Do you often feel that there’s much in the world of pills that doesn’t make sense? Does it sometimes cause you to question your sanity? You’re not alone. It had that effect on retired pharmacist Dennis Miller.
Dennis Miller, R.Ph. is a retired chain store pharmacist. His book, The Shocking Truth About Pharmacy: A Pharmacist Reveals All the Disturbing Secrets, can be downloaded in its entirety at Amazon for 99 cents.
Do You Have Suspicions About Pills?
In my opinion, even though there are many drugs that are effective and even life-saving, Pharma has grossly mischaracterized and misrepresented pharmaceuticals.
I’ve been writing occasional articles as a guest for The Peoples Pharmacy since 2019. Many of these articles are critical of pills and the pharmaceutical industry. I always enjoy comments posted by readers in response to my articles.
I’ve noticed that, over the years, several readers have posted comments saying something like “I’ve felt this way for a long time. Thank you for validating my suspicions. I thought I was insane. Finally a pharmacist is verbalizing what I’ve felt for years.”
In my opinion, lurking somewhere in the psyche of many pharmacy customers is the inchoate or amorphous suspicion that the world of pills is royally messed up. Many people feel that something is dreadfully wrong but they’re unable to crystallize their feelings in light of the fact that pills are such a central part of our lives and our approach to health.
A People’s Pharmacy reader posted a comment stating: “What you say convinces me that I am sane!!!”
Here is a comment posted by a reader named Susan on July 17, 2024, in response to an earlier article I wrote for The People’s Pharmacy titled “Just Shut Up and Fill Prescriptions!”
“Ever since I can remember, I have had reactions to meds: rashes, hives, pains, swollen tongue, weakness, constipation, severe headaches, etc., etc.
“Now that I am 87 years old, my doctor does not believe me when I tell him I am having a problem with a med. In fact, he told me a few days ago that the reaction I’m having to a new drug cannot be real since it is listed as rare, therefore impossible for me to have, and I must continue to take it. Yes, he must think I am demented because I’m old.
“Thank you. What you say convinces me that I am sane!!”
Here are three additional comments posted by People’s Pharmacy readers in response to some of my recent commentaries:
Monica posted the following comment on March 31, 2024
“Thank you for validating what those of us who apply discretion to using pharma already intuited!”
Carol posted the following comment on March 29, 2024
“This validates how I have felt after I have taken a prescribed medication, it’s not all in my mind, after all.”
Alan posted the following comment on March 29, 2024.
“Suspicions confirmed! Thank you. I’m in my mid 80s and have recently titrated down or stopped several Rx meds and feel much better, especially in regard to “brain fog.” Keep up your good work.”
Why I often felt I was insane in pharmacy school and during my career working at chain drug stores
I’m now retired but I confess that I often felt that I was insane during pharmacy school and during my career working in chain drug stores. That was because I felt so differently from how the other students in my pharmacy class seemed to feel and from how other pharmacists working for chain drug stores seemed to feel.
A narrow range of acceptable discourse in the health professions
There is a narrow range of acceptable discourse in pharmacy school and at chain drug stores. In my experience, criticizing pharmaceuticals in pharmacy school would have been viewed by my classmates and professors as anti-drug or anti-pharmacy. Chain drug store corporate management would definitely look unfavorably upon a pharmacist who criticizes pharmaceuticals or who uses his position in the drug store as a platform to promote prevention rather than pills.
In addition, an inescapable fact is that a paycheck has the powerful ability to cause employees to believe and espouse what their employer wants them to believe and espouse. Pharmacists have bills to pay like everyone else: mortgage payments, car payments, saving for the kids’ college education, etc.
It is, of course, possible that some (or many) of my classmates in pharmacy school and some (or many) of the other pharmacists working at chain drug stores had the same major concerns about pharmaceuticals that I have but were afraid to verbalize those concerns. It is possible that some (or many) of them felt that they, too, were insane for viewing the world of pills so differently from the establishment view.
Pharmacists and techs occasionally verbalize heresy among themselves
During extremely busy times in the pharmacy, it was not rare that pharmacists, in exasperation, would comment to technicians: “If this person would just take better care of his/her body, eat better, lose weight, avoid tobacco and alcohol, he/she could get off most (or all) of the medications he/she takes.”
