When I was young the only pill I remember hearing about was Aspro. Today we have a pill for every ill. If it’s what the doctor prescribed, well then it is ok. Or is it? Are we taking too much for granted and thinking doctors know it all? Seeing that everyone over 65 years of age now takes between two and seven prescription pills every day, maybe we should all take more responsibility for fully understanding the consequences of prescription drugs and their use and misuse. The largest numbers of drug users in the country are always those on prescribed drugs and according to the National Advisory Committee on Drugs (NACD) more people die from prescription drugs than all other drugs combined, including heroin and cocaine. That is a challenging statistic. Statistics also show that people over 65 consume more than 30% of all prescribed medicine and purchase 40% of all over the counter (OTC) medications.
So who are the beneficiaries? In 2012 the top 11 global drug companies made 85 billion dollars nett profit. This is surely a flabbergasting and immoral reality. Let me just take one example of a drug to show you why this happens. In Europe the prescription cost for Nexium, a commonly prescribed drug used to reduce acid in the stomach, is on average €20. In the USA it costs a whopping 187 dollars, six times more than in Spain, France, the UK and Ireland. Consumers are being ripped off by greedy drug companies. On top of that, according to the World Health Organisation (WHO) more than 50% of all medicines prescribed or dispensed are wasted. Furthermore half of all patients fail to take medicines correctly resulting in further huge wastage, thus increasing the vast amounts of medication that is manufactured. This adds further to the coffers of drug companies.
In every country a substantial amount of healthcare budgets are spent on medication (between 10 and 40%) which means that lots of waste costs taxpayers billions, and reduces the health budget available for other areas. In the USA alone, 175,000 adults age 65 and over are seen every year in emergency departments due to adverse reactions to drugs taken, and every year around 106,000 senior people die from prescription drug use. In addition, some prescribed medications have mind altering substances which lend themselves to abuse.
The most commonly abused substances by teenagers and adults in the USA are over the counter and prescription drugs. There is evidence that the same statistics apply across every country. So what are the drugs prescribed that may be abused?
Opioids: for pain relief,
Benzodiazopines: for anti-depressants, anxiety, sedation and tranquilisers,
Stimulants: for ADHD, sleep disorders and obesity.
There is a misconception about the safety of prescribed drugs because they are given by a doctor and are assumed safe to take. In the USA between 1991 and 2010 prescriptions for stimulants increased from 5 million to 45 million and for opioids from 75.5 million to 209.5 million. Such a vast escalation of these drugs comes with serious risks to peoples mental and physical health. Take for example the abuse of painkillers which when coupled with alcohol or other drugs, greatly affects the respiratory system. This can, and does cause death. The unintentional overdose of pain killers has quadrupled since 1999 and these deaths now outnumber deaths from heroin and cocaine combined. Antidepressants can cause withdrawal symptoms and people can suffer life threatening seizures, psychosis, and heart complications. A recent report showed that 50% of young people who inject heroin had abused pain killers beforehand.
When someone is dependent on drugs they will experience withdrawal symptoms when they are stopped abruptly or even reduced and dependence is often accompanied by tolerance or the need to take higher doses to get the same effect.
In Ireland the misuse of benzodiazepines is a significant problem according to a report in 2002. Dr. Suzi Lyons, Senior Researcher with the Health Research Board said that while they are considered safe for short term use, the risk of over use, abuse and dependence is well documented. Diazepam is the drug most misused and is the most widely prescribed. The Medical Research Board found that 1 in 10 people on medical cards were being prescribed benzodiazepines and this results in more abuse and deaths. While these drugs are safe for the effective treatment of anxiety, insomnia, and seizures, their overuse and dependence by people is a matter of grave concern. A recent report by the Irish Examiner from figures derived from the Primary Care Re-Imbursement Service, (PCRS) show an increase in one brand of benzodiazepines from 283,000 to 383,000 prescriptions over the space of three years. Latest statistics from the Health Research Board shows an increase in numbers seeking treatment and dying from the use of benzodiazepines and these drugs are implicated in one third of all deaths by poisoning. Twice as many women as men die as a result of their use. In the UK the prescribing of Benzodiazepines have been substantially reduced, with some brands removed completely from pharmacists.
