The American Dilemma and How We Can Fix It

Posts tagged ‘safety’

“IT’S NOT NICE TO FOOL MOTHER NATURE” (PART ONE)

If you’re old enough you may remember the Chiffon Margarine commercials featuring a rather annoyed Mother Nature who was irritated that this new man-made product tasted so similar to the butter which the world had been consuming for years.  As with all other foods and drugs which are sold in America, the FDA has the responsibility of evaluating and passing on the safety of these products.

The Food and Drug Administration has its origins in the year 1862 when the Department of Agriculture was entrusted with the responsibility for conducting chemical analyses of various agricultural products.

The actual agency was officially established in 1930 as an outgrowth of the Pure Foods and Drug Act which Congress passed in 1906.  The FDA has an extremely long history of trying to make sure that the foods and drugs which enter our supply chain are safe and beneficial.  So how are they doing?

I don’t remember if the catch phrase, “Bald is beautiful,” started when the late Telly Savalas played Kojak on television but at one point you heard that statement (notably expressed by bald and balding men) whenever someone discussed hair and hair loss.  In light of recent developments regarding drugs that are intended to reverse this process, perhaps we should change the phrase to, “Bald is safer.”

The following is excerpted from a Yahoo News story:

Kevin Malley was almost 30, and he was starting to lose his hair.  He went to his doctor to see if there was a way to keep from going bald, and his doctor prescribed Propecia.

“I looked young for my age, so I wanted to hold off my hair loss for a little bit,” Malley said.  “I didn’t plan on taking Propecia for more than a year.”

Malley started taking the drug in May 2011, and by October he was completely impotent and had no sex drive whatsoever.  His body changed, even his genitals shrank, and he slipped into a mental fog that he just couldn’t clear.  His doctor told him the side effects would go away if he stopped taking the drug, so he did.  But nothing changed.

“I kept expecting the side effects to go away, but they did not, they only got worse,” he said.

Malley is not alone.  A new study published today in the Journal of Sexual Medicine suggests that for some men, the sexual side effects of Propecia may last for months to years, even after they stop taking the drug.

Researchers from George Washington University interviewed 54 men under age 40 who reported side effects for three months or more after taking Propecia, also called finasteride, to treat their hair loss.  None of the men reported have any sexual, medical or psychiatric problems before they took the drug.  Some of the men took the drug for a few weeks, others took it for years, but all of them reported side effects such as erectile dysfunction, decreased sexual drive, problems with orgasms, shrinking and painful genitals, even some neurological problems, such as depression, anxiety and mental fogginess.

Propecia was approved by the U.S. Food and Drug Administration in 1997, and at that time Merck noted that a few men reported sexual side effects during clinical trials of the drug.  On its website, the agency said those side effects were resolved when patients stopped taking the drug.

But the agency received more than 400 reports over 13 years from consumers reporting sexual dysfunction, and nearly 60 men reported that those side effects lasted longer than three months after the men stopped the medication.

In a statement, Merck said no evidence has proved a causal relationship between Propecia and long-lasting sexual dysfunction.

But researchers say many physicians who prescribe finasteride are likely not aware that the side effects of the drug may haunt patients for years.

“These things just get handed out left and right for any urinary symptoms,” said Dr. Ryan Terlecki, an assistant professor of urology at Wake Forest School of Medicine, who has prescribed the drug for some of his patients with enlarged prostates.

Terlecki said the findings about long-term side effects from the drug are alarming, but more research will likely be needed before doctors can know for sure that the symptoms are completely attributed to the drug.

Steven Rossello, 29, said his doctor made no mention of the potential for any sort of side effects from finasteride when he prescribed it to treat Rossello’s hair loss in 2010.

“That’s what really makes me mad.  He never mentioned any side effects, not to mention that they last forever,” Rossello said.

But after four months of taking Propecia, Rossello said he began suffering anxiety and crippling depression, along with the drug’s sexual side effects, and decided to stop taking the drug.

But his symptoms only got worse.  He was demoted from his job as an investigator for the Department of Homeland Security in Texas after his symptoms were evaluated by a psychiatrist, who pronounced him unfit for duty.  Rossello said the psychiatrist was unfamiliar with the neurological side effects of Propecia.

Abdulmaged Traish, a professor of biochemistry and urology at Boston University School of Medicine, said scientists are just beginning to investigate finasteride’s effects on the brain and nervous system.

“We are just beginning to venture in that direction.  It might be in the next five to 10 years that we may find there’s more to this story than we know now,” Traish said.

Apparently the FDA has determined that only about three percent of patients who take finasteride experience the symptoms described in this story.  Perhaps their conclusion is that is an “acceptable casualty rate,” when we consider the drug’s benefits for the remainder of the population.

But this story is hardly unique.  There are countless drugs which have been approved by the agency and which have now been recalled as being unsafe – and a concurrent number of class action law suits which have been filed because the general public was prescribed these medications.

