I do not know where Bob Scroggins got his medical and journalism degrees. However, his letter of April 10th (“Bad Medicine”) was both irresponsible from a pharmacological standpoint and misanthropic from a human perspective. To condemn the pharmaceutical industry ex cathedra which has saved millions if not billions of lives in the last century is to disregard those people who need these medications to stay alive – and to enjoy a quality of life that, even 50 years ago, was just a fantasy. Cancer, diabetes, depression, bipolar disease, schizophrenia, bacterial, viral, and fungal infections, and in fact the entire Merck Manual is replete with sound, medication treatments for these ailments, with indications based on the results of controlled clinical studies.

Bob Scroggins latest weekly missive has hit a new low in accuracy and a record high in pontificating how he thinks the world should be according to Bob. First, a 2010 report published by the US Department of Health and Human Services stated that of older Americans, aged 60 and over, more than 76% used two or more prescription drugs and 37% used five or more. Not the 15 prescriptions mentioned in Bob’s predominantly unreferenced diatribe.

More importantly, the mean spiritedness of his remarks in which he pooh-poohs significant medical breakthroughs underscores his hollow haughtiness at the reader’s expense. Since 1900, the health and life expectancy of Americans improved dramatically, with our lifespan lengthening by more than 30 years, with 25 years of this gain attributable to advances in public health. In 1999, The Centers for Disease Control and Prevention (CDC) issued the 10 greatest public health achievements in the United States during the 20th century and why they were epic. Six of these achievements have to do directly with the development of pharmaceuticals:

1) Vaccinations have eradicated smallpox; eliminated poliomyelitis in the Americas; and controlled measles, rubella, tetanus, diphtheria, mumps and Haemophilus influenzae type b. Vaccines are in the works to either prevent or treat HIV, tuberculosis, malaria as well as cancers of the lung, breast, pancreas, cervix and brain.

2) Control of infectious disease through the advent of antibiotics has impacted all of us. Common, yet deadly, infections seen in the early part of the century, such as typhoid and cholera, transmitted by contaminated water, have been reduced radically by antimicrobial therapy. Antibiotics have been critical in controlling infections such as tuberculosis and sexually transmitted diseases.

3) Decline in deaths from coronary heart disease and stroke are attributable to the development of anthihypertensives, cholesterol-regulating drugs, diabetic drugs, anticoagulants and antiplatelet molecules. In the last 40 years, death rates from coronary heart disease have decreased 51%.

4) Since the dawn of the 20th century, infant mortality has decreased 90%, and maternal mortality has decreased 99%. Healthier mothers and babies are the products not only of better hygiene, nutrition, and technologic advances in maternal and neonatal medicine but also of the availability of antibiotics and neonatal pulmonary surfactants.

5) Access to family planning and contraception has provided health benefits such as smaller family size and longer interval between the birth of children and fewer infant, child, and maternal deaths. My grandmother died at age 42 in the 1920s after 17 pregnancies. Her body simply wore out. Family planning would have extended her life and improved the life quality of a more manageable number of children.

6) Since the 1964 Surgeon General's report on the health risks of smoking, the prevalence of smoking among adults has decreased, and millions of tobacco-related deaths have been prevented. The pharmaceutical industry has been diligently developing products that can assist smoking cessation in those addicted to nicotine.

As for drug side effects, every object on Earth has a side effect. Your car has potential side effects: your tire might go flat; your gas might run out; your transmission may blow; your headlight might burn out. Should we abolish cars because of these possible dangers? No, because they do more good than harm. They get us to work, to school, to see the world, to help others. It’s risk versus benefit, Bob. As intelligent human beings, we rely on professionals to make the best choices for us based on their expertise. It is the same way with medications and the physicians and pharmacists who prescribe and monitor them: A drug may or may not work out. No promises, just risk versus benefit.

The final slap in the face was Bob preaching about how diet and otherwise clean living can prevent poor health. The only person you could possibly be talking to would be a newborn before he swallows his first artery-clogging bacon cheeseburger. I am 62 years old and, while my body mass index, blood pressure, and other parameters are in the normal range, it takes 6 prescription medications – and a whole lot of exercise – to maintain my health. And have you not heard of the genetic basis for disease and its impact on drug therapy? Matching patients to the drugs that are most likely to be effective and least likely to cause harm is the chief focus of modern therapeutics. Although a genetic contribution to variability in drug action has long been recognized, the sequencing of the human genome now offers a new opportunity for using genetic approaches to improve drug therapy.

