A warning for pill poppers

In 1673, J.B. Molière wrote, “Nearly all men die of their medicines, not of their illness.” And while imprisoned on the island of St. Helena, Napoleon commented, “Take a dose of medicine once and, in all probability, you will be obliged to take an additional hundred afterward.” So neither of those great men would have been surprised at the bombshell announcement that Vioxx, heralded as the “Super Aspirin” for arthritic pain, has been found to increase the risk of heart attack and stroke and been removed from the market.

It’s the old story of caveat emptor: let the buyer beware. But think again if you naively believe Vioxx is the only problem.

Remember that the new kid on the block is not necessarily a better kid. He may be dressed in the latest fashion but, as my father cautioned me, you can’t tell the egg by the shell. In this case, Vioxx was touted as relieving arthritic pain and also decreasing the risk of gastric bleeding, which is sometimes caused by over-the-counter non-prescription painkillers.

Now we know that Vioxx and its competitors, Celebrex and Mobicox, can also trigger stomach hemorrhage. There’s no guarantee that switching to either of them imore beneficial. No one can be totally sure these other drugs won’t also be implicated in causing stroke and heart attack.

Can safety be assured?
U.S. Senator Charles Grassley has suggested an independent board may be needed to ensure safe medications. This is utter nonsense. We know that all existing drugs have potential complications. You could appoint a hundred esteemed boards and still have Vioxx-like deaths. There is simply no group of scientists nor magic formula that can assure long-term safety of new drugs. We live on planet Earth, not in Heaven.

Don’t rush out to buy super drugs. Initial studies may be misleading. It’s much wiser to first use drugs that have been around for years. For instance, Aspirin, like old wine and old cheese, has stood the test of time for more than 100 years. In fact, every year researchers are finding new ways Aspirin fights disease, such as decreasing the risk of heart attack, diabetic complications, and ovarian, esophageal and colon cancer.

Kidney and liver damage due to painkillers
Today, medical consumers are not adequately warned of the potential hazards of even minor painkillers. Every week I see patients who are swallowing multiple doses of these pills for minor discomfort as if they were jelly beans. They’re totally unaware that excessive and chronic use of pain medication may cause kidney and liver damage.

A report from Johns Hopkins University claims the number of people with advanced kidney disease has doubled during the last 10 years. And the number of people who require renal dialysis is growing at the rate of seven per cent a year.

Today, five per cent of those needing the procedure have injured their kidneys because of the overuse of so-called minor painkillers. The result is not so minor and a terrible price to pay for the relief of a little pain.

It’s going to be hard to prevent future pharmaceutical disasters like the Vioxx case. Sir William Osler hit the nail on the head when he wrote, “A desire to take medicine is perhaps the great feature that distinguishes man from the other animals.” Today, there’s an epidemic of “pillitis,” with people craving medicine for every ache and pain. And pill takers must accept the fact that pills never grant total freedom from possible drug reactions.

For years, I’ve stressed the need for effective pain control when there’s bona fide terminal pain. But there’s no need for painkillers for minor discomfort because tincture of time usually cures it. Osler, noted for his sense of humour, often advised his patients who had a cold to “go to bed, put your hat on the bedpost, start drinking scotch and stop when you see two hats.”

Or as Sir Thomas Sydenham once remarked, “The arrival of a good clown exercises a more beneficial effect upon the health of a town than 20 asses laden with pills.”

I say, “Amen to that.”