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Kellie Jarvies
English 2010
Position/Proposal Paper



                          Prescription Drug Abuse: Enough is enough




       Drug, alcohol, and prescription drug addictionsexistin many people’s lives; addiction’s

outreach can be persistent,strong and relentless. Addiction doesn’t sleep;it picks and chooses

victims without regard to religion, race, or financial status, strikes without warning, and leaves

you staring at the shell of someone you once knew. Addictions to illegal drugs, alcohol, and

prescription drugsmirrormany of the same symptoms, a change in personality, social

withdrawal, defensiveness, blackouts and forgetfulness, to name a few. Whether you buy drugs

on the street, purchase alcoholin a store or have prescription drugs filled at the local

drugstore;addictionrears its ugly head in the samemenacingway. Loved ones of the addict get

caught up in the ugliness of addiction,leavethem with feelings of emptiness, questioning what

role they might have played in the addiction, and wondering where it all went wrong. We will

focus on our nation’s fastest growing drug problem, addiction to prescription drugs. In order to

make decisions regarding prescription drug abuse it becomes necessary to look at the medical

profession’s role in overprescribing and prescribing incorrectly, the pharmaceutical industry

incentives for “pushing” their drugs, and each patient’s individual responsibilityconcerning their

own personal health and well-being.
Jarvies/2


       A definition from Indiana University states: “Prescription drugs are controlled by the

federal government, requiring a patient to receive authorization from a doctor or other medical

professional to allow access to a specific quantity of the drug” (Health Billing and Insurance

Definitions).The tenmost abused prescription drugs are as follows:


               Ambien and Lunesta; primarily for insomnia treatment

               Xanax and Valium; anxiety and depression

               Hydrocodone; pain control

               Codeine; cough suppressant

               Adderall and Ritalin; ADHD and issues with trouble concentrating

               Fentanyl; pain control in cancer patients

               Morphine; moderate to severe pain treatment


(Morris). These prescription drugs marketed under many different names and reliefvalue, all

have the same effect; they become addictive and produce some kind of high whichbrands them

as valuable, leading to their misuse.This misuse often begins innocently with legitimate

prescription reasons, such as feeling pain, having anxiety, or becoming ill. Prescription drugs

can be a difficult addiction from which to break free, as time goes on the body becomes

accustomed to receiving this medication and builds a tolerance, requiring a higher dosage or

quantity to achieve the same results. When individuals try to detach themselves from the

drugs, the original problem seems to come back stronger, creating a powerful cycle which

needs professional help and treatment (Addictive Drug Index).
Jarvies/3


       A study of patient Robert Reynolds revealed that his family physician, Dr. Kevin

Buckwalter, prescribed Reynolds 180 hydrocodone and oxycodone pills per month for his lower

back pain. Reynolds, 50, became addicted and eventually shot himself in the head in October

2008. Buckwalter’s license was stripped when the Drug Enforcement Administration (DEA)

linked him to eight other patient deaths (Allen). Although physicians are providedwith

information informing them that prescription drugs can become highly addictive, they continue

to over-prescribecertain drugs, why? Much of the advertising, direct-to-consumer (DTC), leads

physicians to over-prescribing unnecessary, expensive, and potentially addictive drugs. Patients

looking for the “magic bullet”jump on the bandwagon and ask for brand names of drugs

advertised. Physicians are yielding to their patient’s requests for more medications rather than

recommend they change poor, unhealthy lifestyle habits. There are many reasons for over-

prescribing in addition to (DTC) advertising. Patient’s demands on physicians, the every-

increasing scientific discoveries, and the physician’spatient overload all contribute to physicians

frequently prescribing medications. Americans have come to expect an immediate cure for

what ails them and medications are fulfilling their requests(Crystal).While many physicians try

to do all they can to help their patients,there are those withstartling,underlying agendas. Some

physicians take the easy road to wealth, sometimes at the expense of patients’ lives. Some

physicians take kickbacks from the drug companies and “push” certain drugs to benefit

themselves financially. “Experts say a primary part of the problem is doctors who are careless

with their prescriptions or who prescribe the drugs as a way to make money” (Allen).This

method encourages physicians to become “legalized drug dealers” (Trescot).Research shows

that many doctors pull the prescription trigger too quickly (Everett).There is no questionthat for
Jarvies/4


many people, prescriptions can be beneficial, even lifesaving in many instances.Many

chronically ill patients lead more productive lives with assistance from prescription drugs.


