Understanding Drugs

UNDERSTANDING DRUGS
By Helke Ferrie
Vitality Magazine March 2008

Street drugs kill about 20,000 people a year in North America, but prescription drugs kill about 700,000 annually, making legal drugs the leading cause of death. Drug side effects cause 8.8 million hospitalizations annually, or 28% of all hospital admissions.

Prescription drugs and street drugs are both designed for symptom control. Drug product monographs clearly state: “This drug does not cure.” In August 2004 The New Yorker ran a full-page ad by Novartis with a cartoon showing a castle wall at the bottom of which was a badly broken Humpty Dumpty. One of two courtiers kneeling beside him says: “We can’t put him back together again, but at least we can lower his blood pressure.”

Drug companies know that most drugs are unacceptably toxic and are re-focusing on “biologicals”, which contain natural peptides, helpful bacteria, biologically engineered drugs (most new cancer drugs), and even drugs that deliver minerals and vitamins. The more bio-identical a drug can be made, the less toxic it will be to the liver. Merck is hoping for financial recovery with its new cholesterol-lowering “drug”, Cordaptive, whose active ingredient is Niacin (vitamin B3), long known to be nature’s cure for cardiovascular disease.  Drug companies have spent $76 billion since 2005 buying biotech companies because synthetic drug development, which earned them about  $1 million per hour, is exhausted. Last December, Sidney Taurel, the chairman of Eli Lilly said: “I think the industry is doomed if we don’t change.”

Pharmaceuticals, like street drugs, are both intended to get addicts and patients hooked; many drugs are addictive and some, like Ritalin, work through the same cellular receptor sites used by crack cocaine. At a marketing conference for the managers of the world’s largest pharmaceutical companies in March 2004 one of the first overheads read: “As a Marketer: which is better for business? Steady continuous use of your drug, or occasional use of your drug?”

There is one way in which street drugs differ from prescription drugs: drug pushers without an MD know exactly what their product does, while drug pushers with an MD don’t know they are drug pushers and are almost completely clueless about pharmacology. Last November, the Health Council of Canada published a report stating that “people are going out into practice without a comprehensive understanding either of how drugs work or how to use them rationally.” Only 4 of Canada’s 17 medical schools require just a short course on clinical pharmacology. Yet, doctors have sole prescription power over some 20,000 pharmaceutical drugs, which generate 400 million prescriptions annually, costing our healthcare system $24 billion. Even if doctors do sometimes read the Health Canada warnings on a drug, they don’t seem to understand them. How else can one explain what Ontario’s Auditor General found in 2007: that year over18,000 alerts on known drug toxicity were provided by pharmacy computers for the prescriptions issued for the residents of 421 long-term care homes – yet, the prescribing doctors ignored these warnings 91% of the time.

The Royal College of Physicians and Surgeons of Canada was so shocked by these reports, they changed medical training requirements, starting this year.  Students must study pharmacology for two years. This is undoubtedly very good news for Canadians, and will turn out to be bad news for undertakers and certainly for Big Pharma, because our doctors will learn what synthetic drugs really do – not just what a drug rep tells them over wine and roses.  Even with this new breed of doctors soon appearing, you might want some help in understanding drugs.

Every class of drugs currently used to treat the symptoms of cancer, diabetes, heart and autoimmune diseases, depression, psychiatric disorders etc is currently under regulatory investigation, the subject of class actions involving tens of thousands of people. They continue to be sold with advisories required by the FDA and Health Canada which inform that antidepressants may increase the risk of suicide and that they do increase the risk of cancer, diabetes, and osteoporosis; that non-steroidal anti-inflammatory drugs, the NSAIDs, and diabetes drugs like Avandia increase the risk of heart attacks; that all estrogenic drugs increase the risk of stroke because of the formation of blood clots; that cholesterol-lowering drugs increase the risk of most of the above and interfere with sleep; that certain cancer drugs can kill you from heart attacks and brain inflammation. All of this information is freely available at your local drug store, in every doctor’s office, and online in the annually updated CPS, the Compendium of Pharmaceuticals and Specialties.

