Thursday, April 24, 2014

Passed out and fully plastered: a comment on free drugs in America

I have never really looked at Allergan but was horrified to find a rewards program for using Botox (a toxin derived from botulism and which makes your skin taught by killing anything that causes wrinkles). Yes, take your Botox injections and earn 200 points... trade your points for free drugs. Downstream cosmetic surgeons can also sign you up for the "Brilliant Distinctions" program and presumably they earn referral fees.

Along with free Fentanyl - something more widespread than the I originally thought, you can be passed out and fully plastered in America. Your chance to look like Chairman Mao under the glass, glazed eyes, skin stretched taut.





John

6 comments:

  1. Drug rebates aside, your description of the mechanism of Botox is quite incorrect. The toxin acts locally to prevent nerves from transmitting, which in turn relaxes the muscles underlying the skin. Despite being derived from one of the deadliest toxins (on a lethal dose basis), the drug is quite safe and well tolerated. Much more so than Fentanyl, to be sure.

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  2. Botox is also a common treatment for severe migraines.

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  3. Botulinum toxin (Clostridium botulinum) is the most acutely lethal toxin known to man.

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  4. From wiki: "On February 8, 2008, the FDA announced Botox has "been linked in some cases to adverse reactions, including respiratory failure and death, following treatment of a variety of conditions using a wide range of doses", due to its ability to spread to areas distant from the site of the injection.[57] In April 2009, the FDA updated its mandatory boxed warning cautioning that the effects of the botulinum toxin may spread from the area of injection to other areas of the body, causing symptoms similar to those of botulism.[58]

    In January 2009, the Canadian government warned that Botox can have the adverse effect of spreading to other parts of the body, which could cause muscle weakness, swallowing difficulties, pneumonia, speech disorders and breathing problems."

    Comment #2 is wrong. Botox does not "relax" anything, it paralyzes your muscles by cleaving (destroying) the SNAP-25 protein, thereby preventing the muscle's neurotransmitters from being released. This is the exact same mechanism as botulism, because it is the same thing.

    Usually this paralysis is temporary, because these proteins are regenerated. However this is not always the case, especially in older patients, and the damage can be permanent. See the case study and related citations on page 1309 here, from the National Center for Biotechnology Information (NCBI):

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1722871/pdf/v083p01306d.pdf

    In many cases the toxin can be found in the body many months or even years later. If it travels away from the injection site it can cause permanent eye damage or even death via respiratory failure. Lastly, the long-term effects are not very well understood because it is relatively new, and received FDA approval based only on short-term testing.

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  5. I do not understand people's obsession with botox.

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