       Even though prescription drugs can help many patients, hundreds of millions of

prescriptions can beprescribed wrong, either they are entirely unnecessary or unnecessarily

dangerous(Liu and Christensen).The responsibility lies heavily on physicians to take their role

seriously in patients’ lives. Patients and physicians should first treat symptoms with

comprehensive lifestyle changes. Patients depend on the expertise of physician’s degrees,trust

their judgments and opinions, often blindly.Problems such as insomnia, abdominal pain, high

blood pressure, mild adult-onset diabetes, obesity, anxiety, and situational depression often

have causes that respond very well to nondrug treatment and often the physicians can uncover

these causes by taking a careful history (Rochon). Physicians should recommend lifestyle

changes, as their first method,in treating these conditions rather than automatically reaching

for the prescription pad(Lazarou).


       Whilephysiciansare responsible for a large part of prescription drug abuse,

thepharmaceutical industryhas a greater role on our American society. The industry becomes

theprimary causein promoting,misprescribing, and overprescribing of drugs. They sell $216

billionworth of drugs in the United States alone.(Ukens)The American public needs to be aware,

when the profit incentivesare thatenormous, the industries agenda is NOTsaving human lives.

Consumers’must question their motives. In addition to American sales, global sales are just as

shocking, as per figure 1.
Jarvies/5




Figure 1- Big Pharma and Consumer Confusion



        There also lies another culprit in the pharmaceutical industry, the patents. Patents allow

the drug makers complete production rights for twenty years before competitors can market

generic versions. Generics save consumers as much as two-thirds of the original drug’s cost,

but they cut deeply into sales and profits of the original name-brand drugs (Greider). This gives

the pharmaceutical companies a huge incentive to invent or reformulate a new drug to replace

the old one. They spend billions on marketing so they will not lose their profits. They refused to

go down without a fight and they are fightingan unyielding battle.


        Therefore, the answer concerning abuse from physicians and pharmaceutical companies

becomes clear. Patients should takea large percentageof the responsibility fortheir ownhealth

and evaluate why new drugs are prescribed. The industry spends well in excess of $21 billion a
Jarvies/6


year to promote drugs using advertising and promotional tricks that push the envelope of being

false and misleading.The fastest-growing portionof drug advertisingdirectsads to patients not

doctors. An estimate from 1991 to 2002 claims (DTC) advertising expenditures in the United

States grew from about $60 million a year to $3 billion a year, an enormous increase in just

eleven years (PhRMA).




Figure 2- Jacky Law-Big Pharma



        Consumers have to question why profits increasedso drastically within such a short time

period.The answer appears obvious: its working and they are continuing tomanipulate us all.


        Consequently, patients cannot trust everything the pharmaceutical companies sell and

everythingtheir physicians say and prescribe.Some of the responsibility falls back on the

consumer. If consumers ceased buying unnecessary drugs, the pharmaceutical companies

recommend, they would lose a significant amount of their profit incentives.Patients need not
Jarvies/7


be paranoid, but need to research for themselves and look for sound lifestyle changes as the

alternative, when appropriate.


                                                             My personal involvement with

                                                     others’ prescription drugs, alcohol, and

                                                     illegal drug addictions entangles me

                                                     profoundly and repeatedly. Close members

                                                     of my own family have recently completed

                                                     rehab for prescription drug addictions

                                                     andother family members still struggle with
   Figure 3-McKay-Dee Hospital in Ogden, Utah
                                                     their addictions. Alcohol addictions continue

totirelessly tug at my heart because of the concern I have for those still affected byits long

termeffects.


