http://1.usa.gov/nDrXOa

In 1997 the United States federal government opened the floodgates for direct-to-consumer marketing of pharmaceuticals by relaxing previous restrictions and legislation.^[1] Just one year prior, reports indicated pharmaceutical sales advertising expenditures ranged around just over half a billion dollars. By 2009, that amount had skyrocketed to nearly five billion dollars, just in direct-to-consumer advertising alone, not including advertising to physicians and clinicians. ^[2]

With the dawn of DTC advertising, consumers were able to see for themselves the plethora of prescription drugs available to them for any and every type of ailment and illness. Until that time, the average consumer was relegated to blind faith in their physician, and his advice to, “Take two of these and call me tomorrow.” A report by AARP from 2010 indicates 90% of Americans aged 18 and over have heard or seen a pharmaceutical advertisement. ^[3]

There are three basic recognized direct-to-consumer ad campaign types: product claim ads, help seeking ads, and reminder ads.^[4] These marketing types fall under various policies and laws, and are not all regulated by the FDA. Their focus on certain drugs goes from unmistakable and deliberate, to mere presumptions of knowledge about a product on the part of the consumer. 

• Product claim advertising has the most restrictions put upon it since it does mention a specific drug. Per the Food and Drug Administration, this type of marketing must make clear what the drug is for, how it can help, and what the risks are in taking it. 
•  Reminder ads, while still considered advertisements for specific drugs, are not under such stringent requirements, since they do not specifically say what conditions they treat. They are not required to list all the possible side effects and risks. Although still regulated by the FDA, the advertisements cannot portray either visually or audibly what the drug is for. Further, there are certain drugs that cannot be advertised by way of reminder advertisements because their side effects are too serious, and therefore must be mentioned, according to the policies of the FDA. 
• Help seeking ads are regulated by the Federal Trade Commission because they do involve trade policies and laws, but there is no oversight by the FDA. Help seeking ads are designed to bring consumers’ attention to such conditions as asthma and erectile dysfunction. However, the marketing does not advertise any specific drug in any way. The ads will sometimes have a phone number and the name of a pharmaceutical company where consumers are invited to call to get more information about certain conditions and their treatments.

Pro-activists for the direct-to-consumer cause tout the benefits of more knowledge on behalf of the individual patient. Such knowledge, they say, allows consumers to make more informed choices, along with their physician, as to the best course for their care. Physicians have reported a more active role on the part of the patient, which leads to a better quality of care in most instances. Patients being more informed about their own medical conditions and having and informed understanding of their healthcare could quite possibly play a very important role in provisional quality care in the United States with all the upcoming changes to healthcare laws regulations.

The question arises as to whether or not the ideals of the stronger physician/patient relationship actually work in retrograde. Naysayers point to the many physicians reporting a more aggressive approach on the part of some patients, who insist they need a certain type of medication or procedure, when it would not, in fact, be beneficial to them. Doctors report a feeling on the part of patients that the doctor is withholding something from them, when in fact the doctor simply wants not to over-diagnose or over-prescribe. Physicians describes incidents where they have had to “fire” patients due to the patients’ refusals to cooperate with what the doctor wants to prescribe for a course of treatment.

With the enactment of laws to prohibit drug companies from overstating the benefits of drugs while understating the risks and side-effects, the pharmaceutical industry has been forced to re-evaluate how it presents its products to the consumer. A 2010 report from Reuters tends to suggest it is somewhat of a cat-and-mouse game, with the FDA constantly trying to stay up-to-date on the most recent hard advertising push by ‘Big Pharma’.^[5]   

As insurance premiums and prescription prices increase, the pharmaceutical industry will have no choice but continue to push sales to stay in the market. There will have to be an eventual understanding between the physician, the patient and the regulating bodies as to how patients are informed of all their treatment options. Until then, it is ultimately up to the consumer to make informed educated choices about their health, while remembering to take into consideration the opinions of the physicians, who are, ultimately, the final authority on what treatments and prescriptions are appropriate to each situation.

That continuous use of steroids is not good for health and causes side effects, is a known fact. But these potentially dangerous products are taken by many body builders.

The worst thing about taking steroids and the reason for so many side effects is that they are mostly taken without any supervision from a qualified physician. Not only does this irresponsible use of steroids lead to serious health problems but also in some cases, death.

