Big Pharma: Creating what ails you (Part 1) - Baltimore Post-ExaminerBaltimore Post-Examiner

Big Pharma: Creating what ails you (Part 1)

*Author’s Note: I wrote this for a Sociology class at WSU, but found the issues are still relevant. Furthermore, all of the complaints, regulations and legalities regarding marijuana, tobacco and perhaps even e-cigarette use are hypocritical considering our history of prescribing much more potent substances.

Medicating For Profit

Currently, the U.S. “uses over … forty percent of all the drugs produced in the world each year, according to the World Health Organization” (Murray, 2009, p.9). Since 2009, that percentage has gone up, which isn’t surprising if you consider that we are one of only two developed countries who allow direct to consumer marketing of pharmaceutical drugs, the other being New Zealand. From blood pressure medication to antidepressants, the average American stands a good chance of watchingcommercials for prescription drugs on a daily basis.

There is no doubt that we live in a culture that endorses the idea of supposed “need.” You “need” to be, have and produce many things, according to our many explicit and implied cultural messages. From toothpaste to tanning, we are constantly being told that we need something.

Naturally, when it comes to matters of health, people are all too eager to get what they need. But what if that’s an issue of dispute? The industrial nature of such a marketing and business alliance — all in the name of medicine — of today’s lobbyists, politicians, psychiatrists and pharmaceutical companies (Big Pharma) presents a major health concern for the average United States citizen.

The History of Pharmaceuticals

In some ways, the use of drugs for medicinal purposes has been even less regulated than it is now. Pharmaceutical drugs used to be sold just like anything else on store shelves (Mosher, 2007). These drugs included some that are now illegal, such as cocaine and heroin (Cohen&Inaba, 2011). In 1970, not only were many of these items off the shelf, but the United States passed the Controlled Substances Act, mostly in response to the prevalent drug use of the 1960s.

According to the Seventh Edition of “Uppers, Downers, All Arounders,” the main obligations of the Drug Enforcement Administration were: “to classify all psychoactive drugs, to control their manufacture and sale, to limit imports and exports, [and] to define criminal penalties” (Cohen &Inaba, 2011, 1.38). To this day, the classifications of psychoactive substances are widely disputed.

An extremely relevant example of this can be found in our recent decision to legalize Marijuana use in Washington and Colorado. Technically, marijuana is classified as a Schedule 1 drug, associated with a high potential for abuse and defined as having no medical value, and yet people have been using it for medicinal purposes to cope with pain for years in several states.

It is perhaps due to such an irrational coexistence of contradicting facts that a leading college textbook can confidently state: “The U.S. government’s views of drug and alcohol use and abuse have varied widely over the centuries, but most policy decisions made in the past 50 years were due to the prevailing political climate rather than scientific and sociological research. The budget for the U.S> “War on Drugs” has gone from $3.7 million in 1971 to $15.1 billion in 2011” (Cohen &Inaba, 2011, 1.39).

Now, although we’ve made “hard” drugs theoretically more difficult to access, pharmaceutical companies have found ways around safety and labeling regulations, as well as increasing sales at an alarming rate due to excessive advertising. Let’s begin with dissecting their marketing strategy.

In 1937 over 100 people died after ingesting what was then called an “elixir” — sulfanilamide. As a result Congress passed the Federal Food, Drug and Cosmetic Act of 1938 the prohibited false advertising and proof that the food, drug or cosmetic were safe for use. As it turns out sulfanilamide is the main ingredient of antifreeze. (Wikipedia)

In 1937 over 100 people died after ingesting what was then called an “elixir” — sulfanilamide. As a result Congress passed the Federal Food, Drug and Cosmetic Act of 1938 the prohibited false advertising and proof that the food, drug or cosmetic were safe for use. As it turns out sulfanilamide is the main ingredient of antifreeze.
(Wikipedia)

Medical Marketing

Before 1997, advertising these drugs was illegal (Murray, 2009, p.213). Since 1997,we have been advertising prescription drugs with very little to no FDA regulation in place to put a barrier between consumers and drug companies. Like any other marketing ploy, the strategy continues to be employed only if it appears to be working—and it does.

Two years after the U.S. began advertising pharmaceutical drugs, Americans were being exposed to nine ads for prescription drugs per day, on average (Mosher, 2007). By 2009, drug companies were spending “more than $57.5 billion per year marketing to physicians” (Murray, 2009), much less consumers.

Not surprisingly, the public’s acceptance of pharmaceutical drugs had more to do with well-trained salesmen than medical science, beginning with “detail men” who were trained with sale literature and in-house company newsletters after World War II (Greene, 2004).

More recently, two Canadian researchers found that drug companies now spend at least twice the money on marketing as they do on the research and development of their drugs (Gagnon &Lexchin, as cited in Murray, 2009).

