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drugs are having a difficult time beating the placebo effect, and increasingly so. In fact, they're finding the placebo effect is getting stronger in people, making it more difficult for drugs to show any improvement over it. The credit for the increased placebo effect has been attributed to the increase in consumer advertising, which makes many consumers "believe" more in the drugs and their effects.
About five months ago I wrote about the situation of Insite, Vancouver’s safe injection site where drug addicts could receive clean needles, medical supervision during drug use, and access to drug treatment. I was very concerned as a skeptic that a new form of science based drug policy known as harm reduction was going to be railroaded by an ideological based policy. Fortunately, that was not the case.
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As skeptics we obviously want to see science based medicine and effective methods to improve public health. What this means is that, we skeptics, want to see medicine like vaccines promoted instead of homeopathy; but, we also want to see science based policy as well. What Insite has proven is that the harm reduction policy is working, in fact, working better than the “war on drugs” policy that the Conservative government has been supporting. Since the evidence is pointing to harm reduction being a more effective method of controlling the harmful effects of drug addiction in society, it should follow that harm reduction as a policy gain the support of our government and health care providers.
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what was really distressing was that the Harper Government wasn’t just arguing against the evidence (saying for instance that it was either wrong or misguided) but actually arguing in spite of the evidence. What they were saying was that, yes, harm reduction appears to be working…but that’s irrelevant because that isn’t the policy we want to use.
Along with most other mental health issues — depression, bi-polar disorder and post traumatic stress disorder, for example — schizophrenia has fallen victim to stigma through society’s attempt to simplify what it doesn’t understand. Such stigma has improved over the years through education and awareness, but we still have a ways to go before scientists figure out exactly what’s going on up there.
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perhaps letting schizophrenic patients comfort and help each other can give them something their doctors and therapists can’t — empathy and simple understanding. That’s what Gail Hornstein, a psychology professor at Mount Holyoke College, had in mind when she brought the Hearing Voices Network to the United States. The HVN is an international organization that gives people who hear voices a way to talk freely about their experiences with others who understand.
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In an interview with The Sun magazine, Hornstein explained how these peer-led group sessions work:
“In psychiatric hospitals they’ve had cameras watching them or been viewed from behind one-way mirrors. When patients started their own groups, they decided that no one who isn’t a part of the group should attend. The last thing I wanted to do was violate their rules, so I agreed not to take notes, and to talk about my own experience just as other people in the group do. Though I don’t hear voices, I have certainly had experiences of vulnerability or isolation…I answer questions in the group, because I know a lot about psychology…but I am not an authority or leader. In HVN’s view each person is an expert on his or her own experience.”
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Thousands of older people are being put at increased risk of death or developing dementia by taking combinations of common medicines to treat routine illnesses, according to a new study published in the Journal of the American Geriatrics Society.
Many are available over the counter at pharmacies as well as being prescribed by GPs, nurses and chemists.
British scientists behind the study are calling for doctors to recognise how dangerous these drug combinations can be and to prescribe harmless alternatives instead.
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The drugs, including common allergy treatments Piriton and Zantac, as well as Seroxat, an anti-depressant, are thought to be used by half of the 10 million over-65s in Britain. Many of the drugs, when taken in combination, were found to more than treble an elderly patient's chance of dying within two years.
Common bladder medications, heart drugs, eye drops and asthma treatments were also among those found to pose a risk.
All the drugs work by blocking a key chemical in the nervous system called acetylcholine.
The scientists also suggested that in patients showing early signs of mental impairment, high doses could "tip them over" into a more confused state.
Cholesterol-lowering drugs called statins, which have been shown to lower a person’s risk for heart attack, can also slightly increase a patient’s risk for developing diabetes, particularly at higher doses, new research shows.
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The findings, based on new analyses of five clinical trials involving 32,752 patients, raise new questions about how much we really know about the long-term effects of statins, which are the most widely prescribed drugs in the United States. The focus on the link between statins and diabetes comes at a time when some medical experts and pharmaceutical companies have pushed to broaden the use of the drugs beyond the 40 million at-risk patients who already use them to healthy people who would take the drugs for prevention of heart disease.
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Doctors cautioned that patients should not overreact to the diabetes news, saying that the increased diabetes risk is very small, and that the benefits of statin therapy still far outweigh any side effects.
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When doctors are deciding which drug to prescribe a patient, the idea behind evidence-based medicine is that they inform their thinking by consulting scientific literature. To a great extent, this means relying on medical journals.
