Re: Drug Rep Tells All

In message <886cafda-6c57-4569-8553-225b0dbd187c@xxxxxxxxxxxxxxxxxxxxxxxxxxxx>, PeterB wrote:

On Apr 6, 8:08 pm, "D. C. Sessions" <d...@xxxxxxxxxxxxxxxx> wrote:

Would you agree that nutritonal medicine is THE most bang for
the buck in human health generally?

Too broad a subject.  Ask me about something narrow
enough to have a useful answer.

Is there data supporting heart disease reduction (not just risk) from
the use of prescription medication? If there is, where is that data?

That's a mixed bag. If there's actual data on a causal
link between serum cholesterol and actual arterial disease,
I haven't seen it -- but there's a huge effort directed at
serum cholesterol.

On the other hand, hypertension *is* causally linked to a
lot of bad outcomes and the meds in that direction, even
though they generally suck, at least do have reasonable
outcome records.

Clotbusters are another with good field studies. You might
(or not) appreciate that the best ones seem to be those
that show the Really Expensive Clotbusters being beaten by
old standard stuff like salicylates.

The tragic part is that they're also a very low funding
priority.  Billions for high-risk obstetrics and neonatal
ICU, pennies for nutrition.  Don't complain to me, write
to the idiots in Congress who get all moral about it.

The real problem with public health policy in the US is
lobbys.  Until the relationship between industry and government
are made illegal, AMA will continue to prescribe preventive
nutrition selectively and remedial nutrition, in adult medicine,
almost never.

In the particular issue of preventive vs. remedial care,
I'm not at all sure that the AMA bears any blame.  

Sure they do. A history of intolerance toward natural treatment
modalities using FDA as enforcement is well documented. Just ask Bill
Faloon of LEF, whose office was raided last year where he was held at
gunpoint. Did AMA repudiate this reprehensible behaviour?

I suspect that your definition of "natural treatment" is
rather different to mine. The first line in most chronic
disease management is the diet/exercise combo and lifestyle
generally.

They've
been lobbying for nonmedical prenatal preventive care for
decades.

In that particular case, the lobbies with the clout to
drive policy in brain-dead directions are the social
conservatives who don't want to subsidize little brown
babies and their mothers who aren't married because the
same social conservatives set up policies that punish
them for being married.

There is always a polarizing political element available to industry
for its management of America's legislature, but the force behind
these things is money, not ideology. Ideology is only the cover.

It must be nice to live in such a simple world.

However, my point was much larger and I'm quite happy
to include infant nutrition and prenatal nutritional
supplemenation in the whole equation -- which I seem
to recall is something you'd agree with.

You inferred that we must consider cost when allocating health
care and yet I doubt you would say that infant life should be
dependent on such criteria.

"Should" isn't my call.  Fact is, they are.

I still do not see where unlimited funds, if applied to infant
healthcare, would be extending life beyond a few minutes.

Unlimited funds would at least get mothers nutrition and
screening to identify the ones who need further care (e.g.
Rh incompatibility) for easily prevented conditions.

Right.  I meant outside of nutritional medicine.  Nutrient
analogues are the basis for most of modern medicine's real
successes (neonatal and the ER), in contrast to long-term use
prescription meds that remain unproven (or disproven)
as "preventive" or "curative."

I'm not prepared to accept that as a generality.  

Can you point to documented life extension outside of these venues
that doesn't involve a very small numbers of patients?

Type I diabetes.

The big
winners in perinatal care are oxygen, surfactants, and a couple
of drugs (including RhoGAM) that get babies past blood-exchange
immune reactions.  All short-term.

Of course, "unlimited funds" are a bad idea too in a finite
Universe.  It's not the lack of funds that torques me so much,
though, as the idiotically inefficient way they're allocated.

Do you agree that the drug lobby (combined with corrupt
governance) is responsible for this?

Not really.  There's a lot of politics that go deeper than
means.  The fact that geezers vote and babies don't is one
of the key ones.  Pharmaceutical lobbying contributes, but
IMHO it's a secondary effect.

A secondary *effect?* So the electorate, not medical science, is
running the show? Modern medicine is really just a dressed up version
of "Vernon Goes to Camp?"

Medical science is certainly not running the funding priorities
in the USA, and IMHO that's as it should be -- even if it does
lead to all manner of disturbing consequences.

So far, you haven't engaged in a relevant discussion
of the issue, except to say that life is sometimes
expendable.  What I
wanted to know is whether there are any drugs proven to extend
life, by how much, and at what cost.

Yes, lifetimes worth, and variable.  Examples includeoxygen
and surfactants (as noted).  Surgical repair of septal defects
are another example, but you asked for drugs.

So, out of thousands of pharmaceuticals presumed to extend life
in modern healthcare, you are unable to provide a list, much less
evidence.  In fact, you would have to admit, if you were honest,
that the only data available to us is that which shows a
reduction in human life as a result of medication side
effects.  The Lazarou study, for instance, which even FDA
includes on its website, reveals a conservative 106,000 deaths
per annum resulting from drug side effects.

We were having a rather nice discussion on a positive note until
you decided to read a lot more into my post than I wrote.

Who was reading anything into what you wrote?  Your statement
about "the idiotically inefficient way [funds are] allocated" in
modern health care doesn't magically stop with neonatal care.  I
mentioned a study on the failures of adult medicine simply to
illustrate that fact.

I'm not prepared to accept that adult healthcare is a failure.

In what way do you describe it as a success?

By direct comparison to the health of our ancestors.
Aside from lifestyle diseases, we're vastly healthier at
50+ than our grandparents.

From the formal research POV, there was a recent historical
project that put together a profile of the adult population's
health in the post-Civil War period. It wasn't pretty.

I'm not inclined to give a great deal of weight to anecdote,
but personal experience leans the same way.

Since when is oxygena drug?

Look it up.  FDA regulations all over the place.  It's an
artificial chemical preparation administered to alter the
operation of the human body (it's also dangerous in some
circumstances.)  Don't ask me to defend the situation, but
that's how it is.

Correct. And when artificially prepared in this manner, it isn't
identical to atmospheric oxygen, thus a nutrient becomes a "drug."
Literally speaking, though, it's a nutrient analogue.

Aside from the obvious partial pressure differences, I'm not
prepared to grant that. However, it's pretty much beside the
point.

Also, surfactants are produced by the human body.

Some are.  Some aren't.  Premature infants often don't produce
them yet and without them to clear their lungs they don't breathe.

My point was that any biochemical substance used or produced by the
human body is a nutrient in terms of metabolic function. Any drug
modeled on such a substance is thus a nutrient analogue.

You are definitely broadening the definition of "nutrient."
However, using your definition then yes, most pharmaceuticals
are "nutrient analogs" in that they target natural biochemical
pathways; for instance, opiates target endorphin receptors.

--
| The most important exclamation in science isn't "Eureka!" |
| The most important exclamation is "What the BLEEP?" |
+---------- D. C. Sessions <dcs@xxxxxxxxxxxxxxxx> ----------+
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