Over the past decade, Big Pharma’s “science engine has stalled”, observed the Wall Street Journal on December 6, 2007.  Computer-assisted “rational drug design” can no longer find new applications to known cellular targets in humans. The main reason being the discoveries made through the Human Genome Project. It was believed that about 10,000 useful targets would be available on human cells for drugs to act upon; in fact there are at most 1,000.  Furthermore, almost all blockbuster drugs are under increasingly successful legal attack for deaths and injury. Merck paid more than $ 4 billion (about one year’s earnings) for the human disaster it created with the NSAID Vioxx, which killed about 150,000 since coming to market. The French government has charged GlaxoSmithKline and Sanofi Pasteur with “manslaughter” for the deaths caused by the Hepatitis B vaccine.  Eli Lilly paid $1 billion in legal settlements to thousands of patients injured or killed by the antidepressant Zyprexa and now faces angry shareholders suing for “recklessly disregarding risks” and “illegal marketing tactics”.

According to Dr. Michelle Brill-Edwards, formerly Health Canada’s top drug regulator,  “Patients are merely road-kill on the highway to profit”; shareholder wrath is more like the highway itself disintegrating. Investors are demanding to know why they are losing money. Wall Street evaluations were grim. Moody’s assessed pharmaceuticals as “negative”, i.e. don’t invest. The FTSE Global Pharmaceutical Index fell by 19%, even though the price of drugs rose by 63% since 2002.

HOW DRUGS WORK

A current pharmacology textbook states that “the symptoms of a disease arise from a deficiency or excess of a specific metabolite in the body, from an infestation by a foreign organism, or from an aberrant cell growth.” The “metabolite” might be the result of inflammation such as in arthritis, the “infestation” could be a bacterium, and “aberrant cell growth” would be cancer. “These problems can be addressed through enzyme inhibition,” the textbook asserts so these symptoms are simply stopped in their tracks.

Almost all drugs are inherently toxic either by often causing a universal allergic response, such as ACE inhibitors, aspirin and antibiotics, or by depleting essential nutrients if they are enzyme inhibitors – and that is most of them. Drugs poison essential chemical pathways when they are “inhibitors” or “blockers”. Enzymes are proteins that cause all the chemical reactions that keep us alive.  Enzymes depend on essential minerals. Drugs are never as specific as their designers intended, so they go after the intended and many unintended targets. At first, symptom relief may occur, but then new symptoms start  – the infamous side-effects. More drugs are needed to cut off the enzymatic action of the new troublemakers, and the battlefield becomes larger and larger as greater numbers of enzyme populations are attacked, until finally even the drugs themselves fall victim to “friendly fire”, and we have a regular world war going on in all bodily systems. This is why synthetic drugs are Killer No. 1.

When a drug is beneficial, it performs the way the Americans had hoped to in Vietnam, namely through successful, specific “search and destroy” missions. Antibiotics, medications used in acute heart failure, and some anticonvulsants are examples. (Note, none are blockbuster drugs under patent protection.) These drugs can act fast, accurately and don’t mess up the surrounding areas much, if at all, if they are used short-term.

According to the current edition of Harrison’s Principles of Internal Medicine, the drugs that cause 90% of the death and destruction (not just transient constipation, nausea, drowsiness, and temporary candidiasis) are:  all the NSAIDs, digoxin, anticoagulants, diuretics, new-generation antibiotics (like Cipro), all cancer drugs, and hypoglycemics (for diabetes). Among the pain killers acetaminophen (Tylenol) is the most dangerous; most liver transplants are due to its long-term use.

The liver detoxifies natural and synthetic toxins. It does this through many enzymes which are divided into various families all of which arise out of one super-family called CytochromeP450. If a drug arouses this super-family, the liver will quite literally fight to the death to protect you.

