D e s e r t E x p o s u r e
March 2010
Rx for Trouble
Is an over-reliance on prescription drugs turning the Land of Enchantment into the Land of the Medicated?
By Jeff Berg |
Sidebar: Ask the Pharmacist |
"One pill makes you larger
And one pill makes you small
And the ones that mother gives you
Don't do anything at all"
— Jefferson Airplane
Author's note: My personal history of drug use is limited to alcohol, tobacco and a couple of joints many years ago. In all the rampant stupidity that I have subjected myself to over the years, I somehow, to the amazement of the therapist who helped me through many things years ago, stayed away from other drugs of all sorts, legal and illegal. As noted an issue or two ago, I took some painkillers after some dental work, but found that they really didn't do anything, so I suspect that substance was milder than the over-the-counter Aleve that I switched to.
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While in high school, I discovered John Barleycorn and its intoxicating properties. I was so pleased with it that I never really had the urge, or perhaps the need, to feel any numb-er and dumber than booze made me feel. It was during that time that a couple of good friends of mine dropped some acid at a party I was at, got in a car, and got the "ultimate" high, by wrapping themselves and the car around a tree and dying.
In retrospect, that was a huge life lesson, and one that stuck with me when I was offered or tempted by other mind- and mood-altering substances. I have always been curious about peyote, but not curious enough to give it a whirl.
It is my personal belief that in-depth studies should be made in order to allow certain drugs that are now illegal to become legal. If one studies the types of prescribed drugs that are legal and available in one way or another, it is beyond idiotic to say that such things as marijuana should be illegal. In my perfect world, though, none of it would even exist. I cannot find a rational reason or excuse for anyone to use, abuse or be addicted to any substance, whether it is 100-proof Scotch or heroin or Xanax. I am being judgmental, but I feel that the reason most people turn to illegal drugs or drinking is to "ease the pain" of their emotions, whether that pain is real or imagined or both. Believe me, dealing with emotional pain, no matter how severe, on an honest level and through hard work is easier than babysitting a six-pack, a vial of tabs or a needle every day.
My own alcohol abuse continued on and off until about 1985, and even though I never suffered through a hangover, missed a day of work, or dug myself into a financial pit because of my drinking, it took its toll in other ways. It took a drunken incident involving my "best" friend at the time and my "girlfriend," who slurred "I love you" five or more times a night to me, for me to finally relieve myself of the midrange buzz that I lived in almost every night after work for many years. Happy hour was my favorite time of day.
And do note that I am aware that there are a number of good and legal medications out there that help people every day. Before dropping medications or changing dosages, you should of course consult a physician — and, if necessary, find another physician who will listen to your concerns.
A few months ago, I had to do what I call a "grin and bear it" trip to the largest big-box store chain in the known universe. It was for a grocery item that no other local store carries, and one that I cannot get online but like to indulge in from time to time: sugar-free tapioca pudding — certainly something with addictive qualities.
While wandering dazed (by the amount of stuff, not from a chemical!) through the pallets of paper towels, 90-pound packs of dead chicken, and thousands of items that I knew I would never use, I stumbled by the in-store outlet of the largest hamburger emporium in the world, and noticed a number of people standing in line waiting to place an order.
Just moments earlier, I had strolled past the in-store pharmacy, where two lines, at least 10 people each in length, awaited service from a pharmacist.
Smugly, I wondered how many of these same people stood in BOTH lines, not knowing, understanding or wanting to embrace the old adage, "You are what you eat."
But I was mildly taken aback by the number of people in the pharmaceutical line. I'd previously driven by a big-box pharmacy store, which had not one, but two drive-up windows for prescriptions. Both lines had enough vehicles idling in them to ensure that vehicle emissions are indeed part of global warming.
Multiplying those two pharmacy lines by who knows how many others just in Las Cruces, and then thinking about how many pharmacies there are just in the US, was a terrifying thought. How many people in this country are on some form of legal medication?
According to a report from the US government's Department of Health and Human Services published in 2004, nearly 50% of all citizens in this country were taking at least one prescription drug. One-sixth of the population, mostly elderly, was taking three or more "scrips" each day.
