Who’s doing the prescribing — doctors or patients?

After mulling over the “logic” behind our medical marijuana laws recently, it was serendipitous that one night last week, I didn’t set my DVR correctly and was subjected to television commercials during the evening news.

Normally, I leave the DVR on NBC and hit “rewind’ to the beginning of the news, and fast-forward through the commercials. There’s nothing I want to watch badly enough on TV to sit through commercial breaks, and thanks to my beloved DVR, I don’t have to.

On this particular day, I was exhausted, plopped onto the recliner to watch the news, discovered the TV on the wrong channel, and frankly, it was just too much effort to hit “pause” and go do something else while some commercial cushion built up. I decided to just endure the commercials.

Rather than getting annoyed, I viewed it as an opportunity to glimpse into middle America’s television experience… see what sort of manure is being pumped into our collective American subconscious these days.

I expected a montage of fast food and fast cars, dish soap and laundry soap, diapers for young and old, but what I discovered was far more insidious. So insidious that I was reenergized, and leapt from my comfy recliner and started taking notes.

Here’s what was being peddled to America during one 30-minute show:

~ Pradaxa, for irregular heartbeat (atrial fibrillation).
~ Restasis, for chronically dry eyes.
~ Enbrel, for rheumatoid arthritis and psoriasis.
~ Cialis, for erectile dysfunction.
~ Plavix, to prevent blood clots that cause heart attack or stroke.

So what, you say. Why shouldn’t drug companies advertise their products. I’ll tell you why. Because Average Joe or Jane American doesn’t know diddly-squat about biochemistry. Ninety-eight percent of the population doesn’t have the educational depth or breadth to understand what these drugs do to the human body, and the two percent that does has “M.D.” after their names. And that two percent doesn’t get its medical information from commercials.

The average person can’t purchase these medications without a prescription. Period. These products are being pitched to consumers who can’t actually consume them. At top dollar during the evening news on a major network, no less.

Why.

Why target an audience that can’t actually purchase your product. There’s only one logical answer: because it’s working.

Every commercial recommends talking to your doctor about taking these drugs. Excuse me? Talk to my doctor about taking this or that medication? I don’t want to talk to my doctor about medications, I want my doctor to talk to ME about medications! I expect her to be fluent on medications and what they might do for me, and to me, not vice-versa.

What sort of bizarro alternative universe have we stumbled into, where patients are educating their doctors about medications? I’m horrified to consider that doctors are actually being persuaded by their patients to prescribe some really heavy-duty drugs. But clearly they are. Or the drug ads wouldn’t exist. Companies don’t throw millions of dollars into advertising unless it’s paying off.

Beyond the lunacy of promoting the idea that patients must educate their doctors about medication, the ads invariably end with a high-speed summary of all the medical contraindications for taking the drug (as if your doctor has no clue about your medical history or the drugs you’re already taking) as well as the potential side effects, ranging in severity from blurred vision to cardiac arrest. Some of the side effects are worse than the condition for which the drugs are prescribed.

Consider Enbrel: “Serious infections have happened in patients taking Enbrel. These infections include tuberculosis and infections cause by viruses, fungi or bacteria that have spread throughout the body. Some patients have died from these infections. Patients treated with Enbrel also may be at risk for other serious side effects including nervous system problems, such as multiple sclerosis, seizures, or inflammation of the nerves of the eyes; rare reports of serious blood problems (some fatal); heart failure, including new heart failure or worsening of heart failure you already have; new or worsening psoriasis; allergic reactions; immune reactions, including a lupus-like syndrome, lymphoma and other cancers.”

Not only can Enbrel cause these diseases, it can actually worsen the condition for which it’s been prescribed! I’d rather have full-body arthritis than roll the dice with this poison.

But, the ad features a friendly-looking golfer (People! He’s an actor!) who can now hit the links, thanks to this drug. And that’s what we remember, and that’s why we ask for the drug, and… that’s why doctors prescribe it? Really? Because patients want it? Where are doctors getting their medical degrees these days? Bizarro U?

To bring this full circle, in the mainstream medical industry, trying medical marijuana for my developing arthritis is out of the question. But taking Enbrel (particularly if I advise my doctor that this is what I need, based on my extensive medical background) is perfectly legitimate; it’s far easier to get a drug that could cause a cornucopia of horrific diseases than an alternative “drug” that doesn’t.

Why.

Ka-ching, that’s why. Big Pharma doesn’t make any money off back yard pot, and selling drugs is big business, whether on a dark alley or at the pharmacy. But drug makers need dealers. In the case of Big Pharma, the pusher clearly has M.D. after his/her name. Which ultimately makes no sense, because doctors don’t profit from drug sales. So why are they complicit?

Why?

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