As Randy Shilts chronicled so well in “And The Band Played On,” the early years of the AIDS epidemic became quickly infiltrated by AIDS-speak. Sometimes deliberately, sometimes less consciously, language was used to obscure the problem, to minimize it, and to make it more palatable to the delicate ears of politicians, lobbyists, and the general public. So the world began hearing about people who were “carriers” of the disease (as if they themselves were not infected, just toting around some mysterious virus like a bag of groceries). Shilts writes:

“…Under the rules of AIDSpeak, for example, AIDS victims could not be called victims. Instead, they were to be called People With AIDS, or PWAs… “Promiscuous” became “sexually active” … The most-used circumlocution in AIDSpeak was “bodily fluids,” an expression that avoided troublesome words like “semen.”

“…AIDSpeak was the tongue designed to make everyone content. AIDSpeak was the language of good intentions in the AIDS epidemic; AIDSpeak was a language of death.”

Of course, AIDS isn’t the only foreign country like this, filled with its own terminology and strange customs. We do this all the time in life. There are all those somewhat more innocuous occasions in daily life, like when we tell someone on the other end of a phone call, “let me let you go,” lest we risk offending someone with the harsh and brutal truth: “I want to get off the phone now.” It’s fun to try to spot the speak (and to practice the sometimes painful process of not letting ourselves off the hook with the flexibility of language).

And I’m sure you can guess where this post is heading. That’s right: PharmaSpeak. Like many for-profit ventures, the pharmaceutical industry uses language to dampen down concerns, create hype, and generally turn us into unthinking automatons that will waltz into the doctor’s office and say “I want this medicine. Give me a prescription.”

The practice isn’t unique to the pharmaceutical industry. There is BeautyProductSpeak, BankSpeak, ParentingSpeak, etc etc etc. (Ambrose Bierce’s The Devil’s Dictionary is probably the original, if somewhat dark, Speak exposé.) But after seeing the Humira commercial for the umpteenth time, introducing a PharmaSpeak post to this blog, one which I’ll try to add to from time to time, seemed like a good idea. The intention here is not to cast the pharmaceutical industry in an unflattering light, but to debunk the language with the goal of making us all a bit more aware about what we’re hearing, reading, and seeing.

To start, two examples of PharmaSpeak.

Less Appropriate
When it’s used:The gentle narrator in the Humira commercial says that your doctor will determine if other medications are less appropriate.
What does it mean? It means, of course, that your doctor will determine what the best medication is for the person’s condition (which could be no medication at all). But by saying “less appropriate,” the consumer is left with the subtly delivered message that other approaches are probably not as good as this one.*

When it’s used: Many clinical trial reports, especially early-stage studies, note that an experimental drug appears “promising.”
What does it mean? From the consumer’s point of view, not too much. It means that testing will probably continue because the study did not reveal the drug to be a dud. The primary purpose of the term is to generate or maintain investor interest, which is crucial in the early phases of clinical studies. But in those small, early studies, a drug is not being randomly compared to a standard treatment in a blinded way; the drug is being studied on its own, or compared to other data from other studies in a retrospective fashion. “Promising” is sometimes used in later-stage reports, and again its meaning is vague. The term doesn’t mean the drug is definitely an effective treatment and better than the current options. Rather, it means it wasn’t extremely harmful and may, or may not be, an approved treatment one day.  The word isn’t meaningless, but it also doesn’t mean all that much in a practical way.

Please add your own PharmaSpeak words to the comments section, and I’ll post more, too, hopefully (that’s Work in Progress speak for “this is an intention that I want to fulfill but am a little worried I might not”) on a regular basis.

* It should be obvious, this is not a statement about Humira’s efficacy, only demystifying the language used in the commercial.

Image by Leo Reynolds, through Flickr

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2 Responses to PharmaSpeak

  1. Old Geezer says:

    How about, “…other adverse effects such as death…” When they don’t want to say, “This stuff could kill you”?

  2. What about 3rd tier antibiotics that have black box warnings that patients are not told of possible side effects… Leviquin, etc…
    Side effects include ruptured tendons, how can you prescribe a drug even knowing that this could happen. Sorry, I rambled on but I have first hand experience…