Tuesday, 1 March 2016

Are Too Many Meds Damaging Us?

Today's post from pressdemocrat.com (see link below) is a different look at the current pain medication debate. It comes from a pharmacist who is on the front line of decision making when it comes to prescribing strong pain medications and his conclusion is that we are all too dependent on drugs in general and that many of us, as we get older, are on several different drugs a day just to keep us going. He mentions a neuropathy patient of his whose drug use for other conditions may well be causing her neuropathy but he doesn't really acknowledge that patients such as that lady may also be in genuine need of opioids and other strong pain killers, purely because they've tried everything else and are at the end of their tether. This debate will go on and on but we must protect those patients who need the benefits of strong pain drugs in order to be able to function as useful members of society - they run the risk of being ignored in the rush to restrict and ban. Definitely worth a read - an interesting article from a different viewpoint.
Close to Home: Fewer medications an Rx for your health

In a recent editorial, The Press Democrat posed pose a dramatic question: What kills more Americans? And the answer was, surprisingly, drug overdoses of opioid painkillers.

As a pharmacist, I think there is a better, more urgent question: Are we, as Americans, over-medicated by all types of prescription medications?

Statistically, we are. We are fooling ourselves if we only react to the opiate and heroin overdoses of middle-class white people (it didn’t get that much press when urban minorities were dying from the same drugs). People are dying or becoming disabled as the result of overprescribing and over-promotion of many classes of prescription drugs.

Many pharmacists will tell you that they are astounded by the number of prescriptions filled by any number of their patients. They wonder, out loud: “How do they even have room for food?” It is not uncommon for a pharmacist to fill 10-12 monthly prescriptions for one patient. (While I was typing this, a patient came in to ask me what she could do about neuropathy pain in her feet. She handed me a list of 17 drugs she is taking. And, yes, two or three of her drugs could be the cause of her excruciating foot pain. She has been to Mayo Clinic and Stanford with this problem.)

Seventy percent of us take at least one prescription medication, and 20 percent of us take at least five prescription medications (without counting over-the-counter medications).

Women and the elderly take the most prescriptions.

Between 2007 and 2010, the number of people taking at least one prescription medication went up 50 percent, according to the Centers for Disease Control.

Though studies prove and pediatric associations emphasize that antibiotics are useless for most childhood ear infections, they are still prescribed and result in reduced immune function.

Nearly 5 percent of hospital deaths are due to an adverse drug reaction, according to a Reuters Health report from 2003

A review of hospital admissions published in the journal Drug Safety found that 57 percent of adverse drug reactions were not recognized by the attending physician at the time of admission. As in numerous other studies, many of these admissions should have been prevented. In fact, 18.6 percent of all drugs prescribed prior to admission were contraindicated.

Well, you can see the problem. It’s not just white people getting addicted to prescription opioids followed by heroin addiction (the heroin is cheaper). We are a drug-dependent society. Period.

And the problem isn’t only drug-drug interactions (what we pharmacists call “poly-pharmacy”). Underneath the hospital admissions and the folks dying in their homes from opioid overdose is the larger, more dangerous piece of the iceberg: Drug-nutrient (as in food) depletions. Acid blockers (for heartburn) deplete magnesium, B-vitamins, folic acid, protein digestion. Osteoporosis drugs, while making bone denser, make poor quality, easily broken, hard-to-repair bone. Blood thinners deplete Vitamin K, which makes sure calcium is added to bone and not arteries. They cause osteoporosis. Broad-spectrum antibiotics kill off good bacteria in the gut responsible for 80 percent of our immune system. I could go on.

The problem is clear: We ask for and rely on too many drugs. The gatekeepers are too busy to advise us properly, and we badger them to give us a prescription based on what we see on TV or what friends are taking.

Drug companies spend too much money on advertising and, like Volkswagen, they mislead us with poorly executed studies that demonstrate a 1 percent advantage over a placebo while making it look like a 50 percent advantage. Let’s take a few deep breaths (it’s actually better than a Xanax), step back and start working on the real problem, not just the latest media darling, opioid abuse by the white, middle class. Our problem is much larger and deeper than that.

Mark Burger, a pharmacist, owns and operates Health First! Pharmacy & Compounding Center in Windsor.


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