The New Straits Times, August 26, 2001
By Professor Dzulkifli Abdul Razak
"A PILL for every ill" is the cliche commonly use to describe how medicalised our society has been since the advent of modern medicine.
Drugs, both licit and illicit, is increasingly accepted as part of modern living. More so now with the raging debate about legalising the use of marijuana or ganja for certain medical ailments for which there is purportedly no cure. The argument against the move is becoming rather difficult given the perspective that morphine, an even more powerful drug of abuse, has its own place in medical therapy. For as long as there is a valid medical reason for using any substance, it would be possible to gain acceptance in medical practice.
The acid test, medically speaking of course, is the observance of the crucial principle that the benefits accrued from using a medicinal product must outweigh the risk that it can cause, intentionally or otherwise. Hence heroin, a drug closely associated to morphine, has to date, failed the test even though it was once regarded as the cure for simple ailments such as coughs.
But this is not all, there are batteries of stringent scientific tests that must be performed and "passed" even before any drug could be submitted for approval. The insistence on such stringent tests is now a legal requirement so that drug tragedies such as that of thalidomide could be avoided. But now safety has taken centrestage in all drug approvals for human use. Among other criteria, unless proven safe, with respect to its alleged medical benefits, new drugs discovered normally do not even see the light of day.
Having said that, various new drugs continue to bombard modern society practically in all walks of life, ranging from those "essential" in life-threatening situations right down to the "nice-to-have" cosmetic ones. But novel and truly creative new substances, like that of antibiotics, are altogether few and far in between nowadays. What seems to be flooding the markets are so-called "me-too" drugs, that is those groups of drugs that have similar uses and even similar sounding names like "statins" as mentioned in last week's column. Such proliferation could easily be an outcome of manipulating the chemical structure of any substance that has won approval. It is an attempt to make better drugs, although this may not always be the case as illustrated by the banning of Lipobay recently (NST, Poison Control, Aug 19).
As a result of tinkering, the treatment of certain more popular diseases has become unduly complicated although the understanding about the disease itself has not changed much. Worse still, a new attitude best characterised as "a pill for every ill" is fast becoming a norm, almost a knee-jerk response when faced with any ailment, including the mildest of them all.
This is further driven by what is labelled as the "medico-industrial" complex that promotes drug use in all possible instances at the time.
Otherwise, attempts will be made to reclassify situations as new "diseases" that would justify the use of some sort of drug treatment. Drug marketing and promotional activities become the mainstay of such an effort to ensure bottom-lines are met. Some spent more on advertising and promotion than researching into new cures. Though regulated by laws, drug companies often find ingenious ways to exploit the loopholes therein, or at least the lackadaisical attitude in enforcement. Others resorted to unethical practices, including sponsoring tournaments and prizes just so that the product would be made visible in the eyes of the public.
Humans being are beginning to lose control over their own health, other than subjecting themselves to various pretty-looking coloured pills, without contemplating available alternatives. This includes non-drug approaches like exercising, eating well and even just simply abstinence.
As such, it is not suprising to see the mushrooming of direct sales companies in promoting every conceivable type of medical product. And more surprisingly, many find good markets for them, supporting the notion: "A pill for every ill". These group of products are even more dubious because they are often not are certified by any authorities as being efficacious, let alone safe. Be that as it may, we are now seeing yet another trend that must be immediately nipped in the bud.
Recently, a news headline screamed Kedah comes up with cure for Black Metal members (Sun, Aug 14, p. 12), which reported that the State government was "literally prescribing a cure for Black Metal cult members by giving the medicine to stimulate their thinking." Allegedly the medicine would make the cult members "mentally alert and think rationally to stay clear of negative activities", the chairman of a State committee on social problems was quoted as saying. "A private company will sponsor the programme" involving for a start 150 students from 15 schools in Kuala Muda, a district most affected by the cult activities.
One is lost for words when faced with such mind-boggling breaking news. If there is a doubt that our society is becoming more medicalised, this piece of news seems to remove it once and for all. In fact. the cliche: "A pill for every ill", has taken a new dimension in that it covers "social" ills as well.
Unfortunately, the name of the so-called medicine was not disclosed, to avoid advertising, perhaps. Even then it raises enough curiosity that it can lead to the mushrooming of another set of companies selling new snake-oil remedies to combat the looming social ills in the country today. In short, the statement is irresponsible as much as it lacks credibility that could stand up to the demands of any scientific tests and scrunity. The public must be assured that they are protected from charlatan who are out to make money from their miseries, social or otherwise. If not, there will soon be a cure for KMM too!
