Editor-In-Chief, Chester "Trip" Buckenmaier III, MD,  COL (ret.), MC, USA

Chester “Trip” Buckenmaier III, MD,
COL (ret.), MC, USA

Humor is everywhere in that there’s irony in just about anything a human does. – Bill Nye

I usually do not watch regular television. I have a real distaste for commercials and no longer have the patience for them. I do consume the nightly news and occasional programs that I record and watch at my convenience, allowing me to blissfully fast-forward through the commercial breaks. I realize this admission is likely causing paroxysms in the ad executives out there, but I feel I am not alone in this particular brand of television viewing heresy. 

Recently I was viewing a rather emotional national news piece showing a preteen girl learning how to administer naloxone (medication used to reverse the effects of opioids) on a stuffed toy rabbit, in case she ever needed to administer the life-saving medication to her older brother. who is a heroin addict. I found these images juxtaposed as both touching (a sister’s insistence to learn to administer the medication for the love of a brother) and horrifying (practicing injecting noloxone on toy stuffed animal for the impending heroin overdose of a family member). This surreal situation is a symptom of the ongoing national epidemic of opioid misuse and abuse. The irony of this news spot caused me such pause that I was not prepared to fast-forward through the following commercial break and found myself confronted with a commercial that moved the touching news story I had just viewed into the Twilight Zone.

The advertisement, which was for a medication to treat a common side effect of narcotic use, depicted the opioid as a cartoonish capsule. No doubt, the producers of this ad were trying to convey the fact that many patients with chronic pain conditions depend on opioid therapy for some modicum of quality of life, and opioid-induced constipation can be a significant issue for them. While that idea may have been the target, I feel the ad trivialized the potentially devastating effects of opioid addition, abuse and misuse.

Whether it is another tragic death due to overdose such as the recent loss of the musician Prince to fentanyl abuse or the ongoing struggle within federal medicine with opioid medications as evidenced by the Presidential Memorandum – Addressing Prescription Drug Abuse and Heroin Use, the opioid problem seems omnipresent in medicine today. Frankly, I was dumbfounded by the irony of viewing the cartoon opioid character immediately following the gritty reality of a young girl learning to inject naloxone to stave off death from opioid addiction in a loved one.

Opioids are not friendly characters; they are serious medications with significant side-effects that should be used only when absolutely required under the supervision of medical professionals. Because the advertisement was directed to consumers, not medical professionals, the ad had neither the time nor sophistication to convey these important concepts about opioid therapy.     

The advertisement I cited became controversial after it first appeared at the Super Bowl, so I will not pile on the criticism.1 Instead, I am arguing that this is another example of why direct-to-consumer drug ads on television should be banned in this country. In fact, of the developed nations, only the United States and New Zealand allow the practice of television drug advertisement. The ads are directed at the general public and are notable for the disconcertingly fast list of potential drug side effects that pharmaceutical manufacturers are required to vocalize. The ads leverage well-known celebrities, picturesque settings and animations, and situations not found in real life. What is up with those people holding hands in separate outdoor bathtubs in the middle of nowhere?

Proponents of this type of advertising suggest the ads provide useful information to the consumer that contributes to general knowledge and destigmatizes medical conditions from which patients would otherwise quietly suffer. While this position might have some merit, I believe the risk of misleading or incomplete information and possible encouragement to overuse prescription drugs far outpaces any advantage. Furthermore, these ads often recommend the most-expensive approaches to treatment that might not necessarily be the safest or most cost-effective therapy. 

I appreciate the substantial investment and development effort pharmaceutical companies must make to bring a new medication to market. Pharmaceuticals, when used correctly under the supervision of a medical professional, do make our lives better. Furthermore, I understand the need for our pharmaceutical industry to make a profit to drive the development of new and better medications. I do believe there is value in print media advertisements of medications directed to medical professionals, where a complete summary of the drug can be provided. I feel patients are best educated about possible medications through their medical professionals, not 60-second commercials. 

Television ads for medications designed to evoke an emotional response toward a drug, rather than a pragmatic and rational assessment of a drug’s advantages and risks, are likely not in the best interest of the public or the pharmaceutical industry. Did I mention that only two developed countries on the planet allow direct-to-consumer advertising of pharmaceuticals on the television? The irony of that statement is not lost on me.

1Super Bowl drug ad spurs big backlash – CNN by Ahiza Garcia Feb. 12, 2016.