Various racial groups have over time evolved differences in CytochromeP450. People of African and Afro-American origin react differently to many drugs than whites and Hispanics do: some people are “extensive metabolizers”, and others are “slow metabolizers”.  Some people lack specific cell receptors for which a drug was originally designed: the cancer drug Herceptin, for example, becomes acutely toxic if the patient lacks those receptors. The new science of “genotyping” tries to do this.

Finally, age and sex are important. Men metabolize drugs differently than women.  Antidepressants are less quickly and less seriously toxic (at first) in men, but tend to have side effects faster in women because their livers are in bodies with more female sex hormones. As we age, we are less able to metabolize drugs, hence side effects, especially when more than one drug is involved, are more severe.

Harrison’s advises that old people should be given minimum doses always, and the use of more than one drug should be avoided. (Given the current norm of polypharmacy, especially in old age homes, one must wonder if doctors read even Harrison’s, their standard textbook.)  When 5 drugs are given, a 5% chance exists of adverse events. However, drug action is “nonlinear”, i.e. more than one target is hit and unpredictable interactions will occur.  So, if 15 drugs are given simultaneously, the chance of serious adverse events is not just three times as much, i.e. 15%, but 40% – and we have that world war referred to above which ultimately is due to the depletion of essential nutrients, especially minerals.

A quick survey of the drugs responsible for 90% of adverse events and deaths, as listed in Harrison’s, showed that they deplete: potassium (responsible for cell-to-cell communication), calcium (bones, central nervous system), all the B vitamins (all bodily systems require these, the liver stores them all), iron (oxygen transport in blood), vitamin D (DNA repair, cancer prevention), zinc and selenium (immune system), Co Q10 (heart function), and magnesium (essential to everything, being the Queen of the Minerals). Some drugs also inhibit melatonin, such as most statins and antidepressants (the immune system does most of its work while you sleep). Antidepressants often wipe out the sex drive; reduced sex hormones adversely affect memory and learning.

LEARNING TO PROTECT YOURSELF

Symptoms are the urgent demand our bodies make on us for intelligent dialogue. The vast majority of synthetic drugs are designed to prevent such a dialogue. Intelligent dialogue may, at times, leave symptom control as the only viable option, as in the case of surgical or chronic pain. However, current drug-dependent medical practice prevents homeostasis (a cure) because the focus is on symptom control.

So, always ask: Does this drug cure or make me into a customer indefinitely? And: What is my body likely to do if I take this drug? The answer to the first protects your purse, to the second your liver. It is naïve in the extreme to take any drug on trust and not check it out in the CPS at the very least. Big Pharma does not deserve any trust; its products are the leading cause of death. Since those deaths were initiated by the prescriptions from well-meaning but pharmacologically ignorant doctors, it is a health hazard to assume “the doctor knows best.” Doctors need to be treated with polite doubt – like politicians. Their assertions must be verified carefully, mainly because they themselves have usually been duped.

The following guidelines may prove helpful, as I know from personal experience.

  1. If media reports tell of a drug’s withdrawal or serious side effects, that entire class of drugs is bad news. All SSRI antidepressants were designed to act on the same targets. If one NSAID, like Vioxx, killed a lot of people, all the others in that family are dangerous.
  2. If the CPS informs you that this drug is metabolized by Cytochrome P450,  you know it is liver-toxic. In situations when such a drug cannot be avoided (e.g. certain antibiotics for Lyme Disease, systemic infections from nano-bacteria or fungi, pain control, etc) we may rely on guidance again from Harrison’s, which suggests taking glutathione supplements, or Alpha Lipoic Acid, or N’Acetyl L-Cysteine to avoid the drug’s known toxicity.
  3. If you develop side effects, or if the drug doesn’t work, do not increase the dose or add another drug to “boost” the first one. Rapid side effects suggest you are a slow metabolizer and must stop the drug, probably immediately; no effect suggest you may be a fast metabolizer and will get serious side effects if you increase the dose.
  4. If you are currently on drugs, check Dr. Hyla Cass’ and Pelton and LaValle’s books to see what essential nutrients this drug depletes and take those, as recommended in each case, for as long as it takes to either wean yourself off,   substitute safer drugs and recover from side effects, or as a safety supplement while you need it.
  5. To find reliable information on drugs, consult Best Pills Worst Pills and especially the World Health Organization’s Essential Drugs List (online).
  6. Drug-drug interactions as well as interactions between synthetic drugs and many foods must be assumed (e.g. grapefruit juice); known interactions are listed in the blue pages of the annually updated CPS.

