>Sender: >To: >X-Original-Message-ID: <078801bf0ffb$bf557540$9acf69cf@pacbell.net> >From: "Peter McWilliams" >Subject: Recreational drugs >Date: Wed, 6 Oct 1999 06:07:30 -0700 >X-Mozilla-Status: 8001 >X-Mozilla-Status2: 00000000 > > >Pubdate: October 2, 1999 >Source: New Scientist (UK) >Page: 52-53 >Copyright: New Scientist, RBI Limited 1999 >Contact: letters@newscientist.com >Website: http://www.newscientist.com/ >Author: Rita Carter > >Pill Power > >If there are drugs out there that will make you smarter, sexier, thinner, >why should doctors control them? > > >"FEELING sluggish and forgetful? Try Cerezox, the cognitive enhancer that >makes you think faster and boosts your memory..." > >Cerezox doesn't yet exist, but give it a few years and something like it >will. Memory boosters are on the way, along with dozens of other supposedly >rejuvenating, beautifying and energising chemical aids for the ageing >baby-boomer. Goodies currently in the pipeline include a clutch of new >appetite suppressants, increasingly subtle mood-tweakers and, rumour has >it, a Viagra-style product for women. > >And whether they live up to the hype or not, the demand they are likely to >generate won't be limited to the clinically impotent, obese or depressed. >Already fuzzy, the distinction between pharmacology and cosmetic >pharmacology, between medicinal and lifestyle drugs, is about to blur still >further. > >Well, let it blur. For too long we have put up with experts drawing lines >in the sand to decide who deserves to be prescribed drugs, not to mention >doctors handing out pills to people as though they were children. And for >what? > >There is no compelling reason why drugs such as Viagra and Prozac should >not be sold over the counter and advertised like any other product. In >fact, there are good arguments why they should be. And while few of these >arguments are brand new, the sheer number of drugs in the pipeline, along >with growing public awareness, makes some sort of action imperative. > >The problems we face if we don't liberalise access to lifestyle drugs have >been looming for some time and can be seen most clearly in Britain where >ministers have already made clear that they will try to ration lifestyle >drugs or even ban their use by people who are not clinically unwell. If >this happens, demand for the drugs won't vanish: people will simply buy >them abroad or at exorbitant prices (and possibly illegally) from >mail-order outlets. > >One way doctors have hung onto their prescribing monopoly is by convincing >us that we are too stupid to treat ourselves. But prescribing through >doctors does not necessarily curb drug excesses -- barbiturate and >benzodiazepine addiction was created on a huge scale by doctors, not >despite them. Until this decade, when European Union regulations started to >bite, people in Spain and France were able to buy many prescription drugs, >including tranquillisers, at their local chemist. Reports of addiction and >overdoses were no worse than anywhere else. > >Obviously, certain safeguards need to be tightened before powerful drugs >could go on open sale. Drugs for children, those with especially dangerous >(and expensive to treat) side effects and antibiotics, which could spread >resistance, should be restricted. But appetite suppressants, memory >enhancers and other potential lifestyle drugs should be sold at the buyer's >own risk, providing the risk is made clear. > >warnings-not to mix them with alcohol or other drugs, or to avoid them if >you have heart or liver problems-need to be made unmissable. And >pharmacists should extend the existing schemes by which they issue smart >cards which carry information about other medications, so the issuing >pharmacist will be alerted to possible bad drug reactions and can warn the >purchaser. Reckless individuals who ignore such warnings are no more likely >to heed the advice of doctors. We don't need a note from experts to buy >other potentially risky products such as alcohol, weedkiller, or skiing >holidays, so why single out drugs? > >A healthy person simply shouldn't need drugs, you might say, but this, too, >does not stand up to scrutiny. It is natural to get wrinkly as we get >older; to lose some memory capacity and libido. It may even be natural, >given the unnatural nature of modern society, to continuously fancy more >food than we need or to feel mildly depressed. But what is natural is not >necessarily nice. > >For centuries, we have sought pharmacological antidotes to nature's nastier >manifestations-lifestyle drugs are simply the latest. The difference is >that, because they are called drugs (as opposed to herbs, unguents, or >tonics), we have allowed them to make us so nervous that we insist on >people being definably ill before they can have them. Thus we have >relabelled shyness as social anxiety disorder, unhappiness as sub-clinical >depression, and night-time raids on the larder as an eating disorder, >buying into the myth that health and illness are either/ or states when >they are on a continuum. > >Viagra fiasco > >But that outlook could disappear fast as a new generation of drugs that >people actually want looms on the horizon-and as the information revolution >gathers momentum. Already, anyone with a mouse can find out more about >their ailments than their real doctor is likely to know-and more about >so-called "offlabel" uses for drugs: oral acyclovir, for example, an >expensive antiviral only available on prescription, is a far more effective >remedy for cold sores than the topical cream available at the chemists. > >As the Viagra fiasco in Britain revealed, it's futile to think you can stop >information getting out. For six months after the drug became available in >the US, Pfizer, its manufacturer, couldn't even mention the drug's name in >Britain because it was still awaiting its European licence. Yet during that >time, people could call up 20 000 sites and 140 000 web pages dedicated to >the drug. The licensing authorities eventually gave up and changed the >rules. > >In Britain, drugs companies have backed the status quo because its National >Health Service provides a guaranteed market and the medical profession >makes a wonderful sales force, with the added benefit that if things go >wrong, it is the doctor who is sued, not the maker. The companies have also >been warned that the cosy price-fixing privileges they currently enjoy >could be jeopardised if they push for deregulation too hard. And doctors >like the set-up because they retain their status and their power. > >What will bring the whole thing tumbling down is when patients complete >their current metamorphosis into consumers, get organised and demand a >change. It will happen, but not without a fight. > >Rita Carter is a medical writer based in London > > > > >================================================================ > >This message is sent to you because you are subscribed to > the mailing list . >To unsubscribe, E-mail to: