Adverse Drug Events – ADE – ADR

SARSS – Suspect Adverse Reaction Surveillance Scheme

A side-effect (side effect), Adverse Drug Event (ADE) or Adverse Drug reaction (ADR) is a phenomenon almost entirely confined to the use of conventional drugs. The ancestor of modern drug medicine, herbal medicine, has the capability to induce side-effects but these are rare, owing to the methodology used. However, modern pharmacognosy and purification processes increase the likelihood of significant side effects occurring with that form of herbal medicine.

In drug medicine, the desired effect of the drug (the reason for giving the drug) is the ‘primary effect’. The unwanted side-effect is the ‘secondary effect’ of that drug, i.e. the product of the body’s reaction to the drug. This reaction by the body is an inevitable part of drug intervention, since the body must inexorably react to ANY agent introduced. However, the reaction is happily not always noticeable or significant. When it is significant, it can range through all grades of seriousness, from inconvenience to death.


Side effects are part of the complex of iatrogenic disease, i.e. medically-induced disease. Some prominent illustrative examples are cited under that heading on this website.

The phenomenon is absent from homeopathy, since the desired effect of homeopathy is the secondary effect or secondary reaction itself. Knowing that the body has inevitably to react to an introduced substance, we give a substance whose secondary effect (the body’s reaction) will be a curative one.

The possibility of dangerous or damaging side effects and the desire to avoid them is one of the factors that drives people to homeopathy.

Side effects are an ever-present and potentially serious welfare risk, when embarking upon strong conventional drug treatments. Human research gives us some idea of the scale of the problem. According to a respected medical textbook, iatrogenic disease has become ‘one of the most prevalent conditions facing modern health services, occupying countless hospital beds all over the Western world.’ (Butterfield, Sir John. (1986). Foreword. In D’Arcy, P.F. and Griffen, J.P. (eds). Iatrogenic Disease, 3rd edition. Oxford University Press).

Nonetheless, there may be times when intervention with a drug becomes necessary, in order to contain a situation, while seeking a cure. Also, in cases of incurable disease, distressing or painful symptoms may necessitate the palliative effect of drugs, despite the risks.

Chris D’s Blog carries this article, among many:

“More evidence-based medicine”
by Chris D on Sat 03 Nov 2007 06:15 GMT

This from 1998:

“Study confirms how dangerous prescription drugs are:
side effects make 2 million sick
Properly prescribed medicine kills 106,000 each year

Drugs that cause worst reactions: heart medications. blood thinners and chemotherapeutic agents for cancer. Most common cause of death: liver or kidney failure, heart rhythm problems and bone marrow destruction.

More than 2 million Americans become seriously ill every year because of toxic reactions to correctly prescribed medicines taken properly and 106,000 die from those reactions, a new study concludes. That surprisingly high number makes drug side effects at least the sixth and perhaps even the fourth, most common cause of death in this country. The analysis, the largest and most complete of its kind, suggests that one in 15 hospital patients in the United States can expect a serious reaction to prescription or over-the-counter medicine and about 5 percent of those will die from it.

If the findings are accurate, then the number of people dying each year from drug side effects may be exceeded only by the numbers of people dying from heart disease, cancer and stroke and may be greater than the number dying from lung disease, pneumonia or diabetes. Experts said the study, which appears in today’s issue of the Journal of the American Medical Association, is stronger than previous ones because it looks only at cases in which drugs were taken correctly. Previous hints of similarly high side effect rates had been attributed in large part to people getting the wrong medicines or taking them in the wrong doses.

Only one quarter of the reactions were due to patients being allergic to the drug in question. In theory, those reactions could be avoided by more carefully asking patients about known allergies. The rest of the side effects were classified as essentially inevitable, bound to affect a certain percentage of the population for unknown reasons.

Pharmaceutical manufacturers, drug regulators and the researchers themselves warned against over-reacting to the numbers, noting that the study made no effort to measure the benefits of the same medicines – an equally important part of the cost-benefit calculation that determines the usefulness of a drug.”

Can you imagine the comfort a dying patient would feel, from the knowledge that someone thinks others have benefited from the same drug?

Let’s face the facts. When profit is the motive, common sense, science, reason, safety, ethics and decency tend to take flight.

The NHS, which can hardly keep its head above the financial surface, partly because of spiralling drug costs, currently appears to be hell-bent on putting homeopathy behind it, once and for all. Never mind reason. Never mind logic. If the punter doesn’t fight for the freedom of choice, it could be flushed down the toilet of vested interest. Homeopathy would then be the prerogative of those who can afford private treatment.

One of the major tragedies of modern veterinary medicine is that adverse drug events are not properly monitored. The Veterinary Medicines Directorate has the SARSS scheme (Suspect Adverse Reaction Surveillance Scheme), which is only voluntary and rarely used (see SARSS).

See also: Evidence-Based Medicine : Animal Experiments : Iatrogenic Disease : Vivisection : Steroids