Ed Note: This is the first of a 5 part series on Pharmaceutical Rape by Laurie Oakley. We are looking for images to illustrate the series and would welcome any cartoons or other images that are germane to themes below. The first image here is Martin Shkreli, the man who raised the price of Daraprim by 5000% recently on the back of claims that profit was necessary for research activities.
PHARMACEUTICAL RAPE is a relatively new phenomenon. It is a culturally invisible harm outside the domains of public, medical, and political discourse. However this type of violation is commonplace and stories of these harms are especially visible on internet forums. This new definition is meant to challenge the current, widely accepted societal assumptions about pharmaceutical harms, their prevalence, causes and consequences. It provides an alternative framework for defining and interpreting serious adverse events that are rooted in corporate pharmaceutical behavior. Through this definition it is hoped that pharmaceutical violence will begin to be publicly recognized as the serious public health problem.
Pharmaceutical rape stems from the collective decisions of powerful individuals within an industry-government-medical trade alliance. It is an offense that results in an invasive violation of bodily autonomy for the victim. A pharmaceutical product is introduced into one’s body that causes harm — something one did not consent to — something that one had a legal right to more information about so that a different choice could have been made. Most often, it involves trusting and having that trust violated.
In April 2011, I was prescribed Cipro (ciprofloxacin) for an uncomplicated, routine urinary tract infection. After only 6 days of 250mg twice daily, I was suddenly hit with a host of symptoms. Within two hours I went from being a healthy, 49-year-old to someone mutilated from head to toe, fighting for my life. My life has changed irreversibly. I have medical documentation of partial paralysis, head to toe tendon damage, hearing loss, heart murmur, kidney and liver damage, erythema multiforme, extreme food allergies.
I was initially told that these symptoms, especially appearing collectively, was “rare.” While this did little to help me, at least I thought I was just unlucky. Imagine my horror when I found that, even using conservative numbers, hundreds of people are poisoned from fluoroquinolones each year with the same devastating result I endure. Not only are there countless scores of facebook, YouTube, and blogs on the internet from people with crippling stories almost exactly like mine, there are many people I have met within just my local area that are suffering in this same way. There is ample documentation to show that the FDA knows that these effects appear syndromically. The FDA knows the devastation caused by fluoroquinolones. Yet, the FDA allows these “medications” to be used in a flippantly casual manner by unknowing doctors with only a black box warning of possible tendon damage. Possible tendon damage implies a bad case of tennis elbow or, at worst, a rupture of the Achilles tendon. Nothing can explain my terror at suddenly having every tendon in my body as fragile as wet tissue paper. Nothing can explain the heartache of having to be fed like a baby by my eight-year-old child or being unable to use the bathroom without the assistance of others. Although I have made improvements in the last seven months, my chance of complete recovery, based upon expert information, is almost non-existent.
MedWatch, as it currently stands, does not work as an accurate reporting system. It requires doctors to report on their own errors. If physicians recognized the error, it is doubtful they would have made it in the first place. My PCP is a conscientious physician but just did not have enough information on the effects of fluoroquinolones. He reported to MedWatch that I was “recovered” only about 10 weeks out from the onset of my initial symptoms because I was no longer using a wheelchair full-time. He simply could not believe that the plethora of symptoms I suddenly had could be caused by a drug. I have to agree that it is completely unbelievable that anything so dangerous would be out on the market.
The subsequent specialists I now see: cardiologist, nephrologist, endocrinologist, immunologist, orthopedist, GI specialist, neurologist, physical therapist, etc., feel they cannot report my symptoms to MedWatch because I was not under their care at the time of the poisoning and, so, cannot confirm the cause and effect.
There is no established first-aid protocol for those poisoned by fluoroquinolones. We called the Poison Control Center. They confirmed that the effects I was experiencing were caused by Cipro but when we asked what to do they said, “Well, if you rupture, go to the emergency room.” This was not helpful. My doctor also prescribed NSAIDS. Not only should physicians be informed that NSAIDS and steroids are contraindicated, there should be an intervention that includes the immediate administration of antacids or something to bind the remaining fluoroquinolone in an attempt to reduce damage.
—RxISK. September 7, 2012
The driving causes of pharmaceutical rape are drug industry influence in the medical setting and the commodification of healthcare. Because this type of violence does occur, it constitutes a social problem that must become an accepted fact to be addressed within wider society.
The word rape
Pharmaceutical rape is not a metaphor for sexual rape*. It is a life-altering violation with parallels to child sexual abuse and rape. This writing borrows from a wide range of activism literature including feminist definitions of child sexual abuse and rape. It should serve to raise awareness for both issues.
For some, the use of the word rape in this context is offensive. I have been told that it trivializes “real” rape and retraumatizes survivors. Speaking only for myself as a survivor, I don’t agree.
If you are not comfortable with this usage and yet think these definitions apply, feel free to use whatever words work for you. If you decide to use the word, please note that there is a radical type of social justice warrior who may challenge (i.e. bully) you on this.
