# Has the "drugs are bad" message gone too far? **URL:** \ **Category:** Great Debates\ **Created:** [October 30, 2001, 6:44am UTC](https://boards.straightdope.com/t/has-the-drugs-are-bad-message-gone-too-far/90478 "2001-10-30T06:44:23Z")\ **Posts on this page:** 13\ **Page:** 2
**Author:** ![occ](https://avatars.discourse-cdn.com/v4/letter/o/8c91f0/32.png) [@occ](https://boards.straightdope.com/u/occ)\ **Post date:** [November 1, 2001, 7:46pm UTC](https://boards.straightdope.com/t/has-the-drugs-are-bad-message-gone-too-far/90478/21 "2001-11-01T19:46:23Z")
\*\* > [@](#): > > \*Originally posted by horhay\_achoa \* > \*\*I very, very rarely take any over the counter medications. I mean if you have a headache and you take Tylenol all you are doing is covering up the symptoms of the headache, and not getting to the cause. > > Why put those extra chemicals into your body if your headache will go away on its own?\*\* You aren’t taking the pain reliever to try to cure the headache, you’re just doing it to try to relieve the pain. If the headache persists, one would assume that you _would_ attempt to find out the cause. However, that’s not to say that it the pain is mild and isn’t particularly bothering you, you’d be wrong not to take a Tylenol or equivilent pain reliever. Every time you take a drug, there’s a manner of risk involved, and obviously by making the decision not to take a “comfort” drug (as opposed to a medication to correct a problem), you minimize that risk. ---
**Author:** ![erislover](https://avatars.discourse-cdn.com/v4/letter/e/71e660/32.png) [@erislover](https://boards.straightdope.com/u/erislover)\ **Post date:** [November 2, 2001, 8:10pm UTC](https://boards.straightdope.com/t/has-the-drugs-are-bad-message-gone-too-far/90478/22 "2001-11-02T20:10:30Z")
I, almost exclusively, ingest only pleasure-drugs. I smoke for the nicotene, I drink for the drunk, I ingest caffeine for the buzz, etc (no need to go into illegal pleasures). When I’ve got a headache I don’t usually take aspirin. Usually a headache is a sign of dehydration in me (because of the diuretics I consume!) so its a friendly reminder to drink some good fluids! Luckily, however, I do not suffer from clinical depression (at least, I never went to find out), migranes, anxiety (though lately I feel like my anxious moments are getting more frequent), and so on, so I seem to be relatively free to avoid “helpful” medication, and only take the fun stuff. When I scientist tells me something I nod thoughtfully and try to grasp it, if I can; when the government tells me something my spider-sense triggers and the bullshit detector goes off. But, I must admit, the “drugs are bad” campaigns have put a lot of mental shortcuts (bromides, popular expressions and or feelings) into the meme pool (if your a meme fan—if not, then just into the social vocabulary). Some people seem to have a tendency to latch onto popular expressions and claim them their own; others, well, just happen to agree with such expressions. I am not sure how to test to see which people are which. 🙂 ---
**Author:** ![kierk](https://avatars.discourse-cdn.com/v4/letter/k/8491ac/32.png) [@kierk](https://boards.straightdope.com/u/kierk)\ **Post date:** [November 3, 2001, 1:57am UTC](https://boards.straightdope.com/t/has-the-drugs-are-bad-message-gone-too-far/90478/23 "2001-11-03T01:57:47Z")
Sort of a response to the comments on anti-depressants above. I take anti-depressants myself for clinical depression, also my father is a psychiatrist so I have second hand info from him. First, I guess i’ll go into my general medication strategy. If I feel I have a headache coming on i’ll generally take some advil. Primarily this is because 90 percent of the headaches I get end up being fairly incapacitating (can’t really focus on anything other than the pain) after an hour or so, and advil clears them right up. Otherwise I don’t generally take OTC meds. like horhay\_achoa i’m pro-fever 🙂 ``` Prescribing anti-depressants is more of an art than a science according to dad, different meds can have very different side-effects in different people, thats why its very important to have a dialog w/your psychiatrist about how your meds are effecting you, and even more important to have a psychiatrist who CARES about how your meds are effecting you. ``` The idea that anti-depressents screw with your brain chemistry is, of course, completely accurate, it’s not so much that i feel differently when on my meds (though I do) as it is that i THINK differently. I respond differently to the same situation. Where before I was on the meds doing something embarassing could fill me with the deepest shame possible, now I just get embarassed. Another important point is that while starting the meds helped my brain chemistry, I still had 13 years of depression-learned reactions to unlearn, which took about 6 years. Basically, yes, psychiatric medication can change how you think,react,and feel, but sometimes thats one heck of a lot better than the alternative. ---
