How can you define a 'drug'? Nobody knows

https://theconversation.com/how-can-you-define-a-drug-nobody-really-knows-216540

by sohkamyung • 3 years ago

24 26 3 years ago

Ajay-p• 3 years ago

Something I did not see in this article, and please excuse me if my thinking is errant on this, but would not pharmaceutical drugs be ones that can be patented? I understood that a drug can be anything which has a deliberate chemical interaction with the body, but so can smog in the air, bad water, etc.

An insightful article but raises more questions than answers.

terminous• 3 years ago

Smog is air with drugs. Bad water is water with drugs.

patmorgan232• 3 years ago

Example: Lithium is used to treat several mental health disorders. You can't patent a naturally occurring element, but lithium is often prescribed. Is lithium a drug?

NoPie2• 3 years ago

Lithium (an active substance) is a drug, Priadel (a brand version of lithium carbonate) is a medicine.

Drug and medicine is specifically distinguished in medical science. But again, in many contexts this distinction doesn't matter and most people don't even know the difference. It doesn't mean that we have no idea what is a drug or what is a medicine.

codegladiator3• 3 years ago

Food is a drug. Hunger is hangover.

mpalmer• 3 years ago

Hangovers end. Hunger is withdrawal.

codegladiator3• 3 years ago

I agree with you

codr7• 3 years ago

Hangover is supposedly also withdrawal.

bryanrasmussen• 3 years ago

logically speaking hunger happens before you ever have food though.

codegladiator3• 3 years ago

It's absence is painful only because we consumed food enough to make it an addiction

bux93• 3 years ago

From a legal (EU) perspective, it's a question how you market something. If you say apples are generally healthy, it's produce. If you say an apple will cure your cancer, it's a medicinal product.

2. Medicinal product: Any substance or combination of substances presented for treating or preventing disease in human beings.

Any substance or combination of substances which may be administered to human beings with a view to making a medical diagnosis or to restoring, correcting or modifying physiological functions in human beings is likewise considered a medicinal product.

https://eur-lex.europa.eu/legal-content/EN/TXT/HTML/?uri=CEL...

iamnotsure• 3 years ago

A drug is a communication protocol, pure and simple.

fuzzfactor• 3 years ago

A drug is a communication protocol, pure and simple.

Very well said.

I'll elaborate a little.

A viable definition should be broad enough to include everything classified as a drug.

Wrong.

Not viable.

As the article implies, you can't get very far with an incorrect assumption, especially with something this admittedly nebulous to explicitly define.

To get a sense of this “everything”, we used the drug bank compiled by the Canadian Institutes for Health Research, which lists more than 16,000 substances.

"Everything" has never been sensible but 16,000 should be good anyway.

I am more familiar with the Physician's Desk Reference (PDR), originally published yearly and containing the details of almost all medications approved by the US FDA at the time. Now available online at https://www.pdr.net

I believe this is a lot fewer than 16,000 materials, but it has always been a very representative example of what medical drugs really are.

we found three broad ways to define drugs: in terms of what they are, how they work and what they’re used for.
Unfortunately, none of these options fall within the Goldilocks zone.

Too bad. I guess Goldilocks-style perfection is not to be expected. How they work is actually not very well-known across-the-board anyway, and what they're intended to be used for is not always why they are prescribed. So the best remaining choice is to define them by what they are.

The overwhelming majority of approved compounds are somewhat complex carbon-based chemicals having unique molecular structures, which also contain one or more nitrogen atoms per molecule. This is where so much of the research is concentrated.

Almost all of the approved substances are also toxic to some extent, and subject to undesirable side-effects, as listed for each compound. This is regardless of whether the medication is a natural product or if it is a completely synthetic compound.

Anything not containing a nitrogen atom within the chemical structure, or when non-toxic materials are listed, those are outliers and not representative of what drugs mainly are, even when they are approved as pharmaceuticals, appear in the current listings, and can contribute to a positive treatment outcome. This is a major difference compared to the conventional wisdom. This is so difficult to pin down when I tend to want a narrow focus and be less inclusive of random chemicals and foods, while others may want to classify way more than 16,000 materials as drugs in an attempt to include "everything" imaginable. I guess each person has to decide where they stand for themselves, so you do get to just make this stuff up. Up unitl a few years ago the PDR was still available as a large hardcover reference, a drug dictionary weighing a couple kilos, and I've always looked through it and every now and then you run across a product which I really don't think is a drug drug.

These outliers need to be considered quite differently and on a case-by-case basis compared to the bulk of the drug company offerings. You really don't want this handful of materials to be lumped in with the rest.

NoPie2• 3 years ago

It just shows that precise definitions are not that important in medical science.

We all know what is a drug. And there are border cases where our ideas of drug and food overlap. It is only a small issue for regulators to decide what regulations to apply. But for doctors it is not a problem.

Saline infusion technically is not an active drug either. And yet it can be regulated as one because obviously quality standards are important for infusions.

giraffe_lady• 3 years ago

Something I've noticed when reading about people in history or even more modern indigenous people is that the clear distinction between "food" and "medicine" seems very new and peculiar to our time & culture. It's obviously a useful differentiation a lot of the time, but not always and at least sometimes it seems useful to not apply it.

hooverd• 3 years ago

Ontologies and their consequences.

patmorgan232• 3 years ago

this definitions precision is not important in medical science. There are definitely lots of other times where precision is important.

hulitu• 3 years ago

We all know what is a drug.

"When Supreme Court Justice Potter Stewart was asked to describe his test for obscenity in 1964, he responded: "I know it when I see it." But do we? " from https://history.wustl.edu/i-know-it-when-i-see-it-history-ob...

LocalH• 3 years ago

We all know what is a drug.

Kindly expand on this thought please. I heavily disagree with your assertion.

WarOnPrivacy2• 3 years ago

I know what makes even less sense than crafting policies for an undefinable category.

Giving law enforcement (DEA) the power to declare medical policy for an entire nation and enforcement powers for the policies it creates.

WarOnPrivacy2• 3 years ago

We know addiction isn't a defining characteristic of drugs, otherwise we'd be taking a harder look at governments' compulsion to surveil.

alwa• 3 years ago

A pharmacist friend mentioned a few years ago that she and her colleagues were wrestling with how best to standardize and dose fecal transplants for antibiotic-resistant c. diff. It fell to the pharmacy department to dispense such a treatment, but is it in that sense a “drug”? How about snake antivenoms, which are not specific compounds but instead antibodies harvested from the blood of animals injected with the venom in question?

LucienSchwab• 3 years ago

A drug is something that gives relief in the short term and is not good in the long term.

o0banky0o• 3 years ago

Any things status as that thing is fleeting, and is dependent on your needs and goals. this is why we call broken electronics "bricks".

Any thing could be a drug if it acts like a drug when used as a drug.

kelseyfrog• 3 years ago

Integer arithmetic[1] is complex enough to suffer from either inconsistency or incompleteness and we're foolish enough to think we can have consistency and completeness with respect to a predicate logic for drugs?

It's insane that we keep duking it out because someone can't admit that they've inadvertently misidentified their subjective ontological reality for that of some external symbolic universe. See every other fight over definitions.

1. First order, finite number of axioms

biomcgary• 3 years ago

Let's take all of the insanity of healthcare economics and apply it to food, too! Their conclusion is going to increase the cost of hospital stays by inventing prescription food, which will eventually be required at home for anyone with any illness.

How can you define a 'drug'? Nobody knows

Related Stories