Women are more likely than men to misuse prescription drugs. The Ballymun Action Project carried out in 2004 found that women were twice as likely to have benzodiazepines prescribed to them for non-clinical symptoms such as stress, grief, acute or chronic illness, physical pain or an adjustment to a life change. The NACD also found that the association between higher usage of tranquillisers and antidepressants to women in lower socio economic groups, those who have long-term dependence on state aid and those who have lower levels of educational attainment was a cause for further worry and need to be addressed by the authorities. Mixed with other substances including alcohol they cause more deaths than any other drug. Minor tranquillisers are involved in more than 40% of unintentional overdose according to the national Suicide Research Foundation. (2008). Opiates are the drug most likely responsible for death by poisoning.
The overuse of antibiotics is also a major problem in their effectiveness to combat disease. In Europe alone it costs €9 billion a year for prolonged stays in hospital and even death as a result. In 2008 the HSE ran a health promotion campaign in conjunction with the European Antibiotic Awareness Day to emphasize the importance of only taking antibiotics when really needed. A similar campaign should be run now to address the problem of tranquillisers and sedatives given the high rate of prescribed tranquilisers and sedatives that are given to women in Ireland. They should be informed about the potential negative effects of what they are being prescribed and other less harmful methods of dealing with their problems sought. People should fight against the constant prescribing of drugs and seek to be treated for core issues rather than being medicated for symptoms only.
The overuse of drugs has many documented problems and people can experience headaches, nausea, diarrhoea, sleeplessness, nervousness, etc. Sometimes, these side-effects can leave the person worse than they were from the condition they were being treated for. Drug interactions can be caused by a seemingly innocuous combination of substances and result in heart attacks, strokes or even death. A growing body of data from researchers suggests that antidepressants are not as effective as many people believe, with their prescribing being second only to cholesterol lowering medication in the USA.
Headaches may be triggered by a physical problem but they can also be triggered by different emotions (anger, guilt, grief, etc) or by relationship difficulties (including, bullying, mistreatment, loneliness, relationship breakdown etc). Yet some doctors adopt a one-size-fits-all approach for all these core problems and simply prescribe a pill. These quick fixes only benefit Drug Companies and do not help to heal any underlying difficulties the person has.
Counselling and psychotherapy may be more beneficial to most patients, but sadly prescribing is far more financially rewarding for the cosy cartel of the medical world and drug companies. The respect that doctors command and the obedience to the authority syndrome, where people obey because they bow to an authority figure, allows the medical profession to continue to prescribe medication that not alone may not heal, but may even kill you. When you examine how medical research is carried out with the use of placebo (where people are given medication that has no active drug ingredient), where people believe the drug cured them, highlights the importance of perception and the role the brain plays in physical health. Doctors and the Drug companies are both well aware of the subconscious and natural abilities of a human being to heal themselves. Yet they continue to follow the medical model to the detriment of so many.
Another disturbing fact is the purchase of drugs on the internet. In 2010 Pfizer conducted a survey and found that 20% of people buy from illegal sources, including online. The Irish Pharmacy Union has stated that counterfeit medicine readily available may be mislabelled, contaminated and contain wrong ingredients. Some blood pressure tablets sold on the internet were found to contain rat poison. Paracetamol was found to have substances like chalk and talcum powder. The latest figures from the Irish Medical Board suggest large quantities of benzodiazepines are being brought into Ireland illegally with seizures of the drug reaching a quarter of a million. The increase in internet and on line pharmacies and the relative ease in which people can purchase these and other drugs has also increased their use. They may be cheaper but at what price? Drug companies need to address their profit margins urgently and not continue to bleed consumers of their products dry. They need to charge an honest price, albeit one that includes a return for both their research and development of drugs that can improve conditions that are being suffered by so many.
Prescription drugs all have the potential for addiction and can alter a person’s judgement and decision making and lead to dangerous behaviours. Parents are the most effective force in preventing and reducing adolescent risky behaviour and help our young to lead health and drug free lives. Research shows that young people who learn about drugs and their dangers at home are up to 50% less likely to use drugs than their counterparts who don’t learn from their parents. When you think of the cost of the misuse and abuse of illegal and prescribed drugs as well as over the counter medication which adds up to a staggering 154.4 billion dollars in the USA annually, is it not time to call halt to the widespread manufacture of such lethal and acceptable practices for the good of humankind?
It certainly is a bitter pill!
Peg Hanafin, MSc. 7/01/2014