July 2009 Archives

I have been a vegetarian since I was a teenager. I have been an anti-capitalist just as long. When I look at the world of agri-business, factory farms and the like I am appalled. It makes intuitive sense to me that food is better eaten close to where it was grown, with as few toxic substances involved as possible.

Yet I found myself yelling at Robert Kenner, the maker of the movie 'Food Inc.' when he was on the Daily Show the other day: "Weak! Weak! Weak! That is bad science!," I scolded the man on the TV. 

As Mr. Kenner was detailing the horrors of processed, cheap food Jon Stewart asked a simple question: if our diets are so much worse than they were in the 1950s or 60s, why are we living longer? An obvious and important question- one that Mr. Kenner should have had a good, solid answer for.

Nope.

Kenner had two responses to the question. First he said he thought that the increasing rates of type 2 diabetes would reverse the gains in life span. Uh, maybe, but just saying it doesn't' make it so. Second he quoted some statistics about how much we spend on food and health care- we used to spend 18% of our money on food, now we spend 9%, we used to spend 5% of our money on health care, now we spend 18%.

And?

The first part of his 'answer' was lazy and ultimately meaningless- he sidestepped the fact that his position fails to explain increased life spans by saying, in effect 'trust me, it will soon enough.'

The second part is just simple 'you flunk logic 101' bad logic. Simply stating, as he does, that the cost of health care has risen at the same time that the price of food has gone down and more than implying there is a causal relationship is the weakest logic.

Logic 101: a temporal relationship (two or more things being related by time) does not prove causality. Both televisions and cars have become much more widespread over the past 50 years. World wide life expectance has risen. This is even more so in countries where cars and TVs are the most widespread. So, cars and TV make people live longer!?

In all fairness the movie might do a much better job at making this case. I am going to see it and will withhold judgment until I have. Nonetheless this kind of thing makes me cranky- especially when it comes from someone whose side I am inclined to take. 

Really, the war on drugs is bad for most everything, save prison contractors and gangsters- but today's news about the FDA considering pulling the popular pain meds Vicodin and Percocet from pharmacies has my focus on the harm that drug laws do to vital organs.

Vicodin and Percocet are compounded opiates. This means they are a two drugs in one pill- a strong opiate pain killer mixed with another drug- in this case acetaminophen- aka Tylenol. Compounded opiates are widely prescribed for pain management and have been famously abused by celebrities and hobos alike.

With all of the fear mongering about illicit drugs, it is interesting that the story here is about acetaminophen- widely considered among the safest drugs in the world. It is safe- most of the time, for most people, when used properly. When too much is used however it can be toxic to the liver.  Acute acetaminophen poisoning is a major cause of emergency room visits, and leads to hundreds of deaths per year.

The FDA's advisory panel voted 20-17 to remove these drugs from pharmacy shelves, citing the high potential for overdose- particularly when people combine these prescription meds with over the counter products that also contain acetaminophen.

The media coverage is missing a crucial element of the story. The popularity of compounded opiates is due largely to the war on drugs. While Vicodin and Percocet are controlled substances, they are less controlled than oxycontin, morphine or other non-compounded opiates.

The extra paperwork involved in 'triplicate' scrips is not just a matter of convenience- although that plays a role. One of the copies of a triplicate goes to the DEA- the Drug Enforcement Administration. The DEA has no expertise in pain management, or any other kind of medicine. Their expertise lies in restricting access to drugs.

Many doctors don't love the idea of a group of cops looking in to their prescribing practices- and an easy way around that is compounded opiates. For people with chronic pain, this leads to an increase risk of liver problems from the acetaminophen and quite importantly the risk of addiction.

The DEA should have no role in medicine. Period. Pain management and other medical decisions should be made by patients and their doctors, not cops (or insurance adjusters, but that is a different story).

The war on drugs is costly, counterproductive and an injustice of monumental proportions. Getting the DEA out of medicine will not end the war on drugs, but it would immediately save lives.