There’s a long ongoing debate about the state of healthcare in these United States of America. I’m not going to hold forth on it for long, but there are some things I think could stand to be repeated and emphasized in the hopes they might sink into the minds of the general population. Is American healthcare bad? No. We’re the top of the world in standard of care, medical technology, and keeping people alive. Is our payment system, balanced as it is on the unstable platforms of health insurance and government subsidies, broken? Yep, sure is. Is the next best step handing the whole kit and caboodle over to the government for single-payer? Um. Have you looked at the Veteran’s Administration and what they do to our brave fighting men and women recently? Noticed the stories about the NHS coming out of England and Canada are not all roses and cherries?
With that out of the way, one of the topics that floats up often and makes me grit my teeth is the cost of drugs and medicine. There’s a lot of moving parts, and most people don’t think it through other than ‘I can’t afford that!’ or ‘Big Pharma is keeping me from getting my miracle drugs that will cure cancer, flatulence, and female orgasm!!!11!elventy!!’
Sigh. That’s not how this works. That’s not how any of this works. Are big pharmaceutical companies manned by angels? Hardly. Look at the recent shenanigans around the sale of a patent to an Indian nation in a desperate ploy to keep the drug from going generic as a recent example. Not to mention the EpiPen debacle. But the fact remains that getting a drug through the stringent trials to develop it from concept to compound to proven safe medicine is a long, arduous, and expensive path. Fully 90% of the compounds that start out, fail. If you follow that link to Derek Lowe’s excellent blog, you’ll find that there are a lot of hopeful remedies that simply don’t do anything, don’t do what was expected of them, or worst of all, potentially injure and kill patients. The FDA has not been deaf to the pleas of the public to fast track drugs that could be of great value. In the end, though, their role is to be a gatekeeper for good reason.
Which brings me to the titular thought behind my post. I do teach wildcraft, in a small way, but one thing I no longer teach is the medicinal value of the plants that can safely be gathered as food. I have a lot of reasons not to. One is that dosing is tricky. Very tricky. The saying one man’s meat is another man’s poison came from this practice, after all, of observing that a natural medicine might cure, or it might kill. And that’s not easily predictable, even in modern medicine. Another good reason I don’t teach is that people don’t listen. Look. You know as well as I do that the vast majority of people, when they learn that a little of something is beneficial, will immediately ask themselves ‘but what about more? More is better!’ and when we’re talking about medicinal compounds, that’s potentially fatal.
Pharmacognosy deals with the natural drugs obtained from organisms such as most plants, microbes, and animals. Up to date, many important drugs including morphine, atropine, galanthamine, etc. have originated from natural sources which continue to be good model molecules in drug discovery. Traditional medicine is also a part of pharmacognosy and most of the third world countries still depend on the use of herbal medicines. Consequently, pharmacognosy always keeps its popularity in pharmaceutical sciences and plays a critical role in drug discovery.
The other thing I see in conversations about natural remedies (which, to be honest, is disingenuous labeling, but I’ll come back to that in a minute) is that Big Pharma doesn’t want to have them discovered, is suppressing them, or wants to claim them and lay a patent on them. That’s woefully ignorant. Big Pharma would adore to find a natural compound that could be easily synthesized, efficacious, and safe for all to use. See above about the 90% fail rate. Big Pharma is trying to use natural compounds, has been for a century if not more.
So let’s dive into natural compounds that humans can use as poiso… er, drugs, for a minute. Plants (or animals, or bacteria) don’t produce them solely for our benefit. There’s a reason they need them to do something, and often that reason is toxicity. Caffeine, cocaine, and capsaicin, just to name a few alliterative examples, are all produced as natural pesticides. Plants don’t care to be chewed on, and all these compounds act as ‘ew, yucko’ to the things that want to eat them. Only, being human, we’re all ‘oh, that tingles…’ and off we go down the rabbit holes where the mushrooms are magic and overdoses are all part of the fun and games.