**Author:** ![mhendo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/mhendo/32/3159_2.png) [@mhendo](https://boards.straightdope.com/u/mhendo)\ **Post date:** [November 3, 2001, 5:39pm UTC](https://boards.straightdope.com/t/has-the-drugs-are-bad-message-gone-too-far/90478/24 "2001-11-03T17:39:21Z")
In response to the OP, maybe **cazzle** ’s experience explains a lot. It may be that America’s obsession with demonizing all types of pleasure-enhancing drugs (except the ones with big Washington lobby groups - tobacco, alcohol, etc.) contributes to people’s reluctance to take prescribed medication. But it might also be that many people are becoming increasingly aware of of the self-serving crap put out by pharmaceutical companies, which do whatever they can to push their products into doctors’ cabinets and into patients’ bodies, seemingly regardless of whether the drugs actually do any good. When people read about doctors being taken on expensive junkets and given “gifts” by pharmaceutical companies promoting their drugs, patients naturally start to wonder whose interest is being served best when the prescription is being written. There are many fine doctors who resist the blandishments of the drug companies and actually put their patients’ interests first, but the fact that many do not can make people wary. And the barrage of advertisements for prescription drugs on television means that people develop the same attitude to those drugs as they do to any other consumer product - a healthy skepticism based on the belief that the commercials don’t tell you all you need to know about the product. Combine this with the concern over doctors’ susceptibility to drug company marketing, and the attitudes described in the OP become perfectly understandable. This is not to say that the drugs don’t help. Many of them are life-saving, and others make people’s lives infinitely more comfortable and pleasant. But this is when they are prescribed correctly and for the appropriate ailment. IMHO, many such problems could be avoided by banning the advertising of prescription drugs on TV, and restricting the type and amount of gifts and incentives that doctors can take from drug companies. Not only might this help bring about a situation whereby doctors are more likely to have their patients’ best interests at heart when prescribing medication, but it could also bring down the cost of prescription drugs considerably. In 1999, of five large drug companies, only one, Merck, spent less than 25% of its revenue on marketing - 15.9%, to be exact. Four others spent the folowng amounts: Pfizer - 39.2%; Eli Lilly, 27.6%; Schering-Plough, 37.4%; and Pharmacia & Upjohn, 38.6%. (These are the only companies for which i have figures. Source: _Dollars and Sense_ (economics magazine), May-June 2001, p. 24) ---
**Author:** ![erislover](https://avatars.discourse-cdn.com/v4/letter/e/71e660/32.png) [@erislover](https://boards.straightdope.com/u/erislover)\ **Post date:** [November 3, 2001, 9:36pm UTC](https://boards.straightdope.com/t/has-the-drugs-are-bad-message-gone-too-far/90478/25 "2001-11-03T21:36:06Z")
**mhendo** , I am extremely skeptical about cutting the pharmaceutical company/doctor tending line. I could probably find some agreement about regular television advertising with some statistics behind it, but I can also see that many people might have a treatable problem that they don’t realize can really be treated. As far as the doctor/pharma link goes, I cannot honestly think of a better way to keep doctors informed of what drugs are available for what. ---
**Author:** ![JRDelirious](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jrdelirious/32/9531_2.png) [@JRDelirious](https://boards.straightdope.com/u/JRDelirious)\ **Post date:** [November 4, 2001, 12:16am UTC](https://boards.straightdope.com/t/has-the-drugs-are-bad-message-gone-too-far/90478/26 "2001-11-04T00:16:13Z")
One thing that I noticed in **DoctorJ** ’s OP was the item about the patient who could not handle being put on a diuretic for hypertension. Not a medication that will alter your brain chemistry to treat some subjective condition – treatment for a condition that has the potential to destroy major organ systems. Now, the only “fear” I could see there would be a fear of overloading your kidneys… **or** a fear that if for some reason you miss your dose you will rapidly bloat up to bursting because your body will be “fighting” the drug. And THAT last bit is something that **MAY** have derived in part from a misapprehension of the Anti-Drug rhetoric: the idea that _everything_ “builds up tolerance” and/or