Panaceia or Hygeia

immunize yourself against the pandemic of lifestyle diseases

Posts Tagged ‘drugs’

Trying to Stop Prison drug dealing

Posted by Colin Rose on February 1, 2009

If it takes at least $30 million per year and 30 Xray machines to make a dent in drug dealing in federal prisons housing 153,000 inmates or 0.13% of the adult Canadian population by extrapolation it would take at least $23 billion per year and 23 thousand Xray machines to control the drug trade in the whole country and that would be a lot harder than in a very confined prison population. Ergo, forget about trying to stop the drug trade by attacking the distribution. Legalize all drugs and deal with addiction, the same way we do with legal addictions to tobacco, alcohol and junk food which kill orders of magnitude more people than all the illegal addictions combined.


Tories take aim at prison drug dealing
CANWEST NEWS SERVICE
The Gazette
01 Feb 2009

OTTAWA – Organized crime may be about to lose its grip on one of its most profitable markets as the Harper government moves to put an end to drug smuggling into penitentiaries. In this war on drugs, Ottawa will spend $120 million over the next four…read more…

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Drug Marketing by “Study”

Posted by Colin Rose on December 13, 2008

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Posted in atherosclerosis, cardiology, cholesterol, drug marketing, professionalism, statins | Tagged: , , , , , , , , , , | Leave a Comment »

Taliban’s super success: opium

Posted by Colin Rose on November 28, 2008

If it weren’t for heroin addiction the Taliban would not exist and we would not be fighting a war in Afghanistan. Until we conquer the problem of addiction in our society there will always be criminals, terrorists and drug companies preying on the misery of addicts. Another example: instead of dealing with junk food addiction we would rather spend $many billions on drugs to treat its symptoms. The recent report of the JUPITER trial, funded by AstraZeneca and really an infomercial for Crestor, is a good example. No attempt was made to treat the addiction of the mostly overweight or obese subjects in trial. Only a drug was tested to treat the metabolic manifestations of the addiction, like “dyslipidemia” and CRP. Consequently many of the subjects became diabetic.


Taliban’s super success: opium
KIRK KRAEUTLER NEW YORK TIMES
The Gazette
28 Nov 2008

UNITED NATIONS  Afghanistan has produced so much opium in recent years that the Taliban are cutting back poppy cultivation and stockpiling raw opium to support prices and preserve a major source of financing for the insurgency, says the head of the…read more…

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Doctors bribed to read online drug propaganda

Posted by Colin Rose on November 18, 2008

It seems not enough doctors are reading the thinly disguised drug propaganda known as free online CME or “needs assessment”. The drug dealers are now offering bribes in the form of Aeroplan miles to to read this stuff.

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“Health” spending in Canada hits $172-billion, outpacing inflation

Posted by Colin Rose on November 14, 2008

Drugs now cost more than doctors and the cost is rising faster than inflation. Sooner or later this insanity has to end. Probably sooner. With a likely world-wide depression in the next few years there will be awakening awareness that most of those expensive branded drugs, such as Lipitor and Crestor, are for lifestyle diseases, like Type 2 diabetes, hypertension and atherosclerosis, related to junk food addiction which can be prevented and treated without drugs. But we need to take a $few billion of that $172 billion and put it into addiction research. Addictions of many kinds are at the root of most of the problems of developed capitalist democracies.

Note that Japan which spends per capita on its “health care” system only 38% of the USA and 70% of Canada has a longer life expectancy than either. Ergo, there is no relation between money spent on hospitals, drugs and doctors and life expectancy; if any, there is an inverse correlation. While everyone uses the term “health care” for the activities and effects of hospitals, drugs and doctors, these are really disease care. Some diseases can be cured but most can’t and in a high tech, fee-for-service medical system with an incentive only to do more, more people will be killed by the technology than saved by it.

Jeffrey Simpson in the Globe and Mail suggests as a solution to exponentially increasing costs more private “health” care. That will only increase the total cost as people with just spend more to support their addictions. Doctors in a fee-for-service regime will be only to happy to oblige. The only long-term solution I can see is to put all doctors on a salary. In such a system the driving incentive is to keep people healthy so doctors have less work to do. Paying doctors per disease is like paying firemen per fire. Would there be more or less fires? Would there be any incentive for fire departments to promote fire prevention? In a regime of totally salaried doctors costs would drop dramatically and the health of the population would markedly improve.


