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Health: Faint Warning - Adverse Drug Reactions

Do we really understand how prescription medications are affecting our health? How much science is really behind this? The issue of adverse reactions to prescribed medications became an important issue to me after hearing Ron's story about his life threatening experience with Lipitor. In Faint Warning CBC news report that outlines the history and current initiatives in tracking and responding to adverse drug reactions. There are a number of important implications for us all...

But critics complain that all is not well, that Health Canada is reactive and not picking up on trends quickly enough.

Canada's Adverse Reaction Drug Database[ADR] documents up to 10% of the total suspected adverse reactions to drugs in Canada. Out of the 10,000 entries that are currently in the data base, 450 people have died through suspected adverse reactions. The word "suspected" is an important qualifier, and after a brief exploration of the data base I could not find one record that presented a direct causal link between a drug and the death of an individual.

Currently the system is voluntary for health professionals, consumers and patients. It may be a good idea to add information about Canada's ADR Database on the labels and/or accompanying info. of all prescriptions - I suspect that the ADR is not as well known as it should be. While pharamceutical companies are required by law to report suspected adverse reactions, health professionals are not. Why? In Ron's case, not only did his GP fail to report the possibility of an adverse reaction, he failed to take the possibility seriously himself.

From a business perspective, the admittance of an adverse drug reaction can have an adverse effect on profitiability - both for the pharmaceutical company as well as the prescribing doctor. I don't believe the answer ultimately lies in a law suit, but instead more effectively integrating the experiences of the patients, consumers, and health professionals with the producers of prescription drugs. If the conversation is to be of a high quality, this means everyone accepts responsibility for investigating and understanding these issues more effectively. This kind of open and responsbile environment is the new market for pharmaceutical companies and a most of the burden should be placed on them for creating it.

Scanning the ADR database is a sterile experience. While there is an obvious need to protect personal information, it is also clear that people's experiences have been reduced to bland statistical "facts." What is missing is the story - the human reality of what actually happened. Adding the picture of a person that died due to a suspected adverse reaction would make us realize that there was a real person behind the data.

Of course, one of the greatest road blocks to this system is the ability to definitely prove a concrete causal link between an adverse reaction and a specific prescription medication. While we seem to have developed a wide range of impressive techniques to produce these medications, we also seem to be wholly lacking in our ability to fully understand the range of consequences that may follow.

Other problems include the current burden being placed on doctors - there are far too few of them, especially for an aging population. The lack of good basic nutrition is becoming more and more serious, and opportunities to develop more preventative approaches to health care are lacking. Our environment is becoming increasingly more toxic, and our foods are laced with all kinds of chemicals. Waiting for health problems to be diagnosed then prescribing a medication for that problem doesn't seem like the best strategy for living. Health is more than just disease intervention, it's a lifestyle.

While the benefits of building a database like this are clear, they are not enough. If the communities of prescription drug producers, prescribers and users are to engage in a responsible dialogue, then an open forum is also required - a forum that captures the stories hiding behind the statistics.

And just as important, we should also capture stories that inspire good health.

From coloured tabs to computerized signals: How Canada tracks dangerous drugs
Paddy Moore | CBC News Online | February 17, 2004

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