April 6, 2010
Consider the ramifications of rules that outlaw drugs or behavior because a few people are injured by them.
I am almost as miserable as yesterday and the basket next to the computer is filling with Kleenex. But here I am, back again with a goal of writing five blogs a week. If I recover, I may actually decide to do this as my “practice” because I notice I had eleven more subscribers since the day before, so maybe people really like to read this more often than I have been producing it.
However, now I have to find a fairly quick topic so I can get on with answering emails that piled up when I was at the conference in Washington, visiting my granddaughters, and on my back with this cold. All of which brings me to a side topic: the speed at which one answers emails.
Do you ever notice that some people will answer an email almost the instant they get it, as though they have been sitting at their computer waiting with baited breath for your specific message so they can send you a quick reply? Are you a fast responder or slower, like me? Let me know in the comments below.
In the past, when we communicated by snail mail, it was understood that it would take time for your letter to get through all the steps of postal delivery from your house or business to mine, then it would take time for me to carefully consider a response, time to get out a piece of paper and write a reply, find an envelope, take it to the mailbox on the way to work, and let it wind its way through the Postal Service and back to your house or business.
Slower? Yes. But it gave those of us who have a full schedule a cushion in which to consider a request. Now we are expected to blast off an email immediately. I realize that not everyone feels that way in the land of instant communication, but I find myself feeling guilty for not answering emails more quickly even when I have a good excuse. So today, again, I am using my Ironing Basket Approach, which I’ve explained several time in the blog, to clean up my inbox — after I get this blog finished — so I better get on with the main topic of the day.
The topic is easy because this cold is so much worse than anything I’ve had for many long years and I attribute my minor or non-existent colds to a Zicam nose gel. For those of you who don’t know what it is, or was, let me tell you that it was a product with zinc gluconate that you gently squirted into your nostril within the first 24 hours of feeling cold symptoms. It didn’t prevent colds, but it was, according to my doctor and reports I’ve read, the only product that was shown to decrease the severity and duration of colds. Always seemed to work for me.
Then last year, because of reports of some people who lost their sense of smell, either temporarily or permanently, following its use, the FDA put out a warning about it. So the company pulled it off the market. Today I’ve tried to get the complete statistics, without spending too much time, to see exactly what percentage of people were affected relative to the number who used it. I’m making guesses but it gives me some kind of context in which to ask you to consider some questions today.
There are several factors in deciding whether withdrawal from the market was a wise move, which is the crux of risk analysis. For example:
- If 3,000,000 users benefited from the over-the-counter drug over ten years and 300 were affected (numbers I’m making up but based roughly on several reports), that would mean .1% had a negative reaction.
- How severe were the problems with lack of smell? If it was a life-long problem, that is a significant negative effect.
- If it was only a moderate loss of smell and quickly disappeared, the questions is whether it would be worth the prevention of a serious cold.
- If the 3,000,000 potential cold sufferers (remember, that’s my made-up number of Zicam nasal gel sales over the time it was on the market) didn’t get a worse cold that could have turned into pneumonia, should that be part of the analysis when balanced against the negative loss of smell?
We seldom are given such a cost-benefit analysis when we read about products taken off the market. If there is such analysis, it doesn’t seem to be a prominent part of the analysis. In any case, we are highly critical about the FDA not stepping in to protect us — a job I want them to do thoroughly. On the other hand, it seems to me, we should insist on being told the number of people injured, but also the potential of harm by not using a product. For example, there is a lot of heated discussion about the “dangers” of vaccinations but not enough discussion of what can happen when children are not vaccinated against diseases that can be serious and life-threatening.
In doing a few minutes of research on this topic, I did find out something I will remember in the future. Apparently there are some oral Zicam cold remedy products, such as RapidMelts and Chewables that are not affected by the FDA’s recent warning. Next time I’ll try them.
I really don’t know where I stand on the matter of my Zicam nasal gel. I relied on it for many years. If I thought there was a higher risk, I may be willing to keep suffering like I am today. I know I’ll survive. Eventually. But I think people should be told the risk-benefit analysis and make up their own minds. I’m not sure I would risk losing my sense of smell, but I would like people to be given the chance to buy a product if they are willing to take the risk. I suppose what that means is that we’d have to protect companies against lawsuits when the risks are clearly stated and someone has a negative reaction.
The questions I have posed today are filtered through a foggy brain, so they may not be as clear as I would like, but they can give you an idea for considering the withdrawal of products that sometimes throw the baby out with the bath water — and our tendency to accept alternative products that are hyped far beyond their proven effectiveness.
ASK YOURSELF THESE QUESTIONS:
- What is the level of risk I would accept from a product sold over-the-counter in stores and pharmacies if the negative effect was life-threatening? .01%, .1%, 1%, 10%?
- What is the level of risk I would accept from a product sold over-the-counter in stores and pharmacies if the negative effect was not life-threatening but minor? .01%, .1%, 1%, 10%?
- Where would I draw the line if a percentage were likely to die from taking a drug that provided a cure for those it benefited?
- Earthquakes, hurricanes, fires and floods all have the potential to kill and maim; how seriously should we expect our government to protect us from them?
- If my answer to the above question is that government should do everything it can to protect us, how willing am I to pay more taxes so, for example, higher dikes can be built or buildings reinforced to the maximum extent?