Health spending hits $172-billion, outpacing inflation
BY BRADLEY BOUZANE Canwest News Service
National Post
14 Nov 2008

OTTAWA  Health care in Canada will cost $172-billion this year, or nearly $5,200 for every person in the country, according to figures released yesterday by the Canadian Institute for Health Information. The independent statistical agency says that…read more…

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From the Globe and Mail, November 19, 2009

Listening to the sounds of health-care silence

JEFFREY SIMPSON

Where did health care go? Pollsters keep reporting that health care is the No. 1 issue for Canadians. We spend way more on it than on anything else. Yet, no one – well, almost no one – talks about it any more, at least not politically.
Sure, citizens recount their experiences with the system to each other. People who work in the system talk about it incessantly, health care being their world.
But as a public policy/political issue, health care has died. Died, despite the Canadian Institute for Health Information’s reporting last week that Canada will spend $172-billion this year on health, about 70 per cent from public sources. That works out to $5,170 per capita.
Health care gobbles up provincial (and federal) resources. It consumes 39 per cent of all provincial program expenditures – that is, spending on everything but  servicing the debt. In some provinces, health care’s share of program expenditures is 45 per cent. Soon, it will be 50 per cent and higher in all of them.
Health care consumed 7 per cent of the nation’s economic output in the mid-1970s, shortly after it was up and running. Now, it consumes 10.7 per cent. That share will keep on rising as the population ages, technology becomes more expensive, and demand grows.
No one knows how to stop the increase; in fact, large increases are hardwired into government spending plans. These increases are not improving the system, but they are keeping it from getting discernibly worse.
The Paul Martin government signed a deal with the provinces for a $41-billion transfer from Ottawa over 10 years starting in 2004-2005, with the transfer indexed yearly to 6 per cent. The Harper Conservatives, then in opposition, signed on to that deal and have never wavered.
Without that federal cash, provincial health-care plans would be struggling or imploding – or provinces would be forced to raise taxes or cut other services. As it is, their annual costs are rising by 4 per cent to 5 per cent after inflation. The federal cash keeps their systems afloat.
That’s one reason why silence surrounds the health-care debate. Caterwauling provinces can hardly complain about parsimonious Ottawa when such mighty rivers of federal cash are flowing their way. Similarly, almost complete silence reigns within federal politics, except for occasional election promises to spend  yet more money for provinces to hire more doctors. But with Ottawa already sending so much money to provincial capitals, these chirpings ring hollow.
It was cheap theatre for provinces to beat up on Ottawa when the federal government seemed to be rolling in dough. But after the Harper government spent the surplus it inherited by shovelling money to the provinces for the ‘fiscal imbalance,’ cut federal revenues through reductions to the GST and let spending proceed above the inflation rate, the surplus almost disappeared.
Now, with the economic tsunami upon us, the small surplus will head into deficit. Even if provinces clamoured for more health-care money, there wouldn’t be any.
The deeper reason for the silence is that no provincial government knows what to do about the system, except to keep it going, fiddle at the edges, try to improve administration here and there, negotiate the best collective bargaining agreements they can.
Nowhere in Canadian public affairs is the gap so wide between what those responsible for policy say and what they do. Privately, almost all of those responsible know that the spending increases are unsustainable and that some means must be found to allow more public services to be delivered privately.
Publicly, none of them dare say so.
Without that debate – and fear of public reaction keeps it closed – politicians spin their wheels, spend lots of money, patch the system, add something new here and there, and carry on.
The only idea for lowering the increase in health-care costs comes from those who claim, rightly, that the fastest-rising part of health-care budgets is the drug bill. Their answer: a national pharmaceutical plan integrated into medicare.
It might be recalled that, in 1997, Quebec introduced such a drug plan. It cost the treasury about $700-million that year. This year, the public cost will be $2.3-billion, a threefold increase in about a decade.

Posted in atherosclerosis, diabetes, diet, drugs, statins | Tagged: , , , , , , , , , , , , | 1 Comment »

Pfizer and Sanofi Join Merck in Abandoning Obesity Drugs

Posted by Colin Rose on November 9, 2008

Pfizer and Sanofi Join Merck in Abandoning Obesity Drugs

By Jim Edwards

November 5th, 2008 @ 6:25 pm

For those of you hoping that America’s obesity crisis could be solved with a pill, think again. Pfizer announced late Wednesday that it is scrapping its anti-fat drug, the as-yet unnamed “CP-945,598,” for essentially political reasons. Sanofi-Aventis today also announced that it was ending its trials on Acomplia/Zimulti, an obesity pill that was approved and then yanked in Europe. And Merck a couple of weeks ago pulled its fat pill taranabant, from its pipeline.

