Adverse Drug Reactions: A Leading Cause of Death In The U.S.

The April 15, 1998, issue of JAMA includes a meta-analysis with a startling conclusion. It reported that the number of fatal adverse drug reactions in the United States in 1994 was estimated at 106,000. This average makes adverse drug reactions the fourth leading cause of death in the United States; behind heart disease (743,460), cancer (529,904), and stroke (150,108). These results were not only unexpected, but also quite alarming.

The criteria for inclusion in this study were to include only those adverse reactions of drugs that were prescribed, dosed and dispensed correctly. They did not include intentional or accidental poisonings, overdoses, drug abuse, incorrect dosing or non-compliance. This basically means that these deaths were due to the inherent nature of the FDA approved dose of a variety of drugs on the human population. It is interesting that this is not included in the leading causes of death lists published by the CDC or FDA. If we included the accidents, overdoses, and chronic effects of years of compliance; FDA approved drugs may even constitute the third leading cause of death in the United States.

We, of course, do not mean to imply that many of these drugs have not played a role in saving lives, they have. These data are just a glimpse into the effects of potent drugs which block receptors, stop enzymatic reactions, and alter membrane potentials. These activities have the ability to alter disease conditions, but come with some powerful consequences. When we analyze the ability of natural ingredients to effect similar conditions, we find that similar activities are implicated, but with fewer (and less severe) side-effects.

As we pursue a natural approach to one of the most ubiquitous ailments in the United States, allergies, antihistamines are the first line of defense. As is well known, they cause drowsiness in a large majority of users. Two of the three anti-histamines that were designed to eliminate this side effect (by not crossing the blood-brain barrier) have been pulled off the market for other, more serious side-effects. While botanical products may not have the potency of many of the pharmaceutical ingredients, they contain a variety of phytochemicals that allow them to stimulate the same outcome as many of the pharmaceuticals, with fewer side effects. Finally, we must mention that adverse supplement reactions are almost unheard of. That is, when correct natural products are taken correctly and with the proper dose, severe adverse reactions are extremely rare. Most adverse reactions come from allergic reactions, incorrect dosing, or accidental mix-up of poisonous botanical (as with the recent incidence of digitalis/plantain). We are quite proud of the safety record of natural medicines, and feel that it is in keeping with the primary oath of physicians: "First, do no harm."

Jason Lazarou, Bruce H. Pomeranz, and Paul N. Corey. Incidence of Adverse Drug Reactions in Hospitalized Patients. JAMA , 1998; 279 (15): 1200-1205.