E-drug: Helsinki Declaration (cont)
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Dear Colleagues,
Like Dr. Offerhaus, I find it instructive at time to reminisce about the
19th century medical history. Two stories of legends come quickly to
mind. Sir William Osler, the father of clinical medicine, had a
favorite
prescription for diabetes: one grain of opium three times a day. I
am sure he had happy patients (quality of life?). Young Sigmund
Freud on the other hand had the cure Osler's induced dependence. The
effective launch of cocaine was 1884, when Freud published his work,
on Coca. Freud
specifically recommended cocaine as a cure for addiction to alcohol,
opium and morphine, hoping to attain medical "immortality." He based
his belief of the drug's therapeutic value on his use of the
substance, uncontrolled observations reported in two obscure American
medical journals, and the manufacturers' claims.
Judging from continuing reports of the extent of drug induced injury, it
does not appear that much has changed since the 19th century
regarding the basis on which physicians prescribe drugs. Requiring
prescribers to take some of the same courses that pharmacists do may
improve prescribing. Both professions need to be much more adept and
critical at evaluating drug information. The only workable solution
to inappropriate prescribing and the public safety may be enforceable
regulations on exactly how some of the more dangerous drugs can be
prescribed and dispensed.
Both medicine and pharmacy have skeletons in their respective closets
and perhaps the reason that the history of these professions is not
taught in great depth is because so much of it is so embarrassing.
Dr. Offerhaus' parting salutation of "Good Luck" should be directed
at patients.
In many parts of the world patients self-diagnose and treat
themselves. In other counties, patients who have diagnosed their
illness are in fact
"treated" by pharmacists if recommending a drug is considered
treatment. In Canada, schedule 2 and 3 drugs are under the control
of pharmacists to treat patients.
Best regards,
Sana R. Sukkari, B.Sc.Pharm., M.Phil.
Oncology/Palliative Care Pharmacist
Joseph Brant Memorial Hospital
1230 North Shore Blvd.
Burlington, Ontario
L7R 4C4
e-mail: ssukkari@jbmh.com
Tel: (905) 632 3737 ext.: 5636
Fax: (905) 336 6492
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