Sunday, January 11, 2015

The New "Dallas Buyers Club" in Healthcare

Anyone who's seen "Dallas Buyers Club" has a pretty good idea how desperation promotes innovation that may be either predatory or compassionate, depending on the substance and your viewpoint. Nobody said death was easy or to be allowed to overtake us whenever the usual medical routes have given up on hope for remission or "cure." Pushing the envelope, however, isn't always easy or legal and sometimes it's downright immoral. By immoral I am referring to the plethora of terminal cancer stem cell promises akin to the laetrile hoax of the latter 20th Century.

Of course, there are those who will hawk their quackery in the guise of "breakthrough" or the equivalent of medical miracles that the medical establishment "doesn't want you to know." Anytime I see these "secrets" revealed, I know we're in for a ride down the slippery slope of hucksterism. Think of those high-profile suits framed against some writers of these books or proponents of supplements. They stand out like sore thumbs, but enough people believe them in their desperation and buy the book, plunk down the credit cards for the supplements and make someone wealthy while they do absolutely nothing for themselves.

Yes, my friends, P. T. Barnum comes with many new pseudonyms these days and I don't need to name them. Just watch enough TV or read specialty magazines and you'll get your education. In fact, read some of the explosively honest writings of medical professionals about psychiatry and you will truly get an education. The "chemical imbalance" theory is now being seen as nowhere near ANY explanation of mental disorders. But consumers still believe that serotonin is at the root of most anxiety and depressive disorders.

Patients still receive FDA-approved medication, insurance companies are billed and lots of metabolites are cascading into our lakes, rivers and streams. We know this by examining the effects on wildlife. One has to question how our water treatment plants protect us or how wells using groundwater may be unexpectedly putting medications down our throats without our permission.

The sanctity of the FDA to approve safe and effective medications is even being questioned today. Board members have not always been free of conflict of interest and most prominent medical providers (the ones appointed to the boards) have done a lot of business with corporations.

True, medical professionals are often reluctant to rush ahead with new medications for those in desperate need. Compassionate use is probably not nearly as available as it might be to help those without hope from traditional medications or treatments. I saw this in research trials and it was heart wrenching. Families pleaded but the rules of the trials were as cement in keeping only the designated few on the meds and the rest out of contention. Even money, sometimes tens of thousands, couldn't make the researchers budge.

How do we weed out the charlatans from those truly wishing to help? How do we get substances that have been actually shown to work with certain illnesses (like epilepsy) into the hands of those in need? Laws are currently being written and offered for consideration.  The intent is to allow "right to try" drugs outside the purview of clinical trials.

Perhaps it is time to loosen the stranglehold of current medicine on treatments but we also have to temper this with reason and some proof of efficacy. We also have to reconsider our biases about what we've come to know as "street drugs." Marijuana and even LSD may be helpful in many disorders such as PTSD, depression and chronic pain.

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