Bitter Pills: Inside the Hazardous World of Legal Drugs [Paperback]

Stephen Fried (Author)

Book Description

Publication Date: May 4, 1999

We take our medicines on faith. We assume our doctors are well-informed, our drug companies scrupulous, our FDA diligent—and our medications safe. All too often we're wrong. Just how wrong is documented in this critically acclaimed portrait of the international pharmaceutical industry by one of our most highly respected investigative journalists.

According to the Journal of the American Medical Association (JAMA), adverse drug reactions are the fourth leading cause of death in America. Reactions to prescription and over-the-counter medications kill far more people annually than all illegal drug use combined.

Stephen Fried's wife took a pill for a minor infection—and ended up in the emergency room. Some drug reactions go away in a few hours or days. Diane's did not. This emotionally wrenching experience launched Fried into a five-year examination of the entire pharmaceutical industry, the most profitable legal business in the world. Rigorously documented, Bitter Pills is a full-scale portrait of pill making and pill taking in America today, presented through the powerful human drama of doctors, patients, drug companies, the FDA, and government regulators as they war for control of our medicine cabinets.

Editorial Reviews

Amazon.com Review

Bitter Pills started as a magazine story, inspired by Stephen Fried's wife's frightening reaction to an antibiotic. After he won a National Magazine Award for that article, he expanded his investigation into this book. What he has uncovered is astounding, starting with the fact that, in the U.S. alone, between 45,000 and 200,000 people die annually of reactions to legal drugs (2 to 9 percent of the 2.3 million Americans who die each year) versus the 5,000 to 10,000 who die of illegal drug use. As Fried compulsively investigates what happened to his wife and how reactions like hers were considered statistically insignificant by drug companies and the FDA, he learns things most of us don't want to know about the mechanisms that cause pills to land on pharmacy shelves. Chances are, after reading Bitter Pills, you'll be much more careful about accepting prescriptions for new medications. --This text refers to an out of print or unavailable edition of this title.

From Publishers Weekly

Five years ago, Fried's wife, after taking an antibiotic for a minor urinary tract infection, developed such side effects as delirium, visual distortions and insomnia, followed by a debilitating manic-depressive illness that the prescription drug apparently triggered. This report on the often lethal hazards of over-the-counter and prescription medications intertwines Fried's personal story of coping with his wife's condition and an informal, scattershot probe into the drug development and approval process, based on interviews with doctors, FDA officials, consumer advocates, neuroscientists, pharmaceutical executives and sales reps, lawyers and pharmacologists. By turns tedious and revealing, his labyrinthine investigation is sprinkled with useful suggestions for revamping U.S. drug testing and regulatory procedures. Freelance writer Fried includes cases involving adverse reactions to heart medicines, anti-inflammatory and psychiatric drugs, skin creams, anti-asthmatics and AIDS medications. He highlights the laxity of safety standards regarding the prescribing of drugs for children and pregnant women. An appendix offers guidelines for consumers on assessing potential drug dangers, and dealing with doctors and pharmacists.
Copyright 1998 Reed Business Information, Inc. --This text refers to an out of print or unavailable edition of this title.

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Product Details

• Paperback: 448 pages
• Publisher: Bantam; Bantam Trade Pbk. Ed edition (May 4, 1999)
• Language: English
• ISBN-10: 055337852X
• ISBN-13: 978-0553378528
• Product Dimensions: 6.1 x 0.9 x 9.2 inches
• Shipping Weight: 1.1 pounds (View shipping rates and policies)
• Average Customer Review: 4.8 out of 5 stars  See all reviews (17 customer reviews)
• Amazon Best Sellers Rank: #423,708 in Books (See Top 100 in Books)

More About the Author

Stephen Fried is an award-winning investigative journalist and personal essayist, and an adjunct professor at Columbia University Graduate School of Journalism. He is the author of five widely praised books--THING OF BEAUTY: The Tragedy of Supermodel Gia (which inspired the Emmy-winning HBO film Gia and introduced the word "fashionista" into the English language); BITTER PILLS; THE NEW RABBI; HUSBANDRY; and APPETITE FOR AMERICA: Fred Harvey and the Business of Civilizing the Wild West--One Meal at a Time (selected by the Wall Street Journal as one of the ten best books of 2010). A two-time winner of the National Magazine Award, he has written for Vanity Fair, Glamour, The Washington Post Magazine, GQ, Rolling Stone, Philadelphia magazine, Ladies Home Journal and Parade. Fried lives in Philadelphia with his wife, author Diane Ayres.