The trouble is that pharmaceutical companies, who stand to win or lose large amounts of money depending on the content of journal articles, have taken a firm grip on what gets written about their drugs. That grip was strong way back in 2004, when The Lancet's chief editor Richard Horton lamented that "journals have devolved into information laundering operations for the pharmaceutical industry." It may be even tighter now
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Drug companies exert this hold on knowledge through publication planning agencies, an obscure subsection of the pharmaceutical industry that has ballooned in size in recent years, and is now a key lever in the commercial machinery that gets drugs sold.
The planning companies are paid to implement high-impact publication strategies for specific drugs. They target the most influential academics to act as authors, draft the articles, and ensure that these include clearly-defined branding messages and appear in the most prestigious journals.
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There are now at least 250 different companies engaged in the business of planning clinical publications for the pharmaceutical industry, according to the International Society for Medical Publication Professionals, which said it has over 1000 individual members.
Many firms are based in the UK and the east coast of the United States in traditional "pharma" centres like Pennsylvania and New Jersey.
Precise figures are hard to pin down because publication planning is widely dispersed and is only beginning to be recognized as something like a discrete profession.
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It seems that Americans are in the midst of a raging epidemic of mental illness, at least as judged by the increase in the numbers treated for it. The tally of those who are so disabled by mental disorders that they qualify for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) increased nearly two and a half times between 1987 and 2007—from one in 184 Americans to one in seventy-six. For children, the rise is even more startling—a thirty-five-fold increase in the same two decades. Mental illness is now the leading cause of disability in children, well ahead of physical disabilities like cerebral palsy or Down syndrome, for which the federal programs were created.
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most psychiatrists treat only with drugs, and refer patients to psychologists or social workers if they believe psychotherapy is also warranted. The shift from “talk therapy” to drugs as the dominant mode of treatment coincides with the emergence over the past four decades of the theory that mental illness is caused primarily by chemical imbalances in the brain that can be corrected by specific drugs.
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after Prozac came to market in 1987 and was intensively promoted as a corrective for a deficiency of serotonin in the brain. The number of people treated for depression tripled in the following ten years, and about 10 percent of Americans over age six now take antidepressants.
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A highly anticipated report on the status of the global ‘war on drugs’ has just delivered what may be one of the sternest rebukes of current policy yet. The report, compiled by the Global Commission on Drug Policy, which includes former UN Secretary General Kofi Annan, top Republican ex-cabinet members in the US, high-profile economists like Paul Volcker and many others, is blunt:
"the evidence overwhelmingly demonstrates that repressive strategies will not solve the drug problem, and that the war on drugs has not, and cannot, be won."
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It calls for decriminalization strategies — like those that worked with such aplomb in Portugal — instead of continuing counterproductive hardline tactics like jailing small-time users. The report is especially critical of the United States. The Associated Press has more:
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The commission called for drug policies based on methods empirically proven to reduce crime, lead to better health and promote economic and social development.
Researchers have become very interested in developing biomedical technologies capable of intervening in the biological processes that affect moral behaviour and moral thinking, according to Dr Tom Douglas, a Wellcome Trust research fellow at Oxford University's Uehiro Centre. "It is a very hot area of scientific study right now."
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Drugs that affect our moral thinking and behaviour already exist, but we tend not to think of them in that way. [Prozac] lowers aggression and bitterness against environment and so could be said to make people more agreeable. Or Oxytocin, the so-called love hormone ... increases feelings of social bonding and empathy while reducing anxiety," he said.
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But would pharmacologically-induced altruism, for example, amount to genuine moral behaviour? Guy Kahane, deputy director of the Oxford Centre for Neuroethics and a Wellcome Trust biomedical ethics award winner, said: "We can change people's emotional responses but quite whether that improves their moral behaviour is not something science can answer."
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Today's FT has this interesting graph and an accompanying story, showing a sort of inverse Moore's Law of drug development. Over almost 60 years the number of new drugs developed per unit of investment has declined in a fairly constant manner, and some drug companies are now slashing their R&D budgets.
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why this trend has occurred. The FT points to a combination of low-hanging fruit that has been plucked and increasing costs of drug development.
To some observers, that reflects the end of the mid to late 20th century golden era for drug discovery, when first-generation medicines such as antibiotics and beta-blockers to treat high blood pressure transformed healthcare. At the same time, regulatory demands to prove safety and efficacy have grown firmer. The result is larger and more costly clinical trials, and high failure rates for experimental drugs.
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THE FOODS YOU EAT OFTEN AFFECT HOW YOUR NEURONS BEHAVE AND, SUBSEQUENTLY, HOW YOU THINK AND FEEL. FROM YOUR BRAIN’S PERSPECTIVE, FOOD IS A DRUG.
Decriminalising drug use could drastically reduce crime and improve health, the outgoing president of the Royal College of Physicians has said.
You can’t handle the truth
A respected scientist set out to determine which drugs are actually the most dangerous -- and discovered that the answers are, well, awkward
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