       Recently, my close family member, whonot long ago went through rehab, required

many visits to the hospital for various reasons. This family memberwas offered an assortment

of opiate/painkillers, even though everyone within shouting distance was informed of the

addictive behavior and past drug addiction. The doctor finally informed all personnel, after

several attempts were made by my sister and me, to stop giving this patient any more addictive

medication. We finally connected to him when we asked, “Would you prescribe these drugs to

your loved one and would you be willing to take them home and start rehab again.” The

medical community is programmed to get a patient out of “pain” and on their way home. This

leaves the families to deal with the aftermath of addiction. Ourpersuasiveness accomplished
Jarvies/8


our goal for that particular visit but there have been additional visits to other hospitalsand the

process starts all over again.Our vigilance has not always constituted success with other

doctors.




  I also experience situations concerning my husband’s health. For the last eight or so years he

has been prescribed many different drugs for his high blood pressure, high cholesterol,

diabetes, chronic back pain, and other ailments. The physician prescribes mixturesof

prescription drugs that have numerous side effects and then prescribes more drugs to combat

the additional side effects.It has been a continuous circle ofdifficulties. Weaning off some of his

prescription drugs slowly helped offset some of the side effects but the battle continues.Some

lifestyle changes, exercise and healthy eating choices, will help him have a more productive and

healthy life. There can be different alternatives and solutions; I have personal proof of their

continued effectiveness.


       In comparison, at different times throughout my life,different physiciansadvised me to

take prescriptions for: high blood pressure, insomnia, hot flashes, panic attacks, and minor back

pain. Instead of caving into the prescription drug monster, I have found alternative lifestyle

changes and alternative doctors whohave successfully balanced any disorder and/or mental

disease. I choose to take the treatment of my illnessesinto my own hands. I use herbal

supplements, with guidance from homeopathic doctors, and my high blood pressure, hot

flashes, and panic attacks have totally stopped. My back pain, which was temporary, diminished

significantly through exercise.I found easy alternatives with low costs and herbal supplements
Jarvies/9


which are usually taken for only a month or two. Instead of a long term pharmaceutical

solutions, which physicians recommend with scare tactics, I haveadopted sensible lifestyle

changes with short term solutions. I realize that all medical conditions cannot be treated this

particular way but I know a sizeable amount of patients can choose the homeopathic way of

life.




Figure4-Etok, Susan Dr.



         Prescription drugs, in moderation, can be helpful in certain treatments but physicians

need to be mindful of the effects of prescribing and pushing so many variations and such large

doses of unnecessary drugs.A monetary incentive to promote prescription drugs is just plain

wrong; they should have unbiased opinions whenevaluatingpatients’ careand when

theirpatients’ lives are at stake.They have taken the Hippocratic Oath which states, “I will

prescribe regimens for the good of my patients according to my ability and my judgment and

never do harm to anyone. I will not give a lethal drug to anyone if I am asked…”(Staff).

Physicians who over-prescribe and misprescribeneed to review their own code of conduct.
Jarvies/10


       In addition, the pharmaceutical industry has ulterior motives when promoting their

“new” drugs and the American public needs to reevaluate their uncontrolled advertising.

Promoting alcohol and cigarettes through advertisingwas stopped and controlled, why?

because they were both contributing to too many deaths. Prescription drugs advertising needs

to have the same regulations, there are just as many people dying.


       Lastly, consumers have got to take their health seriously, stop taking the easy route with

prescription drugs and develop alternative solutions with personal research and conscience

decisions. When patients allow physicians and the pharmaceutical industry to dictate what is

“good” for them,they open themselves up for addictions todevelop, for interactions and side

effects to change their lifestyle,and they expose themselves to possible death.When you or

someone you love becomes addicted or dies from our Nation’s fastest growing drug problem

then the problem will become personal.
Jarvies/11


                                             WORKS CITED


Addictive Drug Index.Destination Hope. 29 September 2011. <www.drugrehabfl.net>


Allen, Marshall. Las Vegas Sun. 14 October 2009. 29 September 2011. <www.lasvegassun.com>


Cohen, EP.New England Journal of Medicine.(1988): Volume: 318: 373-376.