Unfortunately, the common practice of DTC (direct to consumer) marketing is one of the biggest culprits for what we now refer to as “Big Pharma,” afive hundred billion dollar industry (Moynihan &Cassels, 2005)that has leaked into the facets of medical education and general medical practice.

Pharmaceuticals Going Mainstream

Merck, a leading international pharmaceutical company, provides a perfect illustration of how all these principles come into play, how they affect consumers, and what actions (if any) are taken against drug companies. Henry Gadsden, the head of Merck over three decades ago, was once quoted as saying he wanted Merck’s brand to be sold to everyone, even the healthy (Murray, 2009, p.15) Essentially, we must ask ourselves whether there is there a need or they are manufacturing one.

Peter Whitehouse, a former consultant for pharmaceutical and biotechnological industries, asserted that large pharmaceutical companies were indeed doing just that. In“Why I No Longer Consult for Drug Companies,” he writes of giving up his careerbecause [the pharmaceutical companies] were “[creating] diseases for drugs” (Whitehouse, 2008). Kristin Barker of Social Science & Medicine holds a similar opinion.

Barker argues that there is a “cultural logic whereby the existence (and marketing) of an officially approved prescription medication for a condition lends support to the biomedical existence of the condition itself,” which she calls “pharmaceutical determinism.”

She cites the example of fibromyalgia, an illness that physicians cannot even agree exists. Not only do patients diagnosed with this disease face skepticism with their symptoms, but they may be taking a drug that was formulated with no purpose other than to relieve symptoms and make profits, rather than actually treat a viable, authentic syndrome. The drug Barker references is Lyrica, an FDA approved prescription medication.

According to her article,“Listening to Lyrica: Contested Illnesses and Pharmaceutical Determinism,” Barker sees evidence that “pharmaceutical companies…[play a large role]in promoting and legitimating contested diagnoses and validating those who are so diagnosed.” (Barker, 2011) In other words, a patient’s diagnosis could have more to do with the greed of pharmaceutical companies than a scientific analysis of their symptoms.

This opinion is echoed by Dr. Marcia Angell, who acknowledges that though drug companies used to make drugs for treatment purposes, the culture has changed drastically. “Now it is often just the opposite. They promote diseases to fit their drugs” (as quoted in Murray, 2009, p.101).

By all accounts, it appears as though there is not so much a rising surge in ailments and mental cases since the early 1900s but a greater number of drugs needing to be sold. To illustrate how this principle works, take into consideration that the ratio of surgeons in an area actually increases the number of surgeries performed (Murray, 2009).

Dr. Michael Murray writes, “One research study found that an area with 4.5 surgeons per 10,000 …experienced 940 operations … whereas an area with 2.5 surgeons per 10,000 experienced 590 operations per 10,000. Basically, when the concentration of surgeons doubles, so does the rate of surgeries” (Murray, 2009, p.14).

This profit-seeking or “pharmaceutical determinism” extends to the decisions made by pharmaceutical companies in regards to patents. In an article released by the Economic Development Quarterly in 2004, they reported a connection between patent activity within the U.S. pharmaceutical industry and economic conditions of a geographic location, finding that “local business conditions play an important role in the innovation and financial performance of U.S. pharmaceutical companies” (MacPherson &Boasson, 2004).

If pharmaceutical companies were truly rooted in fulfilling the needs of a specific population, it stands to reason that economic factors would not have such a notable impact.

Part 2 of this post.





About the author

Megan Wallin

Megan Wallin is a young writer with a background in the social sciences and an interest in seeking the extraordinary in the mundane. A Seattle native, she finds complaining about the constant drizzle and overabundance of Starbucks coffee therapeutic. With varied work experiences as a residential counselor, preprimary educator, musician, writing tutor and college newspaper reporter/editor, Megan is thrilled to offer a unique perspective through writing, research and open dialogue. Contact the author.
COMMENT POLICY

4 Comments

  1. Brian Kelly says:

    There is absolutely no doubt now that the majority of Americans want our politicians to provide us safe, legal access to Medical Marijuana Nationwide. Our numbers grow on a daily basis.

    The prohibitionist view on medical marijuana is the viewpoint of a minority of Americans.. It is based upon decades of lies and propaganda.

    Each and every tired old lie they have propagated has been thoroughly proven false by both science and society.

    Their tired old rhetoric no longer holds any validity. The majority of Americans have seen through the sham of medical marijuana prohibition in this day and age. The number of prohibitionists left shrinks on a daily basis.

    With their credibility shattered, and their not so hidden agendas visible to a much wiser public, what’s left for a medical marijuana prohibitionist to do?

    Maybe, just come to terms with the fact that Medical Marijuana Legalization Nationwide is an inevitable reality that’s approaching much sooner than prohibitionists think, and there is nothing they can do to stop it!

    Legalize Nationwide!…and Support All Medical Marijuana Legalization Efforts!

