Jewish World Review Dec. 17, 2004 / 5 Teves 5765
Drs. Michael A. Glueck & Robert J. Cihak
Life after Vioxx? Pharmacetical competition good for patients and the industry
Your Medicine Men have written often on pain management and related issues
especially on what happens when the Drug Enforcement Agency (DEA) decides
it doesn't like the way some doctor is practicing, or the Food and Drug
Administration (FDA) places bureaucratic business-as-usual over patient
This week, we add a few more items to the pastiche.
Pain atrophies your brain. Literally. According to a study published in
the 23 November issue of the Journal of Neuroscience, people enduring
chronic pain (n this study, backaches) have brain mass up to 11 percent
smaller than those of people without similar conditions.
A. Vania Apkarian of Northwestern University, the study leader, exclaims
that those in chronic pain lose about a large pea's worth of gray matter
for each year of suffering.
Possible reasons: stress, hyperactivity of the neurons, exhaustion.
Apkarian concedes that some of the gray matter loss may relate to
relatively minor brain functions, and notes that no attempt was made to
correlate brain size with loss.
But two conclusions seem clear. One is that although a little suffering may
be good for the soul, a lot may leave you soul depleted.
A second conclusion: Thank G-d for the pharmaceutical industry. Every
decade, it seems, has its businesses that right-thinking people are
supposed to hate: Wall Street, Madison Avenue, investment banking, real
estate development, Wal-Mart.
Nowadays, and not for the first time, a major culprit seems to be the
pharmaceuticals: their sales and PR practices, their profits, their
allegedly dangerous side effects.
Forget for a moment that only one research compound in 5000 ever makes it
to the market, and that the FDA can withhold vital medications
indefinitely. Those medications save and improve our lives. And when one
turns out to be questionable, often there's a substitute ready and waiting.
Last September, Merck & Company pulled Vioxx, a popular anti-arthritis
drug, from the market after a study showed that people using the drug for
longer than 18 months doubled their risk of heart attack and stroke.
A second study, by the University of Pennsylvania, found that Vioxx users
had almost three times the risk as those taking another drug, Celebrex.
The problem relates to cox-2 inhibitors, which block inflammation and are
easier on the stomach while simultaneously blocking a substance that
prevents heart problems.
The question: Are all cox-2s equally nasty, or are some worse than
others? The FDA, which has known of the problem for years, has promised to
investigate next year.
Presumably, a number of companies are hard at work looking for substitutes.
Such is the nature of pharmaceuticals. When over time, wonder drugs turn
out to be not so wonderful, back to the lab. Mistakes, disappointments,
occasional disasters, yes. But who could deny the spectacular progress of
the last few decades?
To add to the Vioxx vexation the popular antiarthritic medication, Bextra,
recently came under fire. Some doctors have been wary of prescribing
Pfizer's Bextra, another cox-2 drug, for fear it might cause the same type
of heart problems as Vioxx. A study discussed at the American Heart
Association's annual meeting in November indicated Bextra more than doubled
the risk of heart attack and stroke.
But physicians across the country who specialize in Internal Medicine,
Rheumatology, Orthopedic and Neurosurgery assure us that there are other
effective pain and arthritic medications they can substitute. Would this be
possible without many American pharmaceutical companies competing for safer
and more effective products with their research and development dollars?
It is true that here in America, we do provide most of the R&D for the rest
of the world. But might not it be better if we were known for our Research
and Development than our Reconaissance and Destruction?
The federal government doesn't deny the spectacular progress of the last
few decades. In fact, they're fascinated. So fascinated that a Bill, HR
3015, (which we recently discussed) has called for a national registry of
all people taking pain medications and any other prescription drugs they're
taking. A fine way to gather torrents of data for medical science and for
So you the readers must remain diligent to protect your basic freedoms. All
of these media and government hot buttons do interrelate and affect the
quality of your life. And our thanks to the readers who spoke out to their
legislators on HR 3015. It seems that the bill has momentarily disappeared
from the Intelligence and other bills. But be reassured it will return in
January when you're not looking or are still sloshed from the holidays!
On that note and in spite of the above - from Drs. Mike and Bob - may you
all have the best and safest of holidays.
Editor's Note: Michael Arnold Glueck, M.D., penned this week's commentary.
Michael Arnold Glueck, M.D., is a multiple award winning writer who comments
on medical-legal issues. Robert J. Cihak, M.D., is a Discovery Institute
Senior Fellow and a past president of the Association of American Physicians
and Surgeons. Both JWR contributors are Harvard trained diagnostic radiologists.
Comment by clicking here.
12/10/04: Fake drugs in your local pharmacy?
12/03/04: A Prescription for Taking Back the Right: The Right Rx
11/25/04: New Weapons in the War on Pain Patients and Doctors
11/19/04: Wedding Psychosis: A new diagnosis is born
11/15/04: What's the right price for pharmaceutical drugs?
