Healthy Skepticism Library item: 2946

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: Journal Article

Waldron I.
Increased prescribing of Valium, Librium, and other drugs--an example of the influence of economic and social factors on the practice of medicine.
Int J Health Serv 1977; 7:(1):37-62

Abstract:

Drug prescriptions per capita in the United States have more than doubled since 1950 without a commensurate improvement in health. Drugs are often prescribed for clinical conditions in which therapeutic benefits do not outweigh the risk of adverse drug reactions. Deaths due to adverse drug reactions are roughly as frequent as deaths due to automobile accidents. Valium and Librium are the first and fourth most commonly prescribed drugs in the U.S., used by one ten adults each year. The rapid rise in use of these drugs has occurred during a period of rising social stress, as indicated by increases in alcohol consumption, suicide, and homicide, Valium and Librium are frequently prescribe for patients who go to doctors with social or other nonmedical problems, often in lieu of attempts to resolve these underlying problems. Overprescribing occurs because the decision to prescribe is influenced not only by consideration of therapeutic benefit, but also by nonmedical factors, for example the widespread expectation by both patient and doctor that the doctor will provide a drug or some other technological treatment. Prescribing decisions are also influenced by the profit-motivated activities of drug companies, including the expenditure of almost one-quarter of every sales dollar on drug promotion. The most widely used source of drug information for doctors is the industry-sponsored Physicians’ Desk Reference, which overrates the therapeutic value of Valium and Librium as compared to disinterested medical sources. Drug companies also contribute to overprescribing by introducing numerous minor variants of existing drugs. The therapeutic benefits of such new drugs are often overestimated in the early years of use when adverse side effects are not well known and apparent efficacy is enhanced by placebo effects in uncontrolled observations.

Keywords:
*analysis/United States/psychotropic drugs/quality of prescribing/medicalization of problems/source of information/quality of information/ PDR/ Physicians’ Desk Reference/ safety & risk information/ Valium/ Hoffman-LaRoche/Librium/doctors/EVALUATION OF PROMOTION: COMMERCIAL DRUG COMPENDIA/INFLUENCE OF PROMOTION: MEDICALIZATION OF PROBLEMS/INFLUENCE OF PROMOTION: PRESCRIBING, DRUG USE/PROMOTION AS A SOURCE OF INFORMATION: DOCTORS/PROMOTION IN SPECIFIC THERAPEUTIC AREAS: PSYCHIATRIC DISEASES Adult Advertising Aged Anxiety/drug therapy Child Chlordiazepoxide/adverse effects Chlordiazepoxide/therapeutic use* Clinical Trials Diazepam/adverse effects Diazepam/therapeutic use* Drug Evaluation Drug Industry Drug Utilization* Economics Female Humans Male Pharmacopoeias Prescriptions, Drug Psychophysiologic Disorders/drug therapy Social Problems United States