The Kaiser Family Foundation reports that in 2007 pharmacists filled 3.8 billion prescriptions. In 2005, 59% of all Americans under 65 had a prescription drug expense, with that figure skyrocketing to 91% for those over 65. The most popular medications include Lipitor and Zocor, both for lowering cholesterol, followed by Prevacid and Prilosec, both used for ulcers and acid reflux (which can be controlled by watching what, how and when you eat).
Of course many of these drugs can be and are beneficial, if used in the proper way. But 3.8 billion is still an awfully high figure.
As an example, I cite this story.
One of my many former mothers-in-law once came to our Montana home for a visit about a year after I had married her daughter. A weeklong visit turned into 30-plus days, and by the time she left, I was ready for some medication myself.
One day, I needed to retrieve something from the closet in the bedroom where we had sequestered her; not receiving a reply when I knocked on the door, I quietly entered the room. She was not there, but next to the bed was a TV tray table, the top of which was covered with the little vials that contain prescription drugs. There had to be at least 15 different forms of medication there, and I am not talking about vitamin bottles or naturopathic tinctures. I was amazed. So amazed that I forgot what I had gone in the room for and fled.
Later, I asked that particular wife about it, and she confirmed that her mom had been taking various things for any number of years. Several medications, I was told, were to help her restless-leg syndrome, a malady said to result from muscular tension, which can often waken sufferers from their nightly slumber. But the odd thing was, she still had the ailment, as I would hear her prowling around the house at night, and when asked about her sleep, she would appoint the restless-leg woe as the problem.
Said daughter also, just prior to our divorce, began taking pills for her own depression and anxiety (not my fault!). They successfully masked those problems while creating other problems, including drowsiness, loss of libido (damn!) and a too-healthy appetite.
Later, both women weaned themselves off some of the capsules of excuses. My former wife turned to herbal remedies and therapy, which helped her much more without the consequences of the "doctor's orders." Her mother also went "cold turkey" with many of her pills, suffering little, if any, after effects.
It is also greatly ironic that I just hung up the phone after my stepmother called with some belated holiday greetings. As it turns out, her sister, whom I remember as being friendly, alert and active during our last visit, has suffered some health issues of late herself. Now 75, she was diagnosed with dementia and given a litany of medications.
"It's been hell for the last four months," stepmother "Geeg" said. "She kept getting worse, and the worse she got, the more medications or increased dosages of current medications they gave her."
"Carla," the patient, was soon pretty much completely incapacitated, and Geeg, who has her own health issues at 80-plus, was having a hard time caring for her (they share a condo). It was suggested that more medication would help, along with a professional caretaker.
But it was here that Geeg's intuition kicked in. "Even though I'm old, I'm not stupid, and I could see that she was always getting worse, not better," she related. "It was to the point where she couldn't even take a bath by herself, and I was unable to help her get out of bed."
So Geeg decided on her own to start eliminating some of the drugs, and cutting back on others. The result was immediate and amazing.
"She was getting 400 milligrams a day of this one prescription, and I just cut that in half. A couple of others I remembered as being used for side effects of OTHER prescriptions, so I dropped those completely."
Geeg was ecstatic as she reported to me that Carla had teased her prior to her telephone call to me because she (Geeg) had promised to call me before noon, and it was now 12:05. "She didn't even know my name at times a week ago, and now she remembered me and you and that I had said I would call by noon. Last night, although I sat in the bathroom while she did it in case she had trouble, she took a bath by herself, and on New Year's Eve, she even played poker with us for a while."
In what might be one of the most unreported stories of 2009, Dr. Scott Reuben — who, until last spring, was considered a respected and influential clinical researcher, one who said he had done many studies on various medications — turned out to be the Bernie Madoff of the medical world.
Not only did he not do any of the nearly 20 studies that he claimed to have done on various pharmaceuticals, Reuben also "invented" patients and was on the payroll of such pharma-giants as Pfizer.
Reuben's "research" concluded that substances such as Bextra (anti-inflammatory drug, since withdrawn from the market due to false marketing claims), Lyrica (anti-epileptic) and the anti-depressant Effexor all had painkiller qualities. Reuben had received several research grants, was on the Pfizer speakers bureau, was on the payroll of Merck, another drug conglomerate, and also wrote to the FDA about the positive qualities of these drugs, citing his own nonexistent research for these in a total of 21 papers.
