(This article is partly adapted from “Polypharmacy: What Is It and Are You at Risk?,” a workshop presented by Jay Gupta at the Houston 2022 Abilities Expo.)
Polypharmacy: the simultaneous use of multiple drugs by a single patient, for one or more conditions. (Google’s English dictionary from Oxford Languages)
The trouble with breakthrough “miracle solutions” is that public and professionals seize on them indiscriminately, using them without regard to possible downsides, until new problems reach the large-scale stage. It happened with pesticides and environmental damage. It happened with opioid painkillers and opioid addiction. And it’s happening today with “prescribing cascades”:
- Patient sees doctor for chronic condition, gets initial prescription.
- Patient takes prescription: original condition improves, but patient experiences unpleasant side effects from medication.
- Patient reports new problem to doctor, gets second prescription to manage side effects while still taking original medication.
- Patient experiences new side effects from second medication and/or interaction of medications.
- Patient updates doctor; doctor adds additional prescription(s).
- Cycle repeats until patient is taking over a dozen medications, to the point of impaired everyday functioning, plus inherent dangers of losing track of exactly what to take when.
If that isn’t bad enough, many people get prescriptions from multiple doctors and pharmacies—and forget to inform every medical professional about everything already being taken. Each year, nearly two million people land in hospitals due to prescription-drug effects. And nearly 850,000 people have serious or fatal reactions to medications administered in hospitals.
Avoiding the Perils of Polypharmacy
Until a better system is established to keep medical professionals updated on everything their patients take—and until avoiding and discontinuing prescriptions becomes a required part of medical training—avoiding overmedication will remain largely the responsibility of patients and their caretakers. And there is much you can do to protect yourself and the family members under your care.
- Stick with one primary-care physician and one primary pharmacist. Get to know your pharmacist personally: they will be your best source of accessible, low-cost medication advice.
- If you need a specialist, choose one your primary doctor knows personally and is in regular communication with.
- Before accepting any new prescription, be sure your doctor is aware not only of other prescriptions you’re taking, but also of over-the-counter meds, and of your alcohol- and marijuana-consumption habits. Plus, keep records of discontinued prescriptions and how long you took them.
- Read the information inserts in all new prescriptions. For ongoing prescriptions, review the “standard” insert at least every six months: details change frequently with new research.
- When you start taking a new prescription, make note of anything that appears to be a side effect. Monitor effects for a week until you’re sure they’re consistent (and more than psychosomatic). Then, update your doctor and pharmacist—not to request a new prescription for the effects, but to help medical research stay updated on the original medication. Do this even for side effects that don’t really bother you: you might save another patient from serious reactions or a prescription cascade.
Do You Need Medication at All?
Many prescription medications are necessary, even lifesaving—and many others are little more than instant-relief substitutes for better long-term solutions. Before you request any medication, consider:
- Are there any healthy diet, rest, or exercise habits you’ve been neglecting? The body has amazing capacity to heal itself when treated right in all controllable areas.
- Are you struggling with negative or anxious attitudes? Many physical symptoms have emotional origins. Consult a therapist, religious counselor, or yoga/meditation specialist for guidance on reducing symptoms by reducing stress.
- Do you have a daily sense of purpose and progress? If not, take up a constructive hobby, volunteer for a meaningful cause, or revive an old dream.
- Are you nurturing your sense of humor regularly? Laughter often is the best medicine.
- Are you receiving adequate human support? Remember, asking for help is nothing to be ashamed of. And if you’re “too busy” to spend meaningful time with loved ones, it’s time to cut back elsewhere in your schedule.
- Have you talked with your doctor and pharmacist—really talked, for at least half an hour in-depth—about the specifics of your individual situation?
Finally, learn to appreciate yourself and what you have to offer the world—no matter how severe your disabilities are. The mere fact of your being in this world is proof that it also needs you!
See also: BridgingApps recommendations for health and medication tools