(Roughly) Daily

Posts Tagged ‘Drugs

“You’re mugging old ladies every bit as much if you pinch their pension fund”*…

Who benefits from the commercial biomedical research and development (R&D)? Patients-consumers and investors-shareholders have traditionally been viewed as two distinct groups with conflicting interests: shareholders seek maximum profits, patients – maximum clinical benefit. However, what happens when patients are the shareholders?…

Adding investments by governmentally-mandated retirement schemes, central and promotional banks, and sovereign wealth funds to tax-derived governmental financing shows that the majority of biomedical R&D funding is public in origin. Despite this, even in the high-income countries patients can be denied access to effective treatments due to their high cost. Since these costs are set by the drug development firms that are owned in substantial part by the retirement accounts of said patients, the complex financial architecture of biomedical R&D may be inconsistent with the objectives of the ultimate beneficiaries…

It has been estimated that of the total $265 billion spent annually on biomedical research worldwide, over a third – $103 billion comes from public sources. Nevertheless, as public input capital is allocated predominantly into early stage research, nearly all output – medicines – is ultimately brought to the market by private firms. Importantly, these firms are not independent agents. They have owners-shareholders to report to. Until the end of the previous century the major type of owners-shareholders were individual households. At the turn of the millennium, however, they have been displaced by institutional investors, the largest of which are public retirements schemes or quasi-public funds, such as occupational pensions.

First, government money underwrites the basic R&D that goes into drug discovery and development, then public pension monies fund the private companies that bring those drugs to market. As the private companies are solving for highest profits, as opposed to optimal public health, those drugs are often priced out of the reach of the very people whose pension contributions funded their development. Drugs “priced out of reach” is certainly not a new phenomenon; AIDS drugs (to take one example) were priced by Western pharma companies at prices that rendered them inaccessible to most citizens of low-income countries in Africa and Asia. The pensioners in wealthy nations were, effectively, living off of the misery of those in poorer companies.

But the dynamic has continued, deepened– and come home to roost. Now patients in high-income countries are denied access to effective treatments due to their high cost, while these costs are being set by the drug development firms, owned in substantial part by the retirement accounts of those same patients, and benefiting from direct and indirect governmental support.

Investing in one’s own misery– the painful irony of pharma funding: “Pension and state funds dominating biomedical R&D investment: fiduciary duty and public health.”

[Image above: source]

* Ben Elton, Meltdown

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As we untangle unintended consequences, we might send healthy birthday greetings to Charles Value Chapin; he was born on this date in 1856. A physician and epidemiologist, he was a pioneer in American public health. He co-founded in first bacteriological laboratory in the U.S. (in 1888) in Providence, were he was Superintendent of Health– a position he held for 48 years. In 1910, he established Providence City Hospital where infectious disease carriers could be isolated under aseptic nursing conditions; his success inspired similar health control measures throughout the U.S. A professor (at Brown) and prolific writer, his impact on health policy and practice was so broad that he was hailed as “the Dean of City Public Health Officials.”

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January 17, 2021 at 1:01 am

“Alcohol is the anesthesia by which we endure the operation of life”*…

 

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Alcohol consumption in the U.S has been trending down for several years; in 2018, alcohol consumption in the United States dropped for the third-straight year. Nevertheless…

America is in the middle of an alcohol epidemic.

That’s one takeaway from a new study published this month in Alcoholism, which found the number of alcohol-related deaths more than doubled between 1999 and 2017 from nearly 36,000 to nearly 73,000, and the rate of alcohol-related deaths rose by more than 50 percent from 16.9 per 100,000 people to 25.5.

To put that in perspective, there were roughly 70,000 drug overdose deaths in the US in 2017. Based on the Alcoholism study, alcohol was linked to more deaths than all overdoses — even at the height of America’s opioid epidemic. Alcohol accounted for 2.6 percent of all deaths among people 16 and older in 2017, up from 1.5 percent in 1999…

The study speaks to a problem in American public health and drug policy: While crises like the opioid epidemic (deservedly) get a lot of attention, even deadlier drug crises are often neglected by the public, policymakers, and media…

Alcohol isn’t even the deadliest drug. The Centers for Disease Control and Prevention previously estimated that tobacco smoking is linked to 480,000 deaths each year, or roughly 1 in 5 deaths. In other words, preventing just 30 percent of smoking deaths would prevent more deaths than preventing all drug overdose deaths and alcohol-related deaths combined.

Yet alcohol and tobacco haven’t filled a big part of public discussions about drugs in the past few years, especially compared to the opioid epidemic…

More at “The number of US alcohol deaths per year has doubled since 1999.”

* George Bernard Shaw

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As we contemplate cocktails, we might recall that it was on this date in 1912, during the First International Opium Conference at The Hague, that the first international drug control treaty, the International Opium Convention, was signed.

