And if they are, what can be done about it?
Dennis MillerThe media have been saturated lately with stories about doctor-shopping addicts, the abuse of prescription drugs such as oxycodone, hydrocodone, lorazepam, and alprazolam - and what some consider the DEA’s draconian efforts to combat this by targeting doctors, pharmacists, manufacturers, wholesalers, and chains, etc., in response.
In my opinion, there is an equally serious problem that is largely ignored by the media: the overmedication of the American people.
Top pick: Are pharmacists pill-happy?
Which do you think is a greater problem in the United States? Addiction to habit-forming opioid-type painkillers and benzodiazepines? Or overmedication with drugs for anxiety, depression, psychosis, obsessive-compulsive disorder, attention deficit hyperactivity disorder, social anxiety disorder, insomnia, constipation, menopausal symptoms, erectile dysfunction, etc.?
Do you agree that overmedication includes the massive use of Rx drugs to treat blood pressure, blood sugar, and blood cholesterol, rather than a focus on preventing these diseases of modern civilization through major lifestyle modifications?
Editor's Choice: What I wish I had learned in pharmacy school
One day, while filling a customer’s 10 or 12 prescriptions, a technician commented to me, “I wonder how he has any room left for food!”
You probably have heard similar comments during your career. Not only do you wonder how this customer has any room left for food; you wonder how so many concurrent medications are affecting his appetite.
In my opinion, the decision to prescribe each drug should be a major one, since patients often remain on those same or similar drugs for many years, if not for the rest of their lives.
As a result of managed-care dictates, however, busy physicians have only limited time to spend with each patient. All too often they end up treating numbers - blood pressure, blood sugar, blood cholesterol, heart rate, etc. - rather than taking the time to work with patients to change deeply ingrained unhealthy lifestyles, such as being overweight, eating processed foods, having a sedentary lifestyle, smoking, drinking alcohol, etc.
I believe that prescribing of drugs for diseases of modern civilization should be a last resort after sustained efforts to change habits and behaviors have failed, rather than a first choice.
I think pharmacists would support an effort to discourage overmedication if they did not fear that this might adversely affect their business.
As I see it, the basic problem is that too many pharmacy schools are graduating too many pharmacists, prompting the opening of too many drugstores. The more drugstores there are, the more each store must fight for a piece of the healthcare pie.
Therefore, pharmacists might view any campaign to discourage overmedication as a threat to their hard-won prescription volume.
In a perfect world
In my dream world, there would be half as many pharmacy schools, half as many pharmacists, half as many drugs on the market, half as many prescriptions written by doctors, and no direct-to-consumer (DTC) advertising for prescription drugs. In such a rational universe, pharmacists would fill prescriptions for medications that are truly needed, rather than participate in a system in which DTC drug advertising causes physicians to write more prescriptions for more patients.
The way things are at present, doctors throw pills at patients each time those patients describe a new symptom. Doctors have become symptom swatters rather than health promoters.
How can anyone seriously consider this system to be rational? How can healthcare professionals find it fulfilling or intellectually satisfying to work in a system in which patients are at risk of drowning in a sea of pills?
The assembly-line approach to health care in the USA has been disastrous for the public, and it has caused widespread disillusionment among those healthcare professionals who desire to promote health rather than push pills.
Should we continue on this endless treadmill based on the need for continuous growth in volume? Or should we build a healthcare system that values quality over quantity?
What do you think? I welcome your comments on either side of this issue at firstname.lastname@example.org.
Dennis Milleris a retired chain-store pharmacist living in Delray Beach, Fla. His books "Chain Drug Stores are Dangerous" and "Pharmacy Exposed" are available at Amazon.com.