Crystal, Dawn. Helium. 31 January 2008. 4 October 2011. <www.helium.com>


Etok, Susan Dr. Say Not to Prescription Drugs. 28 April 2011. 20 September 2011.

        <www.susantok.wordpress.com>


Everett, DE,AvornJ.,Baker MW.America Journal of Medicine.(1990): Volume: 89: 357-362.


Greider, K. The Big Fix, How the Pharmaceutical Industry Rips off American Consumers. 2003.

       (p. 189). New York: Public Affairs.


Health Billing and Insurance Definitions.Indiana University. 19 September 2011.

        <www.iuhealth.org>


Law, Jacky.Big Pharma. 16 January 2006. 20 September 2011 <wwwlbookdepository.com>


Lazarou J,Pomeranz BH, Corey PN.Journal of the American Medical Association.(1998): Volume:

        279:1200-1205.


Liu GG, Christensen,DB.Journal of the American Pharmaceutical Association.(2002): Volume:

        42:847-857.


Morris, Gail.Live Strong.9 March 2011. 25 September 2011. <www.livestrong.com>
Jarvies/12


PhRMA, Staff. The prescription drug industry’s U.S. trade association. July 2002. 4 October

        2011. <www.phrma.org>


Rochon, PA. Misprescribing and Overprescribing. 1 July 1995. 7 September 2011.

        <www.worstpills.org>


Smith, Madelyn. Big Pharma and Consumer Confusion.28 Spril 2011. 20 September 2011.

        <www.wordpress.com>


Staff.The Free Dictionary. 20 September 2011 <www.thefreedictionary.com>


Trescot, Andrea, Dr. Las Vegas Sun.14 October 2009. 20 September 2011.

        <www.lasvegassun.com>


Ukens C. Modern Medicine.22 March 2004. 4 October 2011.

        <www.drugtopics.codernmeciicine.com>

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Position proposal paper 2010

