Understanding Side Effects
The real story on drug side effects, and why you need to know.
Current media reports on the safety - or lack thereof - of commonly used prescription and over-the-counter drugs are making front pages and prime-time news reports. A lot of experts have been talking about this issue for years, but they were on the fringes until recently, when the blockbuster arthritis drug Vioxx was called onto the carpet for increasing heart disease risk. On the heels of that report was another that showed dramatic increases in risk of pneumonia in users of acid-suppressing drugs. Now, it seems, we can't open a newspaper without news of some other drug and its threats to our health.
This new trend towards awareness of potentially hazardous side effects of prescription drugs most likely began with the recent Women's Health Initiative Study, where hundreds of millions of postmenopausal women who were once told that they needed hormone replacement pills were suddenly being told that swallowing those very pills increases their risk of breast cancer, stroke, and heart attack. The drugs that had been pushed on these women to prevent disease were, in the end, the cause of tens of thousands of deaths.
Hey... wait a minute, people are saying, aren't drugs supposed to make me healthier? How could this happen?Why is the government not protecting us? Why don't doctors know better? What can I do to protect myself?
How Could This Happen?
First off, let's make one thing clear: too many of us have an unreasonable expectation when it comes to drugs. We expect the magic bullet, the pill to cure our ills, without any kind of tradeoff. We swallow pills to treat ailments that arise from unhealthy lifestyle choices - often, a lifetime's worth of them - and shout foul! any time those pills cause unpleasant side effects. Sure, our medications have on their labels or in their packaging that long, dreary list of potential adverse effects. Print ads have that same list in small print, usually on the back side of the page. The announcer on the direct-to-consumer TV ads rattles off that same list while we watch actors depict ill people freed from the grip of their symptoms, frolicking happily, and we just don't think any of that stuff will happen to us.
Let's also be clear that many medical drugs are invaluable. They save lives. They have played a major role in increasing lifespan and reducing child and infant mortality, and in alleviating pain and suffering. Antibiotics, painkillers, vaccines, and steroid drugs are a few examples of drugs that, when used appropriately, are lifesaving, and we have the drug industry to thank. Unfortunately, most of the drugs that are hard-sold to consumers today are not lifesaving. The drugs that save the most lives today have been around quite some time, and don't get marketed the way newer drugs do.
Why? Because drug companies are focused on creating novel drugs for chronic conditions. These novel drugs enjoy patent protection for at least 17 years. No other drug maker can compete, and this allows the novel drug's maker to charge whatever exorbitant price they like until patent protection runs out. Chronic conditions - depression, anxiety, arthritis, acid reflux, or high blood pressure, for example - require long-term drug treatment. So, if the drug companies can sell their newest, most expensive products to as many people as possible for as long as possible, they take home a bigger pot of gold.
Drug companies don't want you to know that side effects are part and parcel of the manner in which medications work. Over 100,000 people die every year because of side effects from properly prescribed medications. This puts drug-related adverse events at number three on the list of top causes of death in the United States. Countless more don't die, but are adversely affected to various degrees.
Drugs are, for the most part, synthetic chemical agents that, when introduced into the human body, will often have effects that were not intended. They don't fit perfectly into the physiological workings of the body. Drug researchers attempt to create drugs that are highly specific, to target a single aspect of a disease process, but any drug is likely to affect other processes at the same time. And because each person's body is different, it is difficult (if not impossible) to predict who will suffer life-threatening or troublesome side effects.
Let's take the recent Vioxx problem as an example. Vioxx is a COX-2 inhibitor drug. This class of drugs inhibits the production of enzymes in the body that transform fats into pro-inflammatory substances in the body. In this manner, they help to control inflammation and the pain and tissue damage that often accompanies it. Unfortunately, the COX-2 inhibitory action of this drug also has effects on the circulatory system - effects that have turned out to raise risk of heart attack in some of the people who took it.
How about the acid-blockers? Well, it turns out that stomach acid, long demonized as the cause of ulcers and heartburn, is actually a needed, necessary thing. It does the lion's share of work when it comes to digesting food, and it kills off bacteria and other pathogens in the foods we eat. When we ratchet down the production of stomach acid, bacteria can flourish in the GI tract, and those bacteria can end up causing pneumonia if they are aspirated.
Hormone replacement? Turns out that the synthetic progestins - a patentable form of the natural female hormone progesterone - were counteracting any positive effects of estrogen on the health of the circulatory system. The estrogens (usually, a mixture of estrogens derived from horse urine - natural to horses, not to humans) and progestins that comprised most female replacement hormones also turned out to have breast cancer-promoting effects that the body's own hormones don't have. And this was not known for a full 45 years after the drugs began to be prescribed!
These problems are compounded when people take more than one medication. Not only must the body contend with the side effects of one drug; it is now dealing with interactions between the various drugs. An increasing proportion of the population is taking three or more prescription drugs every day, and many take additional drugs that are available over-the-counter.
Most clinical drug research only looks at the effects of a drug over a short period of time. Drugs for chronic conditions may be taken for months, years, even decades. We have no reasonable way of knowing how those drugs will affect the body over such an extended time period. In essence, people who take patent-protected (i.e. newer) medications long-term are a part of a massive, uncontrolled scientific experiment - an experiment that is highly profitable for the drug companies.
Side Effect, Allergic Reaction, or Toxic Reaction?
