A few years ago, my bad knee was giving me fits. So I went to see an orthopedic surgeon who told me my knee was basically sound but I had developed a little arthritis due to a fracture suffered awhile back in a ski accident.

He told me I should be fine but he gave me a handful of Vioxx and a prescription as I walked out the door. To hear him tell it, Vioxx was a wonder drug. I have to say, it worked very well.

Little did I know, walking out of that office that day, that I had been baited by the lure of free pharmaceuticals into buying one of the more expensive nonsteroidal anti-inflammatory drugs at the time. But it seemed to work well, so I filled those prescriptions several times. A couple of months later, though, my darling Vioxx became Public Enemy No. 1. The manufacturer announced a voluntary withdrawal of the drug due to safety concerns of an increased risk of heart attack and stroke.

That experience left me with a bad taste in my mouth. I had trusted the FDA's approval process. What now? Second-guess every drug my physicians prescribe?

Sadly, my confidence hasn't been bolstered over the years. Granted, clinical trials and double-blind studies probably don't provide the breadth and depth of information that comes from thousands of people taking a prescription drug after it has been approved for the market. Still, it gives me pause each time I'm prescribed a new medication or worse, when my children are prescribed.

Is it going to do what it's supposed to do? If not, can I rely on it not to cause other problems?

To me, that's the point of the regulatory process. Many drugs behave differently in different people. Sometimes it takes awhile for a prescribing caregiver to find a drug that best addresses a patient's condition.

And sometimes we discover that older, tried-and-true treatments are the best option after all. That's what leading doctors said this week after a pharmaceutical trial showed cholesterol-fighting drugs Vytorin — and a related drug Zetia — failed to improve heart disease. The two drugs have racked up $5 billion in sales despite limited proof of benefit.

We shouldn't place the blame solely at the feet of drug manufacturers, though. They are under tremendous pressure from patients to deliver the next cure for their particular malady. They are also under pressure from shareholders who expect handsome returns for their investments. The medical establishment, too, wants more tools to assist patients.

But the price of that pressure can be drugs that don't work as advertised or, worse, cause other problems that can be fatal. Presently, the FDA is investigating a possible connection between the allergy drug Singulair and suicide.

Perhaps my Uncle Francis is right. Our best bet may be aspirin. Unlike a lot of drugs, science keeps finding more and more wonderful uses for the little white tablets. And it's cheap, too.

Unlike my uncle, who only takes aspirin, I tend to trust the advances of medical science. But it's disconcerting when we learn about drugs that are essentially ineffective or treat the main issue but may have frightening side effects, such as suicide ideation.

At the same time, I'm troubled by many advertisements I come across from law firms seeking patients who have taken this or that medicine and had bad outcomes. It's a feeding frenzy for some. Potential product liability lawsuits add to the cost of developing new drugs. But that pressure might also ensure that new drugs are placed under extreme rigor to ensure they are safe and effective.

In a perfect world, medical science would have prescription drugs nailed. Then there would be no need for lawsuits or news reports that scare the daylights out of little old ladies and little old men who take certain drugs.

Until that happens, I'm going to be asking my doctor and my pharmacy a lot more questions before I fill prescriptions for me or members of my family.


Marjorie Cortez, who prefers a world with prescription drugs, even acknowledging their limits, is a Deseret Morning News editorial writer. E-mail her at [email protected].