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Over Dose: The Case Against the Drug Companies: Prescription Drugs, Side Effects, and Your Health
An associate professor of Family Preventative Medicine takes on the pharmaceutical industry, arguing that the "acceptable" side affects of many drugs are in fact unnecessary and dangerous. 25,000 first printing.
318 pages, Hardcover
First published October 1, 2001
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June 22, 2026
A CALL FOR ENHANCED DRUG TESTING, TO REDUCE ‘SIDE-EFFECTS,’ ETC.
Jay Sylvan Cohen (d. 2015) was a medical doctor and professor of family and preventative medicine at the University of California at San Diego.
He wrote in the ‘Author’s Note’ to this 2001 book, “The purpose of this book is to help readers become more informed consumers of medical services and prescription drugs and to assist them in consulting more effectively with their own physicians. The use of prescription medications can be directed and managed only by a doctor.”
He wrote in the first chapter, “In 1998 an extensive study published in the Journal of the American Medical Association (AMA) showed that 106,000 people die annually in American hospitals from medication side-effects. Medication reactions are the fourth leading cause of death in the United States, dwarfing the number of deaths caused by automobile accidents, AIDS, alcohol and illicit drug abuse, infectious diseases, diabetes, and murder. In addition to the medication-related deaths, the JAMA study also tallied 2,216,000 severe medication reactions in U.S. hospitals annually.” (Pg. 2)
He reports, “Dr. Thomas J. Moore of Georgetown University… determined, '51% of approved drugs have serious adverse side-effects not detected prior to approval.’ Think about this: More than half of our drugs, after being deemed ‘safe’ by the FDA and then prescribed to millions of people, are subsequently detected to have previously unrecognized, medically serious side effects. No wonder we have a side-effect epidemic.” (Pg. 8)
He continues, “46% of Americans take at least one prescription drug daily… Most of these people are taking medications long-term, so their exposures aren’t brief…. In 1999 Americans purchased 2,587,575,000 prescriptions: that’s nine prescription drugs for every person in America.” (Pg. 8)
He reports, “I found that the drug companies dominate the entire process of medication therapy---from early research to ultimate usage---as few other industries control their products today. Drug company research and development often serves marketing strategies more than sound science of patients’ safety.” (Pg. 9)
He states, “the drug companies underwrite 70% of all medication research today. This gives the pharmaceutical industry tremendous power over the entire medication research effort, including the threat of lawsuits or loss of future funding for physicians wanting to publish unfavorable findings. More and more, drug companies are requiring researchers to sign confidential agreements before receiving any funding, giving the companies the power to suppress findings they don’t like.” (Pg. 10)
He explains, “Beyond these direct influences, drug companies exert broad influence over the drug information received by doctors and consumers. The vast majority of everything physicians and consumers read and know about medications comes from the drug companies. Medication package inserts, drug advertising toward physicians and consumers, and the ubiquitous ‘Physicians’ Desk Reference’ (PDR) come directly from the drug companies. Where do most doctors turn for medication and dosage information? To the PDR, to drug company representatives who make the rounds of doctors’ offices, and to advertising in medical journals. Yet, the medication information offered by these drug-company-sponsored sources is often biased, incomplete, and sometimes inaccurate.” (Pg. 11)
He states, “The drug companies’ influence even extends to the FDA… The FDA is required to ensure the effectiveness and safety of medications, but changes in the law and political pressure from Congress, as well as a massive shortfall in funding, have led to weakened FDA standards. Furthermore, some of the FDA’s own policies make matters worse. Funding for the FDA’s monitoring of newly approved drugs is so limited that some drug toxicities weren’t identified by the agency but by investigations conducted by newspapers or health interest groups. Limited funding also hampers the ongoing monitoring of important drugs with recognized risks. After Viagra was on the market for 7 months, the FDA reported 230 cases of deaths associated with the drug. The FDA responded, as usual, with required changes in Viagra’s labeling---yet, the agency hasn’t provided any follow-up reports on Viagra-related deaths or any analysis of whether the labeling changes have helped.” (Pg. 12)
He notes, “Experts with drug company ties fill many important advisory positions at the FDA. An investigation by USA Today found that more than half of the experts on FDA advisory committees, ‘have financial relationships with the pharmaceutical companies that will be helped or hurt by their decision.’” (Pg. 12-13)