induces an even-worse “rebound effect.” Some have already mentioned that, as to OTC meds for mundane everyweek ailments, they just feel like relying on the body’s own healing capacity for mild, passing discomfort. I’m sure many of those who have taken that stand in this thread have NO problem with getting a script from an MD if the problem seems really serious. I have no real problem with that stance (indeed I’m myself a little puzzled at the idea that folks now take OTC H-2 blockers for common heartburn a TUMS, or sensible eating, could handle) as long as they don’t become overconfident and overlook an early sign of a bigger health problem. I’ll take my Excedrin for my headaches, and for colds a decongestant (plus Zinc lozenges, natch 🙂 )for when I can’t stay home having chicken soup, but if the headache persists or the breathing becomes labored, I’m calling the doc. For yet others in the no-med camp, I would venture to say it’s more a question of the fear of “unnatural chemicals” polluting our Precious Bodily Fluids – so, no fluorine in the public water, no meds in the bloodstream. Or at least make them “natural” (as if “natural” couldn’t hurt you just as bad). Recently I was diagnosed with hypertension. My MD started me on low-dose Cozaar, later upped to usual-dose. I really respected that approach, starting with as low a dose as possible. Yet it did not depress me or panic me to hear that I’ll probably be on some sort of BP-control regimen (be it medication or diet) for the rest of my life, since that beats an increased risk of stroke, kidney damage, retinal damage, etc. hands down. The only medications on which I tend to be extra, extra cautious are antibiotics and the controlled substances that have an addiction risk. Bacteria already have a 3 Billion year head-start on us, I definitely do not feel a need to give them an accelerated-evolution workout by overdoing the abtc’s. I’d rather we save the latest, kill-all monster-cycline for things like the flesh-eating bug, or weapons-grade anthrax, and try to take the time to appropriately target other germs [sub](BTW, I can see the headline now: “Next great medical horror story: Tetracycline-resistant Juvenile Acne!”)[/sub] And the schedule drugs have a proven dependency/tolerance risk which I greatly respect. ---
**Author:** ![Punki](https://avatars.discourse-cdn.com/v4/letter/p/db5fbb/32.png) [@Punki](https://boards.straightdope.com/u/Punki)\ **Post date:** [November 4, 2001, 12:51am UTC](https://boards.straightdope.com/t/has-the-drugs-are-bad-message-gone-too-far/90478/27 "2001-11-04T00:51:02Z")
While I am totally comfortable taking any medication I really need–antibiotics for a serious infection, even Dayquil when my head is so stuffed up I can’t work, etc.–I do think that there are some doctors who lean too heavily on medication–especially those in the mental health field. HMOs are looking for the fastest, cheapest solution and that translates to drugs. Modern Psychiatrists are drug dispensers pure and simple. Most have little or no training for any solution but drugs. Sad, sad, sad. We are already in the beginnings of an epidemic of diagnosis of Bipolar Condition, much of which I am convinced has been brought on by the over prescribing of Ritalin and other stimulants to calm every highly active kid that entered a classroom in the 80s and 90s. Why are we so amazed that when we give kids highly addictive drugs that they become addicted. ---
**Author:** ![Kaje](https://avatars.discourse-cdn.com/v4/letter/k/f04885/32.png) [@Kaje](https://boards.straightdope.com/u/Kaje)\ **Post date:** [November 4, 2001, 4:58am UTC](https://boards.straightdope.com/t/has-the-drugs-are-bad-message-gone-too-far/90478/28 "2001-11-04T04:58:39Z")
> [@](#): > > \*Originally posted by JRDelirious \* > **For yet others in the no-med camp, I would venture to say it’s more a question of the fear of “unnatural chemicals” polluting our Precious Bodily Fluids – so, no fluorine in the public water, no meds in the bloodstream. Or at least make them “natural” (as if “natural” couldn’t hurt you just as bad).** Oh god do I hate that. I half jokingly invented a scenario in my head in which people considered the “natural” products to be completely innocuous (and yet somehow more effective?), and then a while later I see this very spiel popping up all over. I get a lot of spam, and a lot of it is for “alternative pharmaceuticals”… you know… herbal viagra, natural weight loss. I browse some out of morbid curiosity, and more often than not I see the line “And it’s all natural so no potentially harmful side effects!” WTF? How stupid can people be. “So something in me isn’t working right… but this substance will magically penetrate and clense that malady without so much as touching another organ.” As eminem would say, “how fucked up is you?” The only ideologies I can imagine that would be consistent with this hogwash would involve either mystical fish-demons or sun worship (no offense to [George Carlin](http://www.januarymagazine.com/nonfiction/napalmand.html)). ---
