Medicines Kill 100,000 U.S. Citizens Each Year Now for some real scientific medicine. A study in the Journal of the American Medical Association10 suggests that adverse reactions from properly prescribed(?) drugs are among the top causes of death in the United States each year. The authors estimate that more than two million adverse drug reactions (ADRs) occur yearly, 106,000 of which result in death. In 1994, they say, this would account for 4.6 percent of all recorded deaths, just behind heart disease, cancer and stroke. Deaths from adverse drug reactions therefore were ahead of pulmonary disease, accidents, pneumonia and diabetes. This study only counted deaths from drugs prescribed in a hospital setting. If you were to combine these results from a recent study (see "Hospital Infections Rising" in last month's column) that found 90,000 deaths per year from hospital-induced infections, one could easily place hospitals as the third leading cause of death in the U.S., ahead of strokes by about 45,000. The researchers suggest that deaths from ADRs have not changed much in the past 32 years. I'll let you do the math. 10. JAMA 1998;279:1200-1205. Hold the Antibiotics A study from Children's Hospital and Regional Medical Center in Seattle1 reports that antibiotics given to children suffering from E. coli infection may trigger complications that can result in the child's death. (The bacteria, E. coli 0157:H7, causes about 73,000 cases of food poisoning in the United States each year.) This study looked at the medical records of 71 children infected. Nearly half who received antibiotics contracted hemolytic uremic syndrome, a complication of the infection that results in kidney damage and blood cell destruction, a significant contributor to death. Among the children that were not treated with antibiotics, the rate of syndrome contraction was about eight percent. The connection to antibiotics, which has been suspected for some time, is thought to be due to toxins being released from the bacteria into the intestines after contact with the drugs.1 1. New England Journal of Medicine, June 29, 2000. Recreational Ritalin The U.S. Drug Enforcement Administration reports a growing pattern of recreational use of the drug methylphenidate (MPH) among pre-teen and teenaged children. MPH (street names "Vitamin R" and "R-Ball") is favored for its stimulant and psychotropic effects, and is among the top 10 controlled substances most frequently reported stolen each year. The pattern of abuse is found by examining data from emergency room reports, poison control centers, adolescent drug treatment centers, and school surveys. MPH is sold by prescription under the brand name Ritalin.3 3. Associated Press, May 5, 2000. Recreational Ritalin. Antidepressants and Intestinal Bleeding Spanish researchers report a statistical correlation between antidepressant drugs and intestinal bleeding. Actually, the danger appears to be taking the drugs with aspirin or other nonsteroidal anti-inflammatory drugs. The combination appears to produce a larger risk than the individual risks added together. The antidepressant drugs studied were selective serotonin reuptake inhibitors (SSRIs), a class that includes Prozac. The study involved 1,600 people with upper GI bleeding.7 7. British Medical Journal, October 23, 1999. Study Reports Acceptance of Unresearched Drugs Researchers from the University of North Carolina at Chapel Hill are questioning the casual prescription of serotonin selective reuptake inhibitors (SSRIs) to hundreds of thousands of children each year. "Our survey data suggests that despite a lack of research support, adequate training and comfort with the management of depression, SSRIs are gaining physician acceptance and becoming incorporated into primary care practice," said a university spokesman recently.8 He warns that it is not prudent to use these drugs for "school problems or nebulous behavioral problems." While SSRIs are approved for patients over 18 years of age, there is little scientific evidence that they are safe and/or effective for mental illness in children. These drugs, which include Ritalin and Prozac, are known to cause sleep disturbances and untoward behavioral changes in children. Nothing is known about their effect on developing nervous systems. They are frequently prescribed in the U.S. to treat children for hyperactivity and ADD, obsessive-compulsive disorder, aggression-conduct disorder and even bed-wetting. 8. Jerry Rushton, a researcher quoted by Reuters news service, May 1, 1999. Heartburn Drug Warning
