The Adventist Rx Drug Problem

Seventh-day Adventist have a drug problem.  

Though there are members who struggle with illegal drugs and intoxicating substances, this, thankfully, is not the issue in this article.  The actual drug problem depends upon which opposing perspective one takes.  One side, the mainstream and politically entrenched segment of the church, places their trust in a pharmaceutically-based health-message as taught and promoted by SDA institutions.  The other side, mostly comprised of laymen and alternative medical professionals, prefers natural remedies while remaining skeptical of prescription drugs and MD-directed (allopathic) medicine.  According to proponents of the pharmaceutical-based health-message, the insistence of avoiding prescription drugs, questioning allopathic medicine, and relying on natural remedies is the actual “drug” problem.

For authorities like John B. Hoehn MD, this troubling skepticism results from an unguided reading Sister White’s writings leading to “confusion” when applying her “counsels.”[i]  After all, with an unguided reading of sister White’s counsels one may find the following statements:

When you understand physiology in its truest sense, your drug bills will be very much smaller, and finally you will cease to deal out drugs at all. The physician who depends upon drug medication in his practice shows that he does not understand the delicate machinery of the human organism. He is introducing into the system a seed crop that will never lose its destroying properties throughout the lifetime. I tell you this because I dare not withhold it. Christ paid too much for man’s redemption to have his body so ruthlessly treated as it has been by drug medication.

Years ago the Lord revealed to me that institutions should be established for treating the sick without drugs.  Man is God’s property, and the ruin that has been made of the living habitation, the suffering caused by the seeds of death sown in the human system, are an offense to God (Medical Ministry 229).

Or this:

Physicians, by administering their drug-poisons, have done very much to increase the depreciation of the race, physically, mentally, and morally.  Everywhere you may go you will see deformity, disease and imbecility, which in very many cases can be traced directly back to the drug-poisons, administered by the hand of a doctor, as a remedy for some of life’s ills.  The so-called remedy has fearfully proved itself to the patient, by stern suffering experience, to be far worse than the disease for which the drug was taken (Selected Messages Book 2, 442).

Time and space will not permit sharing the plethora of unflattering statements toward medicine and medical doctors.  Therefore, I will stop after this:

Many might recover without one grain of medicine, if they would live out the laws of health. Drugs need seldom be used.  It will require earnest, patient, protracted effort to establish the work and to carry it forward upon hygienic principles.  But let fervent prayer and faith be combined with your efforts, and you will succeed.  By this work you will be teaching the patients, and others also, how to take care of themselves when sick, without resorting to the use of drugs (Medical Ministry, 259, 260).

For Hoehn, this distrust is misdirected. He agrees the “drugs” referenced Sister White’s day were deadly, but he argues that these cannot apply to drugs today, which are regulated by powerful government agencies.  For this reason“Ellen White” could not be “talking about the prescription drugs” of today.  The drugs she indicted “are in almost all cases poisons no longer medically used or narcotics now used only for severe pain control.”[ii]  Technically he is correct—the drugs of her day were not as refined or controlled—as drugs today.  However, his optimism toward modern drugs is severely misplaced.

Today, America is experiencing an opioid epidemic.  In 2015 alone, over 30,000 Americans died from taking opioids, many of which were prescription doses.[iii]  Unfortunately, the usage and deaths from these drugs have increased. Ironically, many of the prescription opioids—to which Americans become addicted—are synthetically derived from the poppy plant (Papaver somniferum), for which opium and heroin are produced. From this plant, common prescription drugs such as morphine, codeine (something once regularly used in cough syrup), vicodin, demerol, oxycodone, and hydrocodone are also produced.  These drugs wreck the human body causing multiple hospitalizations and deaths.  Each year, about 5 in 1000 women giving birth in a hospital are using some form of opioids.[iv]  This tragically impacts infants born suffering under its effects.  It is strange to be assured that drugs are better today and yet, there was no prescription drug epidemic like this in Ellen White’s day.  

As a practitioner, I cannot deny that, in certain cases, drugs are needed.  For instance, I would never counsel a patient to endure surgery without anesthesia.  Though necessary for surgical procedures, it—like any other drug—carries a risk. One report estimates about 1 in 10,000 patients die from anesthesia each year in developed nations.[v]  Additionally, surgical errors are responsibility for significant hospitalizations and deaths each year, as well.  Despite the risks, it cannot be denied that, in some cases, surgery and its accompanying anesthesia is a necessity.  Most licensed natural practitioners would readily admit these facts.  Yet, this does not mean that one should discard all healthy incredulity toward prescription drugs no matter how routine or refined.