**Author:** ![mhendo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/mhendo/32/3159_2.png) [@mhendo](https://boards.straightdope.com/u/mhendo)\ **Post date:** [November 4, 2001, 5:05am UTC](https://boards.straightdope.com/t/has-the-drugs-are-bad-message-gone-too-far/90478/29 "2001-11-04T05:05:12Z")
**erislover** wrote: > [@](#): > > mhendo, I am extremely skeptical about cutting the pharmaceutical company/doctor tending line. I could probably find some agreement about regular television advertising with some statistics behind it, but I can also see that many people might have a treatable problem that they don’t realize can really be treated. > > As far as the doctor/pharma link goes, I cannot honestly think of a better way to keep doctors informed of what drugs are available for what. With respect to the issue of advertising informing people that they have a treatable condition, i suppose there is a certain argument to be made for this. You might disagree with me here, but i think that this is a good area for public health announcements. If statistics show that people with clinical depression are tending not to seek treatment, then maybe an ad sponsored by the surgeon-general or someone like that could be put out. This would help inform people of such issues without pushing them towards a particular drug or drug manufacturer. And i really think that there are not that many ailments which fall into this category. For example, one of the most common drug ads that i see on TV at the moment is for a herpes drug. Another is for an asthma drug. These are hardly conditions about which the sufferer is likely to be unaware. I certainly don’t advocate cutting all ties between drug companies and doctors. I never suggested such a thing. What i asked for was legislation that would prevent doctors from receiving what seems to me to be excessive largesse from the pharmaceutical companies. We legislate against police and other public servants taking gifts above a certain value, because when they take such gifts it can give the impression of impropriety or corruption. I know that doctors are not all “public servants” in the true sense of the word (some are not public servants in any sense of the word), but it seems to me that they can learn about new drugs without an all-expenses-paid trip to some plush hotel in the Caribbean and similar incentives. What’s wrong with giving them papers containing the results of clinical trials and the FDA report on the drug’s approval? Surely this would give all the relevant medical information, and would take up less of the doctors’ valuable time. And that is also what medical journals are for. I should stress again that i’m not trying to bash all doctors here. I know that there are many doctors who advocate similar reforms, and who fight against the drug-pushing of the pharmaceutical companies, and against the unnecessary use of prescription drugs. ---
**Author:** ![Kaje](https://avatars.discourse-cdn.com/v4/letter/k/f04885/32.png) [@Kaje](https://boards.straightdope.com/u/Kaje)\ **Post date:** [November 4, 2001, 5:15am UTC](https://boards.straightdope.com/t/has-the-drugs-are-bad-message-gone-too-far/90478/30 "2001-11-04T05:15:06Z")
> [@](#): > > \*Originally posted by mhendo \* > **but it seems to me that they can learn about new drugs without an all-expenses-paid trip to some plush hotel in the Caribbean and similar incentives. What’s wrong with giving them papers containing the results of clinical trials and the FDA report on the drug’s approval? Surely this would give all the relevant medical information, and would take up less of the doctors’ valuable time. And that is also what medical journals are for.** Good lord… what kind of doctor do you go to? My dad has been a doctor for almost 30 years and private practice for about 5 or 6, and the most he gets from pharm companies is logo items (desk clocks, pocket knifes, the usual junk with the ocassional interesting items) and the occassional free meal (apparently they find out what the doctors’ favorite restaurants are and have food from there brought to the office for a meal while they discuss their medication. One of my dad’s friends went fly-fishing with a pharm rep… but I was under the impression that he knew the guy outside of the business relationship. I’m really not sure what medical journals my dad subscribes to, he gets JAMA at home… I do know he finds the pharm reps useful in obtaining information. ---
