Local doctors talk about pill obsession

Published 12:28 am Sunday, August 26, 2007

Computer-animated bumblebees and glowing green butterflies flit across the television screen, targeting adults rather than children with their products.

The bumblebee — voiced by Antonio Banderas — has a passion for flowers and the nasal spray Nasonex, and the butterfly is presumably peaceful enough to convince insomniacs to try sleep aid Lunesta.

Those are only two examples of an ever-growing industry dedicated to convincing Americans they need treatment for whatever ails them, from depression and sexual dysfunction to less-than-attractive toenails.

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Natchez pharmacist Frank Ernst said he thought advertising greatly affected consumers.

“It familiarizes them with the drug,” Ernst said. “For example, you can’t turn on the TV without seeing a commercial for Claritin. Then, when a patient goes to the doctor with the hay fever he suffers every summer, his tendency is to mention it.”

Dr. Kenneth Stubbs of Internal Medicine and Associates in Natchez, said he has mixed feelings about the drug industry’s advertising efforts.

“Informing the public on health issues is good, but the industry tends to promote the latest and greatest drugs, when an older product may work just fine,” he said.

By doing just that, the industry can actually misinform the public, Stubbs said.

“The advertising can be misleading,” he said. “It can paint an incomplete picture.”

For example, some of the studies touting a new product’s benefits are actually conducted by the pharmaceutical company, Stubbs said.

“The drug industry has abused their trust by limiting negative studies,” he said. “Regardless of what we think, if a researcher works for the pharmaceutical company, you’re going to get more positive studies.”

Overmedication.

One of the problems stemming from greater public drug awareness is patients may come to a doctor asking for a certain medication even if it may not be the best course of treatment — all they know is it is the latest in a long line of treatments, and it is supposedly better.

“Sometimes, we’re put into the position of having to dissuade somebody a product they’re enthused about in favor of a more mundane product,” Dr. Lee England, an internal medicine specialist, said.

“Personally, I’m not in favor of advertising to the general public,” he said. “It contributes to a culture of expecting the drugs to do more than people should expect them to do.”

Jerry Brown of Fayette said now and then he’ll see a commercial that lists symptoms that might match his. But he’s never asked his doctor for a specific brand name, he said.

Most of the time, he just ignores them.

“I don’t really have that much wrong with me,” he said.

Prescription commercials don’t catch her eye much, but over-the-counter drug commercials sometimes point Tammy McCurley of Vicksburg toward a medicine she can use, she said.

McCurley said she’d try medicine for coughs or aches, “especially for kids, if it has a good flavor to it. I have two boys, and they need to have flavor.”

And after seeing a commercial for a migraine headache medicine, she tried it.

“I teach, so I need something, and it works,” McCurley said.

According to the Centers For Disease Control and Prevention, approximately 18 percent of the population is on at least three prescription drugs during any given month.

Pharmacist Liz Farmer said most of the people she sees on multiple medications are on the ends of the age spectrum.

“They’re either pediatric or geriatric patients,” she said. “They’re either really sick or are on medications for ailments older people face like heart disease.”

Even over the counter medicine sales tend to follow that pattern, Farmer said.

In some instances, it may be common for someone — a diabetic, for example — to be on three prescriptions to treat that single disease.

“If they also have high blood pressure, that adds another two or three (pills) and before you know it, you’re at 10,” he said.

Stubbs said he always tries to eliminate at least one prescription from a patient’s pill regimen if he can.

“The problem is, I can usually justify all of them,” he said.

A medication-happy culture?

Though Stubbs said some people look to medication desperate in the instance of a devastating disease, many prescriptions could be done away with with simple lifestyle modifications.

“People don’t modify lifestyles to treat diseases anymore,” he said. “If we do some things better, illnesses won’t occur.”

Statistics say the most commonly prescribed drugs in are antidepressants, Stubbs said.

“People want a pill now when they’re sad, happy or can’t sleep,” he said. “Everybody wants to get fixed.”

England agreed.

“If you stand back and look at a lot of commercials, it gives people the sense that the easiest thing to do is take a pill,” he said.

Buying a cure.

On the one side, patients are pushing doctors to place them on new medications, and on the other side drug company representatives are pushing them to use a certain brand-name drug.

England said such representatives could be useful if their comments are taken with a grain of salt.

“I try not to let it have an influence on me,” England said. “I try to read (about new drugs) from medical journals, too. On the other hand, a drug rep might be able to inform a doctor about dose strength and other information.”

Doctors have to bear in mind that drug company representatives are salesmen, England said.

“They’re obligated to tell you about some of the reactions to the drug, but they are salesmen and they try to emphasize the good,” he said.

At one time, it was a common practice for drug representatives to fly a doctor to a desirable location — such as Florida — and to pay for their hotel rooms and meals as long as the doctor would attend a conference where a speaker would talk about a disease and whatever new drug was supposed to treat it, Stubbs said.

Though that is not a common practice anymore, it is still routine practice for drug representatives to sponsor a nice dinner and a speaker, he said.

A blessing and a curse.

Despite some of its flaws, the pharmaceutical industry should deserves a lot of praise, Stubbs said.

“They have developed drugs that are nothing short of miraculous,” he said.

“Overall, the U.S. (drug market) should be grateful for the pharmaceutical industry,” he said. “Most new drugs are out of the U.S.”

The bottom line when it comes to drugs is for patients to trust their physician to treat them well.

“People should rely on their doctor to treat them soundly,” Stubbs said.