Pfizer’s statement contained an interesting mystery. It said there was nothing wrong with the compound, but they were booting it from the pipeline because they couldn’t be bothered to navigate the bureaucracy required to bring it to market:

Pfizer believes that the CP-945,598 compound has the potential to be a safe and effective treatment for weight management. However, the Company has decided to discontinue the development program based on changing regulatory perspectives on the risk/benefit profile of the CB1 class and likely new regulatory requirements for approval.

“While confident in the safety of the compound, we believe that this is the appropriate decision based on all available information regarding this class of agents, as well as recent discussions with regulatory authorities,” said Martin Mackay, president, Pfizer Global Research and Development.

Really? The company has an effective drug but won’t attempt to sell it — clearly we’re lacking some important details.

Sanofi was more forthright. Acomplia was pulled from shelves because Euro regulators thought the pill was too dangerous for sale; and the same authorities asked Sanofi to stop its ongoing trials for the same reason. Merck stopped its version because it had similar side effects seen in Sanofi’s — weird mood changes and depression.

Interestingly, all three drugs acted on cannabinoid receptors. So how likely is it that Merck and Sanofi’s drugs were riddled with side effects while Pfizer’s was just fine? Hmmm.

None of this news is surprising to BNET readers. Back in July we noted that “Drug companies have been down this route many times before, and always failed to find success. A safe and effective weight-loss pill is like Big Pharma’s El Dorado — a lost city of gold that no one can find.”

It’s worth repeating the explanation for why these pills tend to fail, provided by Derek Lowe of In the Pipeline:

Evolutionary pressures have been too strong — our metabolisms try to make absolutely sure that we have plenty of reserves against the lean times, because over most of the history of our species, it’s been nothing but lean times….

So many of the weight loss drug attempts have been in the area of appetite suppression — stop the problem before it develops. But you run into those multiple pathways there, too — any animals whose feeding behaviors can be easily shut down are long dead. We’re the descendants of the opposite population: the ones that scrambled for food no matter what.

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Disastrous Epidemic of Type 2 Diabetes in Children

Posted by Colin Rose on November 7, 2008

Many more children on medication, study says

‘Surprising’ rise targets diabetes, other obesity-related diseases

November 3, 2008

Baltimore Sun

Hundreds of thousands more children are taking medications for chronic diseases, with a huge spike over a four-year period in the number given drugs to treat conditions once seen primarily in adults and now linked to what has become an epidemic of childhood obesity.

In a study appearing today in the journal Pediatrics, researchers saw surges in the number of U.S. children taking prescription medicines for diabetes and asthma, with smaller increases in those taking drugs for high blood pressure or high cholesterol. All of those conditions, to varying degrees, have been associated with obesity.

Though doctors have been seeing the trend in their practices, “the rate of rise is what’s surprising,” said Dr. Donna R. Halloran, a pediatrician at St. Louis University in Missouri and one of the study’s authors.

The study found a doubling in the number of children taking medication for type 2 diabetes, with the largest increases seen among pre-teen and teenage girls. The number of asthma prescriptions was up nearly 47 percent.

The findings come from a study of 3 million privately insured children that was designed to be a nationally representative sample. The researchers used the sample to measure increases from 2002 to 2005 in the number of children taking various medicines but did not estimate how many youngsters nationally were on the medications.

There is nothing inherently wrong with giving medication to children with chronic diseases, doctors say, especially when the drugs are shown to be safe and effective. The increase in children receiving asthma medication appears to be partly because more children have asthma, but also because new guidelines recommend using medication in more cases.

The use of cholesterol medication for children appears to have become more accepted as well. The American Academy of Pediatrics recommended last summer the use of statins to lower cholesterol in children as young as 8.

Meanwhile, the federal Centers for Disease Control and Prevention say the number of children with type 2 diabetes is on the rise, but officials do not have estimates for how much. Type 2 diabetes, which used to be called adult-onset diabetes, begins when the body develops resistance to insulin and can no longer use it properly. Eventually, the body can no longer produce sufficient amounts of insulin to regulate blood sugar.