Aspirin or non-steroidal anti-inflammatory drugs (NSAID’s) ubiquitously found in American medicine cabinets, are not as safe as most people think.  NSAID’s which are commonly recommended to patients to prevent cardiovascular disease, have not only shown to be minimally protective, they actually increase risk of myocardial infarction.[vi]  Additionally, aspirin has well documented risk of increasing bleeding in the gastro-intestinal (GI) tract and in the brain.[vii]  According to the American College of Gastroenterology GI bleeding from NSAID’s results in annually 100,000 hospitalizations and approximately 8,500 deaths.[viii]

Despite these facts SDA’s are told to trust in pharmaceuticals because “God [using] Governmental Regulations,” has made drugs safer and perhaps more efficacious.[ix]  This is an oversimplification of the facts, bordering on blasphemy.  It would be nice to believe the Pure Food and Drug Act, passed in 1906, protected people from the dangers of drugs, but it did not.[x]  Not until “an untested pharmaceutical”—thalidomide—“killed scores of patients, including many children, as soon as it went on the market,” in 1937,[xi]  that the Food, Drug, and Cosmetic Act was passed in 1938.  This horrific drug spread throughout the world causing polyneuritis, fetal growth retardation of hands, arms, feet, legs, organs, ingrown genitalia, loss of hearing, and infant death until it was withdrawn from the market in 1961.[xii]  This led to the passage of the Kefauver-Harris Amendments of 1962, which meant drug manufactures did not simply have to show their drug to be safe, but also effective.[xiii]

Even with the existence of the Food and Drug Administration (FDA) drugs still kill.  For example, an article published in the Polish Archives of Internal Medicine noted that prescription drugs kill approximately 200,000 Americans each year, making it the 3rd leading cause of death after heart disease and cancer.[xiv]  Half of these deaths are caused when patients take prescription drugs correctly.  Peter C. Gøtzche, a director at the Cochrane research center, speaking of the modern epidemic of polypharmacy (when the patient is on five or more drugs) wrote that “any drug can come with 20, 30, or 40 warnings, contraindications, and precautions, and no doctor can possibly master all this.”[xv]  Now patients take drugs to treat the symptoms caused from other drugs.  This certainly did not exist in Sister White’s day either.

Even with regulatory oversight many dangerous drugs remain on the market for decades leaving a legacy of death and disease.  Here are a few examples of FDA approved drugs which had to be removed:

Diethylstilbestrol (DES) was synthetic estrogen drug given to women to prevent miscarriages and pregnancy complications.  This drug not only proved to be ineffective, but caused cancer, infertility, still birth, and serious birth defects.[xvi] DES was on the market for 31 years.

Darvocet, a drug given to reduce pain and inflammation, was shown to be toxic to the heart, causing hallucinations in the elderly, and severe drug to drug interactions.[xvii]  Darvocet was pulled from the market after internal studies by the manufacturer came to light, demonstrating the risks outweighed the benefits.[xviii]  For parents who lost a 22-year-old daughter to heart failure, the risks certainly outweighed the benefits.[xix]  This drug was on the market for 55 years.

Cylert was thought be an anti-fatigue cognitive enhancement drug.[xx]  Although studies early on demonstrated Cylert was no better than a placebo to improve academic performance, it was still prescribed.[xxi]  Even the CIA failed to find any benefits when tested on prisoners in California.[xxii]  However, by 1975, Cylert was given new life as it was approved to treat the newly popular childhood diagnosis of Attention Deficit Disorder or Attention Deficit Hyperactivity Disorder (ADD, ADHD).[xxiii]  Although the drug was known to cause liver toxicity in children as early as 1978, it took lawsuits and deaths for the drug to be banned in 2005.[xxiv]  Cylert was so toxic it caused a 7-year-old to be hospitalized with acute liver failure.[xxv]  Another child at 13 years of age received a liver transplant after the drug destroyed his liver.[xxvi]  Cylert was given to children for 30 years.

Accutane was a popular drug given to teens and young adults for acne.  In 2002, Accutane accounted for over $700 million in sales.[xxvii]  Studies since the 80s showed causation of severe birth defects in infants and that women pregnant using this drug had spontaneous abortion rates 3 times higher than the general population.[xxviii]  Additionally, Accutane caused muscle pain, headaches, fatigue, bone malformation, vomiting, blurred vision, and was linked to increases in suicide.[xxix]  Accutane was taken off the market in 2009, it was on the market for 27 years.

Any Adventist who believes E. G. White’s counsels regarding drugs are less relevant because of these legislative measures (or who trust in the alleged “radical changes” in drug medication) are unfamiliar with the facts or uninterested in examining them.