Dr. Richard Smith, for 20 years the editor of the British Medical Journal, during a lecture at the University of Toronto (November 21, 2007) said: “Doctors and patients are in this bogus contract. The patient believes the doctor can fix my problem. That is a very powerful fantasy! Patients need to invest time and energy in researching their condition and be smarter than their doctors.  That is quite possible these days.” Amen.

Sources & Resources:

Alliance for Human Research Protection website reported in January 2007 various studies showing that SSRIs (a class of antidepressant drugs that include Prozac, Zoloft, Paxil etc.) increase risk of bone fractures. The publications cited came from the Archives of Internal Medicine, the McGill Centre for Bone and Periodontal Research, and the US National Institutes of Health:http://ahrp.blogspot.com

D. Armstrong. “Pfizer Is Sued Over Lipitor Marketing”, on Bill Sardi’s website December 20, 2007: Bsardi@aol.com

Associated Press, November 7, 2007. “Report: Merck Discloses 4 Tax Disputes”

B. Bartali et al. “Serum Micronutrient Concentrations and Decline in Physical Function Among Older Persons”, JAMA, January 23, 2008

A. Berenson. “Cholesterol has No benefit in Trial, Makers Say”, New York Times, January 14, 2008

P. Biron MD et al. “Pharma-co-dependence exposed: Would it be time to say No thanks?”, Canadian Family Physician, October 10, 2007

Y. Caraco MD. “Genes and the Response to Drugs”, New England Journal of Medicine, December 30, 2004

Dr. H. Cass. Supplement Your Prescription: What Your Doctor Doesn’t Know About Nutrition, Basic Health, 2007

Center for Disease Control, MMWR Weekly, February 9, 2007: “Unintentional Poisoning Deaths – United States 1999-2004” www.cdc.gov.mmwr

M. Eichenbaum & O. Burk. “CYP3A genetics in drug metabolism”, Nature Medicine, Issue 7, p. 285-287, 2001

A. Elixhauser & P. Owens. “Adverse Drug Events in US Hospitals 2004”, Agency for Healthcare Research and Quality, Statistical Brief # 29, April 2007

M.-A. Gagnon MD & J. Lexchin MD. “the Cost of Pushing Pills: A New Estimate of Pharmaceutical Promotion Expenditures in the United States, PloS Medicine, January 3, 2008

Compendium of Pharmaceuticals and Specialties, 2007 edition

Genetic Engineering News, February 1, 2008, “Annual Wall Street Analyst Roundup”

K. Giacomini et al. “When good drugs go bad.” Nature, April 26, 2007

M. Goozner, The $ 800 Million Pill, University of California Press, 2004

Harrison’s Principles of Internal Medicine, (current) 16th edition

CNNMoney.com, January 7, 2008. “Pharma Forecast Calls For More Of The Same”

G.F. Van Hare MD. “Antiarrhythmic Drug Dosages and Preparations for Children”, 6th edition, posted on internet by the Pediatric Arrhythmia Center at UCSF and Standford: http://pediep.stanford.edu/Drug_guide-2000.html

A. Harris. “FDA approves natural ingredients in new non-toxic cancer drug”. Posted on www.thiskillscancer.com, June 7, 2007

