# Why do doctors over prescribe drugs? **URL:** \ **Category:** Great Debates\ **Created:** [March 23, 2012, 3:22am UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575 "2012-03-23T03:22:14Z")\ **Posts on this page:** 20\ **Page:** 7
**Author:** ![dataguy](https://avatars.discourse-cdn.com/v4/letter/d/eada6e/32.png) [@dataguy](https://boards.straightdope.com/u/dataguy)\ **Post date:** [March 28, 2012, 1:26am UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/121 "2012-03-28T01:26:41Z")
> [@Qadgop\_the\_Mercotan](#): > > Statins certainly do reduce the risk of heart disease. The data on them is excellent in showing they make a real difference in not only improving the quality of life, but extending it too. > > Other cholesterol lowering agents such as niacin & fibrates have not been demonstrated to be effective, and may even be associated with a rise in morbidity and mortality, despite lowering cholesterol. > > But the evidence for statins being extremely beneficial is very strong. Please post references to support your assertion about the evidence for statins. I have evidence that shows just the opposite. We can compare. ---
**Author:** ![Marley23](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@Marley23](https://boards.straightdope.com/u/Marley23)\ **Post date:** [March 28, 2012, 1:34am UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/122 "2012-03-28T01:34:42Z")
The data about nutrition curing some cancers is coming afterward, right? ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [March 28, 2012, 2:02am UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/123 "2012-03-28T02:02:05Z")
> [@dataguy](#): > > Please post references to support your assertion about the evidence for statins. > I have evidence that shows just the opposite. We can compare. Statins for the primary prevention of cardiovascular disease. Taylor F, Ward K, Moore TH, Burke M, Davey Smith G, Casas JP, Ebrahim S Cochrane Database Syst Rev. 2011 > **[Statins for the primary prevention of cardiovascular disease - PubMed](https://pubmed.ncbi.nlm.nih.gov/21249663/)** > > Although reductions in all-cause mortality, composite endpoints and revascularisations were found with no excess of adverse events, there was evidence of selective reporting of outcomes, failure to report adverse events and inclusion of people with... > [@](#): > > A 2011 meta-analysis of 14 randomized trials (n = 34,272) with a minimum duration of one year, and where fewer than 10 percent of patients had a history of CVD, found that statins reduced all-cause mortality (relative risk [RR] 0.83, 95% CI 0.73-0.95) and combined fatal and non-fatal CVD endpoints (RR 0.70, CI 0.61-0.79) Data shows somewhat limited Cost-effectiveness and quality of life improvement. Statins for secondary prevention of CV disease. Data is very strong here. > [@](#): > > PubMed > Effect of two intensive statin regimens on progression of coronary disease. > Nicholls SJ, Ballantyne CM, Barter PJ, Chapman MJ, Erbel RM, Libby P, Raichlen JS, Uno K, Borgman M, Wolski K, Nissen SE > N Engl J Med. 2011;365(22):2078. > > BACKGROUND: Statins reduce adverse cardiovascular outcomes and slow the progression of coronary atherosclerosis in proportion to their ability to reduce low-density lipoprotein (LDL) cholesterol. However, few studies have either assessed the ability of intensive statin treatments to achieve disease regression or compared alternative approaches to maximal statin administration. > > CONCLUSIONS: Maximal doses of rosuvastatin and atorvastatin resulted in significant regression of coronary atherosclerosis. Despite the lower level of LDL cholesterol and the higher level of HDL cholesterol achieved with rosuvastatin, a similar degree of regression of PAV was observed in the two treatment groups.. more info here: [Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. West of Scotland Coronary Prevention Study Group - PubMed](http://www.ncbi.nlm.nih.gov/pubmed?term=7566020) and now to bed ---
**Author:** ![JoelUpchurch](https://avatars.discourse-cdn.com/v4/letter/j/f05b48/32.png) [@JoelUpchurch](https://boards.straightdope.com/u/JoelUpchurch)\ **Post date:** [March 28, 2012, 2:57am UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/124 "2012-03-28T02:57:14Z")
Is there any biological evidence that Antidepressants can ‘cure’ depression. To me it sounds a lot like claiming that insulin can ‘cure’ diabetes. I don’t mean anecdotes. I mean actual measurements of brain chemistry. I thought antidepressant were for treating depression. ---
**Author:** ![misterW](https://avatars.discourse-cdn.com/v4/letter/m/f1d935/32.png) [@misterW](https://boards.straightdope.com/u/misterW)\ **Post date:** [March 28, 2012, 4:39am UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/125 "2012-03-28T04:39:06Z")
> [@cmyk](#): > > As somebody once put it (perhaps here?), alternative medicine that works is just called “medicine.” Well, if you define it as you did that eliminates the debate. But that is not how alternative medicine is usually defined. Are you saying that no medical techniques outside of the routine/standard approaches of the medical community have ever been effective? ---
**Author:** ![dataguy](https://avatars.discourse-cdn.com/v4/letter/d/eada6e/32.png) [@dataguy](https://boards.straightdope.com/u/dataguy)\ **Post date:** [March 28, 2012, 2:18pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/126 "2012-03-28T14:18:33Z")
> [@Marley23](#): > > It’s not clear what causes those cases, and unfortunately, they are rare. Are you asserting that diet is responsible for all of them? Some? How do you know? I’m asserting that sometimes the body can heal itself of cancer when it is healthy enough. Good health is primarily a result of good nutrition. But you just want to wave this away with “It’s not clear what causes those cases” is that right? In response to repeated requests to post evidence that food can cure cancer, I was responding to this statement: > [@Marley23](#): > > Medicine can cure cancer. It can’t cure all cancers and can’t cure everyone who has any type of cancer, but some cancers have become very treatable. My response was this: > [@dataguy](#): > > Well, if you’re going to say that, then I have to say that nutrition cures some cancers too. Some cancers disappear on their own, without medical intervention as a result of being handled by a healthy body’s natural defenses. This has especially been noted with prostate cancer. The PSA test has been deprecated because it led to too many unnecessary surgeries. The point being, that if you cannot make the unqualified statement “Medicine can cure cancer” but pick a few cases where medicine is effective, I can do the same for a healthy body that is produced by good nutrition. That would include those cancers that exhibit “spontaneous self remission”, which is a fancy way of saying “we have no idea why that happened”. Why not just attribute it to the effective operation of a healthy body? ---
**Author:** ![dataguy](https://avatars.discourse-cdn.com/v4/letter/d/eada6e/32.png) [@dataguy](https://boards.straightdope.com/u/dataguy)\ **Post date:** [March 28, 2012, 2:23pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/127 "2012-03-28T14:23:30Z")
> [@Qadgop\_the\_Mercotan](#): > > Statins for the primary prevention of cardiovascular disease. > Taylor F, Ward K, Moore TH, Burke M, Davey Smith G, Casas JP, Ebrahim S > Cochrane Database Syst Rev. 2011 > [http://www.ncbi.nlm.nih.gov/pubmed?term=21249663](http://www.ncbi.nlm.nih.gov/pubmed?term=21249663) > > Data shows somewhat limited Cost-effectiveness and quality of life improvement. > Statins for secondary prevention of CV disease. Data is very strong here. > > more info here: [Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. West of Scotland Coronary Prevention Study Group - PubMed](http://www.ncbi.nlm.nih.gov/pubmed?term=7566020) > > and now to bed Okay, here’s mine. It also includes support for the assertion that anti-depressants have been shown to be no better than placebos: Evidence for Drugs that Don’t Work ANTI DEPRESSANTS Journal of Clinical Psychiatry [http://article.psychiatrist.com/dao\_1-login.asp?ID=10007663&RSID=39911233426060](http://article.psychiatrist.com/dao_1-login.asp?ID=10007663&RSID=39911233426060) Summary: This trial of urban MDD patients failed to confirm that either active treatment was better than placebo. Public Library of Science Medicine > **[Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data...](https://pmc.ncbi.nlm.nih.gov/articles/PMC2253608/?tool=pubmed)** > > Meta-analyses of antidepressant medications have reported only modest benefits over placebo treatment, and when unpublished trial data are included, the benefit falls below accepted criteria for clinical significance. Yet, the efficacy of the ... Summary: Drug–placebo differences in antidepressant efficacy increase as a function of baseline severity, but are relatively small even for severely depressed patients. The relationship between initial severity and antidepressant efficacy is attributable to decreased responsiveness to placebo among very severely depressed patients, rather than to increased responsiveness to medication. CHOLESTEROL-LOWERING DRUGS With cholesterol-lowering drugs, there are two issues: 1. Do they effectively lower your blood cholesterol? 2. Is lowering your blood cholesterol beneficial to your health? The answer to the first question is yes. Especially the statin drugs. They do dramatically lower your blood LDL levels. The answer to the second question depends on who you listen to. If you perform independent review of the available information, and just evaluate which conclusions are supported by evidence, you may conclude, as I have, that the whole notion that high blood cholesterol as a causal factor in heart disease is not supported by the evidence. I’m assuming that we are operating in the realm of scientific analysis, where facts are not determined by majority opinion, or weight of authority and reputation, but by the weight of supporting evidence. Where a single counter example is sufficient to call a theory into question. When I have done this, I have found two distinct categories of sources: 1. Those who has some interest in the outcome (profit, professional reputation). 2. Those who have no interest in the outcome. Remarkably, those in the first group come to conclusions totally different from those in the second group, based on identical data. If you’ve never spent time reading research reports, this happens all of the time. It’s similar to a courtroom. Everyone is presented with the same facts. The judgement favors the strongest argument. So, have at it. General discussion of statin drugs with many references from the Weston A. Price Foundation > **[Dangers of Statin Drugs: What You Haven’t Been Told About Popular...](https://www.westonaprice.org/health-topics/modern-diseases/dangers-of-statin-drugs-what-you-havent-been-told-about-popular-cholesterol-lowering-medicines/)** > > By Sally Fallon Morell and Mary Enig, PhD Discussion of a particular cholesterol-lowering drug found to be ineffective Contains a general discussion with several embedded links. > **[For Widely Used Drug, Question of Usefulness Is Still Lingering (Published 2008)](https://www.nytimes.com/2008/09/02/business/02vytorin.html?_r=2&oref=slogin&partner=rssnyt&emc=rss&pagewanted=print)** > > Zetia and Vytorin are heavily prescribed despite a lack of proof the cholesterol drugs help to prolong life or prevent heart attacks. One other thing about statins. There is supporting evidence that statins have a small positive effect on people with a previous history of heart disease. However, further investigation has shown that the improvement is not due to to lower cholesterol, but due to the anti-inflammatory action of statins. ---
**Author:** ![kayaker](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kayaker/32/441_2.png) [@kayaker](https://boards.straightdope.com/u/kayaker)\ **Post date:** [March 28, 2012, 2:35pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/128 "2012-03-28T14:35:57Z")
> [@dataguy](#): > > I’m asserting that sometimes the body can heal itself of cancer when it is healthy enough. Cite? (other than your assertion). ---
**Author:** ![Marley23](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@Marley23](https://boards.straightdope.com/u/Marley23)\ **Post date:** [March 28, 2012, 2:56pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/129 "2012-03-28T14:56:52Z")
> [@dataguy](#): > > I’m asserting that sometimes the body can heal itself of cancer when it is healthy enough. And I’m asking for data. (Must… not … point out… irony…) Where is the data that proves people who have experienced spontaneous remission have better nutrition? Where is the evidence that says they are healthier in some fashion than similar patients who didn’t experience spontaneous? > [@](#): > > But you just want to wave this away with “It’s not clear what causes those cases” is that right? I’m not waving anything away. It _isn’t_ clear what causes those cases, and the fact that their cause is unclear does not mean you can make up any theory you want and assert that it’s the real reason. Some spontaneous remissions are linked to high fever, although I don’t think that is universal. Do you have a theory about their cause that is more specific than “good nutrition?” > [@](#): > > The point being, that if you cannot make the unqualified statement “Medicine can cure cancer” but pick a few cases where medicine is effective, I can do the same for a healthy body that is produced by good nutrition. Not unless you want to look silly. Millions of people have been cured by medicine. That’s not “a few” when we’re comparing them to spontaneous remissions, around 1,000 of which have been documented anywhere. > [@](#): > > Why not just attribute it to the effective operation of a healthy body? Because that’s a vague and meaningless statement that tells us nothing about what happened or why it happened. ---
**Author:** ![JoelUpchurch](https://avatars.discourse-cdn.com/v4/letter/j/f05b48/32.png) [@JoelUpchurch](https://boards.straightdope.com/u/JoelUpchurch)\ **Post date:** [March 28, 2012, 3:21pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/130 "2012-03-28T15:21:57Z")
> [@kayaker](#): > > Cite? (other than your assertion). The key phrase is Spontaneous Remission. Translation:Sometimes people get better and we don’t know why. Of course, in the context “don’t know”, means “don’t know” and if the general level of health of the patient is relevant except in the sense that it keeps them alive until remission can occur is unknown. [http://en.wikipedia.org/wiki/Spontaneous\_remission](http://en.wikipedia.org/wiki/Spontaneous_remission) ---
