Thursday, October 13, 2005

The War on Unpatented Drugs

A lot of folks have called the War On Drugs, the War On Some Drugs. Which some drugs might they be? There in lies a tale.

Let us start with one drug Welbutrin. Clayton Cramer in a private e-mail message told me it was a wonder drug for some mental conditions. So I did my research and found this on the drug:

Welbutrin is used as a stimulant for a person who suffers from depression.
Clever wording "used as a stimulant". Actually if you look at the side effects listed it is a stimulant. So is cocaine. So is methamphetamine.

I get a drug industry newsletter by e-mail called Reed Business Information & Datamonitor Geonomocs and Proteonomics, Bioscience Technology, Drug Discovery and Development. In the October 7th edition they are reporting (more like flacking) a new drug for ADD/ADHD here is what they say about it:
The global ADHD market is set to grow from $2.7 billion in 2005 to $3.3 billion by 2015 (CAGR, 2.0% 2005–15), driven primarily by the launch of numerous novel pipeline products and the continued uptake of Strattera.

However, with the forthcoming genericization of Adderall XR and Concerta, manufacturers need to consider novel approaches to differentiate their marketed products in this increasingly competitive market.

The report Commercial Insight: ADHD - Strattera Will Reign Supreme When Branded Stimulants Slump....
Notice what is going on. New patented stimulants must come on the market to replace drugs whose patents expire. You know how it is. Doctors and patients always want the latest miracle drugs. Even if they are not much different from drugs going off patent. So how long has cocaine been off patent? How about methamphetamine?

It seems even old line stimulants have competition for the ADD/ADHD market. Here is a report on research by a doctor who has found pot effective against ADD/ADHD, anxiety, and alcohol and tobacco addictions.

Now why do you suppose a relatively benign drug like marijuana gets the lions share of drug war money? What exactly are we being protected from? My best guess is a decline in drug company profits.

The Drug Companies have become a cartel. And like any cartel they endeavor to wipe out their competition. They are very clever to see that there is no blood on their hands. They get the government to do the job for them.

Update: 13 Oct '05 1206z

While looking around for other Reed business reports I found this gem:ADHD - Prescriber Attention Still Held by Short Acting Stimulant Drugs
Despite the plethora of once-daily drugs available for the treatment of ADHD, physicians consistently prescribe immediate release formulations. To bolster revenues, manufacturers must continue to promote awareness of ADHD at all levels, but most also seek to further differentiate their once-daily products from generics and other branded products in the eyes of both the patient and the physician.
Followed by this blockbuster:
Only 12.3% of patients are diagnosed, indicating that a huge proportion of patients remain undiagnosed and untreated. Although the awareness of ADHD is ever growing, there are still significant gaps between, knowledge, recognition and referral of the disease. Datamonitor has highlighted these and provides counteractive strategic recommendations.

Only 20% of patients receive longer-acting, once-daily drugs at first-line, falling to 3% at second-line, with physicians preferring immediate-release formulations. Consequently, Datamonitor has identified numerous lifecycle strategies to bolster long-acting drug sales.
The drug companies have their eye on you and don't want you messin with none of those dirty, adulterated, unpatentable street drugs. They want to sell you a patented drug. Clean pure and legal like. Of course there will be a slight surcharge to pay for all the expensive research and development required to come up with new stimulants. On a regular basis as the patents run out.

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15 comments:

Anonymous said...

Well and succinctly said M. Simon, interesting information. The drug industry does do some good things, obviously, but the 'war' is a winner for all but the user. I doubt that will change.

Luther McLeod

Anonymous said...

Just happened to run into this, this morning. It appears to quite handily add to your thesis.

http://www.nature.com/news/2005/051010/full/051010-12.html

Luther McLeod

M. Simon said...

Luther,

Thanks for the heads up.

Send me an e-mail and I will put you on my drug war articles announce list.

Simon

Anonymous said...

just wanted to leave a note to let you know i've mentioned this entry in my blog: http://tinyurl.com/bnkkn

D.P. said...

Nicely said . . .and I agree with Luther McLeod's comment that "the war is a winner for all but the user." *sigh*

Anonymous said...

I'll verify that Wellbutrin is a 'stimulant.' I was on it for depression, and it stimulated the Hell out of my testosterone & adrenaline! My resting heartbeat was around 120, and I was getting agressive as a pitbull. I feel MUCH more relaxed and saner now that I quit that stuff.

The shrink convinced me to take it by really downplaying the side effects. They also do that to every new drug that comes out. I'm sorry, but I'm not the pharmaceutical industry's guinea pig.

Nathaniel said...

One of the debate cases my partner and I ran senior year in high school (under a secondary education resolution) was to stop the promotion of drugging kids as a solution to problems in school. You can find some fun anti-stimulant quotes in the research!

More generally, I am certainly of the camp that the modern war on drugs (essentially stemming from the Controlled Substances Act) is a laughable failure. Except of course that the tremendous destruction it has wrought is anything but funny. One of the most interesting questions is why our country, which is supposedly a market-oriented democracy, pours so many resources into something so ineffective and wasteful, and no doubt the drug industry has something to do with that.

M. Simon said...

Tim,

The wiki article says the drug is in the amphetamine related family. As in meth.

If you look at the side effects wiki lists:

Common side effects include dry mouth, tremors, anxiety, loss of appetite, agitation, dizziness, headache, excessive sweating, increased risk of seizure, and insomnia. Bupropion causes less insomnia if it is taken just before going to bed, or in the morning after arising.

Activation of mania and psychosis have both been encountered.


It is a classic stimulant.

cabdriver said...