He states, “Today, the FDA approves drugs much faster, and sometimes on fewer studies, than required ten years ago, and FDA oversight wasn’t exactly robust then, as multiple drug withdrawals in the 1980s demonstrated. Since 1997, more drugs have proven toxic and been withdrawn than ever before. Some of these withdrawn drugs… were prescribed millions of times… Safer alternatives to these drugs existed, but intense marketing convinced physicians to prescribe them anyway---and to continue prescribing them even as the FDA prepared to withdraw them.” (Pg. 13)
He summarizes, “Aggressive marketing, slanting research, unethical publishing of results, pressuring medical centers, intimidating researchers, influencing physicians, limiting information, manipulating the FDA, marketing drugs with inaccurate safety information and inappropriate doses---all of these have created an environment in which medication development has become, in Dr. Angell’s fitting term, a ‘race to the bottom.’” (Pg. 14)
He notes, “The drug companies also claim that they need large earnings … to conduct their research. They have a point---to a point. Aggressive research is indeed essential. The medications produced by the pharmaceutical industry have greatly improved the quality and length of life of millions of people. But this justification loses credibility when: *Just one of every five dollars the drug industry collects goes to drug research. *Some drug companies spend almost twice as much money for marketing and advertising than for research. *Drug industry profit-taking is so large it outstrips every other industry by far.” (Pg. 17)
He states, “The sad irony is that not only would patients, physicians, insurers, and health-care organizations benefit from reducing the high incidence of medication side effects, but so would the drug companies. When 50% or more of patients quit treatment for conditions such as high blood pressure, high cholesterol, and osteoporosis, no one wins. These patients become exposed to markedly increased risk of premature disease and death, and the health-care system is burdened with billions in extra costs. However, if the priority in producing medications wasn’t expediency but maximizing the risks of medication treatment, many of these problems could be avoided. And keeping patients satisfied and in treatment would increase drug sales.” (Pg. 17)
He summarizes, “ending the side-effect epidemic doesn’t require some new insight or discovery: It simply requires restoring sound, practical, scientific principles to the ways we research, develop, regulate, and prescribe medications… we already have all of the information we need to do this---to drastically reduce the occurrence of medication side effects and to end the side-effect epidemic today.” (Pg. 18).
Those seeking critiques of the FDA and Big Pharma, will enjoy this book.
Jay Sylvan Cohen (d. 2015) was a medical doctor and professor of family and preventative medicine at the University of California at San Diego.
He wrote in the ‘Author’s Note’ to this 2001 book, “The purpose of this book is to help readers become more informed consumers of medical services and prescription drugs and to assist them in consulting more effectively with their own physicians. The use of prescription medications can be directed and managed only by a doctor.”
He wrote in the first chapter, “In 1998 an extensive study published in the Journal of the American Medical Association (AMA) showed that 106,000 people die annually in American hospitals from medication side-effects. Medication reactions are the fourth leading cause of death in the United States, dwarfing the number of deaths caused by automobile accidents, AIDS, alcohol and illicit drug abuse, infectious diseases, diabetes, and murder. In addition to the medication-related deaths, the JAMA study also tallied 2,216,000 severe medication reactions in U.S. hospitals annually.” (Pg. 2)
He reports, “Dr. Thomas J. Moore of Georgetown University… determined, '51% of approved drugs have serious adverse side-effects not detected prior to approval.’ Think about this: More than half of our drugs, after being deemed ‘safe’ by the FDA and then prescribed to millions of people, are subsequently detected to have previously unrecognized, medically serious side effects. No wonder we have a side-effect epidemic.” (Pg. 8)
He continues, “46% of Americans take at least one prescription drug daily… Most of these people are taking medications long-term, so their exposures aren’t brief…. In 1999 Americans purchased 2,587,575,000 prescriptions: that’s nine prescription drugs for every person in America.” (Pg. 8)
He reports, “I found that the drug companies dominate the entire process of medication therapy---from early research to ultimate usage---as few other industries control their products today. Drug company research and development often serves marketing strategies more than sound science of patients’ safety.” (Pg. 9)
He states, “the drug companies underwrite 70% of all medication research today. This gives the pharmaceutical industry tremendous power over the entire medication research effort, including the threat of lawsuits or loss of future funding for physicians wanting to publish unfavorable findings. More and more, drug companies are requiring researchers to sign confidential agreements before receiving any funding, giving the companies the power to suppress findings they don’t like.” (Pg. 10)
