Every substance may have more than one effect, and to dub prescription drugs Weapons of Mass Destruction is unacceptable

Fluency, felicity and flamboyance in language do not always fit in with finer analysis of facts or rigour. When George W. Bush and Dick Cheney went looking for Weapons of Mass Destruction (WMD) in Saddam Hussain’s Iraq, and did not find them, they famously said: “absence of evidence is no evidence of absence.” In the event, Saddam Hussain was done away with. I was reminded of this when I read Dr. B. M. Hegde’s column, “Medicine is too much with us” in the Open Page of The Hindu of Sunday, May 12, 2013.

The good doctor says: “I dare say the greatest weapons of mass destruction are prescription drugs.” Even though this claim was (hopefully) made in a lighter vein, making such statements in the popular press can be misleading. I suspect what he had attempted to emphasise was that overuse, wrong use or abuse, plus possible contra-indications can lead to serious adverse reactions and even death.

Aspirin is prescribed for headaches, and more recently even as beneficial for patients with high blood pressure (though “the jury is still out” on this). And it is widely used by millions who benefit from it; yet we hear of some people committing suicide by swallowing dozens of Aspirin tablets in one go. Should we then ban aspirin as a potential WMD? Many drugs — prescription, over the counter, modern medicine or traditional — often have adverse side-effects on some people, particularly those with conditions not related to the reason behind the prescription. Drug companies are obliged to include detailed statements (yes, almost always in fine print) about what adverse reactions a given drug may have on people with other pathologies.

Similarly, certain drugs act faster and at lower doses on some people than on others, while some others are even dependent on the family history of the user. These have ushered in the age of ‘personalised medicine”, which attempts to factor in the genetic profile and predisposition to a given treatment, and suggests adjusting the dose or even alternative medication.

Every substance may have more than one effect, and to dub prescription drugs WMD is as unacceptable as was the rumour spread in some parts of Uttar Pradesh against polio drops — that they may make you impotent or affect pregnancy. (Recall the case of Dr. Andrew Wakefield in the U.K., who published papers in The Lancet, no less, associating measles vaccine with autism and other disorders, all of which had to be retracted, having been found fraudulent and exposed by the British Medical Journal (BMJ), Dr. Hegde’s weekly dose of happiness).

Dr. Hedge has referred to another point, this one a more challenging and counter-intuitive. This had to do with reports in professional medical journals which state that fewer lives are lost when doctors go on strike than when they are working! This is intriguing and needs a Sherlock-Holmesian analysis of the factors involved. Any off-the-cuff explanation would be inadequate or even misleading. One group has suggested that perhaps the number of emergency surgeries on terminal cases was few. But to use this as an argument, or debating point in popular press is egregious. I believe professional experts who write in the “lay” press and influence opinions need to be more circumspect.

(The writer is a scientist, who also works on the public understanding of science. Email: dbala@lvpei.org)

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