**Author:** ![mhendo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/mhendo/32/3159_2.png) [@mhendo](https://boards.straightdope.com/u/mhendo)\ **Post date:** [November 4, 2001, 6:18am UTC](https://boards.straightdope.com/t/has-the-drugs-are-bad-message-gone-too-far/90478/31 "2001-11-04T06:18:26Z")
I don’t want to imply that lavish trips are the norm, but they do occur. There are also other ways that drug companies appeal to doctors. I have quoted some examples below. Sorry the quotes are so long, but i got them from the Lexis/Nexis newspaper database, and i can’t give a link to the stories because they are only available to people with a Lexis/Nexis account, or to people (like me) whose university subscribes to the database. For those who do have Lexis/Nexis access, you can find these articles by using the keywords DOCTOR, DRUG, COMPANY, PERK. For those without, you can go to the newspapers at your local library if you want to check up on my citations. From the _Boston Globe_: > [@](#): > > Dr. Joseph Gerstein has spent a decade writing newsletters about what he calls “scams, shams, and schemes” in the pharmaceutical industry. > > Nonetheless, the Tufts Health Plan administrator was scandalized when a drug company saleswoman offered him a $40,000 cash grant if he would encourage other doctors to prescribe its cancer drug. > > “The industry is more gimmicky than car sales,” he said. “But this was strictly quid pro quo.” This time, Gerstein decided, a newsletter article was not enough. With Tufts’s support, he called in federal prosecutors and helped build a case that, over 4 1/2 years, resulted in charges against 11 doctors and officials of TAP Pharmaceutical Products of Illinois and, last week, brought the largest health care fraud settlement in US history… > > TAP agreed to plead guilty to health care fraud last Wednesday, settling charges by the US attorney’s office in Boston it inflated the price of Lupron that was used for government reimbursement while selling the drug to doctors and health plans at a price that ensured them a profit of at least $100 per dose. > > In essence, the government said, TAP used taxpayers’ money through the Medicaid and Medicare health insurance programs to bribe doctors to prescribe their drug instead of a cheaper competitor. > > While paying the record fine, TAP officials insisted the company’s pricing policies were proper. > > New charges were lodged last week against six TAP employees, including its former top sales executive and two allegedly involved in the Tufts scheme. > > From the start, it was a decision about money that put Gerstein at the center of the case. > > In 1996, after several years of study by Gerstein and others, Tufts decided it would no longer pay for Lupron, TAP’s injected prostate cancer drug, because it cost an average of $1,200 more a year per patient than a medically equivalent drug, Zoladex, which is made by Astra Zeneca. Gerstein said the extra costs for Tufts patients would be about $1 million per year. > > “We decided this was not a rational way to be spending money,” he said. > > Shortly thereafter, Gerstein got a call from Janice Swirski of Chestnut Hill, a national account representative for TAP. According to a federal indictment, she offered Tufts a $40,000 “unrestricted educational grant” if Gerstein would reverse the Lupron decision. > > (_Boston Globe_, 7 Oct. 2001, p. B1; see also _New York Times_, 4 Oct. 2001, p. C1) A _USA Today_ article focused on the same doctor and looked at the issue more broadly: > [@](#): > > In the past few months, Dr. Joseph Gerstein could have enjoyed a Broadway show, a Texas Rangers baseball game, golf outings and a stay at an Austin, Texas, resort – all paid for by the prescription > drug industry. > > Gerstein refuses such offers. But such pitches – he says he gets one free travel offer a week – raise a growing concern about the role such marketing efforts play in what doctors prescribe for patients and how much the USA spends on drugs. > > From simple pens and notepads to lavish dinners and trips out of town, doctors are increasingly being offered an array of goodies as incentives to listen to drug sales pitches or to offer their “opinions” to drug companies in focus groups. > > The drugmakers hope that, in turn, the doctors will prescribe their products. And they do. A study published May 8 showed that of the drugs most responsible for the nearly 19% rise in spending on pharmaceuticals last year, the four top sellers were also among the top 10 drugs most heavily marketed to doctors. “Physicians don’t seem to be making the connection between the exorbitant prices for drugs and what is spent to lure them into prescribing,” says Gerstein, director of pharmacy services for Tufts Health Plan in Massachusetts… > > The drug industry sponsored more than 314,000 physician “events” last year, ranging from catered lunches in hospital conference rooms