    Reply
    • Brian Kelly says:

      When a loved one is in pain, wasting away unable to eat, and needs this marvelous herb in order to increase their appetite, reduce the overwhelming pain, and live as as healthy and happily as they can with the time they have left, let’s have the compassion to allow them to have it.

      Stop treating Medical Marijuana Patients like second rate citizens and common criminals by forcing them to the dangerous black market for their medicine.

      Risking incarceration to obtain the medicine you need is no way to be forced to live.

      Support Medical Marijuana Now!

      “[A] federal policy that prohibits physicians from alleviating suffering by prescribing marijuana for seriously ill patients is misguided, heavy-handed, and inhumane.” — Dr. Jerome Kassirer, “Federal Foolishness and Marijuana,” editorial, New England Journal of Medicine, January 30, 1997

      “[The AAFP accepts the use of medical marijuana] under medical supervision and control for specific medical indications.” — American Academy of Family Physicians, 1989, reaffirmed in 2001

      “[We] recommend … allow[ing] [marijuana] prescription where medically appropriate.” — National Association for Public Health Policy, November 15, 1998

      “Therefore be it resolved that the American Nurses Association will: — Support the right of patients to have safe access to therapeutic marijuana/cannabis under appropriate prescriber supervision.” — American Nurses Association, resolution, 2003

      “The National Nurses Society on Addictions urges the federal government to remove marijuana from the Schedule I category immediately, and make it available for physicians to prescribe. NNSA urges the American Nurses’ Association and other health care professional organizations to support patient access to this medicine.” — National Nurses Society on Addictions, May 1, 1995

      “[M]arijuana has an extremely wide acute margin of safety for use under medical supervision and cannot cause lethal reactions … [G]reater harm is caused by the legal consequences of its prohibition than possible risks of medicinal use.” — American Public Health Association, Resolution #9513, “Access to Therapeutic Marijuana/Cannabis,” 1995

      “When appropriately prescribed and monitored, marijuana/cannabis can provide immeasurable benefits for the health and well-being of our patients … We support state and federal legislation not only to remove criminal penalties associated with medical marijuana, but further to exclude marijuana/cannabis from classification as a Schedule I drug.” — American Academy of HIV Medicine, letter to New York Assemblyman Richard Gottfried, November 11, 2003

      Reply
      • Brian Kelly says:

        Fear of Medical Marijuana Legalization is unfounded. Not based on any science or fact whatsoever.

        So please, all prohibitionists, we beg you, give your scare tactics, “Conspiracy Theories” and “Doomsday Scenarios” over the inevitable Legalization of Medical Marijuana a rest. Nobody is buying them anymore these days. Okay?

        Furthermore, if all prohibitionists get when they look into that nice, big and shiny crystal ball of theirs, while wondering about the future of Medical Marijuana Legalization Nationwide, is horror, doom, and despair, well then I suggest they return that thing as quickly as possible and reclaim the money they shelled out for it, since it’s obviously defective.

        The prohibition of marijuana has not decreased the supply nor the demand for medical marijuana at all. Not one single iota, and it never will. Just a huge and complete waste of our tax dollars to continue criminalizing sick patients and senior citizens in pain for choosing a natural, non-toxic, relatively benign plant proven to be much safer than daily handfuls of deadly, toxic, man-made, highly addictive, narcotic pain pills and other pharmaceuticals.

        If prohibitionists are going to take it upon themselves to worry about “saving us all” from ourselves, then they need to start with the drug that causes more death and destruction than every other drug in the world COMBINED, which is alcohol!

        Why do prohibitionists feel the continued need to vilify and demonize marijuana when they could more wisely focus their efforts on a real, proven killer, alcohol, which again causes more destruction, violence, and death than all other drugs, COMBINED?

        Prohibitionists really should get their priorities straight and or practice a little live and let live. They’ll live longer, happier, and healthier, with a lot less stress if they refrain from being bent on trying to control others through Draconian Marijuana Laws.

        Reply
        • Brian Kelly says:

          Nobody can deny the Medical effectiveness of Medical Marijuana. Below is a small sampling of Professional Medical Organizations Worldwide that attest to Medical Marijuana’s effectiveness and Support Legal Access to and Use of Medical Marijuana. . Along with over 20 U.S states that have legalized medical marijuana.

          Are they ALL wrong?

