Posted 12 October 2010 - 01:29 AM
Only in the perverted and ignorant world of medicine could this happen! If I didn't know doctors as well as I do, I'd say it was incredible that people are still not being told the truth about Accutane/ Roaccutane.
To answer the specific question about erectile dysfunction, two mechanisms have been suggested. One is a "neurological route". In other words, brain damage makes it impossible to have a psychogenic erection, either because the part of the brain, which deals with sexual arousal, or the part, which controls reflex actions, is damaged. Another possibility is damage to the goblet cells in the testes, possibly affecting hormone levels and sperm production. However, the second seems less likely. Testosterone levels have very little influence on erectile function.
[The unimportance of testosterone in ED was demonstrated in harems, where eunuchs had had their testes removed. Most could still have sex with the women under their care but obviously, without testes, couldn't make them pregnant. The prevention of pregnancy (and thus the preservation of the blood line of the king or chief) was the main concern in the ancient World. Unknown to many, the Biblical commandment, which forbids adultery, originally banned one Jewish man from making the wife of another Jewish man pregnant. Strictly speaking, there was nothing wrong with having a bit of an inter-Hebrew fling, which didn't put any buns in the oven, or with knocking up a gentile.]
Today, andrologists estimate that 90% of cases of ED are of physical origin. The bona fide pharmacology reference works have listed ED [more accurately "chemical castration", in many cases, as the effect is, without highly specialised and almost experimental treatment about which very few doctors know, permanent] as a side effect of Roaccutane for a number of years. It is accepted by everyone (except perhaps Roche and its cronies) that the nature of the complaint has led to massive under-reporting. Therefore, what an earlier contributor said about Roaccutane-associated ED being "all in the mind" was a load of bo***cks.
Roaccutane was, in origin, a chemotherapy drug; a highly toxic retinoid designed for use in oncology. Ask an oncologist whether chemo drugs can be given to anyone, who doesn't have a life-threatening disease and he'll say "No way!". As it happens, Roaccutane was envisaged as a skin-cancer treatment (the type of cancer probably being basal-cell carcinoma, the one that has lesions like squashed strawberries). The biochemist, who created it [Werner Bollag] said it was so dangerous that it should never have been licensed- period- and stopped work on it, back in 1971. Roche's American subsidiary withheld his research from the scientists [Yoder and Peck], whose work led to it being licensed in the USA. In the UK, the main expert [Cunliffe], on whose opinion the drug regulator, the MCA, relied, was in the pay of Roche for years. He covered up the suicides of two participants in the pre-licensing trial. He ought to have been struck off, at the very least, but was merely criticised by an official enquiry. Whether this investigation was headed by a certain bearded, Hyde-based GP on a rare day off from slaughtering the old ladies of Greater Manchester, I haven't been able to discover.
When Roaccutane was licensed, it was so SOLELY for the most severe form of acne, which affects around 3% of sufferers. That says something for the American FDA and the British MCA. However, dermatologists (prompted no doubt by enthusiastic sales reps and offers of research funding, free holidays, golf outings etc) decided that it was OK to prescribe it ("off label" or in breach of the terms of its licence) for bog-standard, teenage acne (from which 70% of adolescents suffer at one time or another). Once it became "accepted practice" to use Roaccutane in this way, British doctors were protected from negligence actions by the Bolam judgement of 1957 (aka the Doctors' Get-Out-of-Jail-Free Card or "OO Licence", a reference to James Bond's authority for assassination), which is possibly the ultimate (but by no means a unique) example of a lawyer scratching the backs of doctors.
Dermatologists lied to their patients, in order to obtain consent for treatment, presenting Roaccutane as a "harmless Vitamin A derivative". In theory, that constitutes assault because consent wasn't "informed" but drug companies and their lackeys in white coats are above the law- in most countries. The police won't touch them and the bodies, which are supposed to monitor them are usually controlled by them [eg the MHRA, the new name for the MCA, and the GMC, which licenses doctors in the UK]. Big Pharma's profits and doctors' careers will always be more important than patients' lives.
A complete lack of accountability probably explains why doctors and drug company executives have as much sense of right and wrong as amoebae. [Apologies to any amoebae, who are reading this and feel aggrieved by the comparison.] They are amoral. Legal systems, created and administered by people from the same class as doctors for the benefit of that class, are ineffective (and inaccessible to the average Joe). The media either depend on Big Pharma for much of their funding (as is the case in the USA, where about 25% of TV ads are paid for by drug companies) or are terrified of it (as in the UK, where medieval-style, judge-made libel law allows white-collar criminals to get away with anything, as long as they're rich enough to be able to hire libel lawyers). Doctors and drug company executives cause tremendous- almost unimaginable- suffering but, like Eichmann and other Nazi doctors, they are incapable (or, in public, pretend to be incapable) of seeing that any of their actions could be wrong- either logically or morally.
Together, the use of Roaccutane for mild or moderate acne, the utterly corrupt licensing process, the abdication of responsibility (for ensuring that drugs are safe) by governments and the lies that doctors told constitute a crime against humanity. The ethical issues, here, are no different from those examined at Nuremberg. Most people just assume that medicine and the pharmaceutical industry are properly regulated and that both attract decent people. Don't medics and sales reps drive nice cars, wear nice suits, live in nice neighbourhoods and send their kids to nice schools? How could they possibly be bad?! A few go into the field with good intentions but the medico-pharmaceutical complex is so inherently evil that the good people can achieve very little within it. They are either marginalised; leave to do something more productive and useful to society; or fall into bad habits themselves.