to getaway weekends at resorts, nearly double the number held 4 years earlier, Scott-Levin reports. The tab? Nearly $ 2 billion. > > (_USA Today_, 16 May 2001, p. 1B) Another example from the _New York Times_: > [@](#): > > Overall spending on pharmaceutical promotion increased more than 10 percent last year, to $13.9 billion from $12.4 billion in 1998. Experts estimate that the companies collectively spend $8,000 to $13,000 a year per physician. In recent years, as demands on doctors’ time have grown more intense, pharmaceutical marketers say they have been forced to become more creative. > > “You have to have a hook,” said Cathleen Croke, vice president of marketing for Access Worldwide Communications Inc., which specializes in drug marketing. “If you offer them $250, that might get them. Or they are attracted to the prestige of being a consultant, that a company is asking for their opinion.” > > The offer of dinner and a $250 consulting fee was sufficient to draw about a dozen South Florida physicians to Morton’s in West Palm Beach on Sept. 18. They gathered there, on a muggy Monday night, in a back room called the boardroom, where a slide show and a moderator from Boron, LePore & Associates Inc., the market research firm hosting the event, awaited their arrival. > > Dr. Moskowitz, who has been in practice in West Palm Beach since 1978 and heads a group of 12 doctors, says he routinely receives – and rejects – such invitations. > > The Morton’s dinner was not open to the public; had Dr. Moskowitz accepted, he would have been required to sign a confidentiality agreement. Instead, he told the companies he intended to take a reporter for The New York Times. > > But when Dr. Moskowitz and the reporter showed up at Morton’s, the Boron LePore moderator, Alexander Credle, told them to leave. “This is a clinical experience meeting, a therapeutic discussion,” Mr. Credle said. “There is an expected degree of confidentiality.” > > Dr. Moskowitz asked Mr. Credle why he was invited; Mr. Credle had no answer. But in an interview a few weeks after the dinner, John Czekanski, a senior vice president at Boron LePore, said the invitations were “based on databases targeting physicians” who prescribe cholesterol-lowering drugs or who might. > > Boron LePore calls these dinner sessions “peer-to-peer meetings,” and in 1997, it acted as host at 10,400 of them. Typically, they feature presentations from medical experts, on the theory that doctors are receptive to the views of their peers. With new drugs coming onto the market all the time, physicians are hungry for information about them. Pharmaceutical companies say it is that desire for education, rather than a free meal or modest honorarium, that draws many doctors to the meetings. > > But the dinners are creating unease among officials of the American Medical Association’s Council on Ethical and Judicial Affairs, which in 1990 published guidelines that limit what gifts doctors may accept. The guidelines, which have also been adopted by the Pharmaceutical Research and Manufacturers’ Association, the drug industry trade group, prohibit token consulting arrangements, but permit “modest meals” that serve “a genuine educational function.” > > Compliance is voluntary, and Dr. Herbert Rakatansky, who is chairman of the A.M.A.'s ethics council, says doctors routinely ignore the rules. That is in part because they are murky, as the dinner at Morton’s reveals. > > Whether the dinner was intended to educate doctors, or was part of a marketing campaign, or both, is not clear. In the $7.2 billion market for the cholesterol-lowering drugs known as statins, Baycol ranks last in sales, with just $106 million in sales last year. Bayer and SmithKline Beecham recently introduced a new dosage for the drug, and the companies said they used the Morton’s meeting to share new clinical data with doctors. > > “As far as we’re concerned, it’s educational,” said Carmel Logan, a spokeswoman for SmithKline Beecham. But Tig Conger, the vice president of marketing for cardiovascular products at Bayer, said the company intended to teach a select group of doctors about Baycol, then use their feedback to hone its marketing message. And Allison Wey, a spokeswoman for Boron LePore, said the dinner was “part education and part marketing.” > > While Dr. Rakatansky, of the A.M.A., could not comment specifically on the Baycol meeting, he had harsh words for these dinners in general. > > “We think 99 percent of those are shams,” he said. “They are marketing devices and not true requests for information.” > > As to whether the dinner fit the “modest meal” criteria, that, too, is unclear, because the guidelines offer no specifics. At Morton’s in West Palm Beach, the entrees range from $19.95 for chicken to $32.95 for filet mignon – a la carte. The