WASHINGTON — It is a fact of American journalism that it is
almost always in a state of agitation. Its practitioners should,
with a few notable exceptions, be on medication at all times. For
the newsrooms of America I would prescribe one of the many fine
tranquilizers produced by our leading pharmaceutical companies.
An example of the agitation afflicting my unsedated colleagues
is the enormous pother they have created over another of the
pharmaceutical companies’ wonders, painkillers. One, Vioxx, when
taken in very high dosages and for a long period of time, is
suspected of causing cardiovascular problems for a small number of
patients. Two others, Celebrex and Aleve, might when taken
in huge doses and for a long time cause similar problems. The
makers of Vioxx imprudently hauled it off the market — an
invitation, that, for the trial lawyers to pounce. The makers of
Celebrex and Aleve have acted more prudently. They understand that
the danger posed by their medications is slight and that tens of
thousands of Americans with chronic pain face dreadful misery
without these medications.
Yet the agitation of the journalists continues and moves from
unwarranted alarm about a painkiller to Great Expectations about
another, newer painkiller, one that sounds grisly to me, something
called Prialt. It is made from poison found in the South Pacific
cone snail. Yes, I said poison. A similar painkiller that has
scientists and journalists giddy in anticipation is made from
fluids found in tree frogs. Of the snail-venom-laced painkiller
Richard L. Rauck, of Wake Forest University and the Carolina Pain
Institute, exclaims: “This drug is very exciting because it’s a
very potent analgesic but isn’t a narcotic.” Very exciting indeed
— wait until it is discovered that Prialt’s baseline risk for
cardiovascular disease over a period of time is not less than 1%
but actually 1.5%.
Then the trial lawyers will be ringing up the snail venom users.
The press will be echoing with charges that Prialt’s producer knew
all along that the stuff was deadly. And forget not the case that
will be made by the animal rights activists when they discover the
impending depletion in the world’s South Pacific cone snail
population.
The increase in baseline risk that I mention as a possibility in
Prialt’s future is not a product of my imagination. It was
precisely this shift in Vioxx’s baseline threat that transformed it
into a matter of hysteria in the press. In the study that indicted
Vioxx the number of cardiovascular events per 1,000 was 15 for the
group using Vioxx in large dosages and for 18 months. The number of
cardiovascular events per 1,000 was 7.5 for the group using a
placebo. Rather than bringing in the Feds and the trial lawyers, I
think such findings should leave it to doctors and patients to
decide whether they wanted a slight increase in danger or enduring
pain.
Instead we now have journalistic hysteria over the Giant
Pharmaceuticals and their alleged reckless pursuit of profit. The
trial lawyers’ pursuit of profit will get little attention.
Witnesses will turn up who will insist that they recognized the
painkiller’s dangers all along. They will claim Vioxx’s producer
did too. Let me say it now. I seriously doubt that in litigious
America any pharmaceutical company would risk putting a drug on the
market knowing it was dangerous. All medications have side effects,
some quite serious. The important question is over the severity and
frequency of the side effects. My guess is that Vioxx’s severity
and frequency are within the bounds of the tolerable.
The suffering of patients no longer allowed to use Vioxx has
gotten little attention in the news stories. Certainly suffering
can lead to death. The Wall Street Journal points out
ironically that it might be a good thing that a growing list of
painkillers is being attacked in the press. Suffering Americans
need painkillers. As the list of painkillers with side effects
lengthens the public may be moved to a sensible conclusion.
Powerful medications have side effects. The afflicted and their
doctors can decide what is best for them — in the case of Vioxx
more pain or a slight increase in the chance of cardiovascular
disease.
The answer to the current hysteria over painkillers is more
information and more consumer freedom — nothing more.
