Yippee! A Drug Vacation!
(October 8, 2019)
Once upon a time, I had an old lady patient. She was a very pleasant and appreciative lady whom I was treating for neck pain and headaches, and she was doing quite well, too, thank you very much. Then all of a sudden, she started throwing up.
Not just a little, but a LOT. It could happen any time, for seemingly no reason at all. She would throw up continuously until she got so dehydrated she had to go to hospital. They'd rehydrate her and wait a bit, she'd seem fine, they'd send her home and then the whole thing would begin again. This went on for a couple of months. She became fatigued, apathetic, started losing weight. I'm not trying to be overly dramatic here, but she really was slowly dying right in front of us all.
Then! One day, while sitting in the waiting room until she could see her useless doctor for the umpteenth time, she picked up a Good Housekeeping magazine and stumbled on an article with a title something like, “Common Prescription Medications and Their Side Effects.” She looked up each of the six or seven medications she was currently taking, and guess what? Every one of them listed a possible side effect of nausea and vomiting.
She had the receptionist copy the article for her (she didn’t tear it out -- I told you she was nice), left without seeing the doctor, and refused to take another medication, prescription or otherwise, for the next two years. And not only did the nausea and vomiting go away – so did her headaches.
Back then, what she chose to do was unheard of. (At least I had never heard of anyone doing it before.) But not anymore. What she did is now a Thing, and it is called a drug holiday (or a drug vacation). Despite what it sort of sounds like, a drug vacation is not where you take two weeks off to go to a resort and then drug yourself into oblivion the whole time, like some kind of middle-aged spring break. It is when someone who is regularly taking a prescription medication deliberately quits taking it (or sometimes quits taking all their medications) for a period of time to see what happens.
What COULD happen? Well, in the case of someone with HIV, sometimes quitting the drugs gets the patient's immune system to step up to the plate and go after the viral particles by itself. In the case of pain medications, many people build up a tolerance and the meds lose effectiveness. If you take a break from them, you can often resume them with a smaller dosage and with more efficacy than you had before the break.
Sometimes a medication has a particularly burdensome side effect (like ED or fatigue), and it can be ceased for a while to give the patient a break from that. Upon resumption, often the side effect isn’t as bad as it was before. Additionally, the patient may find out that the dosage can be reduced, or the medication quit altogether.
There are many conditions where conventional practice is simply to put someone on a medication (or medications) and leave them there indefinitely. High blood pressure, sleeping problems and allergies are three that come to mind. The thing is, very often either your environment changes or your body finally figures out how to handle a problem on its own. But you’ll never know as long as you keep taking the medication forever. Acid reflux is especially notorious for this, but it’s far from the only one.
Drug holidays are so useful that some doctors use them regularly to judge how necessary a medication is for someone. 70% of Americans are taking at least one prescription medication, and 20% of us are regularly taking five or more. When you look at those numbers as well as the statistic that well over 100,000 Americans per year die from prescription medications THAT WERE USED AS PRESCRIBED, it makes you kind of sit up and say howdy, doesn't it?
In the case of my old lady patient, it turned out that not only were her medications making her sick, but if she had ever needed to be on them in the first place, she didn’t anymore. She was happily prescription-less for over two years, and the last I heard she needed to get back on only one medication (for hypertension). Who knew?
Maybe your blood pressure is usually good, but you’re undergoing a lot of stress, it goes high and the doctor puts you on a couple of hypertension medications. When the stress lessens down the road, you may not need the things anymore. The same thing can happen with pain medications. And with heartburn medication. And with others as well. But if you don’t step up and ask about it, probably no one else ever will, and you'll never know.
So if you want to try a drug vacation, have a chat with your M.D. first and let them know what you want to do and why you want to do it. You two then can work out together how and when to do it, how long to do it for, if anything you’re taking really should not be stopped at all (like insulin), that you’ll do X if Y happens, etc.
Don’t do it on your own, cold turkey. If you can’t talk to your doctor about it, you need another doctor. Drugs are not to be dropped casually, but neither are they to be taken unnecessarily. The fewer, the better, and this is something that might help you get there.
--dr. diane holmes
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