Most of us have been prescribed and taken prescription drugs at one time or another: an antibiotic for a strep throat, a muscle relaxant or pain medication for a bad back, statins when those cholesterol numbers are high…Seeing patients every day, it seems like a large segment of the adult population is taking multiple prescription drugs on an ongoing basis. This issue is called polypharmacy, and a new study shows that the phenomenon continues to increase.
Importantly, we need to remember that prescription medication is one of the wonders of the modern age of medicine. Before antibiotics, countless people died from simple bacterial infections. Individuals with compromised respiratory systems who struggled to breathe can now live relatively normal lives. Cancer research has amazingly turned cancer from the automatic death sentence it once was into a disease that is conquered by many. As wonderful as these advances are, there are two problems. Let me explain.
Drug Side Effects and Interactions
First, Big Pharma is still making sledgehammer drugs, meaning while they are targeting these issues, what’s needed is a precision nail, and the closest they can get to the issue is hitting the general area with a sledgehammer. This lack of focused effects means unintended targets are being hit as well, resulting in the numerous side effects you hear listed very quickly at the end of TV prescription-drug ads.
It’s the unintended interaction of known, and unknown, side effects that can cause enormous problems. For example, while steroids injected epidurally (around irritated back nerves) can act as a potent anti-inflammatory, in middle-aged and older women, they can also cause significant bone loss and increased fracture risk. This unintended damage highlights the complexities of drug mechanisms and the potential for unexpected drug interactions.
Prescription-medication side effects can also interfere with the effectiveness of medical procedures. For instance, our research has shown that certain common prescription drugs negatively affect stem cells, which is why our initial candidacy evaluation goes over all prescriptions. Our goal is to temporarily suspend the problematic ones to ensure a better outcome for our patients.
Second, the FDA-approval process for prescription drugs is incredibly long and unimaginably expensive, (average 359 million for drug approval in 2012). Add to that, for every one drug that the drug company gets through FDA approval, they have funded the research of an average of 100 that have not. That enormous financial pressure to get a drug to market can result in the “we’ll deal with that later” plan for side effects. In addition, you want your drug to be a sledgehammer so that it’s more likely to get through the FDA gauntlet.
National Health and Nutrition Survey Looks at Taking Multiple Prescription Drugs
To evaluate if we’re taking more or less medication over time, a new study out of Boston and New York looked at the trends in prescription-medication use in two distinct time periods. To do so, the new study reviewed data from the National Health and Nutrition Survey, representing almost 40,000 patients. Their findings were that the use of any prescription drugs was increased by 8% in 2011 to 2012, and the use of five or more prescription drugs (polypharmacy) increased by 6.6% in the same period! Not surprisingly, the meds that most increased in this time period were cholesterol-lowering drugs, antidepressants, muscle relaxants, and stomach-acid-reducing drugs. Meaning we’re increasingly out of shape, depressed, in pain, and stressed out!
The upshot? Back in the day, the town GP knew everyone, their family, and their medical history. It was a close relationship, and the cons of medication were weighed against the benefit in that particular patient for that particular situation. With the advent of prescription medication being hawked on TV and with dividing patients up into body parts and systems treated by specialists, some of the big-picture checks and balances of that primary relationship have been lost to history. The modern-day issue of taking multiple prescription drugs makes me think of my Venezuelan grandmother. Every evening, she used to look at her handful of pills, line them up on the table in groups that made sense to her, and proclaim, “I can’t let this one get together with that one or they’ll have a party together and make me loco in the head!” Not a lot of science in there, but maybe she was on to something!