Let’s think about the process of how a drug gets approved as a clue to why this might happen.  The research for developing the drug and the various stages of testing it are left to the pharmaceutical company.  They have a responsibility to conduct their tests in an ethical and scientific manner and then present their results to the FDA to evaluate.  Literally, billions of dollars can go into the development of a particular drug – an investment that is no small matter – and in the case of smaller companies can mean the difference between life and death.

As I said, these companies are supposed to complete their testing in an ethical and scientific manner and I’m sure that most tests are conducted that way.  But when money is involved, sometimes even the highest theoretical standards might take a back door to the “root of all evil.”

Even assuming that a drug company meets its fiduciary responsibility to the FDA and ultimately to the public, let’s consider if that is sufficient.  A typical drug, once it has been developed might endure five years of rigorous testing.  Few side effects are noted in these tests – and those results are passed along to the FDA which, seeing nothing harmful, approves the use of the drug for the stated condition.

Consider the use of cigarettes.  We know that long-term use of tobacco, however it is ingested, has serious adverse consequences – lung cancer and emphysema being two of the most obvious.  Yet if we evaluated cigarettes in the same way we evaluate new drugs using a five year time horizon, we might well conclude that there is really nothing harmful in smoking a couple of packs a day.

In other words, neither the company who has developed the drug nor the FDA really knows what, if any, the long-term consequences of taking it will be – just as we had no idea what the consequences of using DDT were.

Being un-PC I decided to begin this two part series by discussing an issue which might potentially  affect my male readers.  But ladies, take heart.  You’re up next.  What I hope that you take away from these two posts is that we’re all probably better off taking a natural rather than a man-made approach to health, diet and wellness.

Otherwise, we’re playing Russian Roulette with our lives – and Mother Nature is loading the chambers.

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GOVERNMENT CAN FUND ITSELF

When I lived in Chicago I had several friends who were members of the city’s police force.  (I met them at the local deli where they regularly had lunch).

One day I asked one of them if it was true that the city had a “quota” for how many tickets each officer in traffic enforcement was required to write each month.  Despite the police department’s official statement that “no such quota system exists”, my friends admitted that there was indeed such an animal.  (As we became more PC, the “quota” was re-named an “index”.  But as the immortal bard said, “What’s in a name?”)

The city derived a lot of revenue from the issuance of these citations and the collection of the fines.

About two and a half years ago I wrote a letter to Las Vegas Mayor Oscar Goodman.  We were in the throes of the recession and Obama-bashing.  The unemployment rate was rising as fast as the housing market was careening downward.  I offered a plan which could both provide employment and bring in a large amount of revenue to the city’s rapidly dwindling coffers.

While I didn’t expect to be featured on one of the nightly news shows as ‘the genius who saved Las Vegas” I did expect to receive a response from the good mayor.  None was ever forthcoming.  Maybe I’ll find the original and send it to his wife who succeeded him in that office.  (Massachusetts had the Kennedys, Chicago had the Daleys and we have the Goodmans).

The plan was simple and sound.  It addressed the disdain that most automobile and truck drivers have for obeying the posted speed limits within the city.  Here was a terrific source of new revenue for Las Vegas.  All the city had to do was to enforce the laws it had already created for the safety of its citizens!

I suggested that the city hire 120 people to be called, “Traffic Speed Enforcers”.  They would be paid a salary of $50,000 per year and be assigned in three shifts of 30 around the clock since Vegas is a 24/7 town.  The extra TSE’s would fill in for those who had days off, were sick or were on vacation.  Their sole empowerment would be to arrest drivers who were speeding.

We would need to purchase 100 vehicles (10 to be held in reserve for repairs) for the use of these TSE’s.  I estimated an inflated cost of $100,000 for the purchase of each of these.

We would modify the speeding ordinance so that apprehension by radar would result in a  MANDATORY fine:  from 6 – 10 miles above the limit – $25 a mile; 11 miles or more over the limit the fine would be $50 a mile.

I assumed that each TSE would actually work for six of his or her eight hour shift –giving them time to get to their street location, to return their vehicle to the garage and allowing for a meal, breaks and relief stops.  I also assumed that they should be able to write two tickets per hour – one low fine and one high fine.

Based on these reasonable assumptions, each of them would produce $4,200 a day in revenue for the city – or $378,000 a day for the three shifts.  That works out to $138 million a year.  But let’s say that much of that is uncollectable so we’ll call it $100 million a year. I think that’s reasonable.

After one year in effect, the city should show a net profit (after having fully paid for the vehicles, TSE salaries and a very generous allotment for gas, auto maintenance, insurance and “administration”) of at least $75 million dollars.  And all this paid for by people who are flagrant scoff-laws.

I see a hand in the audience.  Your question ma’am?

For those who didn’t hear the question the young lady asked let, me repeat it.

‘“Wouldn’t people stop speeding, thus reducing the income to the city?”

In answer to your question, if that did happen we would have hit THE JACKPOT!

We all would be rewarded by being safer when we drove.   Ultimately, the improved safety should translate into lower insurance rates for all Las Vegas drivers.  That would make Las Vegas a better place to live, work and drive.

Well that’s one example of how government can fund itself.

It’s a thought.

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