Still, there is an increasing unease in some circles that doctors are prescribing medication without exhausting nonpharmacological options.

“There are concerns that we’re moving too quickly to drug therapy,” said Emily R. Cox, a researcher at Express Scripts, a St. Louis-based pharmacy benefits management company, and lead author of the study. “We don’t know that drug therapy is best for some of these conditions.”

Cox and her colleagues looked at the rates of medication among children ages 5 to 19. They did not look at all medication use, but focused on drugs for high blood pressure, diabetes, cholesterol, asthma, depression and attention-deficit disorders.

Since the study used figures from commercial insurance providers, it did not include the uninsured or those covered by programs for low-income children. Other studies have shown that the urban poor have some of the highest rates of childhood obesity in the United States.

According to the study, antidepressant use was essentially flat, though the numbers have gone down significantly among children under 10. Attention-deficit medication, the proper use of which has long been debated, rose 40 percent, with the largest increase among girls taking medicine for a set of disorders traditionally seen more in boys.

In raw numbers, the number of children on diabetes medication is relatively small, but the findings included one of the more surprising trends, a large number of girls on the drugs. The number of girls ages 10 to 14 on the medication rose 166 percent, and the figure for those ages 15 to 19 rose 133 percent.

One expert said those numbers cannot by accounted for by rises in child diabetes or by a secondary use of one of the drugs, metformin, to treat polycystic ovary syndrome.

“It’s definitely not due to a doubling of type 2 diabetes in children, because type 2 diabetes has not doubled in children and we have data on that,” said Dr. Silva Arslanian, an endocrinologist at the Children’s Hospital of Pittsburgh, who was not involved in the study.

She said overweight children regularly come into the hospital’s Weight Management and Wellness Center on metformin, having been told that they have diabetes, but tests of their blood sugar turn out normal. Arslanian said she believes that some doctors are using metformin, which can lead to appetite loss, as a diet pill – an “inappropriate” use.

“Management of obesity is very frustrating,” she said. “We talk about lifestyle changes, but how many of us are successful in changing lifestyle when the environment is so toxic? When you give somebody a medication, the psychology of the patient is, ‘The medication is doing the job, so I don’t need to change the way I’m eating or moving or drinking.'”

Dr. Debra R. Counts, head of pediatric endocrinology at the University of Maryland School of Medicine, said she does not think that diabetes drugs are being improperly prescribed. She said more children are taking diabetes medication because more children have diabetes. And even though more boys are becoming obese than girls, she said, studies show that girls are more likely to develop diabetes.

“Most pediatricians try not to prescribe medication unless it’s indicated,” she said.

Another reason that more children are being given medications could be that more drugs have been approved for pediatric use in recent years. In the past, doctors in some cases had prescribed the drugs anyway, but many feel more confident now, knowing that proper studies have been done in children.

Medication is not by itself a solution in many cases, especially when it comes to diseases like type 2 diabetes and hypertension, which are most closely linked to obesity, doctors said. Lifestyle changes have to begin as early as possible, Counts said, sometimes even in toddler years.

She noted recent recommendations that overweight 1-year-olds be given low-fat milk as opposed to whole milk. Doctors used to believe that babies needed the fat in whole milk for their brains to properly develop and recommended whole milk until a child’s second birthday.

“We get a lot of kids referred to us. The problem is, we have no magic,” Counts said. “The whole family needs to eat healthier and get more active and turn off the TV. … By the time people are teenagers, it’s hard to change them.”

Posted in addiction, children, cholesterol, diabetes, Type 2, diet, drugs, moral hazard, obesity | Tagged: , , , , | Leave a Comment »

Pharma marketing sways Canadian doctors

Posted by Colin Rose on October 15, 2008

Unlike their American colleagues, many Canadian doctors admit they are influenced by drug propaganda. But they don’t think those free sample compromise their judgement. Really? Let’s say a patient has a routine blood lipid test and the “bad” cholesterol is high and the patient is obese and smoking. What is a busy doctor going to do? Grab a box of Lipitor off his or her cabinet full of free samples or spend half an hour explaining the necessity of lifestyle choices in preventing atherosclerosis or diabetes?

