Why do Americans need so many prescription drugs?

If you are like most Americans you start your day with breakfast, perhaps eggs and toast, along with a side of pills. According to a recent Consumer Report survey, more than half of Americans take at least one prescription medication daily, with the average person actually taking four medications. Since 1997, the total number of prescriptions filled has increased by 85%, whereas the population has increased only 21% in the same amount of time.

Prescription drug use increases with age as well. In 2014, one in four children took one or more prescription drugs as compared with nine out of ten adults aged 65 and older. Worldwide, the United States comprises 5% of the world population, yet we consume 50% of all pharmaceuticals sold – more than the United Kingdom, Germany, France, Canada, Japan (and the rest of Asia) and all of Latin America combined!

These statistics are frightening. As a physician I see this and ask myself, “With all these drugs, are we getting healthier or sicker?” More people than ever are being treated for chronic conditions such as high cholesterol, diabetes, depression and hypertension. As a society we would like to believe that all of these prescribed medications are actually saving lives, ideally with no harmful effects. However, we know that this is not the case.

We know that patients demand whatever pill will solve their problem. The “quick fix” has become “the way” as opposed to modifying lifestyle. Nowadays, we are bombarded with commercials promoting a plethora of drugs to solve any and all problems. And even though the side effects can be devastating, we have become a society unwilling to achieve health through our own efforts.

Many chronic medical conditions will improve with better lifestyle choices. Weight loss can be achieved simply by cutting out sugary drinks and preparing healthy meals at home as opposed to eating at fast food restaurants. Incorporating moderate amounts of exercise can provide even more health benefits. Taking a short brisk walk, or taking the stairs will burn calories that wouldn’t have been burned by remaining sedentary. Quitting smoking or reducing alcohol use are other changes in lifestyle that have real benefits. Individuals who have difficulty doing this on their own can easily find the assistance they need in various support groups. Reducing stress, although difficult, can also lead to a significant reduction in health related illness. Many people have chosen the path to health through these lifestyle changes and have reaped the benefits. And all of these changes can be brought about without the use of medications. It comes down to personal choice.

Many people are dissatisfied with the doctor that tells them to modify their lifestyle and offers them natural options. It seems that now, more than ever, so many people are unwilling to make personal changes, and instead want that “magic pill” to take away all of their ailments. It’s the easy way, as it requires no real effort nor discipline. They seem to be willing to accept the potential risks that come with consuming pharmaceuticals.

So who is to blame for this drug epidemic? The doctors? The patients? The pharmaceutical companies? In 2015, $325 billion was spent on medication purchases here in the United States. This amount is estimated to increase 4-7%, reaching close to $600 billion spent annually by 2021. Costs have become staggering and strain many household budgets, even forcing many people on fixed incomes to choose between their prescriptions and food.

What about the dangers associated with the side effects of medications? All one has to do is watch a television commercial about a prescription medication and hear the litany of side effects that seems to go on and on.

But don’t be fooled by the smiling actors and gentle music playing in the background; these side effects are real. At the end of the commercial they encourage you to ask your doctor if this medication is right for you. One might wonder why doctors tell their patients about the benefits of a medication they are prescribing but fail to tell them the dangers as well. Typically we learn of the risks only after reading the printed form attached to the medications from the pharmacy. Unfortunately, many patients want “a pill” to fix whatever ails them, and many doctors are willing to accommodate. As well, many doctors are true believers in the power of “the pill” and hand prescriptions out like candy. This is where we are today.

The statistics are staggering. Almost 1.3 million people here in the United States went to emergency rooms in 2014 due to adverse drug effects from prescription medications, and about 124,000 people died as a result. And what happens to others who experience less serious side effects? Typically, other medications are prescribed to treat them. We are certainly a society that seems to have no trouble adding more pills on top of the ones we already take.

Many Americans and their doctors feel that every symptom or even a hint of a disease requires a drug to treat it. As sad as that sounds, this is the culture we live in. Even health insurance companies find prescriptions the easiest and least expensive way to address a patient’s health. In light of the narcotic epidemic, some medical organizations are now advising doctors to try non-drug approaches for a host of symptoms. For example, people that suffer with back pain may benefit from modalities such as physical therapy and massage. Yet health insurance companies need to be on board. Often times, out of pocket expenses for these options are much higher than for the medications. And unfortunately, many people want instant results and are not willing to play an active role in their healing.

People seeing multiple doctors will receive prescriptions from each of them, and one can only wonder about the potential risk of drug interactions. A 2017 Consumer Report found that more than half of those surveyed received prescriptions from two or more healthcare providers. In addition, 75% of them also took at least one over-the-counter medication on a regular basis.

Doctors must remember to get patients off unnecessary prescriptions. All too often patients remain on a prescription drug long after it’s needed or even after the science has shown that long term use is not ideal.

The same 2017 Consumer Report found 35% of those surveyed never had their doctor review their medications to see if they could stop taking any of them. Medications that were once prescribed like candy have now been found to be beneficial for only short term use, yet doctors seem reluctant to suggest stopping them.

There are many conditions that often would benefit more from lifestyle changes than from medications. Back pain, heartburn, and insomnia, as well as pre-disease states such as elevated blood sugar, elevated blood pressure, or mild bone loss, are often treated with prescriptions as opposed to lifestyle modifications.

And what about alternative health options? Before starting on a new prescription consider your alternatives. Finding information is not the problem, as it is readily available. But deciding what to do is the hard part. And to whom does one turn for guidance? Doctors of my generation were taught to treat medical problems with medications. We had no specific training in nutrition or alternative health options. Unless a paradigm shift is currently underway, and the doctors of tomorrow are learning a more holistic approach to care, not just medicating symptoms and disease, we will continue as we have been, going down the same long road of prescription drug dependency.

The number of doctors that will never consider a natural alternative as a method of treatment still outweighs the number that will. Unfortunately, until more studies are done to confirm the efficacy of a natural treatment and subsequently approved by organizations such as the United States Food and Drug Administration, the debate of prescribed medication vs. natural alternatives will continue.

Over the past three years I have made changes in my lifestyle choosing to eat even healthier, exercise more, remove toxic chemicals from my home and even stop my prescription medications. I had approached my healthcare provider about weaning off my prescriptions, and under his supervision I was successful. I don’t suggest doing this on your own since there are real consequences to stopping some medicines abruptly. But a conversation with your doctor regarding your desire to reduce your number of prescription medications may be indicated. If they are unwilling to consider this option perhaps you might consider finding one that will.

Again, it comes down to personal choice. Do you want to take prescription medications, knowing you are adding synthetic chemicals to your body that will further tax your liver, kidneys and other organs, or would you rather make changes to your lifestyle now that could preclude your need for those drugs and benefit you for many years to come?

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Text established by  Antonia Lorenzo Iturralde