The retinoids, which are used in chemotherapy, destroy the ability of cells to regenerate. That might be acceptable, if those cells happen to be in a tumour, which could end someone's life within months. It's not so good [understatement warning!] if the cells in question are normal, healthy cells [such as neurons or those in the lining of the bowel]. Roaccutane has more side effects than any other prescription drug and many are very severe- not to mention permanent. For instance, Roaccutane is practically the only drug, used outside the field of psychiatry, which can cause psychiatric disorders (although it is highly doubtful that psychiatrists, members of by far the most pseudo-scientific and corrupt branch of medicine, have any idea what causes these symptoms or are aware of any problems with the drugs they use themselves).
Doctors aren't scientists: they pose as scientists and some of them come to think that they are, just as many start to believe the propaganda they trot out on behalf of drug companies. One article in the British Medical Journal asked why journals constantly bombarded doctors with scientific papers, the vast majority of which they couldn't possibly understand. Of course, doctors never admit that they don't know something. If they were to do that, patients would start to ask why they are paid so much and have so much power.
It has been known, for many years, that chemo drugs cause brain damage and, in fact, the research conducted by Sarah Bailey in Bath showed how Roaccutane probably caused depression- by damaging the ability of certain brain cells, which are responsible for making seratonin, to replace themselves. Roaccutane treats acne by limiting production of new cells in the sebaceous glands, thus making the skin drier. That doesn't sound too bad but it is really the medical equivalent of a farmer dealing with an infestation of insects by dropping a 100-megaton H-Bomb from his crop duster. It might kill the insects but, then again, it might not. On the other hand, it is a cert that it will kill him.
75% of doctors, surveyed for medical journal articles in the UK, said that they wouldn't have chemo, even for terminal cancer. They know that it could actually SHORTEN the time they had left and that the side effects could be horrendous. Yet, they still "sell" these drugs to their patients. How much worse is it that a drug like this was prescribed to 15 million people, worldwide, for ACNE! There is some evidence that rates of cancer among pharmacists, who regularly dispense chemo drugs are much higher than those in the general population. That would be the ultimate irony, if chemo drugs could cause cancer.
As Hitler said, if you want to tell a lie, tell a really big one and no one will question it. Getting Roaccutane on to the market and stuffing it into children as young as twelve involved telling very big lies. Incidentally, Roche should know all about the Third Reich, since, in accordance with normal Swiss-German practice, the company collaborated with the Nazis, using slave labour in its European factories during WW2. It was a firm controlled by the Hoffmann/Oeri/Sachser family, through holding companies in Switzerland and Uruguay [as it still is today], so it seems slightly strange that it became involved with the Nazis at all.
The whole affair, which spans more than forty years, shows that human rights are largely fictional even in self-styled liberal democracies; that medical education, which recruits rich teenagers and puts them through a five-year-long pub quiz on biochemistry and anatomy, is more or less useless; that medicine operates like an organised crime syndicate, religious cult and a nightmarish government department, created jointly by Orwell and Kafka; that the concept of a single medical profession is decades out of date; that doctors are really chosen because they meet certain social criteria and not because they might actually look after their patients properly; and (as psychologists have proved elsewhere) how people's moral standards fall, in direct proportion to the amount of money at stake.
Roche makes annual profits of around $14 billion and used to make $2 billion a year from Roaccutane alone. It is reported to have operating cash reserves of [or, if you prefer, a piggy bank containing] $82 billion. The average family doctor in the UK now earns around $207,000 a year for a 35-hour-a-week desk job, with no house calls (unless he wants to earn overtime by moonlighting in the out-of-hours service). The love of money may not be the root of absolutely all evil but it certainly accounts for a lot of it.
An individual doctor/drug company exec will often attempt to justify his behaviour by comparing his profession/ company with the average lawyer, a rival drug company exec or any other villain, with whom he probably socialises. Unfortunately, there is a great deal of truth in the statement, "Doctors are no different from anyone else.", although the argument cuts little ice with me. In the criminal justice system, penalties for a crime are increased, if it is committed more often. The opposite principle seems to apply among professionals and business people: the more people are thoroughly evil, the more "normal" it becomes. In 1987, Margaret Thatcher told "Woman's Weekly" that there was no such thing as "society". The Roaccutane scandal makes me question whether "humanity" has been abolished too.
The idea that sociological factors are irrelevant and that the actions of individuals are responsible for everything is known as "methodological individualism". The concept was gleaned from one of the few books on philosophy Thatcher had ever read. It's a pity, though, that the doctrine of personal responsibility is applied only to those in shell suits and seldom (if ever) to those in pin-striped suits. I'm with the retired NYPD Lieutenant, who said "A criminal is a criminal, whether he dresses like a rapper or wears Armani." He is campaigning for the establishment of a Medical and Pharmaceutical Division of the force. He reckoned that, in thirty-five years as a cop, doctors and drug companies were the biggest criminals he came across.
National governments are heavily under the influence of drug companies. [Roche is no longer among the largest but it is extremely profitable. Glaxo Smithkline and Pfizer are the two real giants, these days.] They are concerned more about jobs, collecting tax and securing party donations or directorships for retired politicians or civil servants than saving the lives of ordinary people. They refuse to take action on Roaccutane, so perhaps it is time for the matter to be referred to the International Criminal Court (with which the USA refuses to co-operate) or to the UN High Commissioner for Human Rights. I'm not holding my breath. A lack of oxygen is nearly as harmful to one's health as taking Roaccutane.
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