Pill nation: Are we too reliant on prescription meds?
When it comes to health, Americans have come to expect the quick fix.
Can’t sleep? Take a pill to knock you out. Problems focusing? Take a pill to boost your attention. Feel edgy? Take a pill to calm you down.
While there is no question that modern medicines help us manage pain and save lives by staving off potentially fatal illnesses like heart disease, there can be a darker side to prescription drugs that can sometimes lead to addiction, and even death.
These days Americans are taking more prescription medications than ever, with nearly 16 million scripts written for painkillers like hydrocodone, oxycodone and tramadol each year, according to IMS Health. A full 5 million prescriptions are written for sleep aids, while 18 million are written for anti-depressants, according to the healthcare information company.
“We seem to be a country that turns to drugs for solutions more than many other industrialized, wealthy countries do,” said Dr. Jerry Avorn, an assistant professor of medicine at Harvard Medical School and chief of the division of pharmacoepidemiology and pharmacoeconomics at Brigham and Women’s Hospital in Boston.
One of the stickiest problems involves painkillers, which can be a boon to some and a nightmare for others.
People like Kathy Nicklas-Varraso, say they owe their lives to them.
Ten years ago Nicklas-Varraso slipped on some black ice. She broke her neck and ended up with permanent nerve damage. The pain was excruciating.
“I would sit in a ball at the bottom of the shower and cry because I didn’t want to cry in front of everybody,” she told TODAY’s Tom Costello.
There were days when Nicklas-Varraso wondered how she would go on. Then, finally, a doctor prescribed methadone and she found relief.
Without it, “I wouldn’t be alive,” she said. “I was at the point where I was seriously considering suicide just because I couldn’t take the pain anymore.”
But pain medications can bring misery, too. That’s something a recovering addict -- Emily -- knows all too well.
“I've lost everything,” she told Costello. “Like, something that started with just a prescription, has led me to places I never, ever, ever thought I would go.”
A cheerleader in high school, Emily had been accepted to Penn State University when she was diagnosed with cancer and underwent surgery to remove a mass from her chest. To deal with the pain after surgery, doctors gave Emily a prescription for pain killers.
But she became more and more dependent on the drugs. She lost her family and was soon living on the street, crushing and snorting the pills for a better high. “It makes me feel more comfortable in my own skin, like I’m invincible,” she said. “I’m prettier, smarter, funnier, more talented.”
Emily isn’t alone. The Substance Abuse and Mental Health Services Administration estimates that there are 2.1 million Americans addicted to prescription medications. Some, like Emily, are in thrall to pain relievers. Others are addicted to sleeping pills, anti-anxiety medications, and anti-depressants.
Harvard’s Avorn says drug advertising is a big part of the problem. In the 1990s when it became legal for drug makers to advertise, the demand for prescription medications skyrocketed, Avorn said.
“That created this sense on the part of many patients that, ‘Oh, I saw that ad on television, I think I should be on that medicine,’” he explained.
For their part, drug manufacturers insist advertisements simply inform consumers that there is help for what ails them.
“All of the research and development in the world doesn’t do any good if the people who could benefit from it, don’t know about it,” said John Castellani, a spokesman for the Pharmaceutical Research and Manufacturers of America.
Dr. Gail Saltz blames America’s quick-fix mentality.
“I think it is a dual problem,” she told TODAY’s Hoda Kotb. “Patients are quick to ask for them and doctors are quick to give them. And some doctors are giving them who aren’t doing the kind of evaluation that you would hope for.”
The big problem, Saltz said, is that some of these drugs can lead to dependence.
“Some of these are actually biochemically addictive,” added Saltz, an associate professor of psychiatry at The New York Presbyterian Hospital Weill-Cornell School of Medicine and a TODAY contributor. “So you start with something, say a benzodiazepine for anxiety and you develop a tolerance. And then you need more and more of the same medication to have the same effect.”
In many cases patients would be better served if they got behavioral therapy instead of drugs, she said. So, people with insomnia would be taught good sleep hygiene instead of being given a prescription. People with anxiety issues or chronic pain might be given therapy to teach them coping skills.
That way, Saltz said, “they have ongoing coping skills and don’t relapse. And that’s really a better treatment. But we don’t do it. Why? Because it’s not as fast.”