Friday, May 18, 2007

One Nation On Drugs

As I visited recently with a friend that is a family practice doctor, he said, “If you come to me with a particular problem, more than likely I will prescribe a pill for it. It’s what we do.”

Injuries will be treated as necessary, but most of those are handled in urgent care rather than in family practice. My friend regularly performs minor procedures in his office, but he will refer patients to appropriate specialists for more serious procedures. Some patients come for regular exams. Still, the majority of patients walk out of my friend’s office with one or more prescriptions.

And it’s pretty much the same throughout the medical industry. It’s not limited to family practice and internal medicine. Most specialists also follow the same regimen. Even surgeons commonly load up their patients with drug prescriptions in addition to performing surgical procedures.

This practice is not limited to strictly medical doctors either. Over the past several decades, psychiatry has moved toward treating all psychological issues as being physically/chemically based. So, a visit to a doctor of psychology will likely garner you one or more drug prescriptions. If you want counseling, you will have to visit a qualified social counselor.

Many people criticize the powerful drug industry. After all, our doctors are their front line sales team and our pharmacies are their retail outlets. But I don’t know very many people that would like to do without many of the drugs we currently have available today. Still, we certainly ought to do something about the ability to extend patents nearly ad infinitum via simple repackaging.

We are indeed a nation on drugs — very often legally prescribed drugs, although street drugs are still popular. There are those doctors that are de facto drug pushers like Dr. Candyman. And there is no shortage of people that illegally obtain prescription drugs like Rush Limbaugh did. But most Americans limit their drug consumption to over the counter (OTC) or legally prescribed drugs.

Why do we take drugs? Well, because the drugs do something for us. Years ago I attended a lecture by a chiropractor. He discussed the incredibly high rate of consumption of OTC NSAIDS in the U.S. He said, “This tells us that painkillers don’t work.” I nearly laughed out loud. No, Americans consume NSAIDS because they do work. I knew what the good chiropractor intended to imply was that NSAIDS do not cure the cause of the pain. But nobody ever claimed that they did.

Prescription drugs have their downsides as well. Following a stroke, my father was prescribed many different drugs, all of which were described as essential. Within a couple of weeks he became so lethargic and loony that something had to give. He is now taking almost no drugs, much to the horror of his doctors, but he is thriving better than at any time in the last nine months or so. The results of the stroke remain, but he has a better quality of life.

Once we had a family friend come to us and say that she was recovering from a prescription drug addiction. She then asked forgiveness for violating our trust. She admitted that once when she had been in our home she had gone through our medicine cabinet and had taken several pills from a prescription bottle. This woman seemed like an upstanding citizen. We would never have suspected her of stooping to this kind of theft. She found her own behavior reprehensible.

I have hypothyroidism, which for most people is easily treatable with a daily dose of thyroid replacement hormone. It’s tiny, it’s relatively cheap, and it has few side effects. Other than that, I rarely take any kind of drug. I can count on one hand the number of times I’ve taken anything else (including NSAIDS, decongestants, etc.) in the last year.

I am truly grateful for the many advances in medical science that can help improve life span and life quality. But many of these treatments are a double-edge sword. Abuse of legal drugs has proliferated like crazy as our medical system has become increasingly drug-centric. I believe it is essential to approach drug therapy with a firm resolve to prevent the therapy from becoming harmful. Doctors and pharmacists can only do so much in this regard, so patients must exercise caution and proper judgment on their own.

Be aware of what you’re putting into your body. Steer away from addictive drugs. If you don’t feel comfortable taking something, don’t take it. Don’t be afraid to ask the doctor to prescribe something that is less addictive. Don’t continue drug therapy past the appropriate time for it. It’s great when drug treatment can improve your life. Just don’t let it ruin your life at the same time.


Anonymous said...

See my comments to your "Reducing Medical Errors" Post.

Charles D said...

I've always been one of those people who is inclined to take fewer drugs than my doctor recommends - not always to my advantage of course. I grew up in a family averse to medication.

It may be interesting to you to look at recent survey of health issues for the 30 member nations of the Organization for Economic Cooperation and Development (OECD). The US ranked highest in pharmaceutical spending per capita by far, perhaps because we have no national health system to drive down costs, and allow drug companies to market powerful, under-tested prescription drugs non-stop on television.

Unfortunately as the study points out, our huge expenditure on drugs does not result in a healthier population.

Quesi said...

I agree. My wife would agree even more. She avoids drugs as much as possible. It is not uncommon for us to come out of the pediatrician's office with a prescription (after a well visit), and my wife throws it away.