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A Pharmacist Explains Why He Likes the Word “Pills”

In popular use, the word "pills" implies a product that may deserve ridicule rather than respect. Do you agree?

Dennis Miller, R.Ph. is a retired chain store pharmacist. His book, The Shocking Truth About Pharmacy: A Pharmacist Reveals All the Disturbing Secrets, can be downloaded in its entirety at Amazon for 99 cents.

There are many words for the products on pharmacy shelves. Which of the following do you prefer: “drugs,” “pills,” “meds,” “medicines,” “medications,” or “pharmaceuticals”? In my opinion, each word has a slightly different connotation. Of the two leading candidates, let me explain why I feel that “pills” is more appropriate, in many instances, than “drugs.”

Meds, Medicines, Medications:

“Meds” has a friendlier connotation than the word “medicines.” In addition, “meds” is a more modern and hip word. “Meds” is a much more friendly-sounding word than “medications.” You’ve probably heard “pet meds” which sounds friendly.

“Medicines” is a somewhat outdated word but it is still frequently used by people who want to cast a favorable light on these products. “Medicines” perhaps implies useful and helpful products, perhaps invoking images of superstar drugs like penicillin or insulin.

I rarely hear pharmacists use the word “medicines.” From my perspective, when pharmacists use this word, it seems to imply a somewhat naïve attitude toward the products on pharmacy shelves. I remember hearing one pharmacist refer to the products we dispense as “medicines” and it seemed odd and somewhat antiquated. He seemed to have no doubts about the safety and effectiveness of the products in the pharmacy.

It appears that drug companies are most likely to use the word “medicines” in TV commercials because this word suggests helpful, beneficial, and benevolent products like the aforementioned penicillin and insulin. I don’t recall drug companies using the term “drugs” in commercials because that term seems to conjure up images of addictive drugs sold on the street like heroin, methamphetamine, crack cocaine, and oxycodone.

Pharmacists rarely use the word “pharmaceuticals”:

The term “pharmaceutical” or “pharmaceuticals” is usually used when speaking about the pharmaceutical industry, often employed by stock analysts and commentators on CNBC or Fox Business. I rarely hear pharmacists use the word “pharmaceuticals.”

The Absurd World of Pills:

My personal favorite is “pills” because I feel that this word most accurately portrays most (but certainly not all) of the products on pharmacy shelves. It seems to convey or imply a feeling of absurdity regarding the world of pills, acknowledging that it is often an absurd marketing circus.

The profession of pharmacy is often referred to as “the pill business.” Pharmacists are often referred to as “legal pill pushers.” When people ask us what we do for a living, pharmacists often like to joke by saying something like “I push pills for ______.” [pick one: CVS, Walgreens, Rite Aid, Walmart, Kroger, etc.]

Happy Pills, Nerve Pills, Water Pills, Sugar Pills, Hormone Pills:

Anti-depressants (Prozac, Paxil, Zoloft, etc.) are sometimes referred to as “happy pills” by laymen. Customers often refer to their anti-anxiety medication (Xanax, Ativan, etc.) as “nerve pills.” For example, these customers tell their pharmacist “I need to refill my nerve pills.” Diuretics are referred to as “fluid pills” or “water pills.” Drugs for type 2 diabetes are often referred to as “sugar pills.” Women often refer to their medication for menopausal symptoms (Premarin) as “hormone pills.”

Pharmacists and Technicians Like to Use the Word “Pills”:

A pharmacist might say to a tech, “Mrs. Smith wants to get her diabetes pill refilled.” Or the pharmacist might say to a customer “You’re out of refills on your blood pressure pill so we need authorization from your doctor.”

I worked in one pharmacy where one of the techs would joke to co-workers in the pharmacy “You need a red pill today.” Her choice of color depended on her assessment of each co-worker that day.

“The Pill” refers to oral contraceptives. I worked with a pharmacy technician who referred to oral contraceptives as “party pills.” She would say (to co-workers in the pharmacy) something like “Jane Smith wants to get her party pills refilled.”