True, life ain’t all beer and skittles. Nevertheless, there is no need to incite the population to flush their pills down the can and to deem them lazy to boot. To paraphrase Alexander Pope, the great 18th century poet, “A little knowledge is a dangerous thing.” The smug pedantic cavalier statements in Bob Scroggins’ epistle are not only supremely dangerous, but also life-threatening. This week, a dear friend of mine, just 30 years of age with two small children, incredibly healthy, smart, athletic, and beautiful, will undergo a double mastectomy. Bob, I would like you tell her to her face why her undeserved disease is the result of, as you say, “poor diet, lack of exercise, and insufficient sleep.”

Push yourself away from your Smith-Corona and take a few drug-free laps around the block. It’s just what the doctor did not order.

Sincerely,

Dr. Ron Gasbarro

New Milford, PA

It boils down to just two numbers: 50,000 and 50,000,000,000.

We'll call it the bodies for bucks business. Since 2006 when Mexican President Felipe Calderon declared war on drugs, 50,000 Mexicans have been killed in drug related violence, many were innocent bystanders caught in the crossfire of mob shootouts.

The number is probably far higher since his administration stopped releasing an official count last year.

The combined effect of Calderon's war and the succession of eight American presidents who have supported the drug crackdown is a study in futility. Their efforts are merely the cost of doing business---and business is booming.

The real war is not Calderon's crusade, nor is it the 40-year war waged by the U.S. against drug smugglers. The real war is among the 12 major Mexican drug cartels fighting to get a piece of the $50 billion that flows annually from the U.S. into the traffickers coffers.

The power of narco dollars cannot be overestimated. In South America where poverty is rampant and law enforcement is weak, entire nations have been corrupted by the cartels. Now their pernicious influence is spreading into the U.S.

Their presence is palpable in the southern states of Arizona, Georgia, Texas, and Alabama and in more than a thousand cities across the U.S. where Mexican-style gang violence is growing.

In a disturbing development, two crime syndicates bitterly divided along racial and ethnic lines may have made common cause for financial gain. The Aryan Brotherhood (AB), a white supremacist group with 20,000 members, may have established ties with a Mexican cartel.

The suspicion is that a Mexican cartel contracted with the AB for hits on three lawmen last year.

Mark Hasse, an assistant district attorney in Kaufman County, Texas, was gunned down in broad daylight by two men on January 31. Thirty-four members of the AB have been indicted for the Hasse shooting.

Less than two months later on March 19, Tom Clements, Colorado's top state prison official, was shot to death. A member of the AB has been linked to the murder and arrested.

Eleven days later district attorney Mike McLelland, also from Kaufman county, was shot 20 times in his home, an attack which also claimed the life of his wife. The AB is eyed for this shooting, too.

The three homicides have the earmarks of murder-for-hire hits by one of the cartels in league with the AB. If this is the case, it marks an escalation in cross-border Mexican drug violence.

The overriding question is this: Is America's War on Drugs---a war responsible for the loss of at least 100 thousand lives and the expenditure of $1 trillion---a failure?

The spreading of domestic drug violence and the shear volume of dollars-for-drugs traffic indicate that it is more than a failure.

Not only is the drug war a long lost cause, it is a war that could not and cannot be won.

When an illicit drug can be processed or grown in South America for $1, then sold on the streets of the U.S. for $1,000 to $2,000, there is a profit incentive that can never be overcome.

The killings of drug kingpins like Joaquin “El Chappo” Guzman, Arturo Leyva, and Herbito Lazcano make fleeting headlines. In reality, they do nothing but change the name of the drug lords.

As for the 5 million pounds of illegal substances interdicted at the U.S.-Mexican border in 2012, it is the overhead cost of doing business passed on to the 22 million customers in the U.S.

What, then, is the answer?

Surely, the answer is not to be found in continuing what we have been doing for the past four decades. It must be a new strategy.

First, admit the war is lost.

Second, legalize marijuana which constitutes 60 percent of the cartels' profit. Legalizing MJ would eliminate the smuggling of weed overnight and would be a crippling blow to the drug cartels.

Third, open clinics where hard drug addicts can be treated not imprisoned.

Fourth, the ad campaign against smoking was a success. Initiate a similar effort to educate the public about the debilitating effects of hard core drugs.

And fourth, let's not kid ourselves by setting unrealistic goals. The drug problem will never be eradicate, but it can be greatly reduced and that's more than has ever been accomplished.

Sincerely,

Bob Scroggins

New Milford, PA