Ventolin: "Rescue Inhaler"?
A narrative by Susie O'Brien
To construct the narrative, click on the elements on the Ventolin label
Dundurn St. South, in west Hamilton, is in an affluent area where asthma rates are much lower than in other parts of the city. Treatment is also more accessible. For a variety of reasons, asthma medication isn't cheap. Ventolin is available over-the-counter in some countries , but not in Canada. Requiring a prescription may reduce sales; however, it can significantly boost profits, since prescription drugs are often covered by insurance companies, which will cover prices that consumers might balk at (Rosenthal). The cost of medications like Ventolin has increased as companies responded to worries about CFCs by creating new (and more expensive) ozone-friendly inhalers. Critics suggest that the switch reflects, not environmental responsibility, as companies suggest, but a savvy move to gain an advantage over generic drug producers (Baumann). Medication often involves complicated trade-offs between effective treatments for illness and broader determinations of environmental health. In these trade-offs, ethics is often complicated by (and sometimes reduced to) economics, affecting people to different degrees based on income.
Works Cited:
Baumann, Nick. “Why You’re Paying More to Breathe.” Mother Jones July/August 2011
Rosenthal, Elisabeth. “The Soaring Cost of a Simple Breath.” New York Times 12 October, 2013.
The stressfulness, and more general difficulty, of dealing with contemporary environmental problems, of which rising rates of asthma are arguably indicative, is that it's very hard to draw a straight line between a problem (e.g. presence of fine particulate matter) and a symptom (over-reactive airways). The complex manifestation of allergic asthma in particular, in which the immediate triggers of bronchial spasm are likely to be ordinary things--things we love (dogs, trees, grass)--rather than industrial chemicals per se, exemplifies the difficulty of tracing the health effects of environmental contaminants. Rather than causing immediate, traceable symptoms, toxins often work at systemically, producing changes at the cellular and even the genetic level, that compromise our bodies' ability to respond to change. Our immune systems become over-reactive, incapable of distinguishing benign from dangerous interlopers, the familiar from the alien, and in the process, compromise our resilience to major disruption.
Ventolin is manufactured by GlaxoSmithKline, described on the company's website as "one of the largest research and development (R&D) investors in the industry, collaborating with academic institutions, governments and other pharmaceutical and biotechnology companies to help people live healthier lives".
GSK and the Environment? In addition to funding a McMaster University Research Chair in Pediatric Asthma, GlaxoSmithKline provides funding to the Asthma Society of Canada, and Lung Associations of New Brunswick, Nova Scotia, Ontario and Saskatchewan. While such collaborations provide much needed funding for cash-strapped universities and charities, the potential for bias is significant. GlaxoSmithKline has been implicated in stories about studies funded by the company whose results are skewed to favour their products. More generally, the role of pharmaceutical companies in medical research funding risks nudging research priorities toward pharmaceutical approaches to health (vs. research into prevention, environmental factors, etc.).
Ventolin has been dubbed a "rescue inhaler", because it works quickly to treat the symptoms of an attack. Many asthma sufferers use Ventolin in conjunction with "maintenance inhalers", which take longer to work, though the effects last longer. Possible side effects of rescue inhalers include jitters and palpitations. Since asthma itself is sometimes exacerbated by stress; the need for periodic "rescue" puffs (that sometimes exceed the recommended dose!) highlights the dilemma of living in conditions that Eric Cazdyn calls the "new chronic", in which we "manage" (to different degrees depending on our resources) serial mini-emergencies in the false belief that we can indefinitely forestall a bigger one, rather than initiating the wholesale change that's required. The idea of a rescue inhaler is comforting , and Ventolin is an effective drug in managing many people’s asthma. Focusing on “rescue” and "maintenance", however, risks masking the bigger context—environmental, social, and economic—in which asthma arises.