I wrote this a little while ago, as a brief general statement of my principles regarding the use of psychoactive drugs- of any sort, whether they be legal pharmaceutical drugs, illegally manufactured or synthesized drugs, or plant-based drug substances. It's incomplete and would benefit from additional commentary and editing, but as a preliminary statement it isn't bad. So I'm putting it here, as a response to the thread that you've opened:

I believe in adult free choice for access to drugs, as a matter of principle.

I abhor mandatory drugging of children.

I abhor the advertising of pharmaceutical drugs on the televison set. It's patently absurd (get it?) to seriously contend that it's possible to get responsible drug education from a television advertisement. And "ask your doctor for this med by brand name" ads are so irresponsible that they should probably best be banned, like liquor ads.

I abhor the practice of drug companies rewarding doctors on the basis of the volume of brand-name medications they prescribe; or for offering material rewards and honorariums in return for endorsements of pharmaceutical drugs.

I'm wary of the use of psychotropic drugs on developing nervous systems- even coffee and pot, which appear to me to be a good deal less profound in their effects than the stimulants, tricyclics, quadcyclics, and serotonergic antidepressants commonly prescribed to children and adolescents at the drop of a hat, these days.

I abhor having free choice restricted so that cannabis is not available as an option to lower blood pressure, an aid to digestion, to cure erectile dysfunction, as an appetitie stimulant, as an antidepressant, or any of the other multitude of other medical uses that it typically performs with fewer toxic physical effects than pharamceutical drugs.

I support the loosening of prescription restrictions for various mild to moderate opiate preparations, particularly for those in chronic pain, and the elderly.

I support research into the use of opiates for their value as antipsychotic drugs. Consider the principal drawbacks of "antipsychotics"- they have such horrible side effects that it's difficult to get schizophrenics to keep taking them. What's up with that? I know how to encourage those folks to keep taking their anti-anxiety meds...seriously, would someone kindly critique this Modest Proposal of mine?

I support having a much wider array of pharmaceutical drugs available OTC in the USA, just as they have been for decades in other countries like India and Mexico, with negligible social costs or public health impact (provided that they're not counterfeit.) Why not?

I'm wary of using any drug prescribed for daily use in a way that produces habitual dependency, whether it be antidepressants, tranquilzers, sleep aids, blood pressure medications, stimulants, or many of the array of medications piled one on top of the other and given to the elderly. I contend that cannabis is less toxic and less habit-forming than any of the pharmaceutical drugs that I've named.

I think it's ridiculous to consider one class of habit-forming drugs "addictive" and the other as simply "perilous to ever stop taking", simply because the "addictive" ones tend to make people feel euphoric and the others don't.

If I'm lying immobile in a bed as a debilitated elderly senior citizen, I'd rather spend that time dreaming out on opium or morphine than simply wait out my days in a state of officially enforced "sobriety." At present, I have no use for opiates. But once I'm permanently bedridden and senescent, what possible difference could it make, to myself or anyone else, if I'm floating in the arms of Morpheus? Just add it to my daily drug cocktail- the one that I can't do without anyway...I'll be a nicer person to be around...all the time in the world to put the headphones on, and treat myself to a music appreciation course....Actually, I'll probably prefer hashish. Considering that I'll be suffering from it's principal negative side effects- lethargy and torpor- anyway...where's the downside?

As a general principle, adults have the right to their own free choice of drugs because no one else is good enough to take that right away from them, a priori.

If they're involved in behaviors that are hazardous to the public- for example acting irresponsibly by driving while impaired, neglecting their children, acting in ways that menace other people, or stealing to support their addictions- then it's permissible for legal authorities to constrain their access to drugs, or to subject them to criminal statutes. But absent such violations of the social contract, people have the right to take whatever they want.

That much needs to be made clear before dealing with the problems associated with uneducated and irresponsible self-medication, substance abuse, and the issues of personal loss of control associated with binging, dependency and addiction.

Kevin L. Connors said...

A great post, Simon. Too bad Luther's Nature article requires a paid subscription.

You might also add the work in Switzerland, The Netherlands, Australia, Canada and others - largely suppressed here, which shows heroin users can be held a "maintenance", rather than the conventional wisdom, which proclaims a never-ending dosage-tolerance spiral.

Kevin L. Connors said...

OK - here's a free version of of that article: http://www.bioedonline.org/news/news.cfm?art=2083

Anonymous said...

I bet cocaine would be an excellent ADD drug, doctors are just too afraid to prescribe it.

aaron said...

I believe Wellbutrin is more like prozac than meth.

The terms stimulant and depressant and all can become vague.

It also depends where in the brain the drugs is acting. Some drugs act like simulants in parts of the brain and depressants in others.

You can say that SSRIs are stimulants since they increase seratonin level. Or (maybe) you could call it a depressant, since it prevents a brain function (seritonin re-uptake).

Alcohol is a depressent, but it acts as a stimulant in the verbal area of the brain. Not only does it decrease your inhibitions (depressant effect), it increases your ability communicate (until the depressant effects cause you to slur your words).

M. Simon said...

Wellbutrin is a stimilant similar to meth or cocaine.

rdr,

I don't believe in "addiction". I believe all chronic use is medical use. We don't call diabetics insullin addicts. I believe the same principle applies for all drugs. The problem is that we do not know all the conditions related to why people self medicate.

Anon 18 March,

The link is to some one selling something. I'm not sure it addresses the questions asked here. It looks parasitical in that it feeds off the "addiction" superstition.

M. Simon said...

Anon,

I get it. If you get your stimulants from a doctor fine. If you buy them on the street you are a druggie.

That makes perfect sense.