Why are oral contraceptives known as just “The Pill”?

According to an article in The Smithsonian Magazine, titled “Why the Oral Contraceptive Is Just Known as ‘The Pill’”:

Rare is the cultural object that can co-opt unmodified the very category of which it is a part: Even the Bible is referred to as the good book. Yet when people speak of the Pill, you know they don’t mean aspirin or Prozac but rather that mother of all blockbuster drugs, the birth control pill.

Do you like the book title “Pill Nation”?

One of the titles I was considering for my most recent book is “Pill Nation.” That title seems to capture the absurdity that surrounds so much in the world of pills. I thought of that title as a consequence of remembering a popular book several years ago titled “Prozac Nation.”

Books with “Pills” in the title include:

“Bitter Pills: Inside the Hazardous World of Legal Drugs” by Stephen Fried

“Do You Really Need That Pill?: How to Avoid Side Effects, Interactions, and Other Dangers of Over-Medication” by Jennifer Jacobs, MD, MPH

“Worst Pills, Best Pills” by Sidney Wolfe, MD and the Public Citizen Health Research Group

“Pills That Work, Pills That Don’t” by Gideon Bosker, MD

“The $800 Million Pill: The Truth Behind the Cost of New Drugs” by Merrill Goozner

“Too Many Pills: How Too Much Medicine Is Endangering Our Health and What to Do About It” by James Le Fanu, MD

“Before You Take That Pill: Why the Drug Industry May be Bad for Your Health” by J. Douglas Bremner, MD

All of these books are critical of pharmaceuticals to varying extents.

The Word “Pills” Sometimes Does Not Connote Seriousness:

The word “pills” sometimes has a comical or less-than-serious connotation. For example, laymen might say something like “There’s a pill for that.” Americans are said to be “pill happy” or “pill-poppers” who want a “pill for every ill.” People used to be told to “relax”; now we’re told to take a “chill pill.” Viagra is referred to as the “little blue pill.”

I once read a comment posted in response to a medical article in a lay publication. The person who posted the comment stated that he/she was unhappy that the word “pills” was used in the article because that word does not connote a seriousness about the products in pharmacies.

Some products in the pharmacy do indeed deserve our respect and admiration:

I agree that it would be disrespectful to refer to life-saving drugs like antibiotics (when properly prescribed) and thyroid hormone tablets as “pills” because these drugs can be essential and even lifesaving.

Naloxone and epinephrine can be life-saving:

There are other products in the pharmacy that are essential and lifesaving even though they are not available in pill form. For example, naloxone for opioid overdose is available as a prefilled nasal spray and injectable that can be life-saving. Epi-Pen (epinephrine) is a drug that can be injected for allergic reactions to things like bee stings and peanuts.

Morphine can be extremely effective:

Morphine (available as an oral solution, tablets, capsules, and injectable) can be extremely effective in relieving moderate to severe pain and I appreciated its availability when both my mother and father died from cancer. (My mother died from colon cancer and my father died from non-Hodgins lymphoma. My brother died from kidney cancer but luckily did not need any morphine). I would not refer to the morphine tablets or capsules as “pills” because morphine can be a very effective and essential drug.

Should We Respect Drugs That Are Routinely Prescribed for Preventable Conditions?

I have a hard time being respectful toward several classes of drugs in the pharmacy, especially those that treat preventable diseases of modern civilization. From my perspective, if a medical condition can be prevented with dietary and lifestyle changes, we shouldn’t be respectful toward those drug companies that aggressively promote these drugs without mentioning or emphasizing that the drug treats a preventable condition and that prevention is better than treatment.

Because most of the prescriptions that pharmacists fill are for the treatment of preventable diseases of modern civilization, I don’t feel that the drugs used to treat these conditions automatically deserve our respect. The pharmaceutical industry does not want you to understand just how preventable so many conditions are with dietary and lifestyle changes, losing weight, stopping smoking, avoiding tobacco and alcohol, avoiding processed foods, avoiding being sedentary, etc.