          International and National Organizations

          AIDS Action Council
          AIDS Treatment News
          American Academy of Family Physicians
          American Medical Student Association
          American Nurses Association
          American Preventive Medical Association
          American Public Health Association
          American Society of Addiction Medicine
          Arthritis Research Campaign (United Kingdom)
          Australian Medical Association (New South Wales) Limited
          Australian National Task Force on Cannabis
          Belgian Ministry of Health
          British House of Lords Select Committee on Science and Technology
          British House of Lords Select Committee On Science and Technology (Second Report)
          British Medical Association
          Canadian AIDS Society
          Canadian Special Senate Committee on Illegal Drugs
          Dr. Dean Edell (surgeon and nationally syndicated radio host)
          French Ministry of Health
          Health Canada
          Kaiser Permanente
          Lymphoma Foundation of America
          The Montel Williams MS Foundation
          Multiple Sclerosis Society (Canada)
          The Multiple Sclerosis Society (United Kingdom)
          National Academy of Sciences Institute Of Medicine (IOM)
          National Association for Public Health Policy
          National Nurses Society on Addictions
          Netherlands Ministry of Health
          New England Journal of Medicine
          New South Wales (Australia) Parliamentary Working Party on the Use of Cannabis for Medical Purposes
          Dr. Andrew Weil (nationally recognized professor of internal medicine and founder of the National Integrative Medicine Council)

          State and Local Organizations

          Alaska Nurses Association
          Being Alive: People With HIV/AIDS Action Committee (San Diego, CA)
          California Academy of Family Physicians
          California Nurses Association
          California Pharmacists Association
          Colorado Nurses Association
          Connecticut Nurses Association
          Florida Governor’s Red Ribbon Panel on AIDS
          Florida Medical Association
          Hawaii Nurses Association
          Illinois Nurses Association
          Life Extension Foundation
          Medical Society of the State of New York
          Mississippi Nurses Association
          New Jersey State Nurses Association
          New Mexico Medical Society
          New Mexico Nurses Association
          New York County Medical Society
          New York State Nurses Association
          North Carolina Nurses Association
          Rhode Island Medical Society
          Rhode Island State Nurses Association
          San Francisco Mayor’s Summit on AIDS and HIV
          San Francisco Medical Society
          Vermont Medical Marijuana Study Committee
          Virginia Nurses Association
          Whitman-Walker Clinic (Washington, DC)
          Wisconsin Nurses Association

          Additional AIDS Organizations

          The following organizations are signatories to a February 17, 1999 letter to the US Department of Health petitioning the federal government to “make marijuana legally available … to people living with AIDS.”

          AIDS Action Council
          AIDS Foundation of Chicago
          AIDS National Interfaith Network (Washington, DC)
          AIDS Project Arizona
          AIDS Project Los Angeles
          Being Alive: People with HIV/AIDS Action Committee (San Diego, CA)
          Boulder County AIDS Project (Boulder, CO)
          Colorado AIDS Project
          Center for AIDS Services (Oakland, CA)
          Health Force: Women and Men Against AIDS (New York, NY)
          Latino Commission on AIDS
          Mobilization Against AIDS (San Francisco, CA)
          Mothers Voices to End AIDS (New York, NY)
          National Latina/o Lesbian, Gay, Bisexual And Transgender Association
          National Native American AIDS Prevention Center
          Northwest AIDS Foundation
          People of Color Against AIDS Network (Seattle, WA)
          San Francisco AIDS Foundation
          Whitman-Walker Clinic (Washington, DC)

          Other Health Organizations

          The following organizations are signatories to a June 2001 letter to the US Department of Health petitioning the federal government to “allow people suffering from serious illnesses … to apply to the federal government for special permission to use marijuana to treat their symptoms.”

          Addiction Treatment Alternatives
          AIDS Treatment Initiatives (Atlanta, GA)
          American Public Health Association
          American Preventive Medical Association
          Bay Area Physicians for Human Rights (San Francisco, CA)
          California Legislative Council for Older Americans
          California Nurses Association
          California Pharmacists Association
          Embrace Life (Santa Cruz, CA)
          Gay and Lesbian Medical Association
          Hawaii Nurses Association
          Hepatitis C Action and Advisory Coalition
          Life Extension Foundation
          Maine AIDS Alliance
          Minnesota Nurses Association
          Mississippi Nurses Association
          National Association of People with AIDS
          National Association for Public Health Policy
          National Women’s Health Network
          Nebraska AIDS Project
          New Mexico Nurses Association
          New York City AIDS Housing Network
          New York State Nurses Association Ohio Patient Network Okaloosa AIDS Support and Information Services (Fort Walton, FL)
          Physicians for Social Responsibility – Oregon
          San Francisco AIDS Foundation
          Virginia Nurses Association
          Wisconsin Nurses Association

          Health Organizations Supporting Medical Marijuana Research

          International and National Organizations

          American Cancer Society
          American Medical Association
          British Medical Journal
          California Medical Association
          California Society on Addiction Medicine
          Congress of Nursing Practice
          Gay and Lesbian Medical Association
          Jamaican National Commission on Ganja
          National Institutes of Health (NIH) Workshop on the Medical Utility of Marijuana
          Texas Medical Association
          Vermont Medical Society
          Wisconsin State Medical Society

          Reply

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