This chapter examines the careless use of prescription drugs such as Accutane in what Steve Findlay called “medicine-chest roulette.” In his May 1988 article in the U.S. News and World Report, Findlay reported that an estimated six million Americans experienced adverse drug reactions each year. He argued that pharmaceutical companies could not be blamed for this situation because they met their legal obligation to disclose their products' known side effects to physicians and pharmacists. Instead, he attributed the problem to the failure of physicians and pharmacists to pass on this vital information to their patients. This chapter considers the consumer drug reforms of the 1960s that contributed to the dismantling of the drugstores' traditional market protections. It also discusses the advent of direct-to-consumer advertising; how the dismantling of long-standing limitations on where prescription drugs could be sold and how they could be advertised affected patients and doctors; and how the confluence of aggressive advertising of new drugs, the growing extent of polypharmacy, and regulatory loopholes exacerbated the dangers associated with medicine-chest roulette.
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