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Thursday, May 7, 2009

A fistful of pills brings a bucket full of trouble

by Dr William B. Ferril

I was struck by a recent article in Prevention magazine, which looked in-depth at how people's lives are being adversely affected not by their illnesses, but by all the pills they are being forced to swallow to deal with those illnesses.

And it turns out, there's a growing feeling among patients and even doctors that many of these pills are simply unnecessary and making lives worse, not better.

Now, I've been labeled an outsider for sharing that viewpoint. But it's nice to see the rest of the establishment finally coming around.

The author, Siri Carpenter, was compelled to write after watching her mother's once- sharp mind decay in a cloud of pharmaceuticals. The poor woman was taking 32 pills, spread out over five times a day. She had so many meds she needed a toolbox to keep them in.

When she started to drop many of the pills that it turned out she didn't need, she began to improve considerably.

And she's certainly not alone. Too many people, especially seniors, take pills for their conditions, and then another set of pills for the side effects brought on by the first round. New conditions appear, new pills are prescribed. New side effects appear, more pills are prescribed. Eventually, many doctors just throw up their hands and conclude that the patient is simply getting worse as they age.

It's a vicious cycle, and it's out of control.

Nearly a fifth of all seniors take more than 10 meds per week. Every year, there are at least 1.5 million adverse drug events, according to the Institute of Medicine.

We have less than a million people living here in Montana, and we're not even the smallest state, population-wise. In other words, there were enough med-related incidents that we could give one to each resident here, and still have enough left over for nearly everyone next door in North Dakota.

And yet I can't think of anything more avoidable.

We need to get away from the endless cycle of medications, especially those that don't cure but simply manage a condition perpetually. And we definitely need to stop using meds that require extra drugs just for the side effects.

And we can.

First and foremost, doctors need to order better and more accurate diagnostic testing. For example, 24-hour urine tests can tell us definitively what critical hormones patients are lacking. Then, instead of prescribing new meds, we can correct those deficiencies. Once that happens, you can put away that toolbox full of drugs for good.

And even better, there will be only one side effect: You get to feel like yourself again.


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