At 7:30am I wake up with a headache. Not a splitting ache. Not yet, at least. This one is more like a warning shot, telling me that if I don't do something about it, that the real attack will soon follow. Knowing my luck, this "attack" will hit me in about 60 minutes when I show up for work. I decide to listen to my body and pop a pill.
In my cabinet, and most likely yours, is a product that is well over a century old: Aspirin. The history of Aspirin, as told by Bayer, dates it back to 1897, the year when German chemist Felix Hoffmann stabilized acetylsalicylic acids to treat his dad's arthritic pain. Hoffmann was an employee of Bayer, a company whose own history includes a direct affiliation with Interessen-Gemeinschaft Farben (or IG Farben), a powerful association of chemical and pharmaceutical companies who were supporters of Hitler and the Nazi party.
Bayer's financial ties to the Nazi party is probably why the mega-company excludes Arthur Eichengrün, a Jewish chemist, as the original founder of Aspirin. Nevertheless, following the fall of the Nazi's in WWII, and the conviction of 24 IGF executives and board members for "crimes against humanity", GF and it's associating companies, including Bayer, became the spoils of war to be divided up among the winning Allies.
Aspirin, touted as the "wonder drug that works wonders", borrows its wonders from the willow tree. Ancient cultures had known long before scientists isolated its pain-relieving compounds that chewing on the bark of the Willow helped to assuage aches and pains. Today, the Willow's Wonders are packaged into tiny pills that block messenger molecules that inform the brain about pain. This usually works. When it doesn't, or when it wears off, I pop another pill. Right now, in my cabinet I have about three bottles of Aspirin. Why so many? Well, there's the default bottle that every home has. Then there are the two emergency bottles I bought while away from home and the all too often unexpected headache creeped up on me. Some people are smart enough to keep a roaming bottle of aspirin with them. Not me. It's only a matter of time before my aspirin collection expands to four bottles. This is my contribution to the 40 billion aspirin tablets that are consumed each year.
Pharmaceutical companies would love it – LOVE IT – if this scenario applied to all of their other drugs. Aspirin commands dream revenues largely because it can be purchased over-the-counter. Most other drugs will never be so lucky and will be prescribed at the discretion of a doctor. The Side-Effect Epidemic keeps most drugs from being easily accessible.
Side-Effects are why society have a strange love-hate relationship with pills. The pill-prescription is like a Devil's Contract. A fast-fix is promised but at a price that may exceed what is gained. For instance, according to the Institute of Clinical Evaluative Sciences in Toronto, Canada, "the prescription drug Spironolactone caused an estimated 4,200 deaths in the United States and 37,000 more hospitalizations each year." No wonder than that the word "Pharmaceutical" is rooted in the Greek word Pharmakon meaning both "cure" and "poison." Depending on the severity of what ails us, many of us feel inclined to gamble on the Devil's poison, hoping for instant relief.
Of course, neither the words "Cure" or "Poison" truly apply to what Pharmaceuticals offer us. Most pills cure nothing at all, but instead relieve the symptoms. Nor are we purposely being "poisoned.” The challenge with designing pills is that lab quantities are very small and do not represent marketplace quantities. "Scaling-Up" for mass consumption presents problems of safety and efficacy. Despite metaphors of the programmable body, the reality is that our chemistry is not as simple as input and output. If they were, one-size-fits-all-scaleable- pills would be common. The best that Pharmaceutical companies can do is test their cures on a hundred people or so and hope to hell it doesn't “poison” them. If their hopes are fulfilled, they’ll test it again. This time on even more subjects with the hope that the “cure actually works. If those hurdles are cleared, which usually they aren't, the pills are tested in the marketplace. As we all know, successful testing does not mean that people won’t start keeling over once the pills are consumed by a population much larger than clinical trial populations. If people start dying, well, now the drugs are recalled and commercials for injury attorneys flood television.
All of this, of course, is a simplified take on what really transpires in pill production. The Devil is really good at politics and patients aren't the only one's who are known to strike up deals with this crafty guy. But this is no article on conspiracies of government collusion. Besides pills may soon be a thing of the past...
Pills aren’t exactly elegant in working their magic. Most drugs are administered orally; their effects taking place from absorption through various epithelia and mucosa of the gastrointestinal tract. Though popular in practice, this method is also infamous for its poor absorption. Consequently, most drugs are slow-acting. In other cases, the drug's solubility can change in response to contact with other materials in the gastrointestinal tract or, worse still, the drug can be destroyed altogether by the stomach’s enzymes and secretions. Drug companies have found ways around these issues with tablets that dissolve in the mouth for faster system absorption. They also use polymeric-based tablet cores for controlled, delayed or sustained release of the formula. But all of this pales in comparison to a pill which bypasses the problems of absorption altogether and goes directly to the problematic area to deliver immediate medication. Of course, these aren't pills, per se, but teencie-weencie robots.
Instead of relying on chemical programs, science is combining molecular electronics with biology to dispatch Nanobots into our bodies as repair-men for cells. Robert A. Freitas, Jr., a senior researcher at the Institute for Molecular Manufacturing, calls this "Chromosome Replacement Therapy." That is, Nanobots swapping out the chromosomes of diseased cells, and replacing them with the correct instructions for building healthy one's.
These Nanobots will carry out search-and-find mission using nanowire sensors, locating problematic cells and delivering "smart drugs" that are tailored, not for the masses like conventional pills, but for the individual. This method, should it ever mature and become commercially available, would replace such broad-stroke technologies like chemotherapy where healthy cells are destroyed alongside targeted one's. The extent of how we can use these Nano-RepairBots is limited only by our imagination.
The extent of our access to this technology will be limited by our budgets.
Nanotechnology is expensive stuff to build (the United States invests over $1.5 billion into Nanotechnology research). The National Science Foundation estimates that by 2015, Nanotech will be a $1.5 Trillion Dollar market. Such precision and expensive technology will undoubtedly be priced beyond the reach of most Americans. Prescription costs remain a thorny issue, especially when tax payer dollars pay for new drug research. As backwards as it may sound, tax-payer financed discoveries do not go into the public domain. Not anymore. The Bayh-Dole act of 1980 (named after senators Birch Bayh and Bob Dole) saw to it that universities and small biotechs could patent and profit from federal government-funded research. If the marketplace for current drugs is any kind of barometer for the future medicine marketplace, than we should expect bigger financial headaches with Nanotherapy. Alas, medicine and man will forever remain a dangerous love affair. There's an old saying about danger-love: Can't live with it. Can't live without out it. Except aspirin. That remains affordable.
By the time I get to work, my headache will have vanished, thanks to a pill.
By the time I retire from work, a new headache will swell in its place.
Thanks to a pill.