It was always interesting to me that this pharmacist would often follow his/her comment with nervous laughter. That was because he/she was verbalizing heresy in the eyes of our chain store corporate bosses. There is subtle yet powerful pressure on pharmacists from our corporate bosses to be positive about the pills we dispense. Pharmacists realize that we are being paid to move pills, not to teach our customers to be healthy so that they don’t need pills.
Pharmacy techs often remark to co-workers, “I wonder how he has any room left for food!”
While filling five or six or more prescriptions for the same customer, technicians often comment to other techs or to the pharmacist, “I wonder how he has any room left for food.” This comment is often met with nervous laughter because we are not supposed to discuss such heresy—the prospect that many pharmacy customers are overmedicated (or grossly overmedicated). We are being paid to be positive about pills.
Abundant absurdities in the world of pills
–Pharmacy customers may feel they’re insane when they realize that our medical system gives priority to pills rather than to prevention.
–Pharmacy customers may feel they’re insane when they realize that pharmaceuticals have a remarkable number of potentially scary side effects and yet these drugs are prescribed and swallowed like there’s no tomorrow.
–Pharmacy customers may feel they’re insane when they realize that most pharmaceuticals are synthetic substances, never before seen during the long course of evolution, which overwhelm or overpower delicate biological processes that have been fine-tuned over hundreds of thousands of years.
–Pharmacy customers may feel they’re insane when they realize that pharmaceuticals are not a natural approach to health which augment the miraculous healing power of Mother Nature.
–Pharmacy customers may feel they’re insane when they see the circus atmosphere which surrounds the promotion of these potent synthetic substances (pharmaceuticals) on TV.
–Pharmacy customers may feel they’re insane when they see how eager people are to take these drugs in light of the potentially scary side effects.
–Pharmacy customers may feel they’re insane when they understand that clinical trials typically do not compare the sponsor’s drug against dietary and lifestyle approaches. Clinical trials typically compare drugs against placebo.
People may think: “I must be insane for thinking these things because no one else seems to be troubled by these issues.”
There are a ton of examples of things that could cause pharmacy students, pharmacists, and pharmacy customers to think they’re insane as regards pharmaceuticals. That’s because the world of pills is absurd in so many ways such as the following:
[1] It is absurd that disease prevention is nearly absent from our medical system
The near absence of prevention in our medical system may cause people to feel they’re insane. Most people seem to have an innate sense that health is dependent on eating lots of fresh fruits and vegetables, losing weight, avoiding tobacco and alcohol, avoiding processed foods, avoiding being sedentary, etc. Many pharmacists feel that very common conditions like elevated blood pressure, elevated cholesterol, and type 2 diabetes are largely preventable with these changes. But the message from Pharma is that none of those preventive measures are important or relevant. According to Pharma, health is directly proportional to the consumption of pills.
Many pharmacists might feel they’re insane for questioning why our medical system focuses on pills to treat these preventable conditions, rather than utilizing non-drug approaches based on prevention. In my opinion, it is absurd that our medical system is based on prescribing pills for largely preventable conditions.
[2] It is absurd that the USA is one of only two nations that allow direct-to-consumer advertising of prescription drugs
Only two countries (USA and New Zealand) allow direct-to-consumer advertising of prescription drugs. How many times have you heard a friend or family member comment on these advertisements on TV by saying something like “Yeah, the drug can nearly kill you.” Or “It’s a wonder why people are so eager to take these medications.”
The only other country that allows DTC advertising has a very active oversight of Pharma
John Abramson, M.D. has been on the faculty of Harvard Medical School for twenty-five years, where he teaches health care policy. He is the author of Overdosed America: The Broken Promise of American Medicine (HarperCollins, 2004) and Sickening: How Big Pharma Broke American Health Care and How We Can Repair It (Harper Collins/Mariner, 2022).
During a 2024 interview on Joe Rogan’s podcast, Dr. Abramson states that, even though New Zealand is the only other country that allows these direct-to-consumer advertisements for prescription drugs, that country has a lot more controls on pharmaceuticals than the USA.
