In defense of drugs

So I gets this comment on a little rant I tossed out a while ago about the absurdity of people who tell you that your table salt is full of glass.

and maybe next you can give us your opinion on why prescription drugs are actually “good” for us

I get something like this question a lot when I wax sarcastic about alt-med. There are two things I want to address here, the first being the framing.

It is almost always stated (or, if not overt, left suggestively ambiguous) that the opposite side from alt-med is that taking lots of drugs is good for you. It’s not. If you are taking prescription drugs that have not been prescribed by your doctor or other licensed medical caregiver after a discussion of your symptoms, diagnosis and effects of the drug, please stop. That shit’s not candy. Each drug is intended to alter a specific biological or chemical phenomena in your body and is likely to alter several others.

However, if you happen to have a serious problem, sometimes it is worth it. The mucus in your airways protects your lungs from particulates and biological contaminants. Stripping it is mostly a bad idea. But if you happen to have Cystic Fibrosis, you will drown if you don’t. Pharmacological intervention is preferable. Your pancreas tightly regulates insulin in your body, keeping all of your tissues properly supplied with glucose. Substantial fluctuation in glucose levels will (among other things) destroy nerves. Supplementing insulin is mostly a bad idea. But if your pancreas happens to be knocked out, you will be unable to control blood sugar any other way and die if you don’t. Pharmacological intervention is preferable.

I have serious (thankfully intermittent) problems with my knee. Very occasionally this is severe enough that I am unable to get up the stairs (where we keep the food!). This is controllable with high (way above OTC dosage) levels of NSAIDs. This dosage level, if used chronically, will damage my liver, heart and kidneys. If used carefully, these risks are substantially reduced and in exchange I get to walk. Freedom of movement is incredibly important to my quality of life, not to mention improving my ability to maintain chronic exercise and all the health benefits that come with it. Pharmacological intervention is preferable.

But you should not take any of these drugs. We as a group should not take any of these drugs. They are not good for us; rather for certain, specific individuals. There is nuance to this medicine business, you don’t just throw pills at symptoms (or, if that’s what your doc wants to do, you should try to find a different one). If there is nothing broken with you, you should be taking nothing at all.

The second thing is that I don’t want to defend the pharmaceutical industry from nuanced and educated criticism. I think that they should be under constant siege from all sides and regulated to death without quarter (and they sometimes are). I think that health marketing should be held to standards as high as we hold clinical trials (it is not even close). Pharmaceutical companies should be on the defensive at all times because it will make them better, which is good for us a group.

There is one thing, and one thing only that I wish to defend the pharmaceutical industry from- being a straw man. The dichotomy of natural vs. industry is false (whole careers in the history of science could be made chronicling the chemists who have made whole careers on products derived from some bug or shrub or pile of dirt). The spectre of Big Pharma is raised with all of it’s scary, unpronounceable chemicals, and we are instructed to compare it to the little guy of alt-med, who bravely stands up to the man. Alt-med is no less crass and profit-hungry than Pharma, they are just allowed a longer leash(for reasons that utterly elude me) when they lie. In setting this dichotomy up, we risk providing shelter to charlatans. And that is bad for us.

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One Response to In defense of drugs

  1. a coward says:

    It puzzles me that this even has to be made an argument. I will say, though, that your introduction threw me off for a bit because I attached too quickly to the mention of table salt, though that’s really my own fault for not reading carefully enough.

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