  • 1. Kellie Jarvies English 2010 Position/Proposal Paper Prescription Drug Abuse: Enough is enough Drug, alcohol, and prescription drug addictionsexistin many people’s lives; addiction’s outreach can be persistent,strong and relentless. Addiction doesn’t sleep;it picks and chooses victims without regard to religion, race, or financial status, strikes without warning, and leaves you staring at the shell of someone you once knew. Addictions to illegal drugs, alcohol, and prescription drugsmirrormany of the same symptoms, a change in personality, social withdrawal, defensiveness, blackouts and forgetfulness, to name a few. Whether you buy drugs on the street, purchase alcoholin a store or have prescription drugs filled at the local drugstore;addictionrears its ugly head in the samemenacingway. Loved ones of the addict get caught up in the ugliness of addiction,leavethem with feelings of emptiness, questioning what role they might have played in the addiction, and wondering where it all went wrong. We will focus on our nation’s fastest growing drug problem, addiction to prescription drugs. In order to make decisions regarding prescription drug abuse it becomes necessary to look at the medical profession’s role in overprescribing and prescribing incorrectly, the pharmaceutical industry incentives for “pushing” their drugs, and each patient’s individual responsibilityconcerning their own personal health and well-being.
  • 2. Jarvies/2 A definition from Indiana University states: “Prescription drugs are controlled by the federal government, requiring a patient to receive authorization from a doctor or other medical professional to allow access to a specific quantity of the drug” (Health Billing and Insurance Definitions).The tenmost abused prescription drugs are as follows: Ambien and Lunesta; primarily for insomnia treatment Xanax and Valium; anxiety and depression Hydrocodone; pain control Codeine; cough suppressant Adderall and Ritalin; ADHD and issues with trouble concentrating Fentanyl; pain control in cancer patients Morphine; moderate to severe pain treatment (Morris). These prescription drugs marketed under many different names and reliefvalue, all have the same effect; they become addictive and produce some kind of high whichbrands them as valuable, leading to their misuse.This misuse often begins innocently with legitimate prescription reasons, such as feeling pain, having anxiety, or becoming ill. Prescription drugs can be a difficult addiction from which to break free, as time goes on the body becomes accustomed to receiving this medication and builds a tolerance, requiring a higher dosage or quantity to achieve the same results. When individuals try to detach themselves from the drugs, the original problem seems to come back stronger, creating a powerful cycle which needs professional help and treatment (Addictive Drug Index).
  • 3. Jarvies/3 A study of patient Robert Reynolds revealed that his family physician, Dr. Kevin Buckwalter, prescribed Reynolds 180 hydrocodone and oxycodone pills per month for his lower back pain. Reynolds, 50, became addicted and eventually shot himself in the head in October 2008. Buckwalter’s license was stripped when the Drug Enforcement Administration (DEA) linked him to eight other patient deaths (Allen). Although physicians are providedwith information informing them that prescription drugs can become highly addictive, they continue to over-prescribecertain drugs, why? Much of the advertising, direct-to-consumer (DTC), leads physicians to over-prescribing unnecessary, expensive, and potentially addictive drugs. Patients looking for the “magic bullet”jump on the bandwagon and ask for brand names of drugs advertised. Physicians are yielding to their patient’s requests for more medications rather than recommend they change poor, unhealthy lifestyle habits. There are many reasons for over- prescribing in addition to (DTC) advertising. Patient’s demands on physicians, the every- increasing scientific discoveries, and the physician’spatient overload all contribute to physicians frequently prescribing medications. Americans have come to expect an immediate cure for what ails them and medications are fulfilling their requests(Crystal).While many physicians try to do all they can to help their patients,there are those withstartling,underlying agendas. Some physicians take the easy road to wealth, sometimes at the expense of patients’ lives. Some physicians take kickbacks from the drug companies and “push” certain drugs to benefit themselves financially. “Experts say a primary part of the problem is doctors who are careless with their prescriptions or who prescribe the drugs as a way to make money” (Allen).This method encourages physicians to become “legalized drug dealers” (Trescot).Research shows that many doctors pull the prescription trigger too quickly (Everett).There is no questionthat for