**Author:** ![dataguy](https://avatars.discourse-cdn.com/v4/letter/d/eada6e/32.png) [@dataguy](https://boards.straightdope.com/u/dataguy)\ **Post date:** [March 28, 2012, 3:24pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/131 "2012-03-28T15:24:01Z")
> [@Marley23](#): > > And I’m asking for data. (Must… not … point out… irony…) Where is the data that proves people who have experienced spontaneous remission have better nutrition? Where is the evidence that says they are healthier in some fashion than similar patients who didn’t experience spontaneous? > I’m not waving anything away. It _isn’t_ clear what causes those cases, and the fact that their cause is unclear does not mean you can make up any theory you want and assert that it’s the real reason. Some spontaneous remissions are linked to high fever, although I don’t think that is universal. Do you have a theory about their cause that is more specific than “good nutrition?” > Not unless you want to look silly. Millions of people have been cured by medicine. That’s not “a few” when we’re comparing them to spontaneous remissions, around 1,000 of which have been documented anywhere. > Because that’s a vague and meaningless statement that tells us nothing about what happened or why it happened. 1. Pardon me, but if the cause of something is unknown how do you rule out anything?. All theories began as hypotheses, which are just assertions. I can make them too. I never claimed this to be a “'theory”. 2. I never argued that medicine has not cured millions of people. The “few” I referred to was types of cancer, not number of people. Also, I’m not comparing the numbers of spontaneous remissions to anything, I’m just noting their existence. ---
**Author:** ![perfectparanoia](https://avatars.discourse-cdn.com/v4/letter/p/a5b964/32.png) [@perfectparanoia](https://boards.straightdope.com/u/perfectparanoia)\ **Post date:** [March 28, 2012, 3:27pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/132 "2012-03-28T15:27:52Z")
> [@dataguy](#): > > 1. Pardon me, but if the cause of something is unknown how do you rule out anything?. All theories began as hypotheses, which are just assertions. I can make them too. I never claimed this to be a “'theory”. > > 2. I never argued that medicine has not cured millions of people. The “few” I referred to was types of cancer, not number of people. Also, I’m not comparing the numbers of spontaneous remissions to anything, I’m just noting their existence. I’m sorry. Perhaps you think we were being rude but given that this board is about disspelling ignorance, we would just like to see some evidence of these peoples’ existence. How did you come about this information? Is there a link you can provide to somewhere on the internet? If not, who told you about it and maybe we can dig up some more information? ---
**Author:** ![Marley23](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@Marley23](https://boards.straightdope.com/u/Marley23)\ **Post date:** [March 28, 2012, 3:29pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/133 "2012-03-28T15:29:43Z")
> [@dataguy](#): > > 1. Pardon me, but if the cause of something is unknown how do you rule out anything? I ruled nothing out. I asked for evidence for your statements and noted you are not posting any. > [@](#): > > All theories began as hypotheses, which are just assertions. Good theories are specific, testable assertions that make predictions. They’re often based on observed data. See where this is going? > [@](#): > > 1. I never argued that medicine has not cured millions of people. The “few” I referred to was types of cancer, not number of people. That wasn’t clear, but let’s move on. > [@](#): > > Also, I’m not comparing the numbers of spontaneous remissions to anything, I’m just noting their existence. No, you’re not just noting their existence. You’re making assertions about their cause, and I’ve been asking for evidence that supports that assertion. ---
**Author:** ![kayaker](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kayaker/32/441_2.png) [@kayaker](https://boards.straightdope.com/u/kayaker)\ **Post date:** [March 28, 2012, 3:30pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/134 "2012-03-28T15:30:50Z")
> [@dataguy](#): > > I’m asserting that sometimes the body can heal itself of cancer **when it is healthy enough**. > [@kayaker](#): > > Cite? (other than your assertion). > [@JoelUpchurch](#): > > The key phrase is Spontaneous Remission. Translation:Sometimes people get better and we don’t know why. Of course, in the context “don’t know”, means “don’t know” and if the general level of health of the patient is relevant except in the sense that it keeps them alive until remission can occur is unknown. > > [http://en.wikipedia.org/wiki/Spontaneous\_remission](http://en.wikipedia.org/wiki/Spontaneous_remission) (bolding mine) I’m aware of spontaneous remissions. I’m unaware of any link between spontaneous remission and overall health of the patient, other than the cases where overall _poor_ health, fever, etc seems to have a relationship. ---
