Power and Dependence - Social Audit on the safety of medicines [London: Social Audit, 1992].

This 280-page book discusses the safety of medicines from a consumer perspective, focusing attention not so much on the properties of molecules as on the conduct of the medical profession, government agencies and the drug companies. It is suggested that drug injury is often avoidable - and that most of it can be traced to misconduct of some kind.

The two main themes, power and dependence, are elaborated in a detailed case-history of the prescribing of tranquillisers and sleeping pills over the past 200 years. This not only charts the development of drug safety regulation; it also explains why millions of people around the world became addicted to benzodiazepine tranquillisers like Valium, Ativan and Halcion. Evidence is given that the risks were always obvious and that the providers of medicine, between them, readily let this happen.

The book argues that levels of drug injury will remain unacceptably high until decision-makers are required publicly to explain and justify what they do. At present, the pharmaceutical industry seems in some ways excessively powerful and government dangerously secretive and unresponsive to consumer needs - while many doctors, as drug prescribers, seem far out of their depth.

The relationships between power and dependence have been developed further in The Antidepressant Web. The latter is available at no cost on this site. Power & Dependence costs £11 (by first class UK, or by air in Europe) or £14 (by air elsewhere). But it does come with a full Money-Back guarantee to anyone who ends up feeling as disappointed as this:

"I was constantly thwarted by the many exaggerations or distortions which litter almost every page ... The author has some good ammunition, tossed away I believe in a book of low scholarship and journalistic excess" [Spencer P.J.J., (University of Wales College of Cardiff, UK), J Pharm Pharmacol, 1992, 44, 625-626].

No-one has ever claimed under this guarantee (the offer was made made public five years ago), and we trust you won't:

"Power and Dependence is a superb work and should be required reading by any physician who prescribes anti-anxiety agents, sleeping pills or other medications. Those concerned with the public health will also find much in this analysis to stimulate reform of a system that is desperate need of overhaul" (Graedon J, Graedon T, Iatrogenics, 1992, 1, 199-200.

"It is dauntingly well-researched and sparkles with incidental detail. As social history it is fascinating. As a call for accountability is is indispensable". (Linehan T: Care Weekly, 6 March 1992).

"Power and Dependence would be an excellent addition to health professional libraries, and it should be read and discussed in courses on pharmaceutical policy, drug development and regulation, and international health-case issues". (Montagne M: Pharmacy Teaching, 1992, 3(3), 89-91.

"It is a compelling book which deserves to be widely read and which raises urgent questions about the safety of medicines and the secrecy surrounding the licensing of medicines in the UK". (Britten N: Sociology of Health and Illness, 1993, 15, 2.

"All health professionals should read this lucid and articulate book. It is a profound and enlightening experience from which you will emerge sadder but wiser practitioners". (Elpern DJ, The Pharos, Fall 1992, 55, 4.

"For unadulterated realism ... one must take Medawar's immensly readable new book. Social Audit, Medawar's energetic one-man band has always documented his views scrupulously, And in Power and Dependence, he excels himself. (Dukes MNG: THS, April 1992, 14.

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