  • 4. Jarvies/4 many people, prescriptions can be beneficial, even lifesaving in many instances.Many chronically ill patients lead more productive lives with assistance from prescription drugs. Even though prescription drugs can help many patients, hundreds of millions of prescriptions can beprescribed wrong, either they are entirely unnecessary or unnecessarily dangerous(Liu and Christensen).The responsibility lies heavily on physicians to take their role seriously in patients’ lives. Patients and physicians should first treat symptoms with comprehensive lifestyle changes. Patients depend on the expertise of physician’s degrees,trust their judgments and opinions, often blindly.Problems such as insomnia, abdominal pain, high blood pressure, mild adult-onset diabetes, obesity, anxiety, and situational depression often have causes that respond very well to nondrug treatment and often the physicians can uncover these causes by taking a careful history (Rochon). Physicians should recommend lifestyle changes, as their first method,in treating these conditions rather than automatically reaching for the prescription pad(Lazarou). Whilephysiciansare responsible for a large part of prescription drug abuse, thepharmaceutical industryhas a greater role on our American society. The industry becomes theprimary causein promoting,misprescribing, and overprescribing of drugs. They sell $216 billionworth of drugs in the United States alone.(Ukens)The American public needs to be aware, when the profit incentivesare thatenormous, the industries agenda is NOTsaving human lives. Consumers’must question their motives. In addition to American sales, global sales are just as shocking, as per figure 1.
  • 5. Jarvies/5 Figure 1- Big Pharma and Consumer Confusion There also lies another culprit in the pharmaceutical industry, the patents. Patents allow the drug makers complete production rights for twenty years before competitors can market generic versions. Generics save consumers as much as two-thirds of the original drug’s cost, but they cut deeply into sales and profits of the original name-brand drugs (Greider). This gives the pharmaceutical companies a huge incentive to invent or reformulate a new drug to replace the old one. They spend billions on marketing so they will not lose their profits. They refused to go down without a fight and they are fightingan unyielding battle. Therefore, the answer concerning abuse from physicians and pharmaceutical companies becomes clear. Patients should takea large percentageof the responsibility fortheir ownhealth and evaluate why new drugs are prescribed. The industry spends well in excess of $21 billion a
  • 6. Jarvies/6 year to promote drugs using advertising and promotional tricks that push the envelope of being false and misleading.The fastest-growing portionof drug advertisingdirectsads to patients not doctors. An estimate from 1991 to 2002 claims (DTC) advertising expenditures in the United States grew from about $60 million a year to $3 billion a year, an enormous increase in just eleven years (PhRMA). Figure 2- Jacky Law-Big Pharma Consumers have to question why profits increasedso drastically within such a short time period.The answer appears obvious: its working and they are continuing tomanipulate us all. Consequently, patients cannot trust everything the pharmaceutical companies sell and everythingtheir physicians say and prescribe.Some of the responsibility falls back on the consumer. If consumers ceased buying unnecessary drugs, the pharmaceutical companies recommend, they would lose a significant amount of their profit incentives.Patients need not
  • 7. Jarvies/7 be paranoid, but need to research for themselves and look for sound lifestyle changes as the alternative, when appropriate. My personal involvement with others’ prescription drugs, alcohol, and illegal drug addictions entangles me profoundly and repeatedly. Close members of my own family have recently completed rehab for prescription drug addictions andother family members still struggle with Figure 3-McKay-Dee Hospital in Ogden, Utah their addictions. Alcohol addictions continue totirelessly tug at my heart because of the concern I have for those still affected byits long termeffects. Recently, my close family member, whonot long ago went through rehab, required many visits to the hospital for various reasons. This family memberwas offered an assortment of opiate/painkillers, even though everyone within shouting distance was informed of the addictive behavior and past drug addiction. The doctor finally informed all personnel, after several attempts were made by my sister and me, to stop giving this patient any more addictive medication. We finally connected to him when we asked, “Would you prescribe these drugs to your loved one and would you be willing to take them home and start rehab again.” The medical community is programmed to get a patient out of “pain” and on their way home. This leaves the families to deal with the aftermath of addiction. Ourpersuasiveness accomplished
