Get the Drug Money Out of Medical Education

It is seriously time to kick the Moneylenders out of the Temple

By Alan Cassels

Vranyo: White lies or half-lies in Russian culture, told without the intention of (maliciously) deceiving, but as a fantasy, suppressing unpleasant parts of the truth.”


You know I’m lying, and I know that you know, and you know that I know that you know, but I go ahead with a straight face, and you nod seriously and take notes. ’”

-Liesl Schillinger in, Feb 2018

Hi, I’m back. That’s right, after a four-year hiatus from Common Ground I’m back and looking forward to many more enlightening exchanges with my loyal readers.

Let me give you a bit of back-story: Joseph Roberts, the long-time and enthusiastic Publisher of Common Ground, came to hear me speak in October 2005 at the Vancouver Book Fair. This was just after publication of my book Selling Sickness, which I co-wrote with Australian journalist Ray Moynihan, a book that went on to become a surprising international best-seller, spawning documentaries and conferences. Joseph convinced me to start writing a monthly column for Common Ground, and my Drug Bust column came out every month for twelve years. Those 144 columns elaborated on many of the themes in Selling Sickness and documented the many ways in which the normal ups and downs of human conditions have been carefully, skilfully, and I argue, deceptively, shaped by the pharmaceutical industry and its medical accomplices into medical diseases which lead to a single solution, a drug prescription. “Are you sad, anxious, lacking in sexual drive, motivation or focus? You could be sick.” The perennial punch line is the pinnacle of pharmaceutical promotional ingenuity: “See your doctor.”

As I explained in that 2005 public lecture in Vancouver, and in many talks since, that unwavering punch line is the most effective ask in the history of marketing, for one specific reason: because they (the pharmaceutical industry) have already ‘seen’ your doctor and they are confident she knows exactly what to prescribe.

Once you can give a name to something you start seeing it everywhere, hence, the Russian word Vranyo which pretty well captures the state of medical discourse at the moment. Probably the closest English translation is “bullshit.” The same year we published Selling Sickness, Harry G. Frankfurt published an enlightening little book, called On Bullshit, which develops a theory of BS in the context of communication and he basically concludes that“bullshit is speech intended to persuade without regard for truth.”

We’ve always lived with bullshit and many of us have developed a keen nose to detect it. Some of us have the courage to call it out. This is what we did with ten different medical conditions in Selling Sickness. Go grab the book from the library and just read the first chapter, which focuses on cholesterol, as I think it’s probably the best thing I’ve written and is as true today as it was seventeen years ago.

The medicalization of a normal essential substance in our blood — cholesterol — is perhaps the most alarming example of medical bullshit in the history of the planet and it predates the recent hyper levels of deception and fear-mongering that we’ve seen over the last two years.

With cholesterol the medical industrial juggernaut has effectively scared millions of people with the spectre of early mortality, medicalizing and medicating something that is unlikely to ever go on to hurt them.

The beauty here is that cholesterol can be easily measured and then altered with drugs, called statins, essentially turning it into a disease in and of itself. The alleged reductions in deaths (very small, if true) and the rates of adverse effects (much higher than advertised) makes medicating this “disease” mostly nonsense, but the act of measuring, altering and measuring again your cholesterol has so much lucrative medical busywork involved that few doctors question the paradigm. Even though scores of independent (ie: unconflicted) scientists and analysts such as Uffe Ravnskov, an independent Danish researcher, have concluded that cholesterol is a very small risk factor for a future heart attack or stroke, and that medicating it doesn’t make any difference in most people, the market marches on making billions for corporations.

Well how small a risk you might ask?

The average 70 year old man with established heart disease might have a 10% chance of having a heart attack or stroke in the next five years. A cholesterol lowering drug, in the best case scenario, might lower that risk to 8%. The result is that two people out of 100 like him would find some benefit of lowering their cholesterol with drugs. The other 98 out of 100? No benefit whatsoever in that group exposed to the expense, and potential harms of the drug (including cognitive and metabolic adverse effects). And there is NO benefit for women. None. Yet how this ‘risk’ is characterized in the medical literature, in lectures given to medical students, in guidelines and ongoing medical education of our physicians? Let’s just say it’s vranyo in spades, with the risk of high cholesterol, and potential benefit of statins wildly exaggerated.

Right at the beginning of the pandemic I asked a very simple question: what is the risk of someone like me, a healthy 58-year-old man dying from Covid? I started to investigate what is called the IFR or Infection Fatality Rate. Probably the best IFR analysis was produced by Stanford professor John Ioannidis who estimated the infection fatality rate increased with age but that for someone my age and health it is around 0.2%. Translation: of a 1,000 people who contracted the disease, only 2 might die from getting Covid. Not quite the Black Death that wiped out half the population in Europe.

