PRESCRIPTION MEDICATIONS

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I’m often asked by patients whether or not they should start a prescription medication or discontinue one they are currently on.  While I always encourage them to discuss their options with the prescribing medical doctor they often feel shy or intimidated and simply ill equipped to make an informed decision.  The purpose of this article is to give you as many resources as possible to help you make informed decisions about your prescription medication(s) and ultimately become a little more responsible for your own health care. 

A recent article in Vitality Magazine (‘The Perils of Being a Patient’ by Helke Ferrie, February 2008, pp. 6-16) provided some excellent tips in this regard which I would like to pass on:

(1) Unless extremely urgent, make sure before taking an antibiotic that a bacteria has been identified through a lab test.  Most colds and flus are viral thus rendering antibiotics useless as they only kill bacteria. 

(2) Insist on being informed. Ask your doctor about the diagnosis and ask for a detailed description of the drug and known side effects.  If they are rushed, ask to see a current copy of the CPS (Compendium of Pharmaceuticals and Specialties) which any MD has in their office and look it over in the waiting room. 

(3) Ask if the drug being prescribed is still under patent protection.  This is an excellent question since the older the drug generally the safer it is.  If it is new, discuss the options of an older equivalent. 

(4) Use the wonderful internet to get more information.  For example, google the following:  “Drug Name + Adverse Events and/or Side Effects”.   Another great search Helke suggests is “Drug Name + Legal Actions”.   The number of lawsuits against a particular drug would certainly be important to consider. 

(5) Be wary of drugs advertised on American TV since unlike Canada, U.S. pharmaceutical companies have much more freedom to openly solicit their drugs to the public.  These drugs are often very new and lack a history on the open market.  A recent study showed that by mentioning these drugs to your doctor you are much more likely to obtain a prescription for them.  (CMAJ September 2, 2003; 169 (5)).

(6) Visit http://www.who.int/medicines/publications/essentialmedicines/en/ to see the World Health Organizations’ Essential Drug List.  Helke notes that you will not find a single patented drug on it (that is the new ones) nor cholesterol-lowering drugs or antidepressants. 

(7) Read Ralph Nader’s monthly publication ‘Best Pills Worst Pills’ published by Public Citizen.  Visit http://www.citizen.org/hrg/ for more information or simply google “Drug Name + Best Pills Worst Pills”.

(8) Lastly, be aware that your doctor is paid by pharmaceutical companies for each patient they sign up for experimental drug studies.

Multiple Medications.  Thousands of overmedicated Canadians experience adverse drug reactions, causing many deaths every year. Since there is no central system in Canada to alert doctors as to what medications you are currently taking, often the cumulative effect of overlapping medications can prove lethal.  To avoid this danger: (1) carry a comprehensive list of all your medications with you to all appointments, (2) inform your general practitioner of any new prescriptions picked up from a walk-in clinic, and (3) fill your prescriptions at the same pharmacy every time (they keep track of all your medications on their database).

Questions to Ask.  A few questions to yourself and/or your doctor can help you determine the need for a medication.  The most important question to ask is, have your exercised all alternatives, especially lifestyle changes, before initiating a drug?  Just because some medications are supposed to be a last resort does not mean they are always used in this capacity.  For example, Statin drugs used to lower cholesterol are to be used only in the event that weight loss and dietary changes have failed.   Depending on the severity of the situation, the same might be said for many medications including those for diabetes, high blood pressure, and more. 

The second obvious question would be regarding the urgency of the situation.  Some medications are necessary to prevent an acute crisis and others are intended to address the hazards of long term problems such as high blood pressure.  If danger is not imminent, then you can use your time to seek alternatives and make the necessary changes in your lifestyle. 

Another important question is: does this drug cure your condition?  In most cases, drugs only control your symptoms but do not heal the body and therefore are taken for life.  You might therefore see your medication as a temporary fix but seek alternative, more curative approaches and make the necessary lifestyle changes to warrant weaning off that medication at some point.  This should be done only under the supervision of the prescribing practitioner. 

Lastly, if you are unsure of what to do, don’t feel shy to seek a second or even third opinion.  Some practitioners are much more eager to prescribe medications than others.  Finding the right doctor to suit your needs is vital. 

The Reality of Drugs Part of our decision to take prescription medications will also be based on our belief system about their efficacy and legitimacy.  If interested in this topic, I would encourage you to read “Death by Modern Medicine” by Dr. Carolyn Dean, MD ND. Her book addresses many disturbing aspects of the drug industry including conflicts of interest, faulty science, media propaganda and more.  Among her most compelling sources is the infamous article in the peer review Journal American Medical Association July 26, 2000;284(4):483-5  which states that doctors are the third leading cause of death in America today, responsible for 225,000 deaths per year,  47% of them attributed to properly prescribed medications.  I suggest reading Dr. Dean’s book for more information if you are interested.

   

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