Another Way to Quit Prescription Meds (December 30, 2014)
A third of us (“us” meaning Americans over 18) are taking prescription medications RIGHT THIS SECOND. The average person fills twelve (12) prescriptions per year. And because some people don't take any at all, that means that lots of us are regularly taking several prescriptions at once. That is technically termed “polypharmacy” and has a well-recognized set of problems all its own. All in all, those are a lot of pills, and that is not a good thing.
Here are some scary numbers, because the scary numbers are always my favorite part of any article I write.
Why so many prescriptions? Well, there's the medicalization of conditions that people at one time considered to be spiritual issues or simply part of life’s journey, like mild to moderate depression or short eyelashes (not kidding -- Latisse). Another is a longer average lifespan that gives degenerative conditions like arthritis and cardiovascular disease a chance to become quite advanced. And a third is the presence of medications for problems like insomnia or restless leg syndrome that weren’t even subject to treatment by medication before. So we turn to them frequently when in another time we would have done something else, or done nothing at all.
But what I mean to write about today specifically is a circumstance that frequently occurs when someone takes a prescription for something that is not intended to cure the problem, which is true for most medications taken for chronic conditions. You start taking it, and you never stop. Some medications are only meant to be taken for a short period of time, like antibiotics (when you have an infection that the prescription should eliminate) or a short course of steroids after an injury. But taking something to lower your blood pressure doesn’t fix its cause, so it's something you're expected to take continuously.
So am I telling you to quit taking something that you need? Not really. But I am saying that you might not need it -- or need it anymore. It’s amazing how many conditions regular exercise and lots of fruits and vegetables will fix, or even a weight loss of 8-15 pounds. And 70% of diabetics who reduce down to a normal weight are able to stop taking insulin. Maybe after you’ve taken something for a while, you might just try to see if you can get off it.
There’s a fairly recent trend in conventional medicine that still isn’t too popular, and it’s called “deprescribing”. It means, of course, to officially take someone off a prescription medication that they have been assigned to take regularly. This is something that you don’t really hear about being done much unless it is clear that a medication is causing somebody obvious harm. However, there is a small but growing group of physicians who recognize that that tapering off or withdrawing medications in order to reduce polypharmacy, adverse drug effects and inappropriate or ineffective medication use should be a regular practice.
Deprescribing involves re-evaluating the ongoing reasons for, and effectiveness of medication therapy. A medication may lose its effectiveness, the underlying condition may recede, it may not be the right one for the condition – but unless you check, you’ll never know. Some doctors think that no medication should be prescribed at all without a plan to stop taking it sometime in the future.
People over 65, women and anyone taking multiple prescriptions are most likely to be taking something that at best they no longer need. So, particularly if you are regularly taking multiple medications with no end in sight to their duration, I STRONGLY recommend you get together with your doctor and talk about this. Completely aside from any problems that an individual medication may cause, when you take multiple medications you see a lot more drug interactions, increased adverse drug reactions, generally diminished quality of life, decreased mobility, and impaired cognition. Not to mention what they cost.
Here is the story of my own first experience with the dangers of polypharmacy. I once knew a lady who rather suddenly began having severe episodes of prolonged vomiting for no particular reason, severe enough to require frequent hospitalizations. No one could find a reason for these and she was truly fading fast. Then one day she just happened to pick up a women’s magazine of some sort in the waiting room of one of the doctors’ offices she was starting to practically live in and ran into an article listing common prescription medications with their side effects. She checked each of the several medications she was currently taking and found that every one had "nausea and vomiting" listed as a possible side effect. She walked out of the office without staying for her appointment, quit taking all her medications -- and the episodes stopped, never to return.
We tend to feel that taking a medication for a problem is "doing something about it". Very often seeking an alternative or even doing nothing is much to be preferred.
So here is what Wikipedia has to say about deprescribing. (Yes,, I use Wikipedia. Half of all doctors do. If your doctor is NOT using Wikipedia, s/he is probably not keeping up and you should find a doctor who does.)
--dr. diane holmes
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