Host Joe Rogan’s first question to Dr. Abramson was, in fact, about these DTC commercials. In my opinion, this illustrates the extreme importance of this issue and it illustrates what an outlier the USA is in this regard. If you’re interested, host Joe Rogan asks Dr. Abramson this pivotal question at approximately one minute into the two- and one-half hour interview.
https://www.youtube.com/watch?v=Pg_uZGohUiU&t=127s
Joe Rogan: How is it that we’re only one of two countries on Earth that allows pharmaceutical companies to advertise?
John Abramson, M.D.: The United States and New Zealand allow drug companies to advertise. But New Zealand has very active oversight of its pharmaceutical program. Active oversight of the evaluation of the efficacy of the drugs and whether the pricing of the drugs is reasonable. So it turns out that even though we and New Zealand allow drug advertising, New Zealand spends the least per person amongst developed countries and we spend the most, by far.
Why Do We Allow TV Advertising Despite Our Suspicions About Pills?
From my perspective, the USA is the Wild West as regards advertising of prescription drugs. These commercials perhaps resemble the claims made by snake oil salesmen from a hundred years ago. Television may serve as a modern-day platform for selling today’s versions of yesterday’s elixirs, tonics, tinctures, potions, and salves which were of very dubious value. The American population is fair game for exploitation by Pharma because profits absolutely take priority over human health.
In my opinion, it is reasonable to ask how many of the products now filling pharmacy shelves are today’s versions of snake oil. Clearly FDA routinely approves products that do not come anywhere close to the layman’s definition of “safe and effective.”
Even though you may reflexively dismiss or ridicule Pharma’s TV commercials or press the mute button on your remote control as soon as they come on, my contention is that these commercials are extremely effective with a huge segment of the population in convincing them to think of pills rather than prevention.
Do you realize what an anomaly and outlier the USA is in allowing advertisements for prescription drugs directly to the public?
[3] It is absurd that FDA allows these drug commercials to be so dishonest and exploitative
Pharma uses silly cartoon characters, images of attractive people having fun on sunny days, and footage of dogs vigorously wagging their tails to distract you from the long list of potential side effects at the end of these commercials.
A rational person might reasonably ask, “Why is there such a circus atmosphere surrounding pharmaceuticals? These are serious substances with potentially very risky side effects. Why does FDA allow drug companies to portray these drugs like they’re a walk in the park?”
[4] It is absurd that the FDA claims that all the drugs the agency approves are “safe and effective”
The FDA states that all the products it approves are “safe and effective” yet many of these products have very serious potential side effects listed, including death. Pharmacy customers may feel they’re insane when they see that the FDA’s definition of “safe and effective” is vastly different from the layman’s definition.
[5] It is absurd that FDA allows drug companies to cite “relative risk reduction” rather than “absolute risk reduction”
This makes the drug look far more beneficial than it is in reality.
[6] It is absurd that FDA allows drug companies to cite “surrogate endpoints” or “surrogate markers” rather than “decrease in all-cause mortality”
This makes the drug look far more beneficial than it is in reality.
[7] It is absurd that FDA does not require that drug companies include NNT (Number Needed to Treat) in all drug advertisements
[8] It is absurd that FDA very often approves drugs that are only very marginally better than a placebo.
Very many drugs are approved that demonstrate only marginal benefit over a placebo. When one factors in the side effects, the placebo might reasonably be considered the superior agent. The placebo effect often accounts for much of the benefit that people receive from many classes of drugs.
[9] It is absurd that many commonly prescribed drugs cause tumors in lab animals
Commonly prescribed drugs are often linked to tumors and cancers in lab animals, often at a dose that is not far from the human dose on a pound-for-pound basis. A rational person cannot, in my opinion, be faulted for asking why these drugs are so commonly prescribed.
[10] It is absurd to give priority to cancer treatment rather than prevention
Pharmacy customers may feel they’re insane when they realize how absurd it is that our medical system gives priority to cancer treatment rather than prevention. This is a massively wrongheaded approach to a mostly preventable disease. The Merck Manual (17th edition, pp. 2591-2592) essentially states that up to 90% of cancer is preventable:
Environmental or nutritional factors probably account for up to 90% of human cancers. These factors include smoking; diet; and exposure to sunlight, chemicals, and drugs. Genetic, viral, and radiation factors may cause the rest.
The National Toxicology Program updates its “Report on Carcinogens” every few years. The latest (15th) edition lists 256 substances.
So why does our medical system give priority to cancer treatment rather than prevention? The answer is that there’s no money in prevention.