My stepmother calls back a short time later, something she rarely does, since we are usually in touch only on holidays. But she is mad, mad as hell about the treatments prescribed by her sister's now-"fired" doctors. She is taking Carla to her new physician tomorrow — one who has so far agreed with Geeg's "diagnoses."
"I thought you might want to know what Carla was taking," she starts. I can hear her fumble a bit as she reaches for the pill vials.
"She's off this Dilantin [anti-seizure] stuff now. There was 75 millihrams of Plavix [anti-coagulant] along with 350 milligrams of aspirin. We took her off of that, but kept her on the aspirin. It worked."
She continues, "200 milligrams of Tegrotol [anti-seizure], 10 milligrams of Aricept [to improve the function of nerve cells in the brain — oddly, there is a caution about giving this stuff to anyone who has seizures]. This one is Exelon [prescribed for dementia patients], which she still does, but with a patch. It is 4.6 milligrams per day. But I took her off the Depakote [another seizure medication], but she still gets 250 milligrams of Keppra [still another anti-seizure medicine]."
Geeg concludes the call be proudly announcing that it was Carla, not she, that remembered the procedure that Carla was having tomorrow, an MRI.
I conclude that my computer's spellcheck will never be the same, since none of these manmade cures make the cut.
According to a report from the Florida Medical Examiners Commission, "An analysis of 168,900 autopsies conducted in Florida in 2007 found that three times as many people were killed by legal drugs as by cocaine, heroin and all methamphetamines put together. According to state law-enforcement officials, this is a sign of a burgeoning prescription-drug abuse problem."
The Florida report continues, "In 2007, cocaine was responsible for 843 deaths, heroin for 121, methamphetamines for 25 and marijuana for zero, for a total of 989 deaths. In contrast, 2,328 people were killed by opioid painkillers, including Vicodin and Oxycontin, and 743 were killed by drugs containing benzodiazepine, including the depressants Valium and Xanax.
"Alcohol directly caused 466 deaths, but was found in the bodies of 4,179 cadavers in all. Across the country, prescription drugs have become an increasingly popular alternative to the more difficult to acquire illegal drugs. Even as illegal drug use among teenagers has fallen, prescription drug abuse has increased. For example, while 4% of US 12th graders were using Oxycontin in 2002, by 2005 that number had increased to 5.5%."
So why should anyone bother to go to the neighborhood illegal drug peddler, when we, as a nation of morons, can go to the doctor, cry "mustache ache" and get four prescriptions to make it all better for us, and have it be perfectly legal?
And while some people may believe that such medicines' legality makes them less dangerous than illegal drugs, Tuolumne County, Calif., Sheriff's Office Deputy Dan Crow warns that this is not the case. Because everybody reacts differently to foreign chemicals, there is no way of predicting the exact response anyone will have to a given dosage. That is why prescription drugs are supposed to be taken under a doctor's supervision.
"All this stuff is poison," Crow says. "Your body will fight all of this stuff." Tuolumne County Health Officer Todd Stolp agrees. A prescription drug taken recreationally is "much like a firearm in the hands of someone who's not trained to use them," he says.
My family generally has enjoyed and been thankful for good, if not great health. My father, despite being a heavy smoker for years, was never sick until he suffered a stroke (eerily, after he quit smoking), and lived to be 82. His mother lived to her 90s, remaining active until a fall concluding in a broken hip took her to the hospital, where, eerily, she got pneumonia and died.
My maternal grandmother was never sick a day in her life, but again it was self-induced suicide that did her in, as she, too, was a heavy smoker for many years, finally falling victim to emphysema at 85.
Mom remains active at 83 (this month) in spite of her two pack of cigs per day habit, and she is rarely ill, other than the "tickle" in her throat that she will always claim comes from sinus issues rather than Virginia Slims.
I also enjoy good health, and will always remember the advice of Grandmother Emily, who never took a prescription drug, but did love her occasional whiskey sour: "If you can't pronounce all of the ingredients, don't take it."
Senior writer Jeff Berg lives in Las Cruces.