11/05/04: Berry Healthy: Health Benefits from Antioxidant-Rich Foods
10/29/04: New Scientific Evidence Refutes Existence of Shaken Baby Syndrome
10/25/04: Fact-checking KerryCare
10/05/04: That old-time rare burger: Healthy or not?
09/24/04: Death is not a final diagnosis Murder rates in US cities comparable to Iraq!
09/10/04: Mercury linked to autism
09/07/04: Sad child disease: Speaking out so that they can speak
08/20/04: Household Olympics: Losing and gaining points
07/30/04: Still Seeking Justice for Dr. Sell
07/26/04: Medicine, genes, sports and longevity
07/16/04: Biotech foods foolishly feared by Franken-Folk
07/09/04: The Runaway Trial Lawyer
07/02/04: Physicians not treating trial lawyers: A shootout at OK Coral and Courthouse?
06/25/04: Dosage makes the poison in 400-year-old mercury murder
06/11/04: Canada's health system dream turns to nightmare
06/04/04: It's A Medical Life I Remember Yesterday
05/28/04: Back to the Future: Patient Pays Directly for Medical Care
05/21/04: Sue Your Boss Month
05/14/04: Death from painful medical myths
05/07/04: Fear in the Medical Garden of Eden
04/30/04: DDT vs. Death by Malaria
04/23/04: In pain do we part!
04/16/04: Free or not free to treat pain
04/09/04: Wrong Military Diagnoses & Treatments
04/02/04: Radiation monster slain
03/19/04: What Do and Don't Bush and Kerry Plan to do to Your Health Choices
03/15/04: Dear Rush: We Feel Your Pain, So Now Feel the Pain of Others
03/05/04: Fraudulent use of fraud laws by government
02/27/04: Population growth, birth control and increased terrorism?
02/20/04: Doctors fighting against doctors, at the behest of the government and lawyers
02/13/04: Legal Cancer in the White House?
02/06/04: Feds Harass Doctors. Who's Next?
01/30/04: Women, the Military and Medical Misconceptions
01/23/04: Welfare for the Wealthy
01/19/04: New diagnoses and strategies create both short and long term problems for medicine and the military
01/09/04: A new plastic phobia?
01/02/04: Baseball Good Medicine?: International Forkball and Split Finger Rotating Our Way Soon
12/26/03: Medicare Bankrupt: A Possible Palliative
12/19/03: Crossing Fruit Street: Some Movies Like "Stuck on You" Cross the Medical Line
12/12/03: Silver Lining in the Medicare Clouds?
12/05/03: Medicare mop up
12/01/03: The Dirty Radioactive Bomb: Rational Response or Fear Itself?
11/24/03: The Caduceus Conspiracy: How the People Lost Medicine and How We Can Take It Back
11/14/03: Mosquitoes kill us; DDT doesn't
11/07/03: Avoiding the Schiavo Scenario: Readers Speak Out With Life-and-Death Comments
10/31/03: The Terri Schindler-Schiavo Case: Speaking out for those who can't
10/24/03: Want health service go on a diet?
10/15/03: The War on Legal Painkillers: Sen. Kerry owes an apology to the more than 48 million Americans who suffer chronic pain
10/13/03: Medicare defrauds itself
09/19/03: Politics prevents women from learning about abortion/breast cancer risks
09/12/03: Medical mischief
09/05/03: Unholy medicine
08/29/03: The California Tea Party and West Coast Determinism; Voter anger coming your way soon
08/18/03: The outlaw prosecutors: A Justice and Civil Liberties Issue
08/08/03: "Toxic Teeth?"
07/25/03: Resuscitating the Constitution; CPR American Style
07/25/03: Drug reimportation: Bill translates to goodnight, patients
07/11/03: Costly Medicare Changes, Without Real Reform
07/04/03: The Painful DEA II: War on legal drugs ensnares too many doctors and not enough dealers
06/20/03: The Medicare Mess: Will President Bush call Congress' Bluff?
06/13/03: Diagnosis: School Insanity: A suit for sanity and school discipline
06/05/03: Soaring Medical Costs: Rational ignorance or rational enlightenment?
05/30/03: A Tale of Two Admirable Women: Jessica and Annika
05/23/03: Latest medical innovation: Cash
05/09/03: We feel your pain; Physicians have it too no thanks to the DEA
05/02/03: Medical Quarterbacking
04/25/03: CNN the "Conscience-Not Network"
04/21/03: Medical Miranda?
04/11/03: Are childhood vaccines shots in the dark?
04/09/03: The PETA Principle -- The lambshank Redemption
03/28/03: American conscience?