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Medical Post
September 26, 2008 Matthew Sylvain

But just because it influences decisions, doesn’t mean physician judgment is compromised

TORONTO | Almost half of respondents to our Medical Post-mdPassport online eithics survey said their prescribing habits have been influenced by drug company advertising and other acts of persuasion. Depending on your perspective, that shows a remarkable honesty.

Then again, if you count yourself among the 54% who answered no, that you are unswayed by the arguments of detailers and the like, you might think that nearly half your colleagues are too easily influenced.

“I think physicians are influenced by it,” said Dr. Gerry Rosenquist, a gynecologist at the Winchester, Ont. District Memorial Hospital, who was asked to share his opinions on the survey findings. He added, however, “that doesn’t mean they (doctors) are influenced negatively.”

Few physicians would compromise their practice of medicine by intentionally prescribing products that were improper for their patients, he said.

Dr. Heidi Carlson, a Moncton, N.B., pediatrician, agreed the marketing isn’t inherently and entirely negative. The ads, rep visits and drug samples allow a busy doctor to quickly learn of a medication’s advantages and disadvantages, she told the Medical Post.

“I would be lying if I said I hadn’t given out free samples before, and I hadn’t taken the free samples before,” she said “because certainly, if there are new things on the market that are supposed to be better, I’d rather have patients trying them first—and seeing if they are of any use to them—before asking them to go out and buy them. So I can’t say I haven’t been influenced by it.”

Dr. Barbara Mintzes (PhD), an assistant professor in the University of British Columbia department of anesthesiology, pharmacology and therapeutics, was surprised by the admission by 46% of respondents that their prescribing had been influenced by marketing.

She said that seemed refreshingly sincere in light of a recent U.S. study of hospital-based physicians that found only 1% of them believed their own behaviour was influenced by pressure from pharmaceutical and equipment makers. Meanwhile, they thought more than 50% of their physician colleagues were swayed. That variance in opinion is so great it’s suggestive in itself, she said.

“I don’t think you would call anyone a dunce for actually saying that yes, they do believe there is some influence on their prescribing from marketing exercises,” said Dr. Mintzes, who is also a part of the Therapeutics Initiative, an independent, non-profit organization that assesses drug therapies.

The president of Canada’s Research-Based Pharmaceutical Companies (Rx&D), an industry lobby group, noted its members follow a marketing code of conduct. According to the code, “Information provided to health-care professionals by our members must be accurate, fair and balanced,” said Russell Williams in an e-mailed statement.

Williams added that information packages on clinical evaluations also meet standards set out in the Food and Drugs Act, and regulations.

Said one doctor, commenting on the survey, “Script ‘buying’ by big pharma, thinly disguised as a phase four clinical trial, is a problem.”

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Food Addiction

Posted by Colin Rose on August 20, 2008

We were delighted to be notified of an upcoming symposium on food addiction. It has finally dawned on the obesity establishment that the pandemic of obesity is caused by the pandemic of food addiction. We have been criticized for even making the suggestion, illustrated in our photo essay on food addiction. Now they must start asking themselves why there is a pandemic of food addiction that began in the early 1980s, coincident with the beginning of the promotion of the cholesterol myth. The most likely explanation is the moral hazard effect of drugs for “treating” the symptoms of self-destructive lifestyles. The population has been indoctrinated in the belief that as long as one takes one’s pills for blood cholesterol, blood sugar and blood pressure, one is free eat anything in any quantity. In this regard, we would hope that the sponsor of the symposium, Merck-Frosst, a peddler of pills for those very symptoms, realizes its culpability in contributing to the problem.

Piazza San Stefano, Venice

Food addiction in children and an adult

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Statins in Women – Useless

Posted by Colin Rose on July 18, 2008

Generally, I’m not a great fan of meta-analysis but if the drug dealers want to play the game anyone can.

On the average women have heart attacks about 10 years later than men but more women than men die from coronary disease. In this meta-analysis from JAMA statins do not reduce total mortality in women in either primary or secondary prevention. They haven’t even been proven in a good controlled trial to prevent “events” in secondary prevention. So until there is a good RCT of statins in women I will not prescribe them for any women without xanthomas.

Dr. Pignone is noted as having received research support from Pfizer and Bayer. I would bet that after publishing this paper he won’t get another cent from the drug dealers.

Posted in atherosclerosis, cardiology, cholesterol, coronary artery disease, drugs, statins | Tagged: , , , , , , , , , , , , | Leave a Comment »