Vioxx – Super Aspirin Not So Super
19 Nov 2004
In 1673 J.B. Moliere wrote, " Nearly all men die of their medicines, not of their illness". And while imprisoned on the island of St. Helena Napoleon commented, "Take a dose of medicine once and in all probability you will be obliged to take an additional hundred afterward". So neither party would be surprised at the bombshell announcement that Vioxx, heralded as the "Super Aspirin" for arthritic pain, has been found to increase the risk of heart attack and stroke, and removed from the market. It’s the old story of "caveat empor", let the buyer beware. But think again if you naively believe Vioxx is the only problem.
Remember that the new kid on the block is not necessarily a better kid. He may be dressed in the latest fashion, but as my Father cautioned me, you can’t tell the egg by the shell. In this case Vioxx was heralded as relieving arthritic pain and also decreasing the risk of gastric bleeding sometimes caused by over-the-counter non-prescription painkillers.
Now we know that Vioxx, and it’s competitors Celebrex and Mobicox, can also trigger stomach hemorrhage. And there’s no guarantee that by switching to Celebex or Mobicox means God is in Heaven. No one can be totally sure these other drugs won’t also be implicated later on with similar complications.
U.S. Senator Charles Grassley has suggested an independent board might be needed to ensure safe medications. This is utter nonsense. We know that all existing drugs have potential complications. You could appoint a hundred esteemed boards and still have Vioxx-like deaths. There is simply no group of scientists nor magic formula that can assure long-term safety of new drugs. We live on planet earth, not in heaven.
Don’t rush out to buy "super’ drugs. Initial studies may be misleading. It’s much wiser to first use drugs that have been around for years. For instance, Aspirin, like old wine and old cheese, has stood the test of time for over 100 years. In fact, every year researchers are finding new ways Aspirin fights disease such as decreasing the risk of heart attack, diabetic complications, ovarian, esophageal and colon cancer.
Today medical consumers are not adequately warned of the potential hazards of even minor painkillers. Every week I see patients who are swallowing multiple doses of painkillers for minor discomfort as if they were M&M candies. They’re totally unaware that excessive and chronic use of pain medication may cause kidney and liver damage.
A report from Johns Hopkins University claims the number of people with advanced kidney disease has doubled during the last 10 years. And that the number of people who require renal dialysis is growing at the rate of 7 percent a year. Today five per cent of those requiring renal dialysis have injured their kidneys due to the overuse of so-called minor painkillers. The result is not so minor and a terrible price to pay for the relief of a little pain.
It’s going to be hard to prevent future bombshells like the Vioxx case. Sir William Osler hit the nail on the head when he wrote "A desire to take medicine is perhaps the great feature that distinguishes man from the other animals". Today there’s an epidemic of pillitis with people craving pills for every ache an pain. And pill takers must accept the fact that pills never grant total freedom from possible drug reactions.
For years I’ve stressed the need for effective pain control when there’s bone-fide terminal pain. But there’s no need for painkillers for minor discomfort as tincture of time usually cures it. Osler, noted for his sense of humour, often advised his patients who had a cold to "go to bed, put your hat on the bedpost, start drinking scotch and stop when you see two hats". Or as Sir Thomas Syndenham once remarked, "The arrival of a good clown exercises a more beneficial effect upon the health of a town than 20 asses laden with pills".
I say, "Amen to that".
