Is this drug safe, doc?

People often assume a drug is safe—but it usually isn’t, says Bryan Hubbard

When we’re prescribed a drug, how do we know it’s safe? There’s the circular reasoning that the doctor wouldn’t be handing out the drug in the first place if it wasn’t safe, and that’s as far as most people’s concerns go.

So, how does the doctor know the drug is safe? The drug company salesperson would have told them and backed that up with documentation, which includes clinical trials that also demonstrate the drug’s safety, and that’s always especially important if it’s a new drug.

That’s as far as most doctors’ concerns go.

So, how does the drug company know its new chemical agent is safe? The short answer is it doesn’t. Worse, it might know the drug is not so safe, and it’s not telling.

Although every new drug passes through four phases that must show effectiveness and, most importantly, safety, drug companies are under no obligation to release the data sets that inform their conclusions. In other words, a drug company can say whatever it wants about a drug’s safety and effectiveness, and there’s no way to challenge it.

The conclusions that appear at the beginning of often very long research papers are usually the only part that people bother reading. These are influenced by the sponsor, invariably the company whose drug is being evaluated.

Marketing companies often write the conclusions to present the results in the best possible light—even to the extent that they’re complete fiction. They recruit a “name” in medical research as the lead investigator even if that person has had no part in the study and sometimes doesn’t even know they’ve been mentioned.

Once the drug has been approved and is being prescribed, doctors may notice that quite a few patients given the drug start developing high blood pressure, for instance. It can take a while for the doctor to make the connection because, after all, they’ve been assured by the salesperson that the drug is perfectly safe.

If the doctor eventually does suspect the drug, they can notify the drug regulators via the Yellow Card system in the UK, but this collects only around 12 percent of cases of adverse reactions.

Even a drug that is an outright killer can spend years being prescribed before it is eventually pulled from the market. The scandal of the anti-arthritis drug Vioxx is possibly one of the most egregious examples in recent times. It has been estimated that more than 60,000 people died as a direct result of taking it—and the manufacturer, Merck, knew about the drug’s fatal flaw but hid the data for years.

But most drugs aren’t outright killers. After taking some, people are just left feeling awful or start suffering life-destroying effects. Most of these people suffer in silence and often get short shrift from the doctor—but now they have a voice.

Social media platforms like Instagram, X, Reddit and Facebook are the democratic equivalent of the Yellow Card system. They’re putting the patient at the front and center of drug safety.

Researchers used an AI system to scan more than 400,000 Reddit posts by 70,000 people and discovered a pattern: People are regularly posting about unknown side effects from drugs like weight loss and diabetes medications Wegovy and Ozempic (semaglutide) and Mounjaro (tirzepatide). Reactions being mentioned include menstrual irregularities and temperature-related complaints like chills and hot flashes.¹

Around 4 percent of the Reddit posts reported menstrual problems—and so the ratio would have been even higher if it had been a female-only platform.

Nausea is another common reaction, and it’s one that is known by the manufacturers, which demonstrates that the others being reported are also genuine, say researchers from the University of Pennsylvania School of Engineering and Applied Science.

“Online patient communities work a lot like a neighborhood grapevine. People who are living with these medications are swapping notes with each other in real time, sharing experiences that rarely make it into a doctor’s office visit or an official report,” said Lyle Ungar, one of the researchers.

Yes, doctors don’t always know, and the manufacturer isn’t always telling. But you know, and now you can tell.

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