  • 8. Jarvies/8 our goal for that particular visit but there have been additional visits to other hospitalsand the process starts all over again.Our vigilance has not always constituted success with other doctors. I also experience situations concerning my husband’s health. For the last eight or so years he has been prescribed many different drugs for his high blood pressure, high cholesterol, diabetes, chronic back pain, and other ailments. The physician prescribes mixturesof prescription drugs that have numerous side effects and then prescribes more drugs to combat the additional side effects.It has been a continuous circle ofdifficulties. Weaning off some of his prescription drugs slowly helped offset some of the side effects but the battle continues.Some lifestyle changes, exercise and healthy eating choices, will help him have a more productive and healthy life. There can be different alternatives and solutions; I have personal proof of their continued effectiveness. In comparison, at different times throughout my life,different physiciansadvised me to take prescriptions for: high blood pressure, insomnia, hot flashes, panic attacks, and minor back pain. Instead of caving into the prescription drug monster, I have found alternative lifestyle changes and alternative doctors whohave successfully balanced any disorder and/or mental disease. I choose to take the treatment of my illnessesinto my own hands. I use herbal supplements, with guidance from homeopathic doctors, and my high blood pressure, hot flashes, and panic attacks have totally stopped. My back pain, which was temporary, diminished significantly through exercise.I found easy alternatives with low costs and herbal supplements
  • 9. Jarvies/9 which are usually taken for only a month or two. Instead of a long term pharmaceutical solutions, which physicians recommend with scare tactics, I haveadopted sensible lifestyle changes with short term solutions. I realize that all medical conditions cannot be treated this particular way but I know a sizeable amount of patients can choose the homeopathic way of life. Figure4-Etok, Susan Dr. Prescription drugs, in moderation, can be helpful in certain treatments but physicians need to be mindful of the effects of prescribing and pushing so many variations and such large doses of unnecessary drugs.A monetary incentive to promote prescription drugs is just plain wrong; they should have unbiased opinions whenevaluatingpatients’ careand when theirpatients’ lives are at stake.They have taken the Hippocratic Oath which states, “I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone. I will not give a lethal drug to anyone if I am asked…”(Staff). Physicians who over-prescribe and misprescribeneed to review their own code of conduct.
  • 10. Jarvies/10 In addition, the pharmaceutical industry has ulterior motives when promoting their “new” drugs and the American public needs to reevaluate their uncontrolled advertising. Promoting alcohol and cigarettes through advertisingwas stopped and controlled, why? because they were both contributing to too many deaths. Prescription drugs advertising needs to have the same regulations, there are just as many people dying. Lastly, consumers have got to take their health seriously, stop taking the easy route with prescription drugs and develop alternative solutions with personal research and conscience decisions. When patients allow physicians and the pharmaceutical industry to dictate what is “good” for them,they open themselves up for addictions todevelop, for interactions and side effects to change their lifestyle,and they expose themselves to possible death.When you or someone you love becomes addicted or dies from our Nation’s fastest growing drug problem then the problem will become personal.
  • 11. Jarvies/11 WORKS CITED Addictive Drug Index.Destination Hope. 29 September 2011. <www.drugrehabfl.net> Allen, Marshall. Las Vegas Sun. 14 October 2009. 29 September 2011. <www.lasvegassun.com> Cohen, EP.New England Journal of Medicine.(1988): Volume: 318: 373-376. Crystal, Dawn. Helium. 31 January 2008. 4 October 2011. <www.helium.com> Etok, Susan Dr. Say Not to Prescription Drugs. 28 April 2011. 20 September 2011. <www.susantok.wordpress.com> Everett, DE,AvornJ.,Baker MW.America Journal of Medicine.(1990): Volume: 89: 357-362. Greider, K. The Big Fix, How the Pharmaceutical Industry Rips off American Consumers. 2003. (p. 189). New York: Public Affairs. Health Billing and Insurance Definitions.Indiana University. 19 September 2011. <www.iuhealth.org> Law, Jacky.Big Pharma. 16 January 2006. 20 September 2011 <wwwlbookdepository.com> Lazarou J,Pomeranz BH, Corey PN.Journal of the American Medical Association.(1998): Volume: 279:1200-1205. Liu GG, Christensen,DB.Journal of the American Pharmaceutical Association.(2002): Volume: 42:847-857. Morris, Gail.Live Strong.9 March 2011. 25 September 2011. <www.livestrong.com>
  • 12. Jarvies/12 PhRMA, Staff. The prescription drug industry’s U.S. trade association. July 2002. 4 October 2011. <www.phrma.org> Rochon, PA. Misprescribing and Overprescribing. 1 July 1995. 7 September 2011. <www.worstpills.org> Smith, Madelyn. Big Pharma and Consumer Confusion.28 Spril 2011. 20 September 2011. <www.wordpress.com> Staff.The Free Dictionary. 20 September 2011 <www.thefreedictionary.com> Trescot, Andrea, Dr. Las Vegas Sun.14 October 2009. 20 September 2011. <www.lasvegassun.com> Ukens C. Modern Medicine.22 March 2004. 4 October 2011. <www.drugtopics.codernmeciicine.com>