Prescription Drug Dangers – a Warning from 1975
Dr Vernon Coleman
The article below is taken from Vernon Coleman’s first book `The Medicine Men’ which was first published in 1975 and which has now been republished as a paperback.
From The Medicine Men
Even under comparatively constant medical supervision there are dangers involved in taking medicines. Dr Hurwitz and Dr Wade, writing in the British Medical Journal in 1969 after intensive hospital monitoring of adverse reactions to drugs, found that of 1,268 patients who were observed 10.2 per cent had drug reactions, most of them severe. Surveys at a university hospital in Ontario had previously shown reactions of between 11 and 15 per cent in medical wards
even when only documented reactions were counted. In another survey it was shown that the hospital stay of every fifth patient going into a university hospital was complicated by some disease of medical progress, most of these disorders involving the use of drugs. Naturally some of the patients involved died.
A study at Johns Hopkins Hospital in Baltimore showed that in patients in the hospital received an average of fifteen drugs. The minimum number of drugs received was six, the greatest number taken was thirty-two. The use of so many drugs makes interactions more likely. According to Professor Girdwood, Professor of Therapeutics at the University of Edinburgh: 'It is not uncommon to find in hospital that something like 15 per cent of patients have been admitted either suffering from an adverse drug reaction or develop one in hospital.' Other experts believe that up to one-third of hospital patients suffer drug reactions. It has been reported according to an American Food and Drug Administration expert that up to one seventh of all hospital days are devoted to the care of patients suffering from drug toxicity. It has even been said that in almost all illnesses in hospital it should be considered likely that at least some of the features are drug-induced – until proved otherwise.
One of the problems is that the dangers involved in prescribing and taking drugs have not yet been fully realised. Some self-poisoning and some adverse reactions are inevitable but most experts believe that with greater awareness some disasters could be prevented. Awareness, however, is growing. In one spring time issue of the British Medical Journal in 1974 the following headings appeared on the correspondence page; 'Other systemic effects of eye drops', 'Amitryptiline and Imipramine Poisoning in Children', 'Anticoagulants and treatment for chilblains', 'Enteric coated potassium chloride – a continuing hazard', 'Analgesics and the Kidney', 'Brain damage after lithium and phenytoin', 'Sensitivity to intravenous anaesthetics'.
Even though there may be growing awareness of the dangers, drugs are still misused in an alarming fashion. For example, two paediatricians from Glasgow reporting on amitryptiline and imipramine poisoning in children, wrote: '.Medicine for a trivial complaint is unlikely to be regarded by parents as potentially dangerous and practitioners should therefore warn them accordingly; if, indeed, the transient effect of these potentially dangerous drugs upon the average case of bed-wetting in childhood can be justified.' The drugs
are prescribed for many children for bed-wetting; and poisoning from these powerful drugs is becoming increasingly' common. It is difficult to see why doctors should prescribe a drug, which can kill, for a condition such as bed-wetting, however upset the parent may be and whatever pressures may be exerted.
In practice what should happen is that doctors should try to assess a drug's usefulness and compare it with its dangers. If the drug is being used to save a life, then a few side-effects are nothing to worry about. If, however, it is being used for some simple and never threatening disorder, then it should not be used if it has bad side-effects. So chloramphenicol, which can cause a fatal type of anaemia, should be used for patients with typhoid, which can also kill, but not for patients with tonsillitis which rarely kills.
It is the problem of drug interactions which is likely to cause most controversy in the future. There are many possibilities. Metabolism of one drug may affect another. Drugs may react chemically together within the body and excretory rates may be modified with devastating results. Patent medicines and even foodstuffs may react. For example, calcium, which is found in milk, inhibits the absorption of tetracycline; blood-clotting drugs are often affected by substances containing vitamin K, some drugs can kill if taken with cheese or wine.
Drug reactions were once fairly simple to assess. This is no longer the case. Harvey and Read writing in the 1973 Medical Annual, wrote: 'The reactions reported have recently tended to be of a more subtle and insidious nature, and it is becoming clear that a great many long-term drugs, even those like the barbiturates which have been assumed for many years to be extremely safe in use, have complex and potentially hazardous interactions with metabolic processes in the body.'
NOTE
This extract is taken from `The Medicine Men’ by Vernon Coleman, first published in 1975. `The Medicine Men’ has been republished and is now available again as a paperback. To purchase a copy please go to the bookshop on www.vernoncoleman.com
Copyright Vernon Coleman November 2024
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