What is a medical drug? If you ask people on the street, they’ll probably tell you that it’s something you drink when you’re not feeling well.
As we will see later, this understanding is wrong. However, after thorough research, my colleagues and I discovered that no other definition exists.
Although they play an important role in medical care, we have no idea what medical drugs are. We cannot tell the difference between medicine and food, much less between medicine and so-called “natural” alternatives.
in recent articles In the Journal of Medicine and Philosophy, my colleagues (pharmacist Sarah Linton and biological philosopher Maureen O’Malley) and I sought to articulate a workable definition of a medical drug.
A workable definition must be broad enough to include everything that is classified as a drug.In order to understand this “all”, we drug bank Compiled by the Canadian Institutes of Health Research, it lists more than 16,000 substances.
The definition should also be narrow enough to exclude substances that are not normally considered drugs. Let’s use food as an example. Eating a sandwich is not usually considered to be taking drugs.
In other words, a viable definition of what a drug is is a “Goldilocks” zone between these two demands: large enough to include all drugs and small enough to exclude everything else. must be accounted for.
Based on early research in pharmacology textbooks, we discovered three broad ways to define drugs: what they are, how they work, and what they are used for.
Unfortunately, none of these options fit into your Goldilocks zone.
Is the drug a specific chemical?
Defining drugs would be easier if all drugs were a specific type of chemical. But this idea is hopeless. Chemically speaking, all drugs have nothing in common.
We also tend to think that the difference is that drugs are “artificial” chemicals made in a lab, whereas “natural” supplements are obtained from nature.
However, many drugs are “natural” in this sense. For example, aspirin is obtained from willow bark.
Read more: The scientific roots of modern medicine lie in the Middle Ages – how the vulture brain cure and the logic of bloodletting continue to live on today
This immediately affects so-called “natural” supplements such as fish oil.
If a “drug” is chemically indistinguishable from a “natural” supplement, then the supplement should not be considered a “safe” alternative. Supplements are just as safe, if not safer, than many medications.
Does the drug perform a specific function?
Perhaps drugs can be defined in terms of their effects. The idea initially seemed promising, since many drugs work by binding to receptor molecules in the body.
Think of a lock and key. The receptor molecule is the key, and the drug is the key that opens it.
The discovery of receptor molecules is important. For some, it’s pharmacology’s “big idea.”
However, this definition of medical drugs is also hopeless. Many drugs do not bind to receptors. For example, antacids work simply by changing the level of acidity (pH) in a person’s body.
Read more: Explainer: What is the Placebo Effect? Can a Doctor Prescribe a Placebo Effect?
Many placebos also bind to receptors. Placebos are often contrasted with drugs, but if a drug is defined as something that binds to a receptor molecule, many placebos will be included in the definition. So this definition also doesn’t work.
Is there a way to clearly define a placebo as distinct from a drug? This is not obvious, as a placebo is also very difficult to define.
For example, some people may think that a placebo is a substance that has no therapeutic effect. However, this definition does not apply because placebos have a therapeutic effect (the so-called placebo effect). Many other definitions face similar problems.
Our study paves the way to an explanation of why it is so difficult to define a placebo. To properly define a placebo, you need to distinguish it from a drug, but you can’t do that without defining what a drug is.
medicine makes me better
This brings us back to health. From this perspective, medical drugs are chemicals used in medical treatment.
This is more effective as it captures any substances used as medicines in medical settings.
But now there is no hope of cutting out food or nutrients.
Read more: Poison or cure? Traditional Chinese medicine shows context can make all the difference
For example, consider total parenteral nutrition. This is a chemical infusion given to people who have difficulty absorbing nutrients in the normal way.
Total parenteral nutrition is used in medicine. But the effect it has on your body is really no different than what a delicious sandwich would do.
Descriptions of drugs based on treatment necessarily erase the contrast with food.
In our daily lives, we make choices based on our implicit understanding of what drugs are.
For example, we take paracetamol because it is a drug. Many of us may take fish oil precisely because we believe it is not a drug.
If we don’t explain what drugs are, we risk making a serious mistake.
Sometimes we take substances that we think are “inert” (placebos) because they are “natural” (such as fish oil), when in fact they are active drugs.
Similarly, all legal regulations regarding medical drugs assume that we already know what the drug is.
But we are not. Our understanding is clearly evolving. This means that regulations also need to change continuously. Therefore, as we continue to rethink what constitutes a medicinal drug, we need to devote significant resources to reforming the law. Recent reclassification The use of MDMA and psilocybin as pharmaceuticals in Australia has been demonstrated.
Then there’s the food. With the exception of total parenteral nutrition and similar substances, foods are not controlled or regulated in the same way as pharmaceuticals in hospitals.
But if doctors use food like medicine to contribute to the health of their patients, perhaps the same standards should apply.
To achieve this, it may be necessary to fundamentally rethink how meals are provided in hospitals. Perhaps food needs to be managed and regulated with the same care as medicine.
Hospital lunch may never be the same. But that could be a good thing.