Customer Reviews

Most Helpful Customer Reviews

28 of 28 people found the following review helpful:

5.0 out of 5 stars Required reading for any empowered patient, February 5, 2002

By 

Mary (Washington, DC) - See all my reviews
(VINE VOICE)   

Amazon Verified Purchase

This review is from: Bitter Pills: Inside the Hazardous World of Legal Drugs (Paperback)

I didn't know about Stephen Fried and "Bitter Pills," much less quinolone antibiotics, until I myself was, like Mr. Fried's wife, "Floxed," just a few weeks ago. I began my search for information on reactions to quinolones after four days of gatifloxacin (brandname Tequin) left me with tingling and weak arms and legs, difficulty swallowing and breathing, visual disturbances, headaches, dizziness, and more. I seriously thought I had a stroke or Guillain Barre syndrome or rapid onset multiple sclerosis, I was so sick.

Let me say that first, Stephen Fried's book is an excellent overview of the circumstances of adverse drug reactions to quinolone antibiotics. And with the increased visibility and use of Cipro, and the ease with which doctors dispense heavy-hitting antibiotics like Levaquin and Tequin, I'm sure I'm not going to be the last person to suffer a reaction and end up being "Floxed" and needing the information and reassurance provided by this book.

But it is also much much more. It's an expose of the pharmaceutical industry's fast and loose way of dealing with drugs, drug safety and the American public. This is not a rant -- it's an impeccably researched and detailed presentation of the intricacies involved in drug approvals and tracking of adverse reactions that exposes the limitations of the system, and the dangers those limitations present to us as patients and consumers.

As a patient advocate and spokesperson for thyroid and autoimmune disease patients, I know all too well the feeling of being held hostage to big pharmaceutical companies at the expense of my health and wellness.

Stephen Fried has finally exposed and explained -- clearly and without rancor -- how the drug industry really works, and his book, including the excellent appendix on how to contact pharmaceutical companies, report adverse reactions, protect yourself against bad drugs, and generally protect yourself as a consumer -- is must-reading for every empowered patient or health consumer.

I highly recommend this book to doctors, patients, and anyone who prescribes or takes prescription drugs.

19 of 19 people found the following review helpful:

5.0 out of 5 stars An Important Issue Gets Excellent Reporting, January 12, 2001

By 

Mark Wylie (Spokane, WA United States) - See all my reviews
(REAL NAME)   

Amazon Verified Purchase

This review is from: Bitter Pills: Inside the Hazardous World of Legal Drugs (Paperback)

This book begins as a personal story. One day journalist Stephen Fried was forced to rush his wife, novelist Diane Ayres, to an emergency room, when she suffered a severe seizure. She turned out to be suffering an adverse reaction to an antibiotic, Floxin, which she had been instructed to take for a minor urinary infection. "Bitter Pills" grew out of Fried's attempts to understand what had happened to his wife.

Fried, and his readers, soon discover that Diane Ayres' case was not unique, or even rare. Floxin is only one of legions of prescription drugs which can cause severe adverse reactions, which cause at least 45,000 deaths per year in the US (some estimates go as high as 200,000). It is a tribute to Fried's excellence as a reporter that he is able go beyond his dramatic personal story to give a comprehensive picture of what he calls " the hazardous world of legal drugs."

Fried reviews the history of drug regulation in the US, and ably documents the shortcomings of the current regulatory system, as well as the inordinate influence drug companies have on the process. Two of the many specific "hazards" he identifies are the desperate need for doctors to have an independent, reliable source of information on the drugs they prescribe (almost all the informatin they currently have comes from drug manufacturers), and the equally crying need for an effective system for reporting and cataloging adverse drug reactions.

I put this book down very impressed with Fried as both a reporter and a writer. He has clearly immersed himself in an important issue long enough, and deeply enough, that he has mastered it. He has then turned around to convey the complex issues involved to readers very effectively and without losing their interest. I look forward to work of similar excellence from Fried in the future.

18 of 19 people found the following review helpful:

5.0 out of 5 stars A Great Expose of Legal Drugs and the FDA, September 9, 2001

By 

Joel M. Kauffman (Berwyn, PA United States) - See all my reviews
(REAL NAME)   

This review is from: Bitter Pills: Inside the Hazardous World of Legal Drugs (Paperback)

"Bitter Pills" is the real-life version of "Strong Medicine" by Arthur Hailey. With a very personal beginning resulting from his wife's near death and slow recovery from taking ONE PILL (Floxin), author Fried went on to find whether there were other victims (many), and why the drug was approved in the first place. Interviews in profusion show why the FDA has its problems. Examples are given of the tendency of drug companies to defend their drugs at any cost regardless of evidence. The end of the book contains addresses of many drug companies, organizations to whom to report adverse drug reactions, and a sample form to send to the FDA. Well thought-out advice for patients (or their helpmates) to investigate drugs are given. A number of other good books on the subject are listed.
Fried is to be congratulated for doing a very accurate job with a minimum number of accusations. I did not find a single technical error in the entire book, and I have about 12 years exploratory drug development and teaching about it as a professor of medicinal chemistry.
Even Fried may not have realized how many drugs not discussed in his book shorten life, because they are tested and accepted based on surrogate endpoints for short periods. This may not be so bad for antibiotics that are taken for two weeks, but can be very destructive for drugs intended to be taken for 20-40 years.