Once on drugs, always on drugs? And if so, are you at the start of a long journey towards serious ill-health and chronic disease?
Pharmaceutical medicine has little problem prescribing drugs. For its patients it is the normal consequence of seeing a doctor, or visiting a hospital, anywhere in the world. Given the growing concerns about the safety and effectiveness of prescribed drugs, deprescribing drug taking is rarely mentioned.
However, a recent paper, outlined in the Medscape journal, “New Deprescribing Guidance Marks an ‘Important Moment’ in Psychiatry” brought this concept to my attention.
“A new expert consensus statement from the American Society of Clinical Psychopharmacology offered clinical guidance on when and whether to discontinue psychiatric medications. The statement, developed by a 45-member international task force, reached consensus on 44 of 50 recommendations addressing when deprescribing is warranted. Among the key points: clinicians should periodically reassess all medications, always verify adherence before concluding a drug isn’t working, and engage patients in shared decision-making about discontinuation”.
What this article demonstrates is taking pharmaceutical drugs, all with known, usually serious adverse health reactions, ‘deprescribing’ them is something not often considered in conventional medicine. What this means is that conventional medicine appears to be content to allow its patients to continue taking drugs, often for a lifetime, without considering the likely health consequences to patients.
As a practising homeopath I routinely prescribed homeopathic remedies for my sick patients and there was never a presumption that a patient would take them for long. If they did not work - I changed them to something that did work. If they worked - the regularity of the prescription was reduced to “take as necessary”. Usually, once a remedy began to work, this proved to be with decreasing frequency. “Deprescribing” remedies was never an issue!
With conventional medicine the situation is different. There seems to be an automatic, inevitable presumption in favour of continuing drugs, almost regardless of the outcome.
If a drug works (even minimally) the patient is presumed to need it, will not be able to cope without it, so patients are encouraged to continue taking it.
If a drug does not work, the patient remains ill, so the assumption is that they still need it, perhaps in a stronger form, or another similar drug; otherwise the illness will get worse.
So all patients need to ask whether these assumptions are medical one’s, or based on the business model of conventional medicine. Selling drugs, after all, is what the pharmaceutical industry, which dominates conventional medicine, does!
Reading the Medscape article reminded me that the prescription of “Lifetime drugs” is common, perhaps even routine. The is despite the fact that taking a drug over an extended period of time is likely to increase both the likelihood of causing serious adverse drug reactions, and the need for increasingly stronger drugs, alongside the creation of drug tolerance and dependency.
Nowhere is this more so than with psychiatric medicine. This can be quickly demonstrated by looking at the known “side effects” of antidepressant drugs (for example see this account from the MIND website), and antipsychotic drugs (see this similar account from MIND). They include many serious illnesses and diseases such as heart and liver problems, diabetes, problems with vision, seizures (fits). But there are others which would clearly prejudice the patients lifestyle and quality of life, including confusion and agitation, sedation, sleepiness, decreased alertness, drowsiness, hallucinations, suicidal feeling and behaviour
Imagine living with a drug that you have to take for the rest of your life that might be subjecting you to these so-called ‘side effects’! Yet this is what conventional medicine does, routinely.
So perhaps it is a positive sign that at least one section of the Conventional Medical Establishment is starting to think about ‘deprescribing’ their use. Whether it happens, or not, is another matter.
Moreover, confidence in the positive impact of pharmaceutical drugs are invariably exaggerated. The ‘medical science’ that informs and supports the use of prescribed drugs is not as strong as most people assume. Most drug trials do not describe ‘cures’ but in the main suggesting that they can help:
to reduce the severity of a condition by 30% (or similar),
and then only in 25% of patients (or similar).
So what ‘medical science’ is usually saying is that 75% of patients will not be helped at all, and even those who are helped are still likely to continue suffering some 70% of the illnesses impact.
In this way pharmaceutical drugs are given too much credit for what they can actually do! I have written about this over-confidence before in medical spheres other than mental health. For instance, when chronic pain is treated (as it is routinely) with pain killing drugs patients will usually find that the more painkillers they take, the more they need, and that increasingly strong doses, with stronger ‘side effects’, are required as the pain gets progressively worse. Eventually, when painkillers no longer work, a limb replacement operation is often required. For two examples of this ‘long journey’ into chronic ill-health see two of my articles, both written in 2018, about “A long journey through pain and painkilling drugs to surgery”, and “Ronald. A patient nearing the end of a long journey through pain, painkilling drugs, chronic pain, and Tramadol”.
These examples of life-time drug prescriptions will be well known to many people. If we open our eyes we can see them all around us. The problem is that most people, brought up to believe in the ‘miracle’ cures of conventional medicine, do not associate the long-term drug taking with the exacerbation of health problem.
Taking pharmaceutical drugs, for any condition, is rarely anything more than a temporary fix, and more often than not is a ‘fix’ that will exacerbate, rather than improve, patient health. Almost inevitably taking one drug leads to two, then more; and to the prescription of stronger, more toxic drugs, ending with major (often brilliant) invasive operations, spiralling ill health, and ongoing long-term chronic disease.