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Pill Popping, a Global Menace


By Brahma Sharma, MD, FACC

Note: Guest blogger Brahma Sharma, MD, FACC, is associate professor clinical medicine at UPMC Passavant and a PAMED member.

Where there is a will, there is a pill, if I may paraphrase.

Pill popping has become a major global public health problem. Though the U.S. is leading, other developing countries are catching up fast.

We have already lost the war on illegal drugs dumped in to the U.S. from Mexican cartels through mules across border. There is a new war on pill popping that has engulfed all ages.

There seems a nexus between pharmaceuticals, policy makers. It is a sad irony that while millions all over the world can not afford the needed medications, for the rest of us pills have become a handy substitute for healthy living.

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Surprisingly, Americans constitute only 5 percent of the world population but consume 75-80 percent of prescription drugs in the world. It is a byproduct of the liaison between pharma and regulators who allow direct advertisement in our living rooms to our patients, who in turn demand the same from physicians. And we are too eager to oblige.

The controversial patient satisfaction scores determine our payment, thus feeding a vicious quick fix system that distracts from traditional evaluation of patient problems. Driven by profits, pharmaceuticals who oppose import of cheaper medications from neighboring countries, outsource manufacturing of these drugs to developing countries in the name of globalization.

This globalization has fueled the generic drug market in China and India, which export two-thirds of all prescription drugs with potential for fake and counterfeit products back in the U.S.

There are no FDA-like quality control systems and oversight is not rigorous. On the contrary, lack of access and affordability pushes patients in developing countries toward the black market through the Internet.

Rather than being a change for good, Internet and social media has led to democratization of heath care and personalized care. Self-monitoring like Fitbit sensors have allowed some high tech patients to take their health care into their own hands. This leads to self-medication and self-doctoring based on information from the Internet which is another dangerous trend.

Though pills can be life-saving and their use wisely makes sense in appropriate medical conditions for patient care and wellbeing, we have gone to another extreme when we want a pill for weight loss but keep overeating. Or we want a pill which works like exercise but we are too lazy to walk.

This is a disturbing trend when pills replace lifestyle changes and take the focus away from prevention and maintenance of health. We can invent new molecules, medications or devices but the war against illness cannot be won unless we pay attention to basic lifestyles like diet, exercise, stress and the environment in which we live.

Hippocrates once said “Make food thy medicine,” and this is still true. Let us ban advertising, educate ourselves and our patients and reverse this trend. If not now, when?

And if not us, then who will do this?

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