“I have decided to stick with Love.
Hate is too great a burden to bear.”
—Martin Luther King Jr.
I would suggest taking the high road:
- Don’t be like them. This type of activist seeks not to understand but to dominate. They often “call out” others whom they choose to be offended by before considering who the person is or where they might be coming from. One thing you will never see this type of social justice warrior do is ask a question. Asking for clarification might lead to a better understanding and that would ruin all the fun.
- Be like them. This type of activist demands to be heard. When the subject is a particular form of oppression that you haven’t experienced, it’s your job to shut up and listen. While I don’t advocate being unkind, I believe these activists are onto something. When the subject is your pharmaceutical reality and one of them starts getting nasty (perhaps demanding you not use the word rape), tolerate none of their nonsense. Call them out for derailing your thread and keep the focus on pharmaceutical rape.
[*As a survivor of multiple traumas, including child sexual abuse/rape, I have found it essential to discover and use precise words to both name and make sense of my experiences. My choice to use the word rape to describe pharmaceutical violation comes not from a misunderstanding of the gravity of sexual assault, but from my understanding of it as an abuse of power that takes one by surprise, leaving confusion and destruction in its wake. It is my hope that this new definition can be approached with an open mind and that survivors of all abuses, regardless of what type, will extend the use of full vocabulary to fellow survivors.]
Other Definitions You Might Want To Know:
Word/Tone Police – One popular Urban Dictionary definition reads: tone police are people who focus on (and critique) how something is said, ignoring whether or not it is true. They will discard a true statement simply because they don’t like how it is presented. People who word/tone police take issue with the speech of others instead of hearing the message. They do not respect a person’s right to choose their own words and tone when expressing outrage for injustice they have experienced.
Dog Pile – Also from Urban Dictionary: a disagreement on an internet message board wherein one person says something [that is unpopular] and a large number of people comment in response to tell the person how wrong and/or horrible they are, and continue to disparage the original commenter beyond any reasonable time limit. People who contribute to a dog pile are usually reacting and therefore not listening. Their only concern is shutting up the person who triggered their reaction.
These kinds of behaviors have been used against the term pharmaceutical rape by people who either subscribe to a social justice dogma that prevents them from thinking critically, or who do not yet understand the seriousness of the current pharmaceutical reality. Fortunately or unfortunately, there are few things that exemplify a pharmaceutical rape culture more clearly, as well as our need to address it, than the knee-jerk reactions of these individuals.
Other things pharmaceutical rape is not:
Involuntary Treatment – Also referred to as forced drugging, this is: medical treatment undertaken without a person’s consent. In almost all cases, involuntary treatment refers to psychiatric treatment administered despite an individual’s objections. While forced drugging is considered a serious violation in its own right and often involves the use of pharmaceutical products that can cause life-altering harms, involuntary treatment in and of itself is not what is meant by this definition of pharmaceutical rape.
Recognized Side-Effects – A side-effect is described as: a secondary, typically undesirable effect of a drug or medical treatment. Recognized side-effects are acknowledged drug reactions that are included on medication warning labels. Some harms are going to occur even when risks are disclosed and precautions are taken. Pharmaceutical assault involves drug risks and reactions that patients have not been sufficently warned about. Many of these risks have gone intentionally unacknowledged, whether through bias in scientific research or failure to conduct follow-up studies, as well as failure to take anecdotal evidence seriously.
Medication Error – A medication error is described as: any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer. Such events may be related to professional practice, healthcare products, procedures, and systems including: prescribing, order communication, product labeling, packaging and nomenclature, compounding, dispensing, distribution, administration, education, monitoring, and use. Medication errors happen when things go wrong. Pharmaceutical violence results from intentional and systemic modes of operation within the drug industry and healthcare systems, as well as within academic, regulatory, and governmental institutions.
Medical Malpractice – The definition of medical malpractice is: any act or omission by a physician during treatment of a patient that deviates from accepted norms of practice in the medical community and causes an injury to the patient. While medical malpractice is considered professional negligence, or conduct that falls short of accepted medical standards, pharmaceutical violations always occur within the common, accepted standards of medical practice.
Tenets of Pharmaceutical Rape:
Full, informed consent is paramount. If any information for a pharmaceutical product is withheld, omitted, faulty, or misleading, full, informed consent is not possible. The lack of awareness of the full range of hazards about a drug should never obscure a basic acceptance that all drugs are poisons. Where adverse events are occurring and yet fail to become the subject of further attention or scientific study, this is pharmaceutical rape.
No pharmaceutical (including vaccines) is completely safe for everyone in all circumstances. Many have more dangers than are acknowledged. In the current climate, it is difficult if not impossible to judge whether or not full information for a product is being made available. Whenever a pharmaceutical treatment is offered, available alternatives must also be discussed.
