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On Statin Drugs, Ethics and My Angst

By Barbara Morris, R. Ph.
When I went to pharmacy school we studied
pharmacognosy (about substances found in nature used
to treat illness), because we were learning to practice what
was called "the ancient and noble art of the apothecary."
It was important to know about the medicinal value of
assorted botanicals, herbs, roots, and berries because
that was pretty much all there was to treat most medical
conditions.
The pharmaceutical industry had not yet grown into the
force it is today, but its power was already on the horizon.
I can recall when we received the first bottles of penicillin
tablets. Soon after penicillin there followed many other
antibiotics and doctors started to routinely prescribe them
for adults and children with simple colds, to prevent
"secondary infections." Several of those antibiotics were
later found to be harmful and were taken off the market.
After the antibiotics came other drug company "miracle"
discoveries that filled the pharmacy shelves that formerly
held botanicals.
Today, for the most part, pharmacists do not practice the
"ancient and noble art of the apothecary"; rather, they
have been co-opted into serving as little more than shills
for the drug companies. Everything older pharmacists
learned about natural remedies "way back when" is now of
little value. Mother Nature has been replaced by the
laboratories of the pharmaceutical companies.
Even though potentially dangerous drugs continue to be
taken off the market, drugs that can cause harm continue
to find their way to the marketplace and into unsuspecting
victims. The "statin" drugs used to control cholesterol
constitute one of the most egregious offenders in my
opinion. Statins are so fraught with serious side effects
that it is difficult to understand why they are still on the
market.
Put Old on Hold Newsletter April, 2008 All rights reserved As a pharmacist, in order to retain my license to practice I must engage in "continuing education" -- which is a good thing. However, I am often at odds with what is taught. For example, a recent continuing education resource dealt with the side effects of statins and how pharmacists should deal with patients who complain about them. It acknowledged that some patients on statins complain about having a problem recalling words, experiencing confusion, and memory loss as well as muscle pain. However, pharmacists were advised to suggest to patients that they not be in too much of a hurry to stop taking the drug because statins "can lower the risk of stroke which can cause cognitive impairment." Do I understand this correctly? If you are experiencing cognitive impairment from taking statin, don't worry about it because taking statin can lower the risk of stroke which can cause cognitive impairment. What a dilemma for the patient! What a dilemma for an ethical pharmacist! When counseling a patient about statin use, do you tell them what you believe is the truth and in their best interest, or do you "fudge" and give them the "party line" and downplay side effects? When pharmacists practiced the "ancient and noble art of the apothecary" they didn't have to think about whether or not they were being ethical. They upheld the Hippocratic oath to "first do no harm" because Pharmacy used to be a noble profession. When you must deal with numerous complaints of statin side effects, advice to gloss over or downplay side effects is infuriating. I recall a patient taking a statin who complained that not only did he have severe muscle pain, but he thought he was losing his mind, which he chalked up to his "old age" of 65. Long story short, he stopped taking the statin and was eventually relieved of his muscle pain and cognitive loss. If memory loss related to statin by Dwayne Graveline, M.D., a physician whose suffered cognitive impairment as a result of taking a statin. There is no question that the pharmaceutical industry has developed some outstanding, helpful drugs. But the reality is that many are overused and prescribed inappropriately. Statin drugs fall into that category in my opinion. Put Old on Hold Newsletter April, 2008 All rights reserved A diagnosis of "high cholesterol" is not usually a problem of too much cholesterol; it's the result of inflamed arterial walls to which cholesterol adheres, builds up, and ultimately results in clogging. It would make more sense to deal with the cause of the inflammation than to lower the cholesterol which is absolutely essential for cell membrane integrity, hormone production and cognition. The degree of arterial inflammation can be determined with two tests: One measures the level homocysteine and the other is for C-reactive protein or CRP. If you are on a statin and your doctor has not ordered these tests, insist that they be done and hope the doctor knows how to interpret the results! It is ironic that arterial inflammation can be controlled with the help of formulations of vitamin B-12, B-6, and folic acid which are available without a prescription. It is no longer possible to practice the ancient and noble art of the apothecary unless you operate your own compounding pharmacy, and "Big Pharma" is leaning on the government to try to put them out of business. The practice of pharmacy has done a 360 degree turn around since I became a pharmacist and it's not all for the better. We could not be doing too much worse if the "ancient and noble art of the apothecary" were still the treatment norm. I think they refer to what we have now as "progress." I am not totally convinced. For an "insider" look at a particularly offensive practice of the pharmaceutical industry, look at "your doctor gives you a handful of samples of the latest miracle drug to help whatever is ailing you. Put Old on Hold Newsletter April, 2008 All rights reserved

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