From Pharma’s perspective, the important fields of environmental toxicology and chemical carcinogenesis do not exist. Pharma refuses to acknowledge the health risks associated with the chemicals that are ubiquitous in the modern world and the fact that the modern world is making us sick.
[11] It is absurd that Pharma views cholesterol as an error in human evolution
Pharma’s massive war on cholesterol with statins is very interesting given the fact that cholesterol is ubiquitous throughout the human body and it is essential for proper cell functioning and for the production of hormones. Shouldn’t the focus be on diet, lifestyles, weight loss, avoiding being sedentary, avoiding processed foods, etc. rather than on the massive prescribing of statins?
[12] It is absurd that Pharma seems to view stomach acid as an error in evolution
Pharmacy customers may feel they’re insane when they understand Pharma’s all-out attack on stomach acid with antacids, acid suppressors, and proton pump inhibitors. Pharma seems to view stomach acid as an error in human evolution even though it is essential for life, essential for digesting food, and essential for killing noxious organisms in the foods we eat.
[13] It is absurd that Pharma views the menopause as a disorder and an error in human evolution
The potential harm from hormone replacement therapy includes cardiovascular disease and uterine cancer. In my opinion, evolution has determined that estrogen production should be very significantly decreased with the menopause but Pharma disagrees.
[14] It is absurd to blame all mental problems on a “brain chemical imbalance”
Pharma’s blaming all mental problems on a brain chemical imbalance rather than life circumstances is absurd. Pharma promotes the idea that all the following factors have no role in the causation of depression: abusive spouses, abusive parents, abusive bosses, abusive co-workers, the scars that remain from childhood, poverty, social isolation, loneliness, physical disabilities, unfulfilling jobs, unemployment, and a vacuous society that relentlessly promotes the idea that the purpose of life is the accumulation of material possessions. Our depressing life circumstances are irrelevant in Pharma’s self-serving, mechanistic, and reductionist view of mental problems.
Biological psychiatry has largely replaced psychoanalysis
Psychiatry has shifted from blaming our cold mother to blaming our brain chemistry. Psychoanalysis went out of fashion and was gradually replaced by what’s referred to as “biological psychiatry,” i.e. blaming brain chemistry rather than blaming our life circumstances. Clearly Pharma prefers a focus on brain chemistry because it legitimizes the massive prescribing of pills. Blaming depression on our life circumstances leaves Pharma out of the loop.
Almost immediately upon working in drug stores, I was struck by the massive number of people in our society who take antidepressants. I had been taught in pharmacy school that mental problems are primarily caused by chemical imbalances in the brain, primarily serotonin. This theory never made sense to me because it ignores the life circumstances of individuals that I felt were surely the primary cause of depression.
[15] It is absurd to expect to find a magic bullet for obesity
Many pharmacists feel that it is absurd for our medical system to focus on pills that treat obesity rather than address obesity with an emphasis on eating less food. The safety track record for anti-obesity drugs over the last several decades has been very disappointing. Yet Pharma remains undeterred because obesity is a gargantuan market for pills. Pharma wants people to view obesity as an error in physiology and biochemistry rather than as an inappropriate relationship with food.
[16] It is absurd that pharmacists’ counseling typically mentions only mild side effects
Is it absurd that, when pharmacists counsel you about your medications, they typically mention only one or two potential side effects even though there may be 50 to 200 or more listed in the official prescribing information. It is absurd that pharmacists typically mention only “mild” side effects like nausea, vomiting, diarrhea, upset stomach, etc. rather than more serious side effects like aplastic anemia, agranulocytosis, thrombocytopenia, leukopenia, lupus, liver damage, kidney damage, etc.
An article in Pharmacy Times (Feb. 2, 2016) titled “10 Scariest Prescription Drug Side Effects” lists many drugs which potentially have the following side effects: hallucinations, memory loss, priapism, blood clots, compulsive behaviors, Stevens-Johnson syndrome, birth defects, cancer, suicidality, and death. You can be sure that your pharmacist doesn’t mention these side effects during your brief counseling session.