**Author:** ![Kolga](https://avatars.discourse-cdn.com/v4/letter/k/e56c9b/32.png) [@Kolga](https://boards.straightdope.com/u/Kolga)\ **Post date:** [March 28, 2012, 3:52pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/135 "2012-03-28T15:52:23Z")
> [@dataguy](#): > > Fact is that lots of pharmaceutical medicine doesn’t work. It’s been shown that some of the latest anti-depression drugs don’t work any better than a placebo. > > Cholesterol lowering drugs don’t affect heart disease (at least not because they lower your cholesterol). > > I won’t clutter the post up with citations, but if you can’t find them on your own, I’ll be glad to supply some. > > Somehow, these things are still called “medicine”, even when they don’t work. Why is that? Other people have addressed various aspects of your non-supported statements, but I’ll address this. None of this has any relevance to my statement about herbal remedies and “alternative” medicines. The fact that some pharmaceuticals aren’t as effective as originally claimed is irrelevant to the issue of whether or not herbal remedies are effective. ---
**Author:** ![Marley23](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@Marley23](https://boards.straightdope.com/u/Marley23)\ **Post date:** [March 28, 2012, 3:56pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/136 "2012-03-28T15:56:03Z")
Talk to your doctor about whether TuQuoque is right for you. ---
**Author:** ![dataguy](https://avatars.discourse-cdn.com/v4/letter/d/eada6e/32.png) [@dataguy](https://boards.straightdope.com/u/dataguy)\ **Post date:** [March 28, 2012, 4:07pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/137 "2012-03-28T16:07:54Z")
> [@kayaker](#): > > (bolding mine) > I’m aware of spontaneous remissions. I’m unaware of any link between spontaneous remission and overall health of the patient, other than the cases where overall _poor_ health, fever, etc seems to have a relationship. You’re telling me that you need proof that the human body is capable of healing itself? Really? And you don’t think a healthy body is more capable of healing itself than an unhealthy body? I suppose you’re going to ask for a link to a study showing this? Do you ever consider that there may be other ways of learning and knowing? ---
**Author:** ![Marley23](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@Marley23](https://boards.straightdope.com/u/Marley23)\ **Post date:** [March 28, 2012, 4:12pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/138 "2012-03-28T16:12:56Z")
> [@dataguy](#): > > Do you ever consider that there may be other ways of learning and knowing? Please tell us how these “other ways of learning and knowing” are distinguishable from bullshit. Nobody has asked you to provide evidence of obvious facts like “the body can heal itself.” You’re being asked for evidence for more specific claims that you made, and the tone you’re taking here suggests you know you can’t back up what you said. ---
**Author:** ![dataguy](https://avatars.discourse-cdn.com/v4/letter/d/eada6e/32.png) [@dataguy](https://boards.straightdope.com/u/dataguy)\ **Post date:** [March 28, 2012, 4:21pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/139 "2012-03-28T16:21:58Z")
> [@Marley23](#): > > Please tell us how these “other ways of learning and knowing” are distinguishable from bullshit. Nobody has asked you to provide evidence of obvious facts like “the body can heal itself.” You’re being asked for evidence for more specific claims that you made, and the tone you’re taking here suggests you know you can’t back up what you said. I’ll take that as a “no”. ---
**Author:** ![kayaker](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kayaker/32/441_2.png) [@kayaker](https://boards.straightdope.com/u/kayaker)\ **Post date:** [March 28, 2012, 4:25pm UTC](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575/140 "2012-03-28T16:25:48Z")
> [@dataguy](#): > > You’re telling me that you need proof that the human body is capable of healing itself? Really? And you don’t think a healthy body is more capable of healing itself than an unhealthy body? I suppose you’re going to ask for a link to a study showing this? > > Do you ever consider that there may be other ways of learning and knowing? You made a very specific assertion, to wit > [@dataguy](#): > > I’m asserting that sometimes the body can heal itself of cancer when it is healthy enough. I asked for a cite to your very specific assertion, which of course you cannot provide since it is pure bullshit. Now you are back-peddling. Goodbye. [Previous page](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575.md?page=6) [Next page](https://boards.straightdope.com/t/why-do-doctors-over-prescribe-drugs/616575.md?page=8)