Proponents of a pharmaceutical-friendly health-message like to point out the scientific rigor and peer-review studies in support for drugs or what is termed “science-based medicine.”  I am all for research and examining the medical literature.  As a practitioner, I want to give my patients the best options available.  But to legitimize drugs while condemning natural remedies in the name of “peer-review” is myopic.  Even respected members of medical and research communities are questioning the peer-review process.  Richard Horton, editor of the Lancet, states that scientific journals—thought to be the objective sentinel of the scientific process—have “devolved into information-laundering operations for the pharmaceutical industry.”[xxx]  Richard Smith, former editor of the British Medical Journal, published an article, titled “Medical Journals Are an Extension of the Marketing Arm of Pharmaceutical Companies,” detailing the multifaceted approach drug companies use to manipulate data to gain influence over physicians and peer review publications.[xxxi]

An article written in the journal Trials, observed a systematic effort by Pfizer to distort scientific findings and deliver misinformation to healthcare providers about their drugs.[xxxii]  In 2009, Pfizer was fined $2.3 billion for engaging in bribery with medical officials.  It would be nice if Pfizer was a lone actor or just a “bad apple,” but the evidence and legal penalties reveal otherwise.  David Klemperer, a professor of Sociology at the University of Regensburg, examined the corrupting influence of the drug industry on the peer-review process and wrote:

Pharmaceutical companies often leave both doctors and patients in the dark about the real effects of their products.  The knowledge base on which we as doctors reach decisions with our patients is often distorted, and doctors thus often unwittingly put their patients at risk.[xxxiii]

Perhaps one of the more egregious examples of this information suppression is highlighted by “study 329.”[xxxiv]  This study was originally submitted by drug company GSK to show that their drugs, Paxil and Tofranil, were safe and effective for the purpose of treating depression in adolescents.  Twenty years later, after examining the raw data from GSK on study 329, researchers found that neither drug was safe or effective when compared to the placebo.  Disturbingly, reports of adverse events and suicide attempts were ferreted away so that the public, regulators, and physicians were kept in the dark concerning the true nature of these psych drugs.  For years, these drugs were prescribed without the true nature being known. Today, Paxil and Tofranil carry strong warnings for increasing suicide risk in adolescents.  Tragically, for many families, these warnings come too late.

Whatever unethical practices supplement companies, health food store salesmen, and alternative practitioners are guilty of, it is a pittance in comparison to the legendary corruption, manipulation, and suppression of information perpetrated by drug companies.  Drug skepticism does not rule SDA hospitals or schools—quite the opposite is true.  Our medical institutions show little difference between themselves and the drug-friendly institutions of the world.  Our culture is inundated by pharmaceutical marketing.  One cannot consume media without encountering its advertisements.  The power it wields in halls of government is formidable.  Few industries have as much power and as much money.  For this reason, it is bewildering for an SDA doctor to think drug leeriness is a bad thing.  Particularly when our institutions were to counseled “educate away from drugs.”  In sum, the SDA drug problem has little to do with drug agnosticism but rather an unmitigated faith in them.

 

Timothy R Perenich MA, DC

Timothy R Perenich MA, DC

 

 

[i] John B. Hoehn, “The Adventist Drug Problem: Must All Remedies Be ‘Natural’?,” Adventist Review, April 25, 2002, accessed July 7, 2017, http://archives.adventistreview.org/2002-1517/story1.html.   

[ii] Ibid.

[iii] Victoria Reynolds et al., “The Role of Pharmacists in the Opioid Epidemic” North Carolina Medical Journal 78, no. 3 (2017): 202–205, doi:10.18043/ncm.78.3.202.

[iv] Kelly Saia et al., “Prenatal Treatment for Opioid Dependency: Observations from a Large Inner-City Clinic,” Addiction Science & Clinical Practice 12, no. 5 (2017): doi:10.1186/s13722-016-0070-9.

[v] Leandro Gobbo Braz et al., “Mortality in Anesthesia: A Systematic Review,” Clinics (Sao Paulo, Brazil) 64, no. 10 (2009): 999–1006, pmcid:pmc2763076.

[vi] Carlos Brotons, et al. “A Systematic Review of Aspirin in Primary Prevention: Is It Time for a New Approach?” American Journal of Cardiovascular Drugs 15, no. 2 (2015): 113–133. PMC. Web. July 8, 2017; Michele Bally, et. al. “Risk of Acute Myocardial Infarction with NSAID’s in Real World Bayesian Meta-analysis of Individual Patient Data,” BMJ 357 (2017): 1909. http://dx.doi.org/10.1136/bmj.j1909.

[vii] “Irritant Action of Aspirin on the Stomach,” British Med Journal 2, no. 4930 (July 2, 1955): 31-32. R.A. Kronmal, et. al. “Asprin Use and Incident Stroke in the Cardiovascular Health Study,” Stroke 29, no. 5 (May 1998): 887-894.

[viii] Frank L. Lanza, et. al. "Prevention of NSAID-Related Ulcer Complications," American Journal Gastroenterology 104 (2009): 728–738; doi:10.1038/ajg.2009.115; published online February 24, 2009. Accessed July 7, 2017.

[ix] Hoehn, Review April 25, 2002.