[17] It is absurd that Pharma utilizes such strikingly crude drugs in a human body which is endlessly complex and miraculous
ne of the biggest culture shocks in my lifetime was the experience in pharmacy school of seeing that pharmaceuticals are such crude substances in comparison to the majestic, marvelous, miraculous, and magical human body and that such potentially risky substances are used routinely to treat preventable diseases of modern civilization. I felt that I was surely insane in pharmacy school because none of my classmates seemed to be questioning the rationality of a health care system based on such potentially risky pills for conditions that are largely preventable.
I think that pharmacists have perhaps learned to compartmentalize the subject of adverse effects so that these risks are just an ancillary or peripheral concern rather than the primary concern. This may help moderate the cognitive dissonance that accompanies pharmacists’ need to be positive about the pills we dispense.
[18] It is absurd that Pharma appends the word “disorder” to medicalize common human behaviors
Pharma appends the word “disorder” to common behaviors to legitimize the widespread use of pills. For example, shyness is now “social anxiety disorder.” The winter blues are now “seasonal affective disorder.” Road rage is now “intermittent explosive disorder.” Excessive handwashing is now “obsessive compulsive disorder.” Excessive gambling is now “compulsive gambling disorder.” Excessive shopping is now “compulsive shopping disorder.” Unruly kids or kids who do poorly in school are now labeled with “attention deficit hyperactivity disorder.” The adverse health effects of working the overnight shift are now referred to as “shift work sleep disorder.”
Pharma-induced insanity disorder
I suggest that Pharma needs to create a pill to treat the feeling of insanity that is a consequence of being exposed to Pharma’s deceptions, dishonesty, and distorted view of reality. I propose that an appropriate label for this condition is “Pharma-induced insanity disorder.”
In my opinion, a large number of pharmacy customers feel they are insane because so much in the world of pills is absurd. Perhaps many of these pharmacy customers are nagged by the suspicion that marketing is what drives pharmacy today, not science.
[19] It is absurd and dangerous that the chain drug store model for profitability is based on understaffing
Basing the chain drug store model on understaffing forces everyone to work at maximum output for their entire shift. Even though this increases store profits, it also increases pharmacy mistakes. The big drug store chains prefer to have pharmacists sling out prescription drugs at lightning speed, and then compensate those customers inevitably harmed by these mistakes, rather than provide adequate staffing for the safe filling of prescriptions.
The big drug store chains feel that settlements for pharmacy mistakes are simply a cost of doing business, no different from the lease, the water bill, the electric bill, janitorial services, landscaping services, payroll, fees for licenses (liquor license, board of pharmacy license), cost of inventory, etc.
Pharmacists can easily feel they’re insane for questioning why the big drug store chains would run their operations in such a reckless manner by making the cold calculation that bottom line profits are more important than the health and safety of our customers.
Chain store pharmacists work all day in insanely understaffed pharmacies that are a constant threat to the public safety. Pharmacists spend their days filling prescriptions for mostly preventable diseases of modern civilization. Thus feelings of absurdity and insanity can easily dominate a pharmacist’s outlook toward his/her job.
In conclusion
In my opinion, the health professions are fundamentally dishonest because they give priority to pills rather than prevention. That’s because there’s much more money in treatment than prevention.
Modern medicine is a rigid belief system in which pill skeptics and critics are marginalized and derided as heretics who are endangering the public health.
Do you ever think that many of the drugs advertised on TV are modern day versions of Dr. Feelgood’s tonic? If you do, you’re not alone.
Physicians prescribe pills and pharmacy customers swallow pills like there’s no tomorrow. Yet I suspect that many people have a nagging suspicion that their local farmers market has more to do with health than their local drug store.
The modern grocery store is under intense criticism for selling so many highly processed foods with poorly understood risks to health. Yet the modern drug store represents an even higher level of artificiality with products that are accompanied by long lists of potential adverse effects.
Pharma’s strategy is to flood the airwaves (“flood the zone”) with BS so that the public is totally confused, doesn’t know up from down, right from wrong, fact from fiction. As a result, people throw up their hands in exasperation and submit to Pharma’s seductive message: There’s a wonderfully safe and effective pill for every ill. It would be a very compelling message if it were true. But it is not true. It’s enough to make you feel you’re insane.
Dennis Miller, R.Ph. is a retired chain store pharmacist. His book, The Shocking Truth About Pharmacy: A Pharmacist Reveals All the Disturbing Secrets, can be downloaded in its entirety at Amazon for 99 cents.
