A prerequisite to making an informed decision about “medication” is knowledge.

Most people, including politicians, assume that doctors are the ones who know all about drugs. Why? Because doctors and only doctors have the authority to decide who takes which drugs, over-the-counter medications excepted. “They must have that authority for a reason,” people think, forgetting why the politicians of their grandparents’ time bestowed that authority on doctors in the first place. They did so not in recognition of physicians’ superior knowledge on the subject, but to exercise government control over drug (opium) use.

The first “opium” law, as the law controlling drug use is called in the Netherlands, was ruled by the United States government in 1914. From there it spread throughout the industrialized world. Few people today remember the era when there was a free pharmaceutical market. We take the doctor’s role as controller of drug use for granted, without questioning it. In addition to addressing the political issue involved, namely free access to medicines versus access to medicines severely limited by the state, we should ask ourselves whether doctors are truly qualified to inform us about these products. If not, who is?

Manufacturers of course are more than happy to inundate us with information about their products. Obviously we cannot expect such information to be unbiased.

Many people trust the government to have expertise in pharmaceutical products. We must remember that “the government” is in reality a collection of people vulnerable to political and other influences. There is no reason to trust our governments’ judgment on drugs more than on any other matter. By nature a stand taken by “the government” is controversial, not objective.

We assume that doctors are unbiased and educated about drugs. In recent years investigative journalists have raised questions about physicians’ objectivity in view of the drug companies’ aggressive marketing strategies. Questions about doctors’ knowledge about the drugs they prescribe have yet to be posed.
Try testing it yourself. The next time your family doctor or psychiatrist writes a prescription, ask him/her what that drug’s half-life is or how it is eliminated from the body. Chances are your doctor will either say s/he doesn’t know or pooh-pooh your question.

Pharmacochemistry – the science that deals with drugs – is not required for a medical diploma and most doctors have not studied it. A pharmacist is likely to know more about drugs than a doctor. The doctor, unless he is a surgeon, is mainly a diagnostician.

Of course before 1914 when doctors first gained their controlling role they already prescribed various treatments for the ailments they diagnosed. Some of those treatments were “medicines.” Today we tend to smile and assume those medicines weren’t much different in efficacy from Coca-Cola, invented by Dr. John S. Pemberton in 1886 and marketed through pharmacies as “an esteemed brain tonic.” (Reader’s Digest Association, Inc., How in the World, 1990). In 1914 there wasn’t much to control besides opium.

The second half of the twentieth century was marked by an explosive expansion in the supply of pharmaceutical products. Physicians, though still performing their government decreed role as controllers of drug use, remained mainly diagnosticians. The medical and pharmaceutical professions were not merged. De facto doctors have acquired a third role. Targeted by the pharmaceutical companies’ marketing campaigns, they have subtly become marketing agents for those companies, again, without pharmacochemical training.

So where do we find reliable information? Perhaps no information is completely reliable. However, we as “patients” should and can have access to whatever information exists.

It may be that when you asked your doctor about the half-life of a drug s/he prescribed or how it is eliminated from the body, s/he took a big book off the shelf and looked up the answer. That book is not a top secret catalogue of magic formulas. You can read that book too. Find out the name and order one too.

Your pharmacist also uses this type of book. S/he can inform you where you can buy one. If it's exhorbitantly expensive, s/he may not object to your borrowing his/hers, as long as you don't remove it from the pharmacy.

Public libraries and the Internet provide a wealth of information. Be sure to check the source of the information, and look for different viewpoints about the same treatment. Many hospitals and medical faculties at universities also open their libraries for the general public.

There is no reason why these sources would be accessible only to physicians. We all have the moral right to be our own doctors. Consumers’ organizations active in the health fields can benefit people by informing them about these resources and encouraging people to consult them before having a doctor’s prescription filled.

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