[x] Frances O. Kelsey, “Problems Raised for the FDA by the Occurrence of Thalidomide Embryopathy in Germany, 1960-1961,” American Journal of Public Health and the Nations Health 55 (1965): 703–707.  

[xi] “How Did the Federal Food, Drug, and Cosmetic Act Come About?,” U.S. Food and Drug Administration (FDA), updated March 4, 2016, http://www.fda.gov/AboutFDA/Transparency/Basics/ucm214416.htm.  

[xii] Ibid.

[xiii] “Kefauver-Harris Amendments Revolutionized Drug Development,” FDA, updated February 19, 2015, accessed October 9, 2015, http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm322856.htm.  

[xiv] Peter C. Gøtzche, “Our Prescription Drugs Kill Us in Large Numbers,” Polskie Archiwum Medycyny Wewnetrznej 124, no. 11 (2014): 628–634.  

[xv] Ibid.

[xvi] National Institutes of Health, “Dethylstilbestrol (DES) and Cancer,” National Cancer Institute (Reviewed October 5, 2011), Accessed July 10, 2017. https://www.cancer.gov/about-cancer/causes-prevention/risk/hormones/des-fact-sheet

[xvii] Letter: FDA: Center for Drug Evaluation and Research, To: Bob Rappaport M.D. (December 15, 2008): https://www.fda.gov/downloads/drugs/drugsafety/postmarketdrugsafetyinformationforpatientsandproviders/ucm234301.pdf (Accessed July 10, 2017).

[xviii] Lisa Bernard-Kuhn, “Drug’s Belated Recall a Bitter Pill to Swallow,” The Cincinnati Enquirer February 13, 2011.

[xix] Ibid.

[xx] George A. Talland, “Improvement of Sustained Attention with Cylert,” Psychonomic Science 6, no. 11 (1966): 493–494.

[xxi] Boyce Rensberger, “Memory Drug Fails to Pass Test on Brighter Students,” Detroit Free Press (Detroit, Michigan), February 26, 1967.

[xxii] “CIA’s Drug Experiments on Vacaville Inmates Confirmed,” Independent (Long Beach, California), April 21, 1977.

[xxiii] Fatma A. Etwel et al., “A Surveillance Method for the Early Identification of Idiosyncratic Adverse Drug Reactions,” Drug Safety 31, no. 2 (February 2008): 169–180, pmid:18217792.

[xxiv] Bloomberg News, “Drugmakers to Halt Attention-Deficit Pill,” Chicago Tribune (Chicago, Illinois), October 25, 2005; Etwel et al., “A Surveillance Method.”

[xxv] J. Gordon Millichap, “Acute Hepatic Failure with Pemoline (Cylert),” Pediatric Neurology Briefs 12, no. 1 (1998): 8, doi:http://doi.org/10.15844/pedneurbriefs-12-1-14.

[xxvi] Matthew Burns, “Taylors Family Sues Four Pediatricians,” The Greenville News (Greenville, South Carolina), April 14, 1992.

[xxvii] Mary Duenwald, “Acne Drug Stirs Safety Debate,” The Desert Sun (Palm Springs, California), January 23, 2002.

[xxviii] Sheila R. Shulman, “The Broader Message of Accutane,” American Journal of Public Health 79, no. 11 (1989): 1565–1568, pmcid:pmc1349820.

[xxix] Eric Wooltorton, “Accutane (Isotretinoin) and Psychiatric Adverse Effects,” Canadian Medical Association Journal 168, no. 1 (2003): 66, pmcid:pmc139322; Diane K. Wysowski, Marilyn Pitts, and Julie Beitz, “Depression and Suicide in Patients Treated with Isotretinoin,” New England Journal of Medicine 344, no. 6 (February 8, 2001): 460, doi:10.1056/nejm200102083440616.

[xxx] Richard Horton, “The Dawn of McScience,” New York Review Books, 51 (March 11, 2004): 7–9. 

[xxxi] Richard Smith, “Medical Journals Are an Extension of the Marketing Arm of Pharmaceutical Companies,” PLoS Med 2, no. 5 (May 2005): e138, doi:10.1371/journal.pmed.0020138.

[xxxii] Vedula et al., “Implementation of a Publication Strategy in the Context of Reporting Biases. A Case Study Based on New Documents from Neurontin Litigation,” Trials, 13 (2012): 136, doi:10.1186/1745-6215-13-136.

[xxxiii] David Klemperer, “Drug Research: Marketing Before Evidence, Sales Before Safety,” Deutsches Ärzteblatt International, 107 (April 2010): 277–278.  

[xxxiv] Joanna Le Noury et al., “Restoring Study 329: Efficacy and Harms of Paroxetine and Imipramine in Treatment of Major Depression in Adolescence,” BMJ 351 (2015): h4320, doi: 10.1136/bmj.h4320.