A research report published on November 3 in the Journal of the American Medical Association (JAMA) revealed that over a 13-year period, there was a significant increase in overall use of prescription drugs among U.S. adults, as well as a parallel increase in “polypharmacy” — defined as the use of five or more prescription drugs.
The report, “Trends in Prescription Drug Use Among Adults in the United States From 1999-2012,” noted in its conclusion that the increases “persisted after accounting for changes in the age distribution of the population.” Furthermore, “The prevalence of prescription drug use increased in the majority of, but not all, drug classes.”
Getting down to specifics, the JAMA report noted that usage of prescription drugs among people over the age of 20 increased from 51 percent in 1999 to 59 percent in 2012. During this period, the number of people taking five or more prescription drugs rose from 8.2 percent to 15 percent.
The study reported a significant increase in polypharmacy in all three adult age groups studied, but, as might be expected, the increases were higher as the ages of those studied rose. The percentage of those taking at least five prescriptions among those aged 20 to 39 years rose from 0.7 percent to 3.1 percent. Among those in the 40- to 64-year-old age range, the figures rose from 10 percent to 15 percent. Finally, among those 65 years of age and older, they rose from 24 percent to 39 percent.
In an article about the JAMA study, a medical reporter for the Milwaukee Journal Sentinel speculated about whether the prescribing trend is beneficial. To answer that question, the reporter quoted Dr. Walid Gellad, identified as an associate professor of medicine at the University of Pittsburgh who is a physician and co-director of the university’s Center for Pharmaceutical Policy and Prescribing.
“The increase in use of prescription medications over time is good for those who need them, and bad for those who don’t,” said Gellad. “We need to make sure we are careful about who’s who.”
This writer rarely interjects personal anecdotes into these news articles, but this study is so reflective of my own personal experience that I will make an exception.
For most of my adult life, I considered myself to be a fairly healthy individual, and so avoided doctors unless absolutely necessary. A well-balanced diet low in saturated fat and refined sugars combined with routine walking for exercise seemed enough to keep me healthy. I seemed almost immune to viral and bacterial infections and usually went to work while many others in the office were out sick during cold and flu epidemics. At the first sign of a cold, I starting dosing myself with Cold Eeze zinc lozenges and almost always felt fine and ready for work the very next day. When you go for years between doctors’ visits, you don’t take any prescription drugs at all.
However, around the age of 63 (the age at which my father died of a heart attack) I started being more vigilant. When I started becoming short of breath while mowing the lawn, I thought it was time to see a doctor. A good friend recommended a doctor he thought highly of so I made an appointment for my first thorough physical exam in many years.
After a blood test showed a high level of cholesterol, I started on what would become the first of several prescription drugs, a statin. After a stress test indicated possible impaired blood flow to my heart, the doctor referred me to a cardiologist, who found I had two coronary arteries that were 100 percent blocked and a third that was 90 percent blocked. He said that the good news was that he was referring me to a surgeon, and not a mortician!
The triple bypass surgery went like clockwork, and I recovered quickly, going back to writing for The New American just a week after the surgery.
However, although I considered myself “good as new,” I found that once you’ve had heart surgery, the doctors consider you to be a “heart patient” for life. This means taking medication to regulate your blood pressure to ease strain on the transplanted arteries and veins.
Several years later, during a routine follow-up visit with the cardiologist, a blood test indicated high blood sugar, and I was diagnosed with Type II diabetes. This means more medication to control my blood sugar. And so, like those people in the survey, I am now on five prescriptions, one for cholesterol, two for blood sugar, and two for blood pressure. My wife takes four, for blood pressure, cholesterol, triglycerides, and a thyroid condition. That makes nine between us. Going on vacations means taking a small bag just for our medications!
However, this does not necessarily mean that our doctors are “pill pushers” who rely on prescription meds to the exclusion of healthier lifestyle choices.
My primary care physician, for example, constantly encourages me to lose even more weight, though I have lost over 40 pounds since my heart surgery. He also applauds the fact that my wife and I regularly walk at least two miles each day. With further weight loss and exercise and healthy eating, he said I may eventually be able to forego the prescription drugs I take for my diabetes. My wife’s physicians also encourage our efforts to adopt a healthier lifestyle.
Commenting on the findings of the JAMA report, Dr. David Katz, head of the Yale University Prevention Research Center, said that the increase in prescription drug use has resulted in a decline in the U.S. death rate, and that prescription drugs are proving effective in treating many diseases.
“But, of course, not dying isn’t the same as truly living, and that leads to the very ominous implications of this trend,” Katz was quoted in a Health Day online article, noting that many drugs are prescribed for conditions that could be prevented by a healthier lifestyle.
“Consider the irony. Here in the U.S., we aggressively peddle foods that propagate illness, and drugs to treat the illness that ensues. Big Food and Big Pharma are the winners — we and our families, the losers,” said Katz.
Katz may well have put his finger on the crux of the dilemma. Prescription drugs undoubtedly have saved many lives and keep millions of individuals healthy. But it appears that there must be a better answer to staying healthy than using medications to cure health problems that developed over a lifetime. Katz’s prescription for a healthier diet, along with other healthy lifestyle choices like regular exercise, are just what the doctor ordered.