FDA Warning To Consumers

Recently, the Federal Drug Administration (FDA) has issued a warning to consumers that products being marketed specifically for body building and claim to contain steroids or steroid-like substances, were not reviewed or approved by the FDA and can be potentially harmful.

These products are sold both in retail as well as online. They are promoted as hormone products or as alternatives to anabolic steroids to increase strength and muscle mass. The manufacturers make these products seem genuine by labeling them as dietary supplements, which they are NOT. They contain synthetic steroids or steroid like ingredients and are also not effective in most cases. In fact, they can be potentially harmful but the products are sold with misleading labels with no clear directions of use. This means they are in effect, illegally marketed.

Dangerous Body Building Products In The Market

In their warning letter, FDA listed a few body building products that are not considered safe. These products are either marketed as anabolic steroids or as similar to anabolic steroids:

• TREN-Xtreme
• MASS Xtreme
• ESTRO Xtreme
• AH-89-Xtreme
• HMG Xtreme
• MMA-3 Xtreme
• VNS-9 Xtreme
• TT-40-Xtreme

FDA received several reports of people; especially men between the ages 20 and 55, having suffered from liver injury, pulmonary embolism, kidney failure or stroke.

Major Health Problems Caused

Many people may be unaware of the fact that products containing anabolic steroids have the potential to cause acute liver injury. They may also cause several long-term health problems not only in men but women and children too, such as male infertility due to decreased sperm count, production of abnormal sperm, decrease in natural testosterone production, shrinkage of the testes, male breast enlargement, adverse changes in blood lipid levels, short stature in children and increased risk of heart attack and stroke.

In women, the side effects of steroids are slightly different and affect the woman’s hormonal system. It leads to masculinity in women, thickening of the vocal cords resulting in a deeper male voice, facial hair growth, enlargement of the clitoris, male pattern baldness, breast shrinkage, infertility, menstrual irregularities and the unfortunate thing is that most of these effects are irreversible.

While most of the negative effects can be reversed with the discontinuation of steroids, there are some irreversible effects like the impairment of the immune system, which is usually not detected until after the usage is stopped. Anabolic steroids could even cause the development of various cancers.

The FDA is also in the process of finding other such products in the market and has even issued a search warrant to American Cellular Laboratories Inc., which markets many of these unapproved new misbranded products.

Symptoms

Due to the potential for extremely serious health risks, if someone is on these products, it helps to be aware of the symptoms. The main symptoms are nausea, fever, weakness or fatigue, chest pain, abdominal pain, yellowing of the skin or whites of the eyes, shortness of breath or change in urine color.

Body Builders And Athletes

Athletes often use these products to improve sports performance and also to recover from training and other events. What many of them are not aware of is that in young athletes involved in either body building or some other sport, these steroids will cause an early end to bone growth and limit the final body height.

Both men and women body builders on anabolic steroids experience increased aggression, altered libido, rage reactions, psychosis, depression, mania, anxiety, panic disorders and many other addictions.

Recently, a decade long study was completed and the results send a chill up the spine. Most of these body building products where they claim to have used anabolic steroids have not actually used steroids, but other prescription drugs that are far more dangerous than the actual steroids. We have seen the side effects of steroids, which can at times be lethal, but these are worse.

It is surprising that with so much information on anabolic steroids pertaining to the health issues and legal implications available, it is seen that many professionals fall for the false claims made by the product manufacturers and continue to use them. This problem is widespread and needs to be controlled. The bottom line is to avoid taking steroids. It is possible to build a body and build lean muscle the healthy way.

Terror is said to wound the brain just as bullets wound the body. Exposure to trauma and events that are extremely tough to handle affect the body chemistry.

This is what happens to soldiers at war, who develop disorders related to the brain or suffer from depression caused by traumatic experiences. Hundreds of thousands of troops serving the nation in Iraq and Afghanistan are said to be suffering from major depression or Post-traumatic stress.

This major health crisis is being handled by the U.S. Military in a way that has never been done in history – by popping the pill.

Growing numbers of U.S. troops are reported to be taking daily doses of Prozac, which is an antidepressant, to calm the nerves.

Officials say that increasing violence in Afghanistan and the isolation caused the troops to rely more on medication; although, it is the same in Iraq, but to a lesser extent. The Army’s fifth Mental Health Advisory Team report reveals data that shows about 12% of the Iraqi combat troops and 17% of the Afghanistan troops are taking antidepressants or sleeping pills.

