PRESCRIPTION DRUGS: Advances Bring New Dangers
Today's New York Times, in the first of a two-part series on the new dangers posed by prescription drugs, reports that "with more medications on pharmacy shelves than ever before and with more prescriptions being written, the nation's health care system is overwhelmed, creating a growing risk that patients will be killed or injured by adverse reactions or mistakes." According to a recent Journal of the American Medical Association study, 106,000 deaths and 2.2 million injuries occur each year from adverse reactions to prescription drugs. Dr. Janet Woodcock, director of the FDA's Center for Drug Evaluation and Research, said, "People are being harmed and some of the harm is preventable. All of these things are raising alarm bells in people's minds that there is a potential for even more serious problems. And the problem is pretty serious right now."
The Times reports that the risks break down into known side effects, such as dangerous drug interactions drugs; unpredicted side effects; and medication errors by pharmacists or doctors. Dr. Kenneth Kizer, undersecretary for health in the Department of Veterans Affairs, said, "There are just so many new drugs available. And keeping current with the information that goes with each drug has become almost impossible. The system is just not designed to help the practitioner." Computer technology is available to assist doctors avoid mistakes, but few facilities have it, and doctors that do use it complain that the "systems produce so many false alarms that they are nearly impossible to work with." Yet another risk arises when drugs have similar names. Dr. Jerry Phillips of the FDA said the agency is moving to install software to avoid future difficulties. But Dr. Lucian Leape of the Harvard School of Public Health said, "The FDA has essentially focused on the safety of the product, whereas the major threat has to do with safety of use and misuse. Their point of view has been that it is safe and effective when used as directed, and the directions are on the label, so read it. We have come to them repeatedly and said, 'That is not enough. People make mistakes.'" Finally, according to pharmacists, the job has grown much more difficult. Adle Joseph, a Rite- Aid pharmacist for 35 years, said, "I worked 12-hour days, and if you get to the bathroom once a day, you're fortunate. The conditions are just not conducive to good safety" (Stolberg, 6/3).