Can we and should we try to reduce the number of medications prescribed? Absolutely. But the forces working in the opposite direction are formidable. From the time we are first able to watch TV, manufacturers are urging us to take medications. We are inculcated with the thought that if we have a problem, then we should take a pill.
I remember when my son was very young, barely able to talk. I came home from work one day, complaining to my wife how badly I felt. I had a cold, I felt tired, I was irritable. My son overheard me and said this: "Dad, you need rest, fluids, and Bayer." At that point I am sure he had no idea what either rest, fluids or Bayer really were, but he was convinced I needed them.
It's no wonder that the message gets mixed up later in life when we tell young people to "Just Say No." Why should they say "No" to some drugs and "Yes" to others?
The prevalence of herb and supplement use does not surprise me either. I think the newsworthiness of this story is that we are an overmedicated society, that marketing forces are at work to fill our medicine cabinets chock-full of drugs, and that more is not necessarily better.
If consumers could be advised of some things they could do to empower themselves to reverse this trend, it would be good. Some of these things include:
Keep good records of all the medication taken, including OTCs and dietary supplements.
When going to multiple practitioners, be sure to share with each of them the records described above.
Establish a relationship with a pharmacist who is willing and able to serve as "coordinator" of medications. Use that pharmacy exclusively.
Periodically review with the doctor the continuing need for a particular medication. Sometimes people get put on drugs intended for short-term and they end up staying on them for life. This is particularly true when patients change doctors and the new doctor is reluctant to stop a drug prescribed by the previous doctor. What results is patients taking drugs for reasons unknown to the new doctor and the patient alike.
When using dietary supplements, make sure to ask the pharmacist or doctor about possible interactions. By all means, tell the doctor if you are taking any supplements, vitamins, minerals, herbal remedies, etc.
Don't be afraid to ask questions of the doctor regarding medications. Remember, the doctor is working for you, not the other way around. If he or she refuses to answer your questions, then maybe it's time to find a new doctor. If enough people begin exerting consumer forces on the paternalistic doctors, then maybe they will wake up.
These are just a few of the things consumers can do.
Dr. Paul Doering is a distinguished service professor of pharmacy practice at the University of Florida in Gainesville.