I find it amazing in that the media attacks us when a single patient has a stroke after a chiropractic adjustment. Maybe 30 people have died as a result of chiropractic over the last 100 years and yet the following article indicates that 80,000-200,000 people die each year from prescription medication and yet the public accepts it. Goes to show that as Chiropractors we have to educate the public about the incredible benefits of chiropractic with little or no side effects! Michael D. Beattie COST OF DRUG-RELATED ILLNESS IS IMMENSE TUCSON, ARIZONA. The sale of prescription medicines in the United States exceeded $73 billion in 1994. Two researchers from the University of Arizona conclude that preventable illness and death from the misuse of these medicines cost the American economy over $75 billion a year; if lost productivity is included the cost rises to between $138 billion and $182 billion annually. The researchers point out that the purpose of prescribing pharmaceutical drugs is to treat disease successfully - not to cause more problems. They estimate that this purpose is achieved in less than 40 per cent of all cases. More than 60 per cent of all people prescribed pharmaceutical drugs end up with a drug-related problem which results in almost nine million hospital admissions a year at an estimated cost of $47.4 billion. As a matter of fact, it is estimated that more than 28 per cent of all hospital admissions in 1992 were due to drug-related illness and that somewhere between 80,000 and 200,000 people died from complications involving prescription medicines. In comparison, it is estimated that the direct cost of diabetes to the American economy was $45 billion in 1992 and that of heart disease was $117 billion. The researchers conclude that drug-related illness and death should be considered one of the leading diseases in the United States. Johnson, Jeffrey A. and Bootman, J. Lyle. Drug-related morbidity and mortality. Archives of Internal Medicine, Vol. 155, October 9, 1995, pp. 1949-56 --------------- Drugs-Serious Side Effects Common SOURCE: The Journal of the American Medical Association (1998;279(19):1571-1573) A trio of healthcare experts are calling for a new federal office of drug safety to step up the monitoring of prescription drugs once they are on the market, a process currently overseen by the US Food and Drug Administration (FDA). About 51% of approved drugs have serious side effects not detected prior to FDA approval, according to their article in the current issue of The Journal of the American Medical Association (JAMA). "This investment in drug safety has the potential to save thousands of lives and prevent tens of thousands of serious injuries per year," write Dr. Thomas Moore of the George Washington Medical Center in Washington, DC; Dr. Bruce Psaty of the University of Washington, in Seattle; and Dr. Curt Furberg of the Wake Forest University School of Medicine in Winston-Salem, North Carolina. The issue of prescription drug safety gained national attention last year when the FDA withdrew the diet drugs fenfluramine and dexfenfluramine from the marketplace after their combined use became tied to an increased risk of serious valvular heart disease. Furthermore, a study published in JAMA this past April found that "adverse drug reactions" may injure 1.5 million people and kill as many as 106,000 Americans each year, making medication side effects the number four cause of death in the United States. Moore, Psaty, and Furberg believe the FDA need to address certain key issues in order to bring the problem under control. First of all, they note that the agency currently has no effective means of monitoring the overall incidence of injury or death tied to medications once they enter the marketplace. "It makes no more sense to monitor drug safety without knowing the extent of serious injuries," they say, "than to have a National Highway Transportation Safety Administration operating without information about automobile accidents." Since just 1% of adverse drug incidents are reported to the FDA, the report authors believe that many of the negative side effects of prescription drugs are not getting the attention they deserve. For example, they say the FDA receives about 82 complaints each year concerning a possible link between irregular heartbeat and use of digoxin, a common heart medication. Because many patients are on digoxin, this small number suggests that the side effect is not a major concern. However, a follow-up examination of Medicare records revealed that over 200,000 such cases had occurred across the nation over a 7-year period. When dangerous side effects are spotted, the FDA revises drug package labeling accordingly and sends out warning letters to US doctors. But is anyone paying attention to these warnings? The authors think not -- they cite the case of the sedative triazolam. Despite new product labeling cautioning that the drug becomes unsafe after being used for more than 10 days, "an FDA task force reported that 85% of the prescriptions were being written for longer periods." They agree that "it is important to discover why important safety warnings are not being heeded." Moore, Psaty, and Furberg believe more federal resources must be directed towards the surveillance of the safety of drugs already in the marketplace. Because the revelation that an already approved drug has dangerous side effects could prove embarrassing to whichever FDA department had granted initial approval, the report authors believe any new drug-monitoring group should be "an independent office reporting directly to the FDA commissioner." Finally, they say, "the funds to pay for this expanded safety program should come from user fees collected from pharmaceutical companies." SOURCE: The Journal of the American Medical Association (1998;279(19):1571-1573)