MEDICINE'S DARK SIDE: DRUGS CAN BOTH SAVE AND CLAIM LIVES

The federal Food and Drug Administration traditionally has only asked --
not required -- that physicians report when a patient dies from an adverse
reaction to drugs. This is how government is supposed to better protect
patients by monitoring the practice of medicine.

Doctors have reported about 3,500 such deaths every year. That, officially,
has been the unintended death toll of medicines meant to heal, not hurt.
Now a new study in the Journal of the American Medical Association provides
powerful evidence that doctors have not taken the time to report all deaths
from drugs, and that adverse reactions to medications may be a far greater
health problem than physicians and patients have realized.

More than 100,000 people likely die in American hospitals every year from
drugs that are supposed to be making them better, according to the study by
Dr. Bruce Pomeranz of the University of Toronto. If his findings are
correct, that would make adverse drug reactions in hospitals the nation's
sixth-biggest killer, claiming roughly twice as many lives as breast
cancer.

And that's just deaths in hospitals. The study did not take into account
deaths due to adverse drug reactions in nursing homes or at home, where a
patient may be seeing multiple doctors who have prescribed different drugs
that together produce a deadly result.

For consumers, the wrong reaction is to conclude that prescribed drugs are
always bad. In the overwhelming majority of cases, they are not. The same
study suggests that for every patient who may die from an adverse reaction
to medications in hospitals, 300 others are helped. Those odds, while not
as favorable as the conventional wisdom held, are still well on the side of
medications. Yet with millions upon millions of hospital patients every
year, a problem that proves deadly even a very small percent of the time
will end up claiming a lot of lives.

It is clear, based on Pomeranz' study, that a voluntary reporting system
relying on busy doctors does not provide complete information on the deadly
side effects of drugs. This should motivate the federal Health Care
Financing Administration to accelerate plans to develop regulations
compelling hospitals to monitor patients for adverse drug reactions.

This is a woefully understudied field of medicine that begs for more and
better research. The challenge is to answer whether there are new ways to
minimize the unavoidable death toll from drugs. It is simply unacceptable
to lose patients by unknowingly prescribing dangerous combinations of
drugs. A far trickier proposition is to weigh the risks and benefits of
medications in deciding whether or not to prescribe. That is helped by
truly knowing what the risks are. Better data will yield better decisions.