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A Pill For All Seasons

April 17, 2013

Writing yesterday about the petty arguments raging in the world of big pharma, I started thinking about pharmaceuticals and how prevalent they are.  I poked around on the world wide web and found that according to the Centers for Disease Control, which really ought to know, 48% of Americans have taken at least one prescription medication in the last month.  31% have taken more than one.  48%.  Were half of Americans sick last month?  Was there an epidemic?  Did I miss something?  234.1 billion dollars were spent on prescription medications in 2008.  Read it for yourself: http://www.cdc.gov/nchs/data/databriefs/db42.htm

These numbers are going up every year.  A modern scourge?  A pill-popping mentality born of insurance companies and SSRIs?  Turns out humans, at least American humans, have always had a tendency to love pharmaceuticals.  In researching my book I have been reading about the Warren family of physicians who were prominent in Boston during the explosion of development in medicine that occurred in the 1800s.  One of the Warren biographers, Rhoda Truax, who wrote  “The Doctors Warren of Boston; First Family of Surgery”, observes that the population of Boston in 1828 did not lack for medicines, being advised to take various pills even when healthy and getting buried in a deluge of pharmaceutical interventions when sick.  And they didn’t even have any medications that actually worked other than some of the herbals.  Everyone had plenty of “the blue pill”, “aloes”, “decoction of sasparilla”, calomel, and prussic acid.  Doctors had as much faith in these substances as the general public did.

Why this tendency to pop pills?  Dr. J Douglas Bremner has written a whole book on the subject:  http://www.beforeyoutakethatpill.com.  He blames the pharmaceutical industry, which would be a great answer except it doesn’t account for what was happening in the 1800s, when there were no pharmaceutical companies, nor any TV or radio to advertise their wares.  In fact, it doesn’t account for what was happening even earlier than that. Socrates observed:

” [medicine] acts as both remedy and poison…”this charm, this spellbinding virtue, this power of fascination, can be­—alternately or simultaneously—beneficent or maleficent.”

This statement really gets to the point of the discussion.  It’s a spellbinding, fascinating idea that problems can be solved so simply.  It IS a charming idea. And sometimes a problem really can be solved with a pill that couldn’t be fixed before: severe cholesterol problems, surgical pain, contraception.  Other times a well-meaning health care provider will try a quick fix, sometimes a patient requests it.  It’s human nature to want to solve a problem the easiest way, and pills can do that.  People have an innate desire to feel better or to feel different, and pills can do that.  Sometimes, it’s true, you want to get a patient out of your office or out of your emergency room, and I’m afraid pills can do that too.  Yes, drug companies contribute to drug use, yes doctors do, yes patients do, yes insurance companies do, yes short doctor visits and production pressures do.  But human nature plays a role too, and last time I checked there’s no pill that can cure that.

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