In natural medicine, it is widely acknowledged that people commonly have allergic or toxic reactions to synthetic drugs. Here is a guide to help you define your own reaction to medications.
A side effect is defined as an often adverse secondary effect. Side effects may take months or even years to show up, or they may show up in the first days or weeks of using a drug and then dissipate as your physiology shifts (unbalances) to cope with the new substance. The best way to know whether your symptoms are a result of a medication is to check the literature that came with the drug, or look it up in the Physicians' Desk Reference (most libraries have them; your doctor or pharmacist will have the most current edition on hand). Keep in mind, however, that new side effects are discovered every day for chemicals that have been available for many years. No manufacturer tests their drug against others' drugs to see how their interaction might cause side effects; dangerous drug interactions are almost always discovered by accident. If you take more than one drug, it may be impossible to know whether you are having side effects from one or both drugs unless you stop taking them. (Do NOT do so without physician guidance!)
An allergic reaction to an ingested substance usually happens almost immediately after ingesting it. You may have nausea, skin rash, diarrhea, fatigue, lightheadedness, gas, bloating, insomnia, or nervousness. If you have this kind of reaction to a drug, see your doctor right away and try an alternative. Or, if you don't really need the drug, stop taking it (with physician guidance) and find other ways to heal.
A toxic reaction can happen immediately or can take many years, depending upon your genetic makeup, general health, immune system health, and liver health. If your liver is overloaded with toxins from poor diet, alcohol, illicit drugs, or exposure to environmental toxins, adding a drug or drugs to the mix may push it beyond its ability to detoxify the body. Toxicity may manifest as moderate to crushing fatigue, autoimmune problems, repeated bouts of infection, bad breath, extremely odoriferous bowel movements, skin rashes, and general malaise.
Why Isn't the Government Protecting Us?
Drug companies are extremely wealthy. The pharmaceutical industry has the greatest profit margin of any industry in the United States. They can afford to keep packs of lobbyists in Washington, D.C., to ensure that government policy does not interfere with their bottom line. Policies on drug approval, drug patenting, and importation of drugs from Canada and other nations nearly always go the way of the pharmaceutical companies.
Why Don't Doctors Know Better?
Doctors, who are the interface between the general population and the wide world of pharmaceuticals, rarely go into detail with patients about the possible side effects of the drugs they prescribe. This isn't out of any intent to deceive; rather, they fear that patients will shy away from using drugs at all costs once they are aware of the risks.
In many instances, physicians aren't fully aware of a drug's risks, either. Physicians are regularly given the runaround by drug company reps who put the prettiest possible shine on a new drug, glossing over the side effects or only mentioning the most common. It's no exaggeration to say that physicians get the majority of their education on newer prescription drugs from these reps, who are enormously motivated to persuade as many doctors as possible that the product they're hawking is safe and effective.
Drug companies also persuade doctors to prescribe their latest, most costliest products by offering continuing education seminars to doctors. There, they present research studies sponsored by the drug companies, designed and manipulated in ways that put the drug in the best possible light, downplaying possible hazards. Most of the drug research that appears in peer-reviewed medical journals - a primary source of information on new therapies for doctors - is also sponsored and designed by drug companies.
It's time for consumers to take a step back and adopt a far warier attitude towards drugs - particularly when so many natural healing alternatives are available, and when lifestyle changes can make many of those drugs unnecessary.
What Can You Do To Protect Yourself?
Side effects are a secondary, and to some extent unavoidable, outcome of any action or treatment that is undertaken, whether natural or pharmaceutical. Everything with which we interact has some secondary effects, some spin-off.” Changes and responses to treatments always occur at multiple levels. Our goal as natural healers is to design treatments that do not merely suppress symptoms (as do most pharmaceuticals) but that act at the fundamental, causative levels at which the problem originates. Once we do that, the resulting side effects tend to be positive ones - shifts towards balanced health, occurring from the deepest levels to the most superficial.
You might compare this approach to fixing a structural problem in a building from the bottom up rather than the roof down. When we start at the foundation, and ensure that all the unstable places are stabilized and that our structure is solid at its bottom, we can rebuild and fortify each subsequent layer with confidence. If there turns out to be a flaw in a higher layer, it is easier to fix, because we know that the foundation holds strong. But if we take the opposite tack - say, we try to fix a crumbling wall by propping it up with a few haphazardly nailed-together two-by-fours - we might hold the wall up for a bit longer, but the foundation is going to continue to crumble, and that wall will eventually come down.
Too often, chemical remedies fail to touch the core of a problem, which may be genetic or may even lie deep within the personality. Chemical remedies may kill some of the superficial secondary bacteria, but they also kill off the healthy probiotic flora of the intestines. This modus operandi of drugs provokes a state of imbalance that manifests as side effects and, possibly, chronic symptoms that seem unexplainable. Natural healing works to address every aspect of the patient, and that is why it truly heals instead of masking symptoms or staving off disease progression.
Drug companies are beginning to accept that natural products may be needed to counter some drug therapy side effects. This is certainly a step in the right direction, towards a more integrative approach between allopathic (mainstream) and alternative medicines. Ortho McNeil is now making a probiotic supplement to give along with antibiotics, for example. At Healing*Edge Sciences, we are tracking this and two other drug industry-created "natural" products (Alluna and Remifemin), to ensure that these products match the standards of the natural products industry.
