars spent paying medical doctors and movie stars to convince other medical doctors to prescribe drugs without any scientific evidence for their use–and sometimes with significant scientific evidence that those drugs do harm. It’s taking over the medical journals with articles actually written by the drug companies and their affiliates, lying eloquently about what the drugs do. It’s packaging strong narcotics in berry-flavored lollipops, and writing “children’s books” about how a particular drug transformed an unhappy child’s life.
Peterson details how drug companies have literally (and consciously) invented “diseases,” (such as “overactive bladder”) because they had a drug (in this case for incontinence) that not enough people needed. She has a chapter on Neurontin: an epilepsy drug so ineffective that the FDA approved only as a second drug to supplement some other seizure drug. (Why was the approval so limited? Because it “had not reduced the number of seizures in most volunteers in the company’s clinical trials” and “5 to 10 percent of the epilepsy patients taking [it] actually got worse.”)
The small-time approved use didn’t fit the company’s bottom line. And the law says once a drug has been approved for any single use, doctors can prescribe it “off label” for other uses. So the company decided to sell Neurontin for profitable uses, “from children with attention deficit disorder to adults with sexual dysfunction,” as well as migraines and uncontrolled hiccups. This would be bad enough, if the company had not then gone on to mount a wide-ranging illegal campaign to bribe doctors to prescribe it for these uses … and to pay doctors to convince other doctors to prescribe it. They spent tens of millions of dollars on upscale events at expensive restaurants and country clubs, where paid doctors spoke about nonexistent benefits and drug company salespeople got huge commissions based on number of prescriptions written.
Peterson comes off as a sensible researcher, not a starry-eyed crusader. She never forgets that most of the drugs she is discussing actually do some good. One thing I thought the book might be when I bought it was a deep critique of “brain meds,” but instead she writes about psychoactive drugs as part of the greater pharmaceutical picture, which is much more useful.
She also discusses some hidden social issues: she estimates the number of drug-related deaths in the U.S. at more than 250 per day (!) and shows how these deaths are hidden in the statistics. (I understand that, because anorexia and bulimia deaths are hidden the same way; the cause is “pneumonia” or “heart failure,” and the underlying issues disappear.) She talks about the measurable presence of trace pharmaceuticals in urban water supply (a 2002 study found prescription drugs, fragrances, insect repellents, disinfectants, and other household chemicals in 80% of the streams sampled in 30 states). She discusses the thriving high-school and street-corner market in pretty pills, and the highway and military deaths caused by prescription drug misuse or overuse. She talks about the marketing of drugs to children and the elderly, despite no studies regarding those groups: this results in particular in overprescribing for the elderly, whose body systems often process drugs less efficiently.
I’m a critical reader: I always look for how the author might be slanting her data to make her points. I saw that occasionally in this book, but the vast bulk of the time, Peterson was either giving me statistics on something I already basically believed, or convincing me it was worse than I thought.
Why is this a body image issue? Because body image isn’t just about how we look; it’s also about how we feel. And one of the nastiest aspects of the whole slimy mess is that by promoting sweetness and light, the drug companies have made Americans perceive ourselves as sicker, more in need of help, and less powerful than people anywhere else in the world. (And America’s government and citizens have supported the effort.)
The U.S. is the only country that has let this madness run unchecked. Peterson’s last chapter is a prescription for how to fix this on a personal level and a social level. If your stomach is strong enough, this book is well worth your time.