Raid

Opium article from The Daily Picayune, February 24, 1912, New Orleans

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January 23, 2020 at 1:01 am

“The rule of thumb is the more profound the experience, the longer you should wait before doing it again”*…

 

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Beyond their visual qualities, mescaline’s hallucinations posed profound philosophical questions. During the mid-1930s three prominent writers and thinkers left records of their experiments with it. In 1934 and 1935 respectively, Walter Benjamin and Jean-Paul Sartre participated in the now-familiar modus operandi of private session between psychiatrist and artist, with the scientific gaze and the philosopher’s insights informing—or, more often, pitted against—one another…

Sartre wrote little directly about his experience, describing it briefly in notes that later found a place in L’imaginaire, his 1940 study of the phenomenology of the imagination. He found its effects elusive and sinister. “It could only exist by stealth,” he wrote; it distorted every sensation, yet whenever he attempted to perceive it directly it withdrew into the background or shifted shape. Its action on the mind “inconsistent and mysterious,” offering no solid vantage point from which to observe it. In contrast to previous descriptions of the “double consciousness” or état mixte, in which the normal self was able to observe its hallucinations dispassionately, Sartre found it impossible to be a spectator of his own experience. On the contrary, he felt submerged against his will in a miasma of sensations that assailed him viscerally at every turn, a world of grotesque extreme close-ups in which everything disgusted him.

The best-known detail of Sartre’s bad trip is Simone de Beauvoir’s anecdote of him being haunted for weeks after by lobster-like creatures scuttling just beyond his field of vision. Sartre, like Aldous Huxley, was partially sighted—a curious coincidence linking two of the most celebrated intellectuals to have taken the vision-producing drug—and his poor vision may have exacerbated his anxieties about shapes lurking just beyond its reach. Later in life he claimed that it had driven him to a nervous breakdown. “After I took mescaline, I started seeing crabs around me all the time,” he recalled in 1971; “I mean they followed me into the street, into class.” Even though he knew they were imaginary he spoke to them, requesting them to be quiet during his lectures. Eventually he sought psychotherapeutic help from a young Jacques Lacan, which generated “nothing that he or I valued very much,” though “with the crabs, we sort of concluded that it was fear of becoming alone.”…

Caveat comedenti: “Sartre’s bad trip.”

* Dr. James Fadiman

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As we contemplate crustacea, we might spare a thought for Jerome Phillip Horwitz; he died on this date in 2012.  A chemist active in cancer research, Horowitz was the first to synthesized AZT (azidothymidine), in 1964, in the hope that it might retard the growth of malignant cells.  It failed at that task, and lay dormant for two decades… until Burroughs Wellcome tested– and patented– Horowitz’s development as a treatment for HIV-AIDS.  The drug company got FDA approval in 1986, and went on to reap enormous financial returns, of which Horowitz saw none.

After AZT, Horowitz went on to create many successful treatments for cancer and other diseases.

(While some believe that Horwitz was referenced in the Captain Underpants books, the Jerome Horwitz Elementary School in the children’s book series was in fact named after Curly Howard (Jerome Lester Horowitz) of The Three Stooges.

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September 6, 2019 at 1:01 am

“Opium teaches only one thing, which is that aside from physical suffering, there is nothing real”*…

 

Opium’s history in the United States is as old as the nation itself. During the American Revolution, the Continental and British armies used opium to treat sick and wounded soldiers. Benjamin Franklin took opium late in life to cope with severe pain from a bladder stone. A doctor gave laudanum, a tincture of opium mixed with alcohol, to Alexander Hamilton after his fatal duel with Aaron Burr.

By 1895, morphine and opium powders, like OxyContin and other prescription opioids today, had led to an addiction epidemic that affected roughly 1 in 200 Americans. Before 1900, the typical opiate addict in America was an upper-class or middle-class white woman. Today, doctors are re-learning lessons their predecessors learned more than a lifetime ago…

Doctors then, as now, overprescribed the painkiller to patients in need; and then, as now, government policy had a distinct bias.  Learn more at: “Inside the Story of America’s 19th-Century Opiate Addiction.”

* Andre Malraux

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As we moderate our intake, we might send insightful birthday greetings to Norman Rufus Colin Cohn; he was born on this date in 1915.  A historian of fanaticism, his remarkable The Pursuit of the Millennium, a tracing back of the mythologies associated with medieval apocalyptic movements that characterized– and ultimately marred– the revolutionary movements of the 20th century, was ranked as one of the 100 most influential books of the 20th century in a survey conducted by The Times Literary Supplement.  He was a Fellow of the British Academy, an honor to which he was nominated by Isaiah Berlin.

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January 12, 2018 at 1:01 am

“I do not wish them [women] to have power over men; but over themselves”*…

 

One of 29 maps from WomanStats, plotting the status of women around the world.  Visit Landesa for more on this particular issue, and for what you can do to help.

* Mary Wollstonecraft, A Vindication of the Rights of Woman

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As we realize that the greater good is in out self-interest, we might send transcendental birthday greetings to Albert Hofmann; he was born on this date in 1906.  As a young chemist at Sandoz in Switzerland, Hofmann was searching for a respiratory and circulatory stimulant when he fabricated lysergic acid diethylamide (LSD); handling it, he absorbed a bit through his fingertips and realized that the compound had psychoactive effects.  Three days later, on April 19, 1943– a day now known as “Bicycle Day”– Hofmann intentionally ingested 250 micrograms of LSD then rode home on a bike, a journey that became, pun intended, the first intentional acid trip.  Hofmann was also the first person to isolate, synthesize, and name the principal psychedelic mushroom compounds psilocybin and psilocin.

He died in 2008, at the age of 102.

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Written by (Roughly) Daily

January 11, 2016 at 1:01 am

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