There seems to be not a week that goes by now that we don’t get another story of medicines that simply don’t work. In the last couple of weeks we have learned that Beta Blockers, a huge class of drugs used to treat high blood pressure and heart disease that have been around since 1964 don’t work. One of the studies involved 45,000 people and the results indicated there was no difference in life expectancy.
This is a big deal, the inventor of the first beta blocker James Black won the Nobel Prize in 1988. There are around 20 different types on the market and the first one was released in 1964. Many hundreds of millions of prescriptions are prescribed every year. I decided to write about this because of the consistent slant taken by the media when they report this increasingly common phenomenon of drugs that offer no benefit. I was reading the TVNZ website I would like to quote a couple of lines from this… ‘A Waikato cardiologist (Dr Nunn) is warning patients not to stop using beta-blocker medication following an American study questioning the effectiveness of the drug’ ‘Nunn said numerous randomised trials showed beta-blockers benefited those who had recently suffered a heart attack, as well as patients with severe heart muscle damage.’ ‘Nunn said he wasn't concerned by the study, adding that in the past decade "more modern" beta-blockers had been introduced "and they're the ones that have been shown to be particularly effective and protective.’ Dr Nunn may well be right, there may well be very specific groups of people who have heart disease, who have already had a heart attack who get some benefit from beta blocker medication, but in all likelihood, the vast majority of people they have been prescribed to do not. In effect, they have been taking drugs for many years that did not do anything positive and worse still, they have been unnecessarily exposed to side effects. Dr Nunn warns us against stopping them, and I ask why? If they don’t work, and by work I mean reduce our chance of dying, what possible reason could there be to continue using them? Based on what he has said, and the evidence from this huge study, then the advice should actually be ‘there may be some people who still need these drugs, but we strongly advise you to go to your doctor and find out if you are in that group’. Instead, we are told outright to continue taking the drugs. Another similar situation occurred with antidepressants. It is the same story again and again, we are told by the medical authorities, ‘it’s an interesting study’ (the study said antidepressants, including Prozac ‘fluoxetine’ are useless http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10494827) we are told in the article that antidepressants are extremely beneficial for specific groups of people, don’t stop using them!, and they roll out a whole swag of ‘experts’ to quickly try and restore the trust. In the structure of all these articles we can generalise a very simple implied message, keep trusting your doctor, do not stop using the drugs. Devastatingly negative studies are portrayed as minor setbacks of no great consequence. Fear is used, ‘it could be unsafe to stop using the drugs’. Hope is used, ‘modern drugs are actually much better and the evidence is very strong for their efficacy’, don’t stop using the drugs…don’t stop… What all of these articles neglect to tell us is that the vast majority of these patients did trust their doctors and specialists; doctors are amongst the most trusted people in the country. All of us have taken their advice for decades and now we see that that trust has been (in many cases) extremely poorly placed. I don’t see why doctors should not take responsibility for what is a scandal attacking the very foundations of modern medicine - prescribing. We are led to believe that doctors or specialists are left ‘shaking their heads’, as though they actually had no idea. I question this; do they not listen to the concerns raised by their patients who may have read something? Do they not use the internet? Do they not read the same things I have read? Books have been written about this for decades, but we are lead to believe that they are just finding out now, that it’s all new to them, and of course it’s all different now because ‘these studies are about older drugs – not the new ones which are (of course) much better’. Drug companies figured out many years ago that you could make a lot more money by prescribing drugs to people who are not actually sick. They have invented new diseases, often called ‘syndromes’, and there is a drug for all of them. Clinical depression is not such a condition, it can be very serious, but antidepressants have been prescribed as a front line treatment to virtually everyone who walks into a GP’s office and says they have been feeling down. The antidepressant article above was dates from 2008, and in New Zealand alone 720,000 prescriptions were prescribed that year. That means hundreds of thousands of kiwis use them, and nearly all got no benefit whatsoever (there is evidence to suggest that various other therapies, such as counselling do work, and organisations such as Youthline and Lifeline offer free advice). These prescribing figures also suggest we must be a pretty unhappy lot. While drug company research often involves fraud of one kind or another, and drug company sales reps have educated and encouraged doctors (often illegally) to prescribe the drugs to pretty much everyone, it’s the entire medical ‘prescribing’ paradigm that’s at fault. Doctors have played a huge role too; the problem they have created for themselves is that we have all been extremely well trained. If you are sick, go to your doctor. The doctor names the disease and gives you a pill. That’s the system. Unfortunately, the medical citadel is crumbling, and it is crumbling fast. The benefit of the internet is that people can now educate themselves; there are huge numbers of sites and articles discussing all aspects of this truly massive scandal. I take great exception to Dr Nunn’s statement that ‘it’s the more modern beta blockers that have proved to be much more effective’. Proved by whom? Virtually all the research that puts a drug on the market is carried out ‘in house’ by drug companies and their paid scientists. If anything, drug companies have become even more about money and less about medicine, and therefore recent research and recent drugs are even more likely to be the result of fraud than older ones. My message in this article is that while these negative drug stories are reported on, they are consistently spun in favour of the system, to give you an impression that there is nothing to worry about. But there really is something to worry about. We now have a situation that people who are desperate and in need of treatment have no real way of knowing whether the drugs they have been prescribed work at all. Worse still, they have no way of knowing whether the drugs are safe. These are increasingly dire times for drug companies and all those who rely on prescribing their products to make a living. I suspect there will be increasingly dishonest tactics employed. The big questions are, how long can all this go on? How long before this house of cards crumbles? And can modern medicine change fast enough before people’s faith in it is completely eroded? Read the New Scientist article here: http://www.newscientist.com/article/mg21628900.200-beta-blockers-are-busted--what-happens-next.html Please note: There are situations where beta blockers may be of benefit to people, so before you stop any medications, please discuss with your doctor first. This article is focussed on the mass over prescribing of beta blockers and other drugs.