S. Hasselberger. “Polypill – miracle cure or insanity?” on his website June 30, 2003; www.mediaexplorer.org/sepp

Healy MD. Let Them Eat Prozac, Lorimer 2003

T. Higgins MD. “Oral Hypoglycemic Drugs”, website of Boulder Medical Center: www.bouldermedicalcenter.com/articles

D. Hodges. “More evidence links use of proton pump inhibitors to C. difficile”, Medical Post, October 6, 2006 (his sources are in the CMAJ September 26, 2006 and JAMA December 21, 2005)

W. Kondro, “Health Canada proposes new regulatory regime for drugs”, CMAJ, April 24, 2007

D. Lednicer. New Drug Discovery & Development, Wiley, 2007

A. Lepage-Monette. “Some statins linked to poor sleep”, Medical Post, January 22, 2008

T. Leveque & J. Mackenzie. “Vaccine Companies Investigated for Manslaughter”, Reuters New Service, February 1, 2008

B. Martinez & J. Goldstein. “Big Pharma Faces Grim Prognosis”, Wall Street Journal December 6, 2007

T.J. Moore et al. “Serious adverse drug events reported to the FDA 1998-2005”, Archives of Internal Medicine, 2007 volume 167:1752-1759

MedicineNet.com, February 10, 2008. “beta Blockers”, “Definition of ACE Inhibitors”

P.K. Myint et al. “Plasma vitamin C concentrations predict risk of incident stroke over 10 years…”, American Journal of Medicine, January 2008

P. Moynihan & A. Cassels. Selling Sickness: How The World’s Largest Pharmaceutical Companies Are Turning us All Into Patients, Nation, 2005

Murphy, T. “Shareholders Sue Lilly Over Zyprexa Woes”, Associated Press, February 1, 2008

NEWSInferno.com January 23, 2008. “Big Pharma Prime for Attacks, Thanks to Defective, Ineffective Drugs”

S.J. Padayatty et al. “Intraveneously administered vitamin C as cancer therapy”, CMAJ, March 28, 2006

R. Pelton & J. LaValle. The Nutritional Cost of Prescription Drugs, Morton, 2004 (for patients); Drug-Induced Nutrient Depletion Handbook, Lexi-Comp (for doctors: fully referenced and cross-referenced with essential nutrients information)

Press Release from Northwestern University (marla-paul@northwestern.edu) “Researchers find deadly prescription drug effects 6 years before FDA”,  May 28, 2007

Qi Chen et al. “Pharmacological asorbic acid concentrations selectively kill cancer cells”. The National Academy of Sciences, PNAS September 20, 2005

L. Richwine. US FDA says reviewing Vyotrin cholesterol drug”, Reuters News Service January 25, 2008

A. Rivkin. “Admissions to a medical intensive care unit related to adverse drug reactions”, American Journal of Health-System Pharmacy, 2007, vol. 64 issue 17

H. Schneider MD. “Mood Disorders: Cognitive Behavioral Therapy and Pharmacotherapy”, GP Psychotherapist, Spring 2008

Science Daily. “Why Anticancer Drug Avastin Causes Potentially Fatal Brain Inflammation in Certain Patients, Study Suggests”, posted February 16, 2008

Science Daily. “Celecoxib Can Adversely Affect Heart Rhythm, Study Suggests” posted January 17, 2008

R. B. Silverman. The Organic Chemistry of Drug Design and Drug Action, 2nd ed, Elsevier, 2004

K.E. Stine & T.M. Brown. Principles of Toxicology, 2nd ed., CRC, 2006

E. Turner et al. “Selective Publication of antidepressant trials and its influence on apparent efficacy”, New England Journal of Medicine, January 17, 2008

K.-G. Wenzel MD & R. Pataracchia ND. The Earth’s Gift to Medicine: Minerals in Health and Disease, Kos, 2005

H.  Young, “lack of pharmacological training causes overuse and misuse of drugs”, CMAJ, January 29, 2008

Worst Pills – Best Pills, Pocket Books, 2005

Most truthful journal: PloS Medicine, free on internet

 

 

 

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