Plan B, the "morning after" pill
It hovers conveniently between being a contraceptive and an abortion aid. It is one or the other, certainly, but how? And do you have moral grounds to refuse to fill a prescription for it? How about the legal grounds? That's what pharmacists are asking all over the country.

Plan B is nothing more than a high dose of the synthetic hormone progestin the same ingredient in traditional birth control pills. Sold in the US, it can be used to prevent pregnancy for up to five days after sex though it is most effective when taken within 24 hours of intercourse. Plan B, its manufacturer says, reduces the odds of pregnancy by eighty-nine percent. Put another way, out of a hundred women having unprotected sex, typically eight will get pregnant; using Plan B, only one will.

But researchers can't rule out the possibility that Plan B may also prevent implantation of eggs in the uterus, unlike a contraceptive which simply prevent the egg from being fertilized. They're not sure because under natural conditions some fertilized eggs fail to implant anyway. So in studies on Plan B, there is virtually no way to tell whether the failure to implant is natural, or caused by the progestin in Plan B and is hence an "abortion pill".

To further muddy the waters, many anti-abortion groups have been branching out to oppose contraception, too. Some see a direct connection between the practice of contraception and the practice of abortion. Religious bodies such as the Catholic church have traditionally been against contraception anyway. This leaves pharmacists caught in the middle, with a few of them choosing sides. Some have actually refused to supply the pill, citing religious reasons. This is one debate that promises to drag out for a long time before pharmacists are sure exactly what they should do.

Illegal here and legal there
The influx of Canadian pharmaceuticals in recent years has shown that not every American agrees with how their representative democracy regulates drugs. A kind of patchwork class struggle has ensued, with some opposing certain kinds of drugs on everything from financial to political to religious grounds and others being the elderly, infirm, or just plain liberal getting what they need however they can.

Though it is still illegal to import pharmaceuticals from Canada or other countries outside the States, the government now says that it is backing off strict enforcements that have irritated elderly consumers buying cheaper Canadian drugs. However, the Bush administration still claims that importing Canadian drugs is dangerous because the medicines could be inferior or counterfeit. The U.S. Customs and Border Protection agency has said that the shift in policy does not mean that Canadian drugs are safe, but that the agency has simply decided to refocus its resources.

Called into question is the purity of motives. America still has no citizen-wide health plan to speak of, and citizens must rely on insurance. Meanwhile Canadians enjoy their health care free (well, taxed), and Americans are quick to cross a border to take advantage of a freer drug economy. One must question that if money weren't involved, would this even be an issue? The FDA's objections are based on the notion that Canadian drugs may be unsafe to take. Yet they seem to be good enough for Canadians to take...

ADHD
Ritalin and other stimulants are increasingly shown to be doing more harm than good, while the diagnosis of Attention-Deficit-Hyperactivity-Disorder is rapidly being shown to be quackery. That would have been heresy five years ago, when it was nothing but a rant for the occasional lone nut. But now child psychologists, neurologists, and pediatric physicians are starting to speak out on it. And they are making these strong accusations.

There's the recently commenced FDA hearings, which pertain to reports of death, strokes and heart attacks in children and adults treated for ADHD Most recently the number one ADHD drug has been reported to cause strokes, some were sudden deaths and others were heart complications. Furthermore, the various drugs used to treat ADHD are always amphetamines, which are potentially as addicting as cocaine. And we prescribe it for half of the population, since the symptom list to ADHD reads pretty much like anybody could have it on a boring day.

It is certain that somebody, somewhere in the system wants ADHD and amphetamine prescriptions to stay around, leaving families, parents, and doctors to wonder whether they are seeing a real disease being treated, or a corporate machine grinding them into it's bottom line.

The marketing of drugs
Every country in the world bans the practice of direct-to-consumer drug advertising... except the United States. Here, consumers are subjected to a never-ending barrage of televised drug ads showing for an increasing array of patented chemicals to treat a mystifyingly trivial array of "diseases" and "disorders". TV commercials get more and more vague as to what, exactly, their product treats. Essentially, it amounts to taking pills for nothing. They actually have an acronym all their own: SMD, "Spontaneous Mass Diagnosis", where a new disorder is "discovered", then a bunch of patients are created who are potential customers for the pill the company which "discovered" the disorder.

A serious backlash against this direct marketing and it's effect on the industry has yet to find a voice. Mostly passive controversy exists. Americans, as it turns out, are more liberal about drugs than we once thought, as even those who strongly oppose the commercial drug racket tend to shrug and say "But if somebody wants to take it, let them!"

Will it get more controversial?
Much of these issues being raised are the result of advances in the way we practice medicine. But they are only a start. There are more advances in medical science being made today, and they will almost certainly lead to more political "hot-button" issues landing in the pharmaceutical industry's collective lap.