Greg Jones has a job that is critical to human survival. He feeds us. Not literally of course. This New Jersey truck driver goes to work at 8 pm and driving by night until 4 am, brings us the food we eat. He has become a nocturnal (nighttime) mammal with a diurnal (daytime) body. He knows what this means. Many of his co-workers have persistent health issues that indicate body deterioration. He has a daily discipline of 2 hours of exercise that he hopes will keep his body going without constant pain and grim trips to the hospital.
Because you see, trying to be a nocturnal mammal in a diurnal body can mean a weakened immune system with a tendency toward diabetes, heart disease and perhaps even cancer. Humans are social mammals. Shift work means one’s family and social life are impaired. If they are parents, shift workers may drag themselves to important milestones in their children’s lives in a mist of fatigue, all the time pushing themselves to show enthusiasm in a way that a stage actor might.
Shift workers are less likely to attend religious services, union meetings, community meetings and family social gatherings. Important emotional ties to friends, family and community can become blurred, weakened and even antagonistic, pumping more stress hormones into an already weakened human body.
But Rest Easy Folks: The Wake-Up Squad Is Here!
The Wake Up Squad has a slick looking website and a traveling road show that goes from town to town. If you can’t make it to one of their personal appearances, you can visit their blue collar-chic website. There you learn how to overcome your “Shift Work Disorder”, what shift workers used to simply call, “being tired all the time.” The Wake Up Squad website does present some sound scientific information. You can learn about human circadian rhythms and how they regulate our wake-sleep cycle. It also explains some of the health risks of Shift Work Sleep disorder. The Squad has helpful hints about how to get better day-time sleep, like having a quiet dark room with a Do Not Disturb sign on the door.
So far so good. But when you sign up for more information things turn nasty.
Your “friends” from the Wake Up Squad are actually a pharmaceutical company calledCephalon. This Big Pharma drug pusher wants to get all of you sleepy heads on a pill called Nuvigil (New Vigil: Get it?). Curiously, the personal appearances of the Wake Up Squad are all at trade shows aimed at women. Mother’s little helper?
Nuvigil may keep you awake, but the possible side effects may also raise your stress levels to the max. Here is quote from the official Nuvigil web site:
“Serious or life threatening rash has been reported in adults in association with the use of NUVIGIL and modafinil, and in children in association with the use of modafinil. NUVIGIL should ordinarily be discontinued at the first sign of rash unless the rash is clearly not drug related. NUVIGIL is not approved for use in pediatric patients for any indication.
Other serious adverse events associated with the use of NUVIGIL or modafinil include angioedema and hypersensitivity, including fatal multi-organ hypersensitivity reactions, psychiatric adverse experiences (including suicidal ideation), and persistent sleepiness. If hypersensitivity reaction is suspected, NUVIGIL should be discontinued. Consider discontinuing NUVIGIL if psychiatric symptoms develop.”
Oh, it can also be habit forming, a polite term for drug addiction. BTW, if you’re jonesin’ for some Nuvigil, you’d better have good insurance. The cost will definitely keep you up at night . For some of the other potential side effects check out the NIH report on Armodafinil, the clinical name for Nuvigil. It’s quite a list and seems to include the entire human body from head to foot.
Cephalon hoped to have Nuvigil approved for treating jet lag which industry experts said could have tripled its sales, but the FDA turned down the request. Apparently what was deemed too dangerous for high flying international business travelers was considered Ok for the working class. Still a lot of people take the drug and experience no obvious side effects. Or they can at least can tolerate the ones that do crop up. But even Cephalon admits they don’t know exactly how the drug works. No one knows what happens when taken over time.
Nuvigil is an altered version of another drug called Provigil whose patent was about to expire. It is common practice for Big Pharma to play musical chairs with the atomic innards of a drug molecule and then slap a new label on it. Provigil is best known for its use by college students cramming for exams and its role in a number of sports doping scandals. Cephalon had its own scandal in 2002 when the FDA sent a stern FDA letter to the company for its misleading Provigil claims. Cephalon later paid a $425 million fine and pleaded guilty to federal charges related to improper uses of Provigil and two other drugs.
So it turns out that the Wake Up Squad is no better than the sleazy guy under the 76 sign peddling amphetamines at the local truck stop. Or maybe that nervous lady who sells them under the counter at the beauty shop.
The Fog Of Work
Greg Jones the truck driver who delivers our food is not the only night shift worker with a job that is critical to the rest of us. Nurses, cops, nuclear plant operators, airline pilots, and fire fighters also must be on duty. Cephalon is clearly aiming at that demographic. No one can deny that fatigue can be a deadly serious problem.
The 1979 Three Mile and the 1986 Chernobyl nuclear disasters both happened when fatigue was an issue. In 2011 a United Airlines Airbus A320 and an American Airlines Boeing 737 landed at Washington National without the help of an air traffic controller. The sole controller in the tower had fallen asleep for 24 minutes. He had worked 4 consecutive overnight shifts. Both planes landed safely–this time. I once had a job driving a delivery truck. After 11 hours on the road I fell asleep in the slow lane of a Virginia highway and woke up in the fast lane. It was a lucky day. I didn’t kill myself in addition to a nice a family enjoying the Virginia countryside.
Seriously, do we want people putting drips in our arms or flying us into airports who are stoned on Nuvigil? It can cause hallucinations, anxiety, depression, lack of concentration and a whole range of distracting effects like dizziness, nausea, itching and severe chest pain. The health effects of shift work do not go away because of Nuvigil, although that is what Cephalon implies in their misleading advertising. And what about those people who take Nuvigil to stay awake and Ambien to go to sleep? What about the effect on their health?
There are no easy answers to the question of fatigue in our always-on-the-go society. We could organize work differently so that the debilitating effects of shift work are reduced. The National Institute for Occupational Safety and Health has a whole range of suggestions for how to arrange shifts and breaks to make life easier for shift workers while increasing productivity and decreasing accidents. We could also put some serious funding into researching non-drug solutions while putting the kibosh on pills like Nuvigil with their potential for sickness, injury, death and increased health costs.
These ideas and others like them would require commitment from lawmakers and a strong push by organized labor. Employer groups are sure to resist any effort to interfere with their “right” to schedule work as they see fit, regardless of the human consequences. With our current dysfunctional Congress and our weakened unions, improving the lives of shift workers and ensuring public safety will be a major challenge.
Until we get sick and tired of people being sick and tired, our national sleep deficit will continue to rob people of their health and the joy that life should encompass.