Prescription drugs
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I first met Dana in the intensive care unit after she had undergone surgery to repair a heart valve. The surgery was complicated by pulmonary hypertension, a condition in which the pressure in the pulmonary vessels (those in the lungs) is much higher than normal.

This contributed to her abnormal heart rhythm and right-sided heart failure. Week after week this 45-year-old in the prime of life became weaker and weaker, and the specialists, the medications, the ventilator, the feeding tube, the dialysis and everything else modern medicine had to offer could not “fix” the problems.

Before her illness, Dana had not smoked, drunk or used illicit drugs. She had been a member of the track team in high school. In fact, years before, an episode of palpitations had results in thorough medical evaluation. This included blood work, a complete history and physical, an electrocardiogram, a 24-hour monitor, and an echocardiogram. Everything was normal. Dana’s palpitations turned out to be from drinking too much caffeine and vanished when Dana increased her caffeine intake and drank more water.

Dana was happily married with two children. Her daughter, Rhonda, was engaged to be married and was graduating from college the same month as her wedding. As one might expect, Dana and her daughter were excited about the upcoming event, and Dana was involved with all the details.

In preparation for the wedding, Dana wanted to lose some weight. She saw her family doctor, who recommended a diet and moderate exercise program. But Dana wanted a quick fix. With the upcoming wedding, she felt she did not have the time to lose the weight slowly as her doctor suggested. Some friends had lost weight quickly with a diet medication cal Fen-Phen. Dana got a prescription for the medication and lost 20 pounds quickly.

At first she felt great, with boundless energy. She was proud when others noticed her girlish figure returning and commented on how good she looked. However, this energetic feeling lasted only temporary. After a while, even the simplest activity left Dana short of breath, and she was tired all of the time. Something was terribly wrong. She saw her doctor who discovered a heart valve problem. How could this have happened? She had never had a heart problem before.

It was about this time that the Mayo Clinic first reported 24 cases of heart valve damage attributed to Fen-Phen. Yes, the medication had damaged Dana’s heart valve to the point that nothing more could be done to help her. She passed away soon after her daughter’s wedding and graduation.

Let me ask you a question: What do Michael Jackson, Whitney Houston, Heath Ledger, John Belushi, Chris Farley, Anna Nicole Smith, Elvis Presley and yes, Dr. Sigmund Freud, have in common? No, it is not that they are entertainment icons or psychoanalysts. Their deaths were the results of the use of various medications—yes, medications.

Did these people die back of a lack of knowledge? Perhaps. But these are just a few of the well-known persons whose deaths have made front-page headlines. Let me tell you, we have a rapidly escalating problem. I do not want one more person to die from a lack of knowledge. Medications can kill. Medications do kill. Medications have killed. Medications are killing, and not nearly enough is being said. I hope to change this.

After I saw down to write the most significant introduction in my life as a physician, I found myself wondering, “What can I write to touch your heart? What can I write to help you to grasp the enormity of the problem? What words can I use that will enter your mind and change the way you think and live? In just a few short pages, these words have the opportunity to save more lives than anything else I have done in my profession as a cardiologist.

Words are sometimes inadequate when faced with a cultural worldwide problem. Words seem just as inadequate when I want to shake up the status quo, open your eyes and help you know the truth.

If doctors had known, most of them would not have written between three and four million prescriptions for Fen-Phen. William Osler, a highly respected Canadian physician and one of the founders of the medical school and Johns Hopkins Hospital, once said, “The person who takes medicine must recover twice, once from the disease and once from the medicine.”

With billions of prescriptions being written each year, medications are killing more and more individuals. I want to raise the possibility and make the case that medications are the leading cause of death, at least in North America, and perhaps the world.

In 2010, according to the National Vital Statistics Report released in January 2012, cardiovascular disease was the number one cause of death, claiming 595,000 lives in that year. Cancer was the second-leading cause of death, claiming 574,000 lives. Respiratory illness took 138,000 lives. These trends hold true throughout the world. The report also indicated that the incidence of deaths from cardiovascular causes was trending downward slightly and that cancer-related deaths were trending upward. Nowhere did the report mention that medications were a leading cause of death. But it should have.

One does not have to be a scientist to realize that there are hundreds of thousands of deaths never reported: deaths because of mistakes made during production of medications, including manufacturing and even labeling; and mistakes made by medical personnel, including doctors, nurses and pharmacists. There are deaths that result from adverse reactions, including anaphylaxis (hypersensitivity); deaths to the unborn caused by medications take by their mothers; deaths from overdoses and addictions, which are not at epidemic proportions; deaths from impairment caused by certain medications; and deaths from misuse and inappropriate use of medication, which are considerable.

All of these deaths must be added to the total number of deaths indicated by the government report. If we were able to factor these in, we would see that medications are the number one cause of death, far surpassing cardiovascular disease. …

It only makes sense that as more and more medications are prescribed and as more and more over-the-counter drugs used for a myriad of symptoms find their way into our medicine cabinets, these numbers will continue to rise. I can say, with logic and with limited statistics, that death by medications is the number one cause of death, and the number continues to rise.

I am a physician trained in internal medicine and cardiology. I try to prevent deaths from cardiovascular disease. But it is plausible to conclude—after studying these numbers and thinking about the problem of medications—that my time seeing patients might be better spent combating deaths from medications and educating the world about the dangers of taking prescription and non-prescription medications. In the long run, I might save more lives.

Note: The preceding is an excerpt from James L. Marcum, M.D.’s book, Medicines That Kill: The Truth About the Hidden Epidemic. Marcum is a board-certified behavioral cardiologist with a thriving practice at the prestigious Chattanooga Heart Institute. USA Today’s Qforma named him one of the nation’s most influential physicians.

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