03/21/03: West Wimps or Wings: Treatment for Hollywood Hypocrisy
03/13/03: Worldwide schmaltz shortage looms --- all because of a featherless chicken
03/06/03: Legal metastases are killing us
02/28/03: Outside the Jury Box: Seeking Justice rather than a Lottery in Medical Liability
02/21/03: Workforce temperature rising; employer TLC in demand
02/14/03: Malpractice Insurance: They Reap What They Sue
02/12/03: Hawk, Dove or Groundhog: Diagnosis Critical List; Prognosis Uncertain
02/07/03: How about tax cuts for the "rich" and "poor"?
01/31/03: AIDS Bug Chasers
01/24/03: Libertarian moment or movement?
01/17/03: It's not just 'sue the docs' anymore
01/03/03: A pox on the critics; diagnosis sour grapes
01/03/03: If protesting is good for your health; then at least let's root for the home team
12/20/02: Obesidemic (obesity epidemic) or not?
12/20/02: Time for voluntary informed smallpox vaccinations
12/13/02: The real reason the state opposes homeschooling?
12/06/02: Conscience of a former conservative: Portrait of a political metamorphosis
11/27/02: Thanksgiving dinner hazard?
11/22/02: Time to think outside the box and inside the nucleus
11/15/02: The military should be protected from abusive environmental laws in times of war
11/11/02: Does Kyoto Treaty pose more harm than global warming?
10/31/02: Deep thoughts on Baseball, the World Series and Life: How about them Anaheim Angels?
10/23/02: "Pediatric rule" guinea pigs
10/23/02: Once the World Series ends, we need to create a Donnie Moore Day of Remembrance: Sports and mental health
10/18/02: Congress to senior patients: Do as we say not as we do for ourselves
10/11/02: Using pollution "scare labeling" to political advantage
10/04/02: The Great Asbestos Heist: Did Litigation and Junk Medical Science Helped Bring Down the World Trade Center?
09/27/02: The imminent rise of civic feminism: A far healthier national alternative in war and peace
09/20/02: A Ray A Day" to replace the daily apple?
09/13/02: Beware of celebrities hawking drugs
09/06/02: Avoid 9/11 overdose: Give blood to begin "September of Service," SOS
08/28/02: From Doubleday to strikeday: Baseball's collective anxiety attack
08/23/02: Should she or shouldn't she?: An alternative view on treating menopause with HRT
08/16/02: Cooking up defenses against germ warfare
08/02/02: Medicine, crime and canines
07/26/02: Lies, pathologic lies and the Palestinians
07/19/02: Medicare Drug Follies … as in "now you see it, now you don't"
07/12/02: Anti-Profiling: A New Medically False Belief System
07/08/02: Don't procrastinate, vaccinate!
06/28/02: The scientific advances on the safe and effective deployment of DDT are being ignored, or denied. Why?
06/21/02: Sex and the system: In seeking healthcare men are different from women
06/14/02: The FDA, drug companies and life-saving drugs: Who's the fox and who's the hen now?
06/07/02: Medical Privacy Lost: A hippo on the healthcare back!
05/24/02: To clean up America's game: A (soggy) ground rule
05/10/02: Free speech is good medicine
05/03/02: Medicine's Vietnam
04/26/02: Attack on alternative medicine could lead to alternative lawsuits
04/12/02: Insure the 'crazies'?
04/09/02: No Time for Litmus Tests: In War We Need a Surgeon General and NIH, CDC, and FDA Directors
04/02/02: The scoop on soot: A dirty rotten shame?
03/22/02: Too many beautiful minds to waste: The first annual Caduceus Movie
03/15/02: Terror and transformation: Defense essential for health & state of mind
03/08/02: Diagnosis: Delusional
03/06/02: The great matzah famine
03/01/02: Is new Hippocratic Oath hypocritical?
02/15/02: Why the recent moaning about cloning?
02/08/02: Searching for Dr. Strangelove
01/15/02: Score one for the value of human life
01/04/02: Medical-legal-financial wake-up call
12/28/01: Who's afraid of a 'dirty bomb'?
12/21/01: End of medicine?
12/14/01: More heroes: Docs deserve a little credit after 9/11
11/16/01: Do we need 'Super Smallpox Saturdays'?
11/09/01: Why the post-9-11 health care debate will never be the same
11/01/01: Common sense good for our mental health
10/26/01: Your right to medical privacy --- even in terror time
10/12/01: Failed immigration policy ultimately bad for nation's mental health: Enemy within leads to epidemic of jumpy nerves
09/28/01: Can legal leopards change their spots: A treat instead of a trick
09/21/01: Civil defense again a civic duty
08/30/01: Shut down this government CAFE
08/23/01: School Bells or Jail Cells?
08/15/01: Time to take coaches to the woodshed
08/10/01: Blood, Guts & Glory: The Stem of the Stem Cell controversy