The use and misuse of medications

I read the following news about drug marketing.

“Boston – Employees at a drug company accused of bribing doctors rapped and danced around a person dressed as a bottle of the highly addictive fentanyl spray in a video meant to motivate sales reps to push the drug.”

I think selling, promotion, marketing are as old as civilization.
So in this case, I see there is the brilliant producer of a new product Fentanyl spray.  That has presumably been approved by some knowledgeable governing body for certain indications. Say for example, palliative pain control.
There is the very talented promoter who earns his salary for the sole purpose of directing the attention of the prescriber to the new product.
There is also the licensed and highly experienced prescriber whose job is to relieve pain and suffering and foremost of all do no harm.  This may be translated to prescribe as per approved indications or off label if necessary.
Finally there is the patient who trust the system, the prescriber, the product and the experience of being on the product.  The patient are at times known to become hyper-compliant with the product and persuade the prescriber to prescribe more.
Now things goes horribly wrong - Opioid crisis.
Who is really responsible?
1. The producer of a new product
2. The knowledgeable governing body
3. The talented promoter
4. The licensed and highly experienced prescriber
5. The patient
The takeaway for me is that perhaps not only the promoters need to bear some responsibility to be aware that every tool can be misused.  
I am grateful for innovations.
If I am dying from cancer I’d be grateful if my prescriber were sufficiently knowledgeable to help me with the best tools.  If I suffer back pain from being sedentary and poor nutrition and didn’t know better, I’d be grateful if my prescriber took the time to teach me self-management instead of giving me a way to avoid addressing the real cause of my pain and suffering by prescribing me a quick fix.

If I suffer pre-diabetes or type 2 diabetes (30% of Ontarians) due to my average Canadian diet and didn’t want to, or think I am just too busy to know better, I’d be grateful if my prescriber took lots of time to share with me that there are great many more pain, sufferings and illness that lays await for me unless I change my ways.
I’d be grateful to the producer, regulator and promoters of diabetic medications to direct some of their resources and creative energy to remind my prescriber of the importance patient self-management in the care of diabetes; and that in many cases by following well publicized dietary guidelines the need for medications can be decreased or sometimes eliminated.  Finally, I’d be grateful to the government elected by the people for the people to make it known to me and constantly remind me that it is foremost my duty as a citizen, a patient, a son, a brother, a father, a teacher and a leader to be be a role model of wellness for everyone around me.




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