Prozac (Fluoxetine hydrochloride) is the third most prescribed antidepressant, with over 22.2 million prescriptions having been filled during the last year alone. It has been approved by the FDA for use in treatment of obsessive compulsive disorder, clinical depression, panic disorder and bulimia nervosa. It is prescribed to alleviate anxiety and improve sleep.

Healthcare professionals say that antidepressants are to be used on people with chemical imbalances and not on people who are justifiably depressed because they see horror every day and they are thousands of miles away from home. If antidepressants are given to people without chemical imbalances, it can lead to adverse reactions and probably made worse by “medication.” They are also of the opinion that these soldiers need to receive appropriate care for the mental health conditions, or else they will have to face long-term consequences.

It is reported that even military physicians are divided on this, some are of the opinion that the exact effects of using medications such as Prozac, Zantac and other antidepressants on soldiers at war, is not very clear and others say that using this medicine for mild depression alleviates the need for replacement of soldiers, which can prove to be a costly affair.

There has been a hue and cry about people who are on antidepressants becoming aggressive or killing themselves. There was even the horrific story about Eli Lilly, the manufacturer of Prozac magically misplacing important information that shows a strong link between antidepressants and suicides. Long before the drug being approved and brought to the public, there apparently were many drug trials that proved this.

Although, there is no concrete evidence that Prozac may be what is actually making them commit suicide, the trauma that goes with killing people, watching friends die, feeling trapped, living in constant fear, knowing that they are going to go out there and do it over and over again, getting divorced, are sufficient to drive people to suicides.

These soldiers, who are fighting for their nation in Iraq and Afghanistan, pay a price not only in terms of endangering their lives but also pay a heavy psychological price. It all starts off with mild anxiety and passing irritability, difficulty in sleeping and increasing feelings of pessimism and apathy. As it worsens, these feelings last longer and the person concerned becomes panicky and angry. These symptoms are not restricted to the battlefield and continue even when these soldiers go back home, which affects their personal lives and results in broken marriages, breakdowns and suicides. This mental trauma is so severe that the Pentagon is planning on qualifying post-traumatic stress disorder (PSTD) as part of the “wounds,” which is currently only restricted to the physically injured soldiers. Defense Secretary, Robert Gates said that “it’s clearly something that needs to be considered and the Pentagon is weighing the change.”

With these soldiers subjected to this turmoil on a daily basis, the big question is, “Does Prozac or any other antidepressant really help?”

An investigation conducted on this suggests that the army is using a little-examined practice of giving antidepressants to get the soldiers going and continue fighting, in order to avoid the cost of deploying replacements and training, and also to maintain troop strength. These antidepressants and sleeping aids used for retention are said to have had tragic consequences and many a soldier in the past went back home in a coffin.

These combat troops that pop the pill and go back to work need follow-up care and more than anything else, they need rest.

This investigation reveals that there is alarming evidence that these medications are being dispensed with not much monitoring and minimal counseling, despite the fact that FDA warned that the drugs can increase suicidal thoughts. Another thing that they noticed was that these soldiers were sent back to the front lines by military doctors, after a three-day drug treatment and rest; whereas experts say that these drugs take anywhere between two and six weeks to actually start showing affect and provide any sort of therapeutic value, but the side effects kick in almost immediately.

Families of these troops also reported that their loved ones were prescribed antidepressants by military doctors, with no regular monitoring or counseling.

An explanation given by an Army Surgeon states that these drugs are only used to assist soldiers in passing through an event and they lay emphasis on keeping these troubled troops close to the front lines in their best interests, because it helps them recover and avoids the stigma of abandoning duty.

But experts outside the command look at this differently and point out that it is a completely irresponsible gesture and is being done as it is “best for the Army” and not the soldiers. Many consider this act of supplying antidepressants to the troops as an inhuman act. They say that the Army is denying these soldiers proper treatment, which entails taking them out of the battle, and adding a drug to this situation is the worst thing they can do.

Health experts say that although, Prozac, Zoloft, Celexa and Paxil are the most commonly prescribed antidepressants, they can worsen depression and may cause suicidal thinking and the FDA states that people who are on antidepressants should be carefully monitored when they are first prescribed; however, this is an almost impossible task to accomplish in a war zone.

The traumatized troops do find solace in these antidepressants and sleeping pills but in a totally different way – by faking a mental illness to be able to get out of duty. The health care professionals are being traumatized too, by having to constantly be on the alert for troops that are faking. Can the troops be blamed?