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Drug companies expediently and glibly list drug actions, meaning beneficial effects for which they are prescribed, separately from another section called side effects, meaning undesirable effects for which they are not prescribed.  The action of a statin drug would be the lowering of bad cholesterol to reduce heart attacks and strokes.  The side effects would be muscle pain and weakness, liver inflammation, malaise and memory difficulties.  It is implied that side effects are unexpected and infrequent, and somehow accidental.

However, the changes resulting from taking a drug are all EFFECTS.  Some are good effects and some are bad effects, but they are still EFFECTS.  They are predictable from the interference the drug imposes on normal body functions.  They are usually dose-related, and do not occur in all people because different bodies have different sensitivities and different rates of metabolism.  However, they are not accidental.  They are a part of the basic nature of the drug, as an explosion is part of the basic nature of a bomb, and one would have to expect that once in a while an innocent bystander will be blown up.

We should be aware that all drugs have good effects as well as bad effects, that sometimes the good effect will fail to appear, and a bad effect will predominate.  We should not be surprised by this, and know that advertising will always stress benefits over damages, and doctors will recommend drugs for their advantages, not their negative consequences.  Several times a year, every year, drugs are taken off the market because the bad effects overcome the good effects.

The old aphorism often holds true- drugs are toxins with sometimes beneficial side effects.  It is part of the art of medicine to decide when it is better to take a drug, and when it is better not to.

Allan Sosin MD

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