Would you like shards of glass with that?

• Jan 9, 2019 • by Paul Ingraham
Get posts in your inbox:

Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of PainScience.com: a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

There have been many headlines in the last couple years about the lack of regulation of the supplements industry, and no one’s really surprised by that (or no one should be) — it’s a massively profitable, unregulated industry. What could possibly go wrong?

However cynical we may be about Big Pharma, most of us assume that industry, regardless of its other sins, is at least tightly regulated and quality controlled. Or is it? Kaiser Health news reports:

Since the start of 2013, pharmaceutical companies based in the U.S. or abroad have recalled about 8,000 medicines, comprising billions of tablets, bottles and vials that have entered the U.S. drug supply and made their way to patients’ medicine cabinets, hospital supply closets and IV drips, a Kaiser Health News investigation shows. The recalls represent a fraction of the medicines shipped each year. But the flawed products contained everything from dangerous bacteria or tiny glass particles to mold — or too much or too little of the drug’s active ingredient.

Many of those recalled products, about 300 of them, had passed an FDA inspection within the last year. Not very effective inspections, apparently.

Those recalls included more than 39,000 bottles of the HIV drug Atripla laced with “red silicone rubber particulates,” nearly 37,000 generic Abilify tablets that were “superpotent,” and nearly 12,000 boxes of generic Aleve (naproxen) that were actually ibuprofen, according to the recall data KHN examined.

While American pharmaceutical manufacturing is obviously more regulated than supplements, clearly it’s not enough, and I’m sure there are similar problems around the world. This is an excellent reason to avoid medications whenever possible, regardless of efficacy and side effects. It’s probably also a good reason to stick to well-known brands rather than generics; it’s no guarantee, but the owner’s of those brands do have valuable reputations to live up to, and are less likely to allow “tiny glass particles” into their products.