The other part about natural medicines, and this is one I’ve written about in the past, is dosing. Plants are producing these compounds for a reason, and they may not produce as much in a given season. Heck, even time of day for harvest can make a difference. Any gardener worth their salt knows that peppers grown in the cool damp weather are simply not as spicy as those grown in hot dry conditions. Herbs are best harvested on sunny afternoons for full aromatic essences to be present. When you buy, or harvest, plants you intend to use as medicine, you DO NOT KNOW how much of that active compound is in them. You might unintentionally underdose yourself, or overdose. You don’t know. You can’t without a battery of tests, most of which require sensitive and expensive laboratory equipment to conduct. The state of modern medicine? Is a lot better than ‘here, drink this foul smelling potion and if you’re still alive tomorrow I’ll give you more.’ Now, we can precisely and accurately synthesize the exact compound we want from that ‘natural remedy’ and give it with confidence knowing exactly how much we’re dosing the patient with. Is it a perfect system? No. Do we live a hellova lot longer than our grand and great grandparents did? Yes, yes we do.
But still, I see the magical thinking pervasive in the culture. “Oh, plants were good enough for my ancestors, that’s good enough for me.” Which completely ignores the reality of snake oil, quacks, and such who have always been with us. Mercury was also a medicine. Do you want to swallow some of that? I thought not.
“Big Pharma is greedy!” Yeah. You saw above about the 90% fail rate? What do you think that costs? I’m not, again, saying pharmaceutical companies are a perfect resolution to the problems. But handing it all over to the government doesn’t solve the money issue. Someone, somewhere, is going to pay for the drugs you want. Government issue? Those super expensive new experimental drugs are simply not going to exist. Also, yes, drugs cost more in America than other places. We don’t subsidize them the way other countries do, and we can afford it. No, Princess, you aren’t poor. Not compared to that kid in Africa who’s going to die, or have his brain development retarded, unless he gets three $5 doses of worm medicine. You picking up the tab for your acne medicine so you don’t have *gasp* a flaw on your skin allows the drug companies to charge less in parts of the world where they can’t afford it like you can. Want to make a difference in the world? Buy your damn medicine and stop whining. Yes, I know there are people who need life-saving medications and can’t afford them. There are also programs to help people like that. Here in the US, if you die because you’re poor, it’s because you chose to do so.
I probably sound harsh. I feel harsh. I’m normally all nice, and empathetic, and I do feel the pain of those who have no treatment for their aches and ailments and seek relief in vain. But I also see that many who seek alternative treatments or who complain about the cost of their medicine don’t actually need them. Don’t realize that they can better afford to pay a bit more so those who are truly sick and broke can have subsidies for their vital medication. Or they want to use homeopathy and ‘natural’ remedies to treat their children and thus cause death and disfigurement because they are too indoctrinated to see the reality that modern medicine is a god-given miracle.
I photographed this Wild Ginger flower a few days ago in the Ohio woods. While Asarum is a folk remedy, it is also a toxic plant, one that can destroy your kidney function. The other common name, Snakeroot, can lead to it being confused with Cimicifuga racemosa, which also goes by that common name as well as Black Cohosh (they look nothing alike, but the similar names are a big problem).
There’s no easy out when it comes to pharmacology and economics. Safe, effective drugs cost a lot to discover, develop, and produce. Illnesses do not always react to medication, but it’s easier to administer drugs than to admit you don’t know what’s going on, as a doctor. Overmedication is a thing. And it’s not always the doctors. Patients who want to feel better demand drugs, antibiotics, and placebos in the form of homeopathy simply because they don’t want to do nothing. They are desperate to get well, or thinner, or back to feeling like 20 with a 60yo body. And desperation is never a good place to make decisions in.
17 thoughts on “Pharmacognosy and Magical Thinking”
Well said and spoken. Thanks for this.
Then there’s the problem that some people often react differently to a given dose of medicine than other people react.
Years ago, the Doctor had to change my Dad from one High Blood Pressure medicine to another High Blood Pressure medicine.
It gave him “interesting dreams” and Mom woke up one night to find Dad about to hit her. He was dreaming that he was Batman and Mom was the “Bad Guy”.
Yes. I cannot take a certain kind of decongestant, and neither can my Dad. So drug interactions can be unique, and genetically determined.
You’re talking to my family. Problem is, they’re not listening.