Without judicious prescribing and adequate information, any patient can become a pharmaceutical rape victim. There are as many types of pharmaceutical violation as there are pharmaceutical products for which information has been withheld, omitted, or is faulty and/or misleading.
The Root of Pharmaceutical Rape:
The production and promotion of commercial products that have undisclosed/unacknowledged adverse outcomes for which complete scientific data has been withheld and/or kept unavailable for independent analysis. It is the continued promotion/prescribing of products irregardless of potential/unknown harms for which no follow-up studies are initiated or undertaken to confirm or rule out risks. It is the caviler prescribing of medications while ignoring or downplaying known risks.
In 2014, writing for Daily Kos, Lynn Vogel noted the lack of any meaningful response by medical authorities to the polypharmaceutically induced death of four-year-old Rebecca Riley:
“Psychiatrist Dr. Kayoko Kifuji of Tufts-New England Medical Center had prescribed 4-year old Rebecca Riley psychotropic drugs for more than a year prior to the child’s drug-induced death in December 2006.
“CBS News reported that Dr. Kifuji had authorized a prescription regimen of ten medications per day for her patient’s symptoms.
“Rebecca Riley’s death prompted national attention because her parents were charged and convicted of murder. Dr. Kayoko Kifuji continues to practice medicine.
“There has been no meaningful introspection on the part of the medical community regarding these polypharmaceutical practices and the FDA has not intervened. Enter ADHD on the computer and one will find numerous practitioners promising quick diagnosis and treatment.
“At the time of the 60 Minutes Rebecca Riley broadcast, one million children were receiving psychotropic drugs, today the figure is 6 million according to The New York Times. The number of deaths and impairments caused by these commonly-prescribed childhood drug cocktails are not dutifully tracked.
“Some of the medications attributed to Rebecca’s death were Depakote /750 mg, Seroquel /200 mg, and Clonidine /.35 mg. PhRMA members have repositioned these epileptic, depression, and hypertension control substances to treat ADHD and Bipolar disorders. These recycled drugs are not approved by the FDA for use in children under the age of six.”
— Daily Kos. Apr 29, 2014.
To simply consider the concept, pharmaceutical rape, (and the fact that it goes so widely unnoticed, not to mention unprosecuted), is to take instruction in the power relationship between the multi-billion-dollar pharmaceutical corporations and the individuals for whom their products are targeted.
Pharmaceutical rape involves the reckless behavior of industry decision makers (and those who collude with them) that results in bodily damage to individual persons. It results from aggressive corporate decisions as well as drug company dominance in governments, regulatory agencies, academic institutions, medical journals, the psychiatric establishment, medical and mental health care systems, front groups, and the media. Because pharmaceutical rape can be so physically and psychologically destructive to its individual victims, it is a type of violence as opposed to being merely an effect of fraud for financial reward.
In 2006, Rebecca Riley’s death brought widespread attention to the the emerging practice of the prescribing of powerful antipsychotics to toddlers who were being newly diagnosed with mental illness. These and other drugs that were being used off-label had never been tested in children. A report in the The Boston Globe, illustrated how “key opinion leaders” are rewarded by the pharmaceutical establishment to make this happen:
“Psychiatrists used to regard bipolar disorder as a disease that begins in young adulthood, but now some diagnose it in children scarcely out of diapers, treating them with powerful antipsychotic medications based on [Joseph] Biederman’s work.
“‘We need to treat these children. They are in a desperate state,’ Biederman said in an interview, producing a video clip of a tearful mother describing the way her preschool daughter assaulted her before the child began treatment for bipolar disorder. The chief of pediatric psychopharmacology at Mass. General, he compares his work to scientific breakthroughs of the past such as the first vaccinations against disease[…]
“Part of the criticism of Biederman speaks to a deeper issue in psychiatry: the extensive financial ties between the drug industry and researchers. Biederman has received research funding from 15 drug companies and serves as a paid speaker or adviser to seven of them, including Eli Lilly & Co. and Janssen Pharmaceuticals, which make the multi billion-dollar antipsychotic drugs Zyprexa and Risperdal, respectively. Though not much money was earmarked for bipolar research, critics say the resources help him advance his aggressive drug treatment philosophy.”
—The Boston Globe. June 17, 2007.
While Joseph Biederman may have faced some criticism after the pharmaceutical rape of Rebecca Riley, this kind of prescribing only escalated. Four years later, Forbes Magazine would report how the pharmaceutical industry responded to her death:
“It is not illegal for a doctor to prescribe a drug off-label, that is, for a non-FDA-approved use, but a drug marketer cannot lawfully encourage a doctor to do so. The profits in psychoactive drugs, however, make it tempting to flout the law. In the past four years, AstraZeneca, Pfizer, Eli Lilly, Bristol-Meyers Squibb, and Forest Labs have all settled federal charges of marketing psychoactive drugs off-label, at a cost running into hundreds of millions.”
—Forbes. June 30, 2011