WHAT IS A DRUG?
Some drugs are easy to identify as such. Everyone knows that heroin is a drug and that penicillin is a drug. But what about aspirin ? What about sodium bicarbonate? And what about alcohol? Is there any difference between an ordinary medicine and a drug?
According to the World Health Organization, a drug is ‘any substance or mixture of substances that is manufactured, sold, offered for sale or represented for use in: 1 the treatment, mitigation, prevention, or diagnosis of disease, an abnormal physical state or the symptoms thereof in man or animal; or 2 the restoration, correction, or modification of organic function in man or animal.’
If you read that definition carefully you’ll see that it includes a good many substances – some of which you may not have thought of as drugs. Aspirin, paracetamol, sodium bicarbonate, alcohol, tea and coffee are all drugs. And those ‘food products’ such as garlic, yeast and so on which are sold to help preserve or restore good health have to be classified as drugs, too.
PLACEBOS AND THE PLACEBO EFFECT
For decades now it has been known that approximately one-third of all patients will obtain relief from tablets and medicines which contain absolutely no pharmacologically active constituents and which work by intent rather than by physiological effect. Knowingly or unknowingly placebos are used more frequently than any other drugs.
Even patients suffering from severe pain can benefit from the placebo effect. Dozens of studies have shown that patients with severe heart pain, usually requiring major pain-relieving drugs, can obtain great relief from nothing more than sugar tablets.
It is this placebo effect which explains the effectiveness of so many home medicines – a large number of which contain nothing of any pharmacological value. For a placebo to work well the patient taking it must be convinced of the potential benefit of the product and there is no reason to suppose that advertising material is any less convincing than words of encouragement from a doctor.
Doctors still do not know exactly why or how placebos work, although recently research work has shown that when a placebo is taken special hormones are released within the brain. These hormones may then have an effect upon the body. Whatever the mechanism is we do know that a placebo will not work unless the patient taking it is convinced thathe will benefit. Strong-willed, self-sufficient, suspicious folk are far less likely to benefit from the placebo effect than nervous, anxious, dependent people.
However it works the placebo effect is important and it explains the effectiveness of a large number of home medicines.
HOW DO DRUGS WORK?
Drugs can work in any one of several different ways. There are drugs which work by killing off minute organisms and thereby preventing or curing infections. There are drugs which alter the way the body Works; drugs which consist of hormones or which affect the blood’s clotting mechanisms fall into this group. Then there are the drugs which can actually prevent the development of disease. Vaccines, which give the human body an advance look at potential infections and therefore enable it to prepare defence mechanisms, are obviously members of this important group.
But most of the drugs that can be bought over the counter in a chemist’s shop or supermarket do not cure diseases, they simply relieve symptoms. Painkilling drugs don’t usually cure the disease that is producing pain (although under some circumstances they may help speed a cure) – they simply relieve the pain. Antacid drugs don’t cure stomach ulcers – but they relieve the associated pains.
It is, incidentally, worth remembering that many of the symptoms home medicines are designed to eradicate are, in fact, manifestations of the body’s attempt to cure itself.
Should you swallow threatening bacteria then you will begin vomiting and develop diarrhoea as your body tries to get rid of the unwanted invaders. If you do heavy work regularly then your skin will become thicker and rougher so that it is more capable of coping – you will get callouses.
Contract an infection and your body temperature will rise to try and kill off the causative organisms. Minor skin infections are sealed off as boils, and your tonsils act as barriers preventing bacteria from getting into your body.
When you have something in your eye the tears will flow in an attempt to wash the foreign body away, and when you have something caught in your throat you will automatically cough in an attempt to dislodge it.
Pain is a warning sign that should be taken seriously. If you ignore muscle pains, for example, then you are likely to do further damage. If you ignore indigestion pains for too long then you may develop a peptic ulcer.
Unhappily, we rarely appreciate the efforts that our bodies make on our behalf. Indeed most of the defence mechanisms which operate automatically are treated as unwanted. When we have an attack of diarrhoea induced by bacteria we take medicine to stop it. When we develop boils we smear them with creams which send the bacteria running for cover instead of breaking out into the open where they can easily be removed. When we’re hot with an infection we take aspirins to help cool ourselves down.
When we sweat we use powders and deodorants. When we develop callouses we soften them. When we cough we take medicines to try and stop ourselves coughing.
The very fact that home medicines work symptomatically, dealing with symptoms rather than diseases, means that they must often directly oppose these automatic defence mechanisms. Naturally it would be unrealistic to expect patients to do nothing about symptoms which are inconvenient or uncomfortable. But it is well worth remembering that your body does know best and that annoying symptoms may be early warning signs of developing disease and your body’s way of protecting you.