February 19, 2002
Kamloops Daily News



On January 5 of this year, fifteen year old Charles Bishop
stole an airplane and crashed it into a Florida office.  He
killed himself but no on else was hurt.

In light of September 11, it looked like the act of a
pathetic copy-cat.  Newspapers reported the contents of a
suicide note left behind.  In it, Bishop claimed that
Afghanistan's al-Qaida had tried to recruit him.

What most newspapers didn't report was that Bishop had been
taking the powerful prescription drug Accutane.  Used in the
treatment of skin acne, Accutane has dangerous side effects
including depression, suicide and psychosis, according to
the U.S. Food and Drug Administration.

The suicidal side effects are significant enough that the
maker of the drug, Roche, had to retract claims that
Accutane was useful in treating "psychological trauma" and
"emotional suffering" associated with acne. 

Accutane is one of many prescription drugs being marketed
directly to the general public.   Direct marketing is
illegal in Canada but legal in the U.S.   As a result
Canadians see the ads that pour over the U.S. border on
television and in magazines.  Canadian media, anxious to get
advertising dollars, have been dodging the law.

The law is there for a good reason.  Direct marketing
bypasses the expertise of the doctor by appealing directly
to consumers.   Canadians who view the ads innocently
diagnose their real or imaginary problems and insist that
doctors write out prescriptions.  Unfortunately, those who
diagnose themselves have a fool for a patient.

Drug companies have convinced governments to look the other
way.  Governments are told to get out of the way of big
business and reduce regulations.  And isn't consumer choice
the saviour of us all?

Not that acne doesn't cause "emotional suffering."  I know
because as a teen, I suffered through the "psychological
trauma" of acne.  In desperation, I would have bought any
drug I thought might work.  But the cure is sometimes worse
than the ailment.  Direct marketing preys on the vulnerable.

Along with suicidal tendencies, another known side effect of
Accutane is a risk of severe birth defects if taken during
pregnancy.  They include mental disabilities, missing ears
and heart problems.  Despite warnings from doctors, by 1988
there had been over 500 children worldwide had been born of
Accutane users with such defects.

The tragic birth of deformed babies prompted calls for
Health Canada to ban the drug.  Instead of banning the drug,
with the regulators' approval, the manufacturer set up this
pregnancy prevention programme.   But it didn't happen.

Doctor Gideon Koren  at Toronto's Hospital For Sick Children
reports four women became pregnant while taking Accutane in
a six month period alone.  All had been warned of the risk,
but only one had been given the pregnancy prevention
programme.

The pressure on doctors to prescribe drugs is great when
patients insist on getting them, convinced of the drug
manufacturers claims.  Doctors are only human and give in to
this pressure, despite misgivings.

Accutane is not alone in the flogging of prescription drugs
directly to consumers.  A smiling woman beckons you to ask
your doctor for Sarafem to treat the world's newest disease,
Premenstrual Dysphoric Disorder.  Ex-NHL great Guy LaFleur
is pushing Viagra in his battle against erectile
dysfunction.  The ads appeal to vanity, hypochondria, and
human frailty.

The cost of drugs to our health care system is enormous.  We
already spent more money on drugs than we do on doctors
wages.   But that fact sometimes gets buried in the health
care debate. The reason is purely political. 

It's easy for the B.C. Liberal government, for example, to
moan at the recent wage increases for doctors.  But you
don't see them trying to regulate the obscene profits of
drug manufactures.   Health care workers are fair game for
this government.

Beware of governments who offer choice in health care.  In
this case, they advocate the urge of consumers to choose
potentially dangerous, inappropriate, and expensive
treatments.

On a recent visit to Canada, Dr. Peter Mansfield from
Australia urged Canada to start enforcing its law against
U.S. style direct-to-consumer advertising.  Only the U.S.
and New Zealand have not yet banned the practice. "The drugs
are the newest, and often most expensive drugs, but not
necessarily the best," he says.  Such advertising distracts
doctors and patients from safer, cost effective therapies.   

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