Kruti:  You and I have both written about the opioid crisis in our novels. Being a US-based pharmacist and having seen the catastrophe up-close, why do you think the government of such a tightly regulated country was so blind-sided in detecting an oncoming drug disaster?    Peter:  In my opinion the government really did not think there was an epidemic until it was too late. These drug companies (Purdue for example) were all abiding by government regulations and laws, so there was no pursuit by the DEA [1] or FBI in the early stages of the problem. They marketed their products to doctors who in turn began writing prescriptions for these opioids.    Once some unscrupulous doctors began noticing a niche market for these drugs and an abundant demand for them, they opened up what became known as "pill mills." In these "pain clinics" doctors would charge their clients $200 cash co-pays and then referred them to pharmacies that would fill their pre...

If almost half the data on drugs is hidden from our eyes, as mentioned in my  previous post,   why is nobody talking about what’s missing? Isn’t it odd that tons of negative data can disappear so flawlessly with hundreds of eyes peeking over them everyday? Not a researcher that calls for past studies, not a journal that protests lack of publication, not a regulator that nabs the offence?   Unfortunately, not everyone is as clever as Sherlock Holmes to solve mysteries by focusing on what’s missing than what is present. In ‘Silver Blaze,’ the story that revolved around the disappearance of a famous racehorse, Holmes had recognized that none of the people he interviewed had mentioned that the watchdog had barked on the night of the incident. Holmes had concluded that if the dog had not barked, then the dog must have known the perpetrator, and this had led him to track down the guilty party.    But Holmes was an exception. Humans have a natural tendency to focus on ...

Imagine you are suffering from depression. Your psychiatrist puts you on a well-known anti-depressant of which millions of doses are prescribed every year, around the world. But you feel worse than ever before. You even receive a professional setback owing to the drug’s side effects. The psychiatrist is perplexed because she had chosen a drug based on well-designed,  fair trials, with overwhelmingly positive results. What could be wrong?    Interestingly, sometime later, your doctor comes across an uncustomary study conducted by a group of researchers. They have discovered that for all the antidepressants that came to the market in the last fifteen years, only half the clinical trials were published in full – the ones with positive results for the drugs. The ones with negative results were simply lost to history, never appearing anywhere other than in the dusty, disorganized, files of the FDA. A few of the negative trials did appear in academic literature, but were writte...

In these days of the COVID-19 pandemic, scientific research has been a source of much hope – the search for a vaccine, trials for preventive medication, surveys suggesting herd immunity in people, and so on. There is also contradictory information to crush our euphoria (no herd immunity, vaccines to take long, promising pills ineffective, et al ). It is difficult to decide which side of the story is true, especially since scientific research is a complex discipline based on several volatile variables. I intend to dwell on some of these variables in my upcoming posts, as they are also an underlying theme in my maiden medical thriller ‘The AquilaTrials.’   I’ll begin by emphasizing that the significance of clinical research as a methodical science to discover new treatments is indisputable. Randomized controlled trials are considered the gold standard of evidence. Yet, as any other field, pharmaceutical research is fraught with errors, omissions – and frauds – especially as the n...