sales manager, Lauren Carteris, said the restaurant frequently was the site of pharmaceutical meetings for Boron LePore. > > “Doctors,” Ms. Carteris said, “will only go to an expensive restaurant.” > > To heighten doctors’ awareness about the ethics of accepting gifts, the medical association is beginning an educational campaign. In addition, The Journal of the American Medical Association devoted the bulk of its Nov. 1 issue to conflict of interest in medicine, including an essay entitled “Financial Indigestion” that questioned the effects of pharmaceutical company gifts on doctors’ professional behavior. > > But some prominent doctors say the medical association needs to address its own role, as a seller of information that helps drug marketers select which doctors to target. > > “It potentiates this gift giving, and implicitly endorses it,” said Dr. David Blumenthal, a professor of health policy at Harvard Medical School who has used the A.M.A.'s data for his academic research. > > (_New York Times_, 16 Nov. 200, p. A1) And from those “wacky” medical socialists north of the border, some oblique support for my proposal: > [@](#): > > Medical residents who were barred from taking free meals and gifts from drug companies and who were not allowed to meet with representatives were far more skeptical about industry pitches once they became doctors, says a new study. > > The findings, published today in the Journal of the American Medical Association, is sweet vindication for Dr. Gordon Guyatt. Guyatt came under personal attack in the early 1990s when he spearheaded a policy limiting industry contact with internal medicine residents at McMaster University in Hamilton. For Guyatt, the issue is black and white. > > “The whole gifts-given-to-residents, as I see it, is softening them up, so accepting gifts from the industry becomes part of the culture.” He said subsequently when the gifts get bigger and the requests get made, there is “a sense these people are buddies and … at some level, people are aware ‘I’ve accepted all this from them’ and at some level do feel they owe them something.” … > > [Allan] Detsky and two colleagues polled three groups of doctors who finished their training between 1990 and 1996; a group was from the University of Toronto, which at that time did not restrict drug company activities aimed at residents; a McMaster group, who went through the program before Guyatt’s policy went into effect, and a third post-policy group from McMaster. > > The study found the last group, which had less contact with drug reps than the other two, placed less value on the contact and were more skeptical about the information the reps gave them about their products. > > Drug companies have been known to lavish all sorts of perks on doctors - and doctors-in-training - in an apparent bid to have the doctors look favourably on their products. Golf weekends, ballet and sports outings, ski trips and cruises have been organized around “education sessions” during which doctors attend seminars on treatments or drugs. Such perks involve little time in the classroom. > > (_Toronto Star_, 24 Oct. 2001, p. LOGIC) Sorry to pile on so much info, but i thought people might be interested. ---
**Author:** ![Dr\_Paprika](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dr_paprika/32/3042_2.png) [@Dr\_Paprika](https://boards.straightdope.com/u/Dr_Paprika)\ **Post date:** [November 4, 2001, 6:35am UTC](https://boards.straightdope.com/t/has-the-drugs-are-bad-message-gone-too-far/90478/32 "2001-11-04T06:35:19Z")
I think people have always been reluctant to take pills for vague conditions that are not easily appreciated… having high blood pressure or cholesterol doesn’t make me feel bad. I do not think this is new or a result of anti-drug campaigns. I see lots of pill seekers. I’d say they equal those who can’t be persuaded to take anything. Most people will if the have enough information patiently explained to them. If they choose to take nothing, they have that right. Before this century such non-compliance probably saved lives. ---
**Author:** ![JRDelirious](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jrdelirious/32/9531_2.png) [@JRDelirious](https://boards.straightdope.com/u/JRDelirious)\ **Post date:** [November 4, 2001, 4:33pm UTC](https://boards.straightdope.com/t/has-the-drugs-are-bad-message-gone-too-far/90478/33 "2001-11-04T16:33:49Z")
BTW, during my work at a pharmacy in the mid-80’s, I was able to almos _fully_ equip my personal stationery needs by taking home DrugCo freebies. Notepads, pens, flashlights, Swiss Army knives, calculators, staple-pullers, mugs… and best of all the fine-art prints in the Hoechst (now Aventis) calendar. 😃 [Previous page](https://boards.straightdope.com/t/has-the-drugs-are-bad-message-gone-too-far/90478.md?page=1)