Got Any Good Drugs?

It was a blast of a New Year's party, but now that 2024 is history and 2025 is here, you're feeling terrible. It's not just a hangover. You're sweating. You're listless. You're aching all over. The doctor nods sympathetically while she pokes around here and there as physicians have done ever since Hippocrates. Then she goes high tech: "Your gene card, please?" she asks.

The computer digests the rectangle of plastic you hand her. "Yes, you've got a bad case of flu," she says reassuringly. "I'm having the pharmacy create a drug for you. It'll be ready before you're dressed, and you should be as good as new by tomorrow."

Maybe that's not exactly the way pills will be dispensed 25 years from now, but you can be sure that at molecular biology's current pace, it will be something like that. By then scientists will have decoded the entire human genome--all 140,000 or so genes that largely say who we are and which of 4,000 diseases our flesh is heir to. They will also have found exactly where common disease-causing errors lie along the genome's long, interlocked chains of DNA.

That will have enormous practical consequences. Your genetic profile, recorded on a chip, will let doctors--or, more likely, their computerized diagnostic tools--determine your exact level of risk for a particular disease and which proteins and enzymes your body lacks. There will be no more wasteful trial and error, with costly pills winding up in the trash because they produced unwelcome reactions or didn't work for you. Instead you'll get customized prescriptions, created to "fit" on the very first try, like a Savile Row suit.

And that's just for starters. In 2025's genetically based pharmacology, you'll not only have your pick of the old standbys--tranquilizers, antihistamines, painkillers and antibiotics, all compounded to your personal specs--but you'll see all sorts of new capsules and tablets for virtually every ailment and condition. These will range from mood and pleasure enhancers--legal and otherwise--for the pill poppers of the future to new medications for diseases likely to be much more common in an aging population, like Alzheimer's, cardiovascular problems and cancer.

"It will be a geriatric world, at least in wealthy countries, with at least 20% of the people 60 years or older," says Stanford chemist Carl Djerassi, synthesizer of the birth-control pill. For that reason, he predicts, drug companies will turn from contraception to conception in an effort to help older women have babies. As for aging men, they'll have at their disposal libido and sex-performance boosters that will make Viagra seem like baby aspirin.