Pharmacovigilance, the process of identifying and responding to drug safety issues, finally has its day in the world of podcasts. What is exciting is that shining the light on side effects in particular has hit podcasts. On my recent epic road trip to Motor City, listening to hours of podcasts made the long drive fly by quickly. I normally listen to audiobooks, but after driving on a long and boring highway in a state that shall remain nameless, I needed to take a break from the British mystery novel. I started listening to news podcasts, and it turns out there are some great shows out there that have some episodes dedicated to side effects, especially news-based podcasts, including our own, Power to the Patient. Before the return drive I did some research, and loaded up on podcasts with side effects as the main focus. When it comes to podcasts who solely address pharmacovigilance, there are two that standout to me.
As we become more aware of the side effects of medicine, and the science and process necessary to achieve it, podcasts have become one of the best ways to learn more about pharmacovigilance. Podcasts have become a daily ritual for Americans to consume news, with half of Americans listening in as a method for doing so.
I listened to two types of podcasts. The first were those that had episodes that were dedicated to how side effects played a role in a larger issue, such as healthy living or trending news. The second category was dedicated solely to side effects. If podcasts fit in your routine, here are six of the best that talk about side effects. And if you’ve never given it a try, these quick hits are a good place to start.
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Quick Hits: Side Effects as Hot Topics
Not all podcasts are dedicated solely to side effects, but they are often an important part of a larger theme.
In Medshadow’s own podcast, Power to the Patient, host Dr. Lille Rosenthal interviews author, chef, and Chopped champion Brooke Siem about how she spent the majority of her adult life on antidepressants, and almost didn’t survive the side effects. Siem’s book, “May Cause Side Effects,” which was also reviewed by Culture Desk, is powerful and relatable. Her interview on our podcast is equally as engaging.
The Daily at The New York Times
The New York Times’ podcast, The Daily, has a timely and informative episode on the newsiest drug of the moment, Ozempic. The episode, The Ozempic Era of Weight Loss, dives into how a drug for diabetes, whose side effect is weight loss, became a pharmaceutical rock star. The episode introduces us to two women who used it for weight loss, navigating the physiological and psychological side effects of their journeys. If you’re curious about what all the fuss is about with this new drug, and interested in whether or not it is a safe option for weight loss, this episode is informative and easy to digest.
Post Reports at The Washington Post
The Washington Posts’ podcast, Post Reports, has a great episode, “Coronavirus, Mpox, and Rabies: A Tale of Three Viruses,” that talks about the recent world response to the three viruses, and how those experiences may help experts prevent and respond to new viruses and outbreaks in this post-pandemic world. You may have sensed a theme here, but the big newspapers have the resources and journalistic muscles to produce podcasts that tackle the biggest issues of drug safety in a way that is informationally accessible, and Post Reports is another example of that.
Tradeoffs
Lastly, Tradeoffs is one of my favorite podcasts. Led by Dan Gorenstein, Tradeoffs is a nonprofit media podcast that takes on thorny public health policy issues by synthesizing difficult topics in an easy to understand and entertaining show. Tradeoffs is not specifically only about side effects or drug safety, but they do hit on it every now and then.
A fantastic episode, “Why Are People Afraid of the Most Popular Opioid Addiction Treatment,” goes into how the rise of an illicit drug use of fentanyl, has prevented different drug treatments to treat opioid use disorder. Buprenorphene is one of only three prescription drugs that are FDA approved to treat opioid use disorder. The other two are less effective (naltrexone) and just plain hard to get (methadone).
Buprephenone stimulates the same receptors in your brain as opioids. In fact, it is an opioid. However, for people with opioid use disorders, it staves off withdrawal symptoms and reduces drug cravings without causing any sort of euphoria or “high.” However, because it blocks the same receptors that other opioids bind to, if you take it when other opioids are still in your system, you can plunge into an intense withdrawal known as “precipitated withdrawal.”
Fentanyl, an opioid frequently found in illicit painkillers or heroin, stays in the system longer than other opioids, and its presence is often responsible for buprephenone’s worst side effect, a crashing withdrawal. I learned a lot in this episode about the drugs like buprenorphine, but I also learned a lot about how policy and research are being forced to adapt around the reality of drug use and its side effects.
Drug Safety Podcasts Worth a Listen
There are two podcasts dedicated to drug safety and pharmacovigilance that stand out as having a dedicated focus to the topic. I can recommend the first to anyone interested enough to be reading this article, and the latter only to those who want a deep dive in the pharmaceutical corporate weeds.
Drug Safety Matters
The first, Drug Safety Matters, is produced by Uppsala Monitoring Centre, a nonprofit organization that advances the science of drug safety around the world, and is the designated World Health Organization Collaborating Centre for the International Drug Monitoring Program. Drug Safety Matters explores current issues in pharmacovigilance and drug safety. The producer and host, Federica Santero, is a communications officer at Uppsala Monitoring Centre. She navigates the various pharmacovigilance topics with ease, and nudges her guests to explain their work in layman’s terms.
