Empty Shelves
The change in drug store shelves has come about rather suddenly, leaving folks asking why and what now.
Lots of people depended on Sudafed (pseudoephedrine) for congestion and were puzzled when it went behind the counter. We can thank our entrepreneurial drug makers for that, since it is the base from which crystal meth is made.
With uncharacteristic haste and certitude, the FDA then banned decongestants and cough preparations for children less than two. Now all compounds intended for children 2-4 years are to be re-labeled and restricted. There is talk of the ban being raised to six or even twelve.
My practice hasn’t been much impacted by these changes because I was never much of a fan. However, the popular medications such as the Triaminic line, Dimetapp, Robitussin, Formula 44 and others were generally harmless and because they were readily available in samples, we dispensed them partly so that parents wouldn’t go home empty-handed. Most practitioners knew that illnesses were not shortened by these nostrums but symptoms might abate a bit. More sophisticated patients increasingly rejected these medications, an attitude I encouraged as I learned more about natural remedies. Symptoms are annoying but do represent the body’s defenses against intrusion, and if possible should be tolerated.
Several trends occurred in recent years that led to the recalls. My Dad was a grocer and taught me a lot of lessons, including some lines I use on a regular basis. (When it’s too noisy in the office I’ll yell “Quiet – you’ll wake up the help!”) He pointed out to me when I was a teenager working in what was one of the first “supermarkets” in our area that marketing products was all about shelf space. If Kellogg made each of its cereals in three sizes, with and without sugar/cinnamon/berries/all the above, they could crowd out their competition. Drug makers went on a space binge in recent years in much the same way, and I believe they brought down the wrath of government and consumer groups for that reason. Combining several ingredients, varying colors and flavors, sizes and delivery systems made sense to corporate types but confused parents and doctors alike, the latter because we no longer got samples and couldn’t keep up with the blitz. I’d often find when patients called after hours that they were using several preparations with similar or even identical ingredients, often counteracting each other (e.g. antihistamines to dry up secretions and expectorants to encourage them).
Truth to tell, almost all over-the-counter stand-bys have never been shown to work, especially in children under 12 who are rarely subject to research. If aspirin were discovered now, it might not be licensed. Ibuprofen is a wonder drug to many in pain, but thousands die every year of GI bleeding, most of it NOT preceded by warning signs. The only expectorant ever proved to work was iodide, too dangerous to be used on a regular basis.
As I tell people every day, a cold lasts a week if you treat it and 7 days if you don’t (or is it the other way around?)