Without modern pharmacology, I would die. I have no thyroid, and while I’m on Armour (dessicated pig thyroid gland, ground up), it takes a modern pharmacy to have the doses uniform.
And uncontrolled, lack of thyroid is a horrifying disease. There was a mystery story by Dorothy Sayers that sticks in my mind about it.
I know most who need to wrap their heads around this won’t listen. But if I can just get a few thinking, that’s all I can ask for.
Ah yes, “THE INCREDIBLE ELOPEMENT OF LORD PETER WIMSEY”.
Have it in the e-version of Hangman’s Holiday. 😉
Thank you! Could not remember the title.
That rarest of beasts, the “market failure” may actually be rearing its head in pharmaceuticals. (No, it is NOT true across healthcare. Price-fixing, subsidies, and rent-seeking regulatory barriers are failures, but they aren’t market failures). It lies in the lack of an adequate market mechanism for distinguishing between “treatment” and “cure”. Most people, given the choice between “here’s a pill you can take for $100/month that will alleviate your symptoms” and “here’s a pill you can take for one week, cost $6000, that will cure you outright” would take the second option. And if out of pocket expenses were a problem, there’d be all kinds of insurance (real insurance, not disguised subsidy) options, or the equivalent of “payday loan” options — take out a loan you pay back at $150/month for 5 years and be cured outright.
But we’ve gotten fixed in our heads that common fallacy that “price” equals “cost plus a little”, whereas it takes at least as much, probably more, development effort for a cure than it does for a palliative treatment.
There ought to be ways to pay to be cured, in a way that’s at least as profitable as paying to be ‘treated’. And of course, if you pay for a cure, and you aren’t cured, there has to be a way to get your money back!
I’ve no perfect solution to propose, but the solution isn’t *just regulate it” or “just subsidize it” — it’s the creation of a new market mechanism, where you pay for *results* (with money-back guarantees), rather than paying for *effort* in healthcare.
Further complicated by the fact that we don’t have cures for many things, and are seemingly no closer to such than we were back in the day of patent medicines.
One of the problems she is relating is that there is a segment of people that believe those $6000 cures exist and are being suppressed by ‘big pharma’, who would obviously much rather get $6000 from you over 15 years than three months…
I have been guilty, myself, of whining about the cost of meds, especially when my insurance coverage wasn’t all that great. With that being said, there’s something very wrong about trying to fill a prescription only to be told that it will cost $1,800/month until my deductible of $5K is met, at which time it will drop to $60/month. Some of this has to do with how we sell/market/pay for prescription drugs, the use of pharmacy benefit managers and the crazy pricing negotiations between the pharma companies and the insurance companies and hospitals and retailers, etc. It’s like you can’t find out what’s the rack rate. I’m not anti pharma by any means whatsoever, but the complexities of the entire industry are mind boggling. That being said, I will forever sing the praises of the manufacturers of Neurontin, who surely saved me from actual suicide when I had the shingles for the THIRD time.
I completely agree about the insanity of pricing, which is largely based on the insurance system we currently use – without that prop, perhaps we’d see a LOT more transparency and market driven pricing based more rationally on supply and demand.
I was in one of the “natural foods and herbs” places a few years ago and groaned. They had a regional plant that is used in traditional medicine. But what they advertised was the highly toxic part of the plant, not the part used for medicine. (How toxic? Eight ounces of tea made from the poisonous part will terminate your kidney function. Not a good thing.) *facepaw* And yes, I told them, and gave them sources to back me up. I didn’t go back to see if they took the stuff off the shelf.
Probably not. If it sells… *shrugs*. People are vile.
two things.. what you put in and on your body dictates a lot of what “sickness” you may get.. and remember just like DDT, a lot of these “conditions” are passed on from your parents as well,from what they have put in or on their bodies. so no matter if you use natural or pharmaceutical means, know what the hell you taking. do your own research.
Big Pharma and hospitals both need to be forced to disclose actual costs, and level pricing for procedure and drugs. Once that happens, I think you will see a dramatic reduction in prices of meds. I know the shot I get every 6-8 weeks in my eye costs 10x of what I would pay if I could afford to fly to Europe to get it.
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