The FDA has issued a warning about a drug commonly used for the treatment of night©time heartburn. Cisapride (also known as Propulsid) is believed to have caused at least 38 deaths from cardiac side©effects. The drug is also thought to interact unfavorably with a number of other drugs, and there is a long list of physiological illnesses that preclude its use. The manufacturer plans to send a letter to doctors asking them to use caution when prescribing the preparation.13 13. United Press, July 6, 1998. Animal Antibiotics Did you think doctors prescribed a lot of antibiotics to their patients? Farmers give their animals eight times as many as the average person gets in the United States, according to a report from the Union of Concerned Scientists. The practice, which spurs livestock growth, is seen as contributing greatly to the problem of antibiotic resistance that has many health officials very worried.10 10. Reuters, January 8, 2001. Acne Antibiotics British researchers at a meeting of the American Society for Microbiology13 warned that antibiotic treatment of acne is producing some very hardy germs that spread quite easily to other members of the population. They have found that the majority of acne patients on antibiotics harbor highly resistant bacteria on the surface of their skin. These can be passed on to others by casual contact. Acne patients treated with antibiotics are typically on the drugs for 8-10 years. "Long-term treatment with antibiotics is insane," one expert opines.14
13. American Society for Microbiology Meeting in Toronto, September, 1997. 14. United Press, September 29, 1997, quoting Marilyn Roberts, pathobiology professor at the University of Washington School of Public Health and Community Medicine, Seattle. Prescribing Doctors Fail Drug Survey The results of a survey7 of medical practitioners who regularly treat patients for angina were announced at a September meeting of the American Federation for Aging Research and Key Pharmaceuticals. Researchers wanted to know if physicians paid attention to labeling information changes of drugs they prescribe. In this case, they specifically queried doctors about isosorbide dinitrate drugs, a common treatment for angina. A year ago, the label and prescription information began noting that the drug was only effective for two hours. Three out of four doctors did not know about the new information, and most were under the impression that the medicine was good for 12 hours. Nearly all the doctors surveyed prescribe the drug regularly.8 7. Conducted by Yankelovich Partners, Inc. 8. United Press, September 5, 1996. Painkillers Slow Healing New research reinforces what many of us were taught in college decades ago: deadening pain resulting from an injury appears to interfere with healing. Research at the University of Medicine and Dentistry of New Jersey found that NSAIDs appeared to slow or modify bone healing after a fracture. Researchers administered Celebrex or Vioxx to rats with broken legs, and noted that most fractures had not fully healed after two months. When new bone formation did occur, it was often weak and superficial. The significant component appears to be the cox-2 enzyme (associated with inflammation and pain) blocked by these drugs. Researchers are starting to realize that the enzyme (and maybe the inflammation itself) plays an important role in healing.4
4. Journal of Bone and Mineral Research, May 2002. Therapy Better than Drugs A study8 from Vanderbilt University in Nashville suggests that cognitive therapy treatment may be a better way to manage depression than pharmaceuticals. The costs and effectiveness for both types of treatment were about the same over a four-month period, but the cognitive therapy appears to have a more permanent effect, with relapses occurring much less often. In the long term, cognitive therapy (which is somewhat slower to show results initially) appears to be much more effective, both clinically and economically. The conclusions of this study are expected to come as a big surprise to many psychiatric professionals who have strong faith in the drugs they prescribe.
8. Reuters, May 24, 2002. Antibiotics in the Food Chain More researchers are warning about the dangers of using antibiotics to enhance food production. Researchers from the University of Maryland School of Medicine have found, in the intestinal tracts of chickens, bacteria that are highly resistant to antibiotics generally considered to be the last remaining drugs effective against many infectious diseases. In addition, they have found resistance to what were thought to be very powerful drugs still under development. These germs are being found in animals raised on antibiotics, which are given in an effort to boost growth andΠ7. United Press, September 25, 1998.
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