Wed, Apr 07, 2004 - Page 16 News List

Drug use or abuse? `Pharmaceutical Man' has arrived

Drug sales are increasing worldwide as people medicate themselves throughout life in the pursuit of happiness

NY TIMES NEWS SERVICE , NEW YORK

In the popular imagination, the technologically altered human being is a cross between RoboCop and the Borg.

The hardware that would make such a mating of humans, silicon chips and assorted weaponry a reality is, unfortunately, still on back order.

Many people, however, have already made a different kind of leap into the posthuman future.

Their jump is biochemical, mediated by proton-pump inhibitors, serotonin boosters and other drugs that have become permanent additives to many human bloodstreams.

Over the past half century, health-conscious, well-insured, educated people in the US and in other wealthy countries have come to take being medicated for granted.

More people shift to the pill-taking life every year, to the delight of pharmaceutical manufacturers. Indeed, drug sales suggest how willing people are to pursue better living through chemistry.

Last year, retail drug sales worldwide were US$317 billion. In the US alone, consumers spent US$163 billion on drugs. In North America, the use of drugs that affect the central nervous system, such as anti-depressants, increased 17 percent. No group has escaped. Last week the US Centers for Disease Control and Prevention reported that 10 million children took prescription medication for three months or longer in 2002, and preschoolers, another study found, are now the fastest growing group of children receiving anti-depressants.

This is a social change on the same order as the advent of computers, but one that is taking place inside the human body. Just 50 years ago, according to a report by IMS Health, a company that tracks the pharmaceutical industry, the two biggest-selling over-the-counter drugs were Bufferin and Geritol. The prescription drug business was tiny. In 1954, according to IMS, Johnson & Johnson had US$204 million in revenue. Now it is about US$36 billion. In 1954, Merck took in US$1.5 million in drug sales; in 2002, that figure was US$52 billion.

To look at it in another way, Americans take so many drugs that some researchers -- such as Dr. Christian Daughton of the Environmental Protection Agency's National Exposure Research Laboratory in Las Vegas, for example -- are worried about the effects on the environment. What does it mean if the sewers run rich with Zoloft? Or to be more precise, what might happen to fish eggs if the rivers soak up waste water with discarded and excreted pharmaceuticals and personal care products, like shampoo?

No one has the answer yet, but the idea that what runs through our collective bloodstream is a potential environmental hazard makes you look at your medicine cabinet in a different way.

In short, while the "Six Million Dollar Man" is still a fantasy, "Pharmaceutical Man" is already here, and largely unnoticed. Swallowing a pill at a business lunch is likely to elicit little curiosity. A high-powered executive who did not have blood pressure or cholesterol problems might be suspect. There are concerns about the widespread use of anti-depressants, but they do not seem to have affected sales.

In fact, the group of anti-depressants that includes Zoloft is the third biggest class of pharmaceuticals by sales in the US, totaling US$11 billion in 2003.

Drugs in the top two categories -- statins to reduce cholesterol levels and proton pump inhibitors to prevent heartburn, gastritis, ulcers and other digestive problems -- had sales of about $14 billion and US$13 billion, respectively.

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