A perfect introduction to the podcast is its most recent episode, “Catching Black Swans – Francois Montastruc.” It deals with adverse drug reactions so serious and hard to predict, that they’ve been dubbed “black swans” per Nassim Nicholas Taleb’s theory and book “The Black Swan, The Impact of the Highly Probable,” and the ensuing possible implications for drug safety.
Santero interviews Francois Montastruc, a specialist in clinical pharmacology and pharmacovigilance at the Toulouse University Hospital in France, who has long been interested in Taleb’s theory. Santero prods Montastruc to use different examples in order to define for listeners what the black swan theory is and how it impacts drug safety, and he uses the COVID-19 drugs as examples.
Montastruc, who researched adverse drug reaction (ADR) reporting in the trials of COVID-19 vaccines and treatments, offers the example of thrombosis and thrombocytopenia with the AstraZeneca COVID-19 vaccines as a black swan event. For some patients, an unexplained death was a very rare ADR, making it an unusual and unpredictable event, and it impacted vaccination strategies.
In France, the AstraZeneca vaccine was stopped in young people because of the ADRs. Montastruc explains that pharmacovigilance in a state of emergency, such as the COVID-19 pandemic, requires review of very different clinical trials; they are shorter in time, for example. This makes ADR reporting and international communication even more important. In contrast, a white swan event, or a more common and predictable ADR, such as the well-documented cardiac and psychiatric effects of hydroxychloroquine, which were more rapidly characterized in worldwide databases, such as VigiBase, were also described in the podcast.
In the end, the ADRs are a reality of pharmacovigilance, and Montastruc shares the importance of efficiently sharing this information worldwide to improve drug safety. During the interview, Monastruc explains how Taleb’s black swan theory informs drug safety research and the policies that come from it. Even though small things like audio editing showed that it didn’t have the budget of some of the large news organizations, I thoroughly enjoyed listening and learning a lot from this podcast.
Innovation and the Future of Pharmacovigilance
Another podcast that addresses drug safety is Innovation and the Future of Pharmacovigilance, hosted by Indy Ahluwalia. For full disclosure, it is hosted by Truliant Talks and its guests are frequently big pharma execs. It was the only podcast where, even with a little research, it was unclear if the guests had any conflict of interests (i.e. connections to pharma). So while its content and guests are at times interesting, it is mostly focused on pharmacovigilance from a corporate and pharma industry standpoint.
Because of this, in many ways I found this podcast less interesting, honestly borderline boring. However, it is also very much a behind the scenes look at pharmacovigilance, and if anyone wants to look at drug safety from a deeper dive, business-centric perspective, this podcast definitely fits the bill.
Its latest episode, “Bill Ringbloom,” host Ahluwalia interviews Ringbloom regarding his work as AstraZeneca’s Head of Global Patient Safety Technical Solutions. Ringbloom breaks down drug safety and pharmacovigilance and the ways these themes thread through AstraZeneca’s corporate strategy and systems.
This podcast episode is not a pharmacovigilance first perspective, but rather a pharmaceutical company perspective on pharmacovigilance. In other words, it is not my preferred orientation. He acknowledges drug safety as a necessity, but is simultaneously constantly seeking financial value and opportunity. The two go hand-in-hand for him.
Nevertheless, I found it fascinating, in a “how the sausage is made” kind of way. One example he brings up early on is his vision of the “data supermarket.” If physicians, scientists, and other researchers could go into a pharmaceutical company’s system online and pick and choose information on trials, support programs, etc., it only works if there are things on the shelves other than drug safety. What those things are, I don’t know. I don’t know if I want to know. And quite honestly, it is hard to parse from the interview the specificities of what would be in a data supermarket, and whether or not it is even relevant to drug safety and adverse events.
But Ringbloom later says, in answering what is next for pharmacovigilance, and in very broad terms, that data is the future. More data, A.I. data, clinical trial data, data not yet accessible to them (I don’t know what that is, but I wanted to know!). Not just clinical trial data, but supplemental clinical trial data as well as deep dive cases data, claims data, electronic health data, and so on. Ringbloom’s concept of a data supermarket might have less to do with pharmacovigilance than profit, but in the end the interview alone is too vague to say one way or another.
The other episodes are similar to this, very industry focused. I am not sure I am the ideal audience for “Innovation and the Future of Pharmacovigilance,” but I could see a PhD student or MBA grad hoping to get into the industry, could get a lot more out of it. However, in the end, and in a very black swan turn of events, I realized that this podcast would be an important listen for those who want to know all of the ways that drug safety and pharmacovigilance are carried out.
Hear, Hear! Podcasts on Drug Safety have arrived
This roundup is not complete by any means, but just some that we’ve come across, and that is a good thing. Podcasts have exploded as a source for news consumption, and drug safety and pharmacovigilance have become even more of an interest post-pandemic. The wealth of interesting podcasts dedicated to drug safety and drug side effects is only going to grow. If you already listen to podcasts, then you are in luck, because the podcast universe is well on its way to exploring all the ways, and personal stories, about why drug safety matters.
