When too many of us take too many drugs, there are consequences. These are both economic and human. The solution is to use drugs judiciously and not as a replacement for being responsible for what we put in our mouths.
Human inventions are not intrinsically good or bad. It is how they are used which determines this. For example a knife is useful to cut your food but can also be used to stab someone. Fire can warm us on a cold night but has the potential to burn the house down if not used correctly.
And so it is with pharmaceutical agents. They have the capacity to do enormous good when used correctly. However when misused or used inappropriately or when they are not really needed problems can and do occur.
Figures from the USA show that almost one in two Americans take at least one prescription drug per month, an increase of 10% over ten years. A staggering one in five children 11 years and younger were in the same boat. Spending on prescription drugs more than doubled to USD 234 billion over the decade to 2008.
Amongst the commoner medications used were those for cholesterol and depression in adults and for ADHD in adolescents.
British researchers have previously noted that 7% of NHS spending on drugs went on drugs for diabetes. Between 2000 and 2008 the number of prescriptions had risen 50% but costs had risen 104%. This reflects use of newer and more expensive (but not always better) medications. One of these is rosiglitazone.
The fundamental question that never gets asked is whether the best way to manage a problem is with medication? The second question which also is rarely asked is what other consequences might occur if medications are used?
We have just seen the withdrawal of diabetes drug rosiglitazone (Avandia) from sale in Europe and severe restrictions on its use in the USA. A report in the British Medical Journal (BMJ) had earlier called for the drugs withdrawal and questioned whether its use should ever have been approved.
The drug has been shown to lead to an increase in rates of heart attack and strokes in people taking the drug compared to those not. In 2007 a study showed a 43% increased risk of heart attack.
John Yudkin of University College London said in the BMJ “We need to be absolutely certain that our long term treatments for type 2 diabetes are not causing the very harm they are meant to prevent”.
Type 2 diabetes comes about predominantly from people eating too much processed and sugary foods, being obese and not exercising. Logic would dictate that the primary treatments would be correcting what led to the problem. Some people may still end up needing drugs but it would be far fewer and they may not need drugs as potent (or costly) as rosigltizone.
It has also emerged that another diabetes drug, pioglitazone (Actos) is being investigated as it may increase the risk of bladder cancer. It has also been shown that bisphosphonate drugs used for osteoporosis can double the rate of esophageal cancer.
None of this is to say that there is not a role for drugs. However when we are dealing with conditions that come about from lifestyle choices we make, reliance on drugs in preference to making the necessary lifestyle changes are not without other consequences. These examples show that just “popping a pill” may seem an easy option but may not be.