Bad, right? Well, just like with cholesterol the recommended multi-course vaccine regime may allegedly reduce that risk “by 90%.” My response? If the vaccine ‘helps’ 2 in 1,000, then the vast majority (998 of 1,000) of those who contracted covid, receive no benefit whatsoever, and are exposed to potential long-term vaccine-related adverse effects that are just coming to light.

Cholesterol has gone on to make major pharmaceutical companies some of the richest enterprises in the history of the world. Which company lead the juggernaut and made billions convincing healthy people to take their statin? That’s right, Uncle Pfizer.

Sound familiar?

Sadly, in the medical world vranyo is everywhere. From my perspective the most troubling thing is the way these little lies, that everyone knows are lies, has invaded the sacred halls of medical academia, creating tainted guidelines, and driven fear into the hearts of both prescribing physicians and their patients. With cholesterol, we saw how well good old fear can sell a product. Witness how the pandemic has turned fear-mongering into a high art.

What are the side effects of this?

In the last two years the world has witnessed immense and unprecedented rises in prescribing of certain drugs, particularly psychiatric drugs. You couldn’t have created a better laboratory experiment than the one that created a massive amount of fear among the population, and then handing out often ineffective and unproven treatments.

Between 2019 and 2022 B.C. has seen about a 25% rise in the use of anti-depressants, a class of drugs which physicians are told will alter the course of a person’s mental distress. At the same time we know that these treatments are promoted on a theory of chemical imbalances in the brain, which is an entirely pharmaceutical industry constructed definition of disease. Not only is this vranyo writ large, many of those new patients taking anti-depressants because of legitimate life stresses, fears and anxiety will find them incredibly difficult to stop. They can cause irreversible sexual dysfunction, increase risks of suicide and homicide, while having almost zero impact on depression. This is not what you are likely to hear in medical education sessions sponsored by Canada‘s major medical schools where our physicians get educated about the newest ways to treat diseases. Those sessions are often stacked with experts with ties to pharmaceutical companies, psychiatry being the most conflicted of all specialties. How can we reasonably expect people to truthfully explain the harms of anti-depressants (or cholesterol drugs or even vaccines) and the attendant harms of these treatments when the major companies sponsoring their work give millions of dollars to the universities, and make extremely generous payments to the specialists who ‘educate’ other doctors?

So you can imagine the young doctors sitting through their lectures listening to the vranyo being put out by the specialists, and learning half truths, as the presenters routinely exaggerate the nature of the disease and the alleged benefits of the promoted drug-du-jour. Everyone seems to gladly go along with the charade.


So you might say, OK Mr. Smarty-pants what is the solution to all of this vranyo swirling around in our medical education system where few challenge the lying liars or the body of well-accepted lies?

I’ve said this before and at the risk of sounding like a broken record I have to say it again: the only way that we’re going to get back to a semblance of dignified and truthful medical care that doesn’t rely on large companies capitalizing on our fears, is to get the drug money out of drug education. Let’s start with university medical schools sadly becoming more and more addicted to pharmaceutical industry funding, as the years pass. Let’s admit the universities need rehab and let’s make sure that our medical students get at least one course in pharmacology taught by an independent expert without drug industry ties. (currently they don’t!)

You need not just medical students but practising physicians to show some spine, to recognize the difference between education and propaganda and call it out.

Basically we have to get the money lenders out of the temple.

Over the last two years many of my friends and colleagues around the world, solid and honest scientists, have been censored, and cancelled. Increasingly they are switching to different media such as SubStack, realizing that the major social media superhighways allow only certain type of thought. I would urge readers of Common Ground to look for names such as Tom Jefferson, Carl Heneghan, Peter Gotzsche, Alex Berenson, Paul Thacker, Vinay Prasad, Jessica Rose, Maryanne Demasi and Igor Chudov.

And to those students who are entering medical school I wish you all the courage you can muster. Universities have become terrible places for the exchange of free thought and critical analysis. If you are willing and able to stand up to the professors who are feeding you bullshit I wish courage to your sword arm.

And to those patients who are on the receiving end of the vranyo I wish you courage and the ability to fend off the capitalists who are trying to scare you into more and more drugs.

Alan Cassels is an unemployed independent drug policy analyst who for 28 years has been examining the marketing strategies of the world’s biggest pharmaceutical companies.

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