He explains, “Beyond these direct influences, drug companies exert broad influence over the drug information received by doctors and consumers. The vast majority of everything physicians and consumers read and know about medications comes from the drug companies. Medication package inserts, drug advertising toward physicians and consumers, and the ubiquitous ‘Physicians’ Desk Reference’ (PDR) come directly from the drug companies. Where do most doctors turn for medication and dosage information? To the PDR, to drug company representatives who make the rounds of doctors’ offices, and to advertising in medical journals. Yet, the medication information offered by these drug-company-sponsored sources is often biased, incomplete, and sometimes inaccurate.” (Pg. 11)
He states, “The drug companies’ influence even extends to the FDA… The FDA is required to ensure the effectiveness and safety of medications, but changes in the law and political pressure from Congress, as well as a massive shortfall in funding, have led to weakened FDA standards. Furthermore, some of the FDA’s own policies make matters worse. Funding for the FDA’s monitoring of newly approved drugs is so limited that some drug toxicities weren’t identified by the agency but by investigations conducted by newspapers or health interest groups. Limited funding also hampers the ongoing monitoring of important drugs with recognized risks. After Viagra was on the market for 7 months, the FDA reported 230 cases of deaths associated with the drug. The FDA responded, as usual, with required changes in Viagra’s labeling---yet, the agency hasn’t provided any follow-up reports on Viagra-related deaths or any analysis of whether the labeling changes have helped.” (Pg. 12)
He notes, “Experts with drug company ties fill many important advisory positions at the FDA. An investigation by USA Today found that more than half of the experts on FDA advisory committees, ‘have financial relationships with the pharmaceutical companies that will be helped or hurt by their decision.’” (Pg. 12-13)
He states, “Today, the FDA approves drugs much faster, and sometimes on fewer studies, than required ten years ago, and FDA oversight wasn’t exactly robust then, as multiple drug withdrawals in the 1980s demonstrated. Since 1997, more drugs have proven toxic and been withdrawn than ever before. Some of these withdrawn drugs… were prescribed millions of times… Safer alternatives to these drugs existed, but intense marketing convinced physicians to prescribe them anyway---and to continue prescribing them even as the FDA prepared to withdraw them.” (Pg. 13)
He summarizes, “Aggressive marketing, slanting research, unethical publishing of results, pressuring medical centers, intimidating researchers, influencing physicians, limiting information, manipulating the FDA, marketing drugs with inaccurate safety information and inappropriate doses---all of these have created an environment in which medication development has become, in Dr. Angell’s fitting term, a ‘race to the bottom.’” (Pg. 14)
He notes, “The drug companies also claim that they need large earnings … to conduct their research. They have a point---to a point. Aggressive research is indeed essential. The medications produced by the pharmaceutical industry have greatly improved the quality and length of life of millions of people. But this justification loses credibility when: *Just one of every five dollars the drug industry collects goes to drug research. *Some drug companies spend almost twice as much money for marketing and advertising than for research. *Drug industry profit-taking is so large it outstrips every other industry by far.” (Pg. 17)
He states, “The sad irony is that not only would patients, physicians, insurers, and health-care organizations benefit from reducing the high incidence of medication side effects, but so would the drug companies. When 50% or more of patients quit treatment for conditions such as high blood pressure, high cholesterol, and osteoporosis, no one wins. These patients become exposed to markedly increased risk of premature disease and death, and the health-care system is burdened with billions in extra costs. However, if the priority in producing medications wasn’t expediency but maximizing the risks of medication treatment, many of these problems could be avoided. And keeping patients satisfied and in treatment would increase drug sales.” (Pg. 17)
He summarizes, “ending the side-effect epidemic doesn’t require some new insight or discovery: It simply requires restoring sound, practical, scientific principles to the ways we research, develop, regulate, and prescribe medications… we already have all of the information we need to do this---to drastically reduce the occurrence of medication side effects and to end the side-effect epidemic today.” (Pg. 18).
Those seeking critiques of the FDA and Big Pharma, will enjoy this book.
August 22, 2017
I wish I would have found this book 15 years ago. Although is was a bit repetitious, it offers intelligent information from Dr Cohen. I will refer to this book whenever I have a new medication prescribed or decide to buy a new over the counter remedy.
I wanted to send Dr Cohen an email, so I searched the Internet. I was saddened when I saw he had passed away. RIP
I wanted to send Dr Cohen an email, so I searched the Internet. I was saddened when I saw he had passed away. RIP
Displaying 1 - 2 of 2 reviews