Drug commercials on TV are a marketing circus:

Why should we respect the drug companies that have turned drug advertisements into a circus on TV with colorful images specifically intended to divert viewers’ attention from the long lists of scary side effects?

Pharma has created an orgy of absurd marketing with commercials on TV featuring a talking turkey to sell the smoking cessation drug Chantix, a talking owl to sell Xyzal for allergies, an animated bumble bee (voiced by actor Antonio Banderas) to sell Nasonex for allergy symptoms, a talking mucous-like creation to sell Mucinex for nasal mucous, a talking gremlin to sell Lamisil for toenail fungus, and a hard-to-describe cartoon character with bulging eyes to sell Xiidra for dry eyes.

In my opinion, most of the drugs advertised on TV deserve the ridicule that the word “pills” invokes or implies. So many of these commercials are for drugs that treat conditions which should be prevented. That includes conditions like elevated blood pressure, type 2 diabetes, and elevated cholesterol. In my opinion, the focus should be on preventing these conditions, rather than throwing “pills” at them unless, of course, the condition occurs in the minority of the population in whom it is genetic.

I don’t want to elevate the drug industry by referring to their products as though they all deserve our respect. That’s why I think the word “pills” is most fitting for most of the drugs we see advertised on TV and for many of the other drugs in the pharmacy.

“Me-too” or “copy-cat” drugs:

Most pharmaceuticals are not “miracle drugs” as many people seem to think. Drugs advertised on TV are often just “me-too” or “copy-cat” drugs that are very similar to products that are already on the market and very often don’t provide significant advantage over existing drugs.

Many drugs demonstrate only a tiny bit more effectiveness than a placebo:

When one factors in the side effects associated with pharmaceuticals, the placebo might reasonably be viewed as the superior agent. If a placebo is safer and more effective than many drugs, do those drugs deserve our respect? Or do they deserve our ridicule?

Drugs for Alzheimer’s Disease Have Difficulty Demonstrating Any Significant Benefit:

If marketing is what drives pharmacy today, do those products which are nothing more than a marketing circus deserve our respect? For example, drugs used in the treatment of Alzheimer’s disease have difficulty demonstrating any significant benefit. Do such drugs deserve our scorn in light of the glowing way in which they are hyped by Pharma?

The FDA approved the Alzheimer’s drug Aduhelm despite the fact that 10 of 11 advisory committee members voted that there was insufficient evidence to demonstrate the drug slowed cognitive decline. (The 11th panelist voted “uncertain.”) Three members of the panel resigned as a result.

I’ll Stop Using the Word “Pills” When Drug Companies Start Being Honest about their Drugs:

I’ll gladly stop using the word “pills” when the drug companies stop exaggerating the safety and effectiveness of their products, when Pharma admits that most of the prescriptions pharmacists fill are to treat preventable diseases of modern civilization, when the drug companies are honest about the incidence of drug adverse effects, when the drug companies are honest about the difficulty of withdrawing from many classes of drugs, when the drug companies explain the significance of tumors and cancer in lab animals exposed to commonly prescribed drugs, when the drug companies explain why Americans pay more for drugs than people in any other country, when drug companies start using the meaningful term “absolute risk reduction” instead of the grossly misleading “relative risk reduction” when referring to the effectiveness of a drug, when drug companies include NNT (number needed to treat) in drug commercials, when drug companies admit that the long-term safety of many drugs is simply not known, etc.

From my perspective, until that happens many of the products on pharmacy shelves deserve to be referred to as “pills” rather than “drugs,” “meds,” “medicines,” “medications,” or “pharmaceuticals.”

What do you think?

Dennis Miller, R.Ph. is a retired chain store pharmacist. His book, The Shocking Truth About Pharmacy: A Pharmacist Reveals All the Disturbing Secrets, can be downloaded in its entirety at Amazon for 99 cents.

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