Drug CompaniesBen Goldacre, the author of Bad Pharma, seems fixated on issues within the pharmaceutical industry which have long been addressed (6 October, p 28).
He claims that "drugs are tested in poorly designed studies... selectively reported, with unflattering data hidden". In the UK there is a robust system of regulation for the undertaking and reporting of clinical trials. They must be approved by both the Medicines and Healthcare Products Regulatory Authority and an ethics committee. We work closely with regulators to ensure that patients are not exposed to ineffective medicines.
Additionally, Goldacre talks about the pharmaceutical industry being "allowed to distort the evidence on how good a drug is", and that it seeks to hide trial data. All clinical trial data relating to the quality, efficacy and safety of a medicine must be submitted to regulatory authorities for review. If the benefits are not deemed to outweigh the risks, it will not be licensed for use.
Trial results are published on websites such as clinicaltrials.gov, and many companies, such as GSK, publish both positive and negative data on their websites. We do acknowledge that it is far more difficult to get negative trial results published in journals, but we are working with healthcare professionals to change this.
One solution to Ben Goldacre's worries over transparency would be to set up a public drug-testing agency. Companies could then pay it to conduct, or commission, trials of safety and efficacy before any licence is issued. The brief would include a requirement to publish the results of all trials, even if the company decided to withdraw its licence application.
AddictionFurther to your look at addiction (8 September, p 36), the overarching clinical and scientific language on this subject is one of puritanical moralism, with drug use and so on being a sin that leads to death and damnation, which can only be escaped through repentance, reform, rehabilitation and salvation.
As a psychiatrist in this field, I have suggested that addictive substances including alcohol and nicotine may, in a minority of users, become the object of brain systems of attachment, such as that governing the attachment of child to mother. The result is that we become attached to the drug, with all the power, passion and drive of an attachment to another person.
Using this picture, we can talk of attachment not addiction, yearning not craving and reunion not relapse.
A significant prediction of this model is that reunion/relapse would be the norm, and abstinence or moderation an unstable state of affairs.
From RedditDuring the Russo-Japanese war the Russians sent their Baltic fleet to Japan in the worst way possible which included firing on British fishing ships and almost starting another war, firing on their own boats, taking clothes fit for Russian weather whilst travelling around Africa and accidentally taking a lot of opium whilst sailing.
You left out the part where they sailed half-way around the world only to be sunk practically immediately.
How did they 'accidentally' take a lot of opium?
Dmitry said it was seasoning!
Gateway DrugsYour interview with Denise Kandel gave the impression that mouse experiments show there is such a thing as a "gateway effect", in which nicotine use leads to the use of other drugs (7 March, p 28). But we have solid and clear human data.
Over the past 60 years, the prevalence of smoking among young men in the UK has declined from 80 per cent to under 20 per cent. If use of nicotine increased use of other drugs, this steep reduction in smoking would have resulted in a drop in the use of other drugs as well. There is no sign of this. The gateway effect is an attractive hypothesis but it does not exist.
Wine Collections(rich guy had his prize wine collection ruined by air-conditioning failure)
I too sympathise with Mr Raptis as I'm an avid wine collector. I've accumulated many collections over the years but I never seem to get beyond 12 bottles or so before some friends arrive and we feel compelled to taste it to make sure it's OK. I then start another collection and so the story goes on.... Oh! The problems life throws at some of us.
It's not flippant. The man has lost £200,000 worth of an investment. Would it make a difference if a mechanic had ruined a vintage Rolls Royce? Or a bad furniture restorer had ruined a houseful of antiques? Why do you think it's flippant because it's wine?
BaileysIcame across some photos of my late grandparents, and reflected upon just how much I loved seeing in the new year with them. They were always warm, funny and optimistic. They were also wonderful Christians. They lived for their faith, but never thrust it down your throat, preferring to show their commitment (which I didn’t share) with kindness.
But I have a confession. Both were teetotal for more than 60 years, believing that alcohol was not in “God’s plan for the world”. And yet one New Year’s Eve, Grandad innocently poured himself a Baileys Irish Cream not realising it contained whiskey.
Nobody noticed until he started laughing even more than usual. The stories from his extraordinary childhood in the Rhondda Valley, where he worked as a miner from the age of 14, were flowing, he poured Nana a glass, and the evening rattled along. It was only when he got up for a refill that the rest of us cottoned on. I caught my mum’s eye, then my brother’s, but none of us breathed a word.
Should we have told them? We debated the question at length the next day, and never quite resolved it. But looking back, I just wish we had got tipsy together more often. They would have laughed even more than usual, and we could have enjoyed more of those magical moments that so often emerge from a shared glass or two.
And I doubt that God would have minded one little bit.