Over dependence and use of medication today

It is quite good to see an MD willing to educate patients to be more self reliant and less dependent on drugs.  Thinking that you need a doctor to prescribe a pill for every little twinge is a sure indication you have turned over your health to some one who might not really offer you the best remedy.

This belief also undermines your right to be in charge of your health.

My advice: Get more education.  And don't be afraid to ask question, demand answers.

All of this is becoming very true too with natural remedies.  Sadly it is true of the new hybrid practice called "naturopathic medicine".

Doctor draws our attention to the uncertainty of medical practice: We are scientists. But the Big Book of Medical Facts is in fact just a pamphlet printed at home, with two paragraphs in a very large font. The only certainty of science is uncertainty. Medicine is often little more than an opinion, a faith system: we believe that what we do is right. This is despite history telling us that what we do now is almost certainly wrong. Our faith has invented words, rituals, elaborate costumes, and a culture of reverence and deference. SOURCE

The over dependence and use of medication in today's society

 

by Nicole Evans M.D.

Everybody over the age of 55 should be on a pill to lower their blood pressure. Oh, and we might as well just go ahead and put statins in the water. Well, at least that's what the latest research suggests.

An impressive study was recently published that analyzed data from over 100 studies on the use of blood pressure medications. This study came to the conclusion that we don't need to measure blood pressure anymore because any decrease in blood pressure is beneficial, whether you have hypertension or not.

These authors suggest we should put everyone on a daily blood pressure pill. Their study came out riding close on the heels of another "landmark" study that was done on statins. The statin study came to a similar conclusion, namely that a daily dose of statin is good for everyone, whether you have high cholesterol or not.

Armed with these study results, a pharmaceutical company is poised and ready to market a break through polypill. A pill that contains a couple blood pressure lowering meds, a statin, and, of course, don't forget the daily baby aspirin. Imagine, all these meds in one little pill for our daily lifetime use. This sounds like a bad sci fi movie about some flawed futuristic society.

Is the human body really so flawed that we all require medications? Have we lost our ability to heal ourselves, to care for ourselves, to prevent disease and illness in ourselves? What in the world is going on?

Our society uses medications to prevent disease, to treat the cause of disease, to treat the symptoms of disease, and to even to treat the side effects caused by all the medications.

Pharmaceutical companies are massively lucrative businesses. Primary care physicians are pharmacists who happen to know how to diagnose and refer patients to surgeons. Natural medicine companies are popping up like wildflowers in response to the consumer's intuitive distrust of prescription meds, allowing individuals to trade one pill for another and feel good about it.

The over dependence and over use of medication is a rampant problem in today's society. Many individual's turn to a pill and away from proactive involvement in their own health. They relinquish power without a second thought but scowl at prescription costs and whine to their doctors about the side effects.

Pills are promising, shiny, colorful little monsters. An easy fix in the palm of your hand. Is there a solution to this problem? Can we empower individuals with alternatives to medications, to means and methods of improving health that could provide benefits far beyond the quick fix?

Some of us would like to think so. The other day a colleague asked if I had any Tylenol for her throbbing headache. Instead I showed her how to rub a few acupressure spots while doing some deep breathing. Problem fixed, no pills involved.

Can we let our food be medicine, our physical activity be medicine, our thoughts be medicine? Can we begin to listen to our bodies and respond to our needs instead of ignoring or repressing them? Can we learn when a pill is necessary and when other medication-free options are the clear answer?

The answer is a brilliant, hopeful YES. But this will require a paradigm shift. Patients, doctors, pharmaceutical companies, medical schools, the healthcare system at large will have to change. Seems like a daunting task, but have hope. Too bad we don't have a pill for that.

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Posted in: dependant on medicine,first natural health news,medication,Niclole Evans

Six Tips for Talking to your Doctor about Medication

By Claudia L. Reardon, M.D.



In my last blog, I addressed the factors psychiatrists consider in choosing a given psychiatric medication for a patient. I emphasized the importance of medication selection being a collaborative process between the physician and the patient. In the midst of an appointment with a psychiatrist, though, it can be difficult for a patient to know what to ask, and when and how to ask it. This article includes tips for patients to help them work with their physicians in finding the best medications.

1. Ask the psychiatrist, “How did you pick that medicine?” Even if you can think of nothing else to ask during an appointment, this single question will probably lead to a wealth of useful information. For example, it might lead to a discussion of the target symptoms, how the medication affects other medications or medical conditions, and side effects.


2. Make a list of medication questions to ask your psychiatrist at your next appointment. I find it extremely useful when my patients come in with a list of questions they have made since I last saw them in my office. This way, patients are sure not to forget to ask anything important to them.


3. Take notes during your appointments. It can be difficult to remember everything your psychiatrist says during your appointment, and so bringing a note pad and pen along to take notes can be useful so that later you can remember what was discussed.


4. Read books. There are a number of excellent books available for patients on psychiatric medications. In my experience, patients find especially useful the book Instant Psychopharmacology by Ronald Diamond, M.D.


5. Visit websites. Patients should be careful about which websites they visit, as not all are reliable sources of medication information. However, in addition to www.HealthyMinds.org, another reputable site is the NAMI medication website. Go to the NAMI webpage (www.nami.org) and click on the “Medications” tab on the top toolbar.


6. Try not to be embarrassed. Many patients are embarrassed to talk about concerns they have about medications, especially side effects that they find difficult to discuss. However, remember that physicians hear about all kinds of different side effects, and it is pretty hard to embarrass a physician when it comes to talk about the human body!

In addition to these strategies, you might have found others that work for you in keeping you engaged in your medication treatment. It is imperative to keep the lines of communication open with your psychiatrist and to remember that your physician is there to answer any questions you have.

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Posted in: Claudia Reardon MD,medication,psychiatrist,treatment

Which Medicines and When: Collaborative Process of Finding the Right Medicines

By Claudia L. Reardon, M.D.

Many patients have long and trying journeys on the way to finding medication regimens that work for their psychiatric symptoms. It isn’t always obvious why psychiatrists choose certain medications and avoid others for given patients. In this blog post, I will review the process by which a physician chooses a psychiatric medication. The more the patient knows about how the psychiatrist is thinking through the medication decision-making, the more active a role that patient can play in the process. 

Psychiatrists consider the following issues when prescribing a medication:

1. Target symptoms. A patient might have many different symptoms, for example, depressed mood, anxiety, trouble with concentration, and severe insomnia. It is important to decide which symptoms should be addressed first, since it is likely that one single medicine will not help all of the symptoms. Doctors often prefer not to start multiple medications at the same time, as it otherwise can be difficult to figure out which medicine is helping or which is causing side effects. Thus, in a patient with the above symptoms, the physician might first choose to address the patient’s depressed mood with an antidepressant. Since trouble with concentration and severe insomnia could be caused by depression, it is possible that treatment with an antidepressant will help those symptoms as well. It is important to address the symptoms in the order that makes the most sense.


2. Psychiatric diagnosis. The physician cannot simply treat a target symptom with a medication without knowing the overall psychiatric diagnosis. For example, depressed mood could be due to many different diagnoses, including major depressive disorder, bipolar disorder, schizoaffective disorder, drug or alcohol abuse, or medical problems such as low thyroid. All of these would have different treatments. Major depressive disorder would be treated with antidepressants, while antidepressants can actually sometimes worsen bipolar disorder. Likewise, if a patient’s depression is caused by a medical problem, it is essential that the medical problem be addressed rather than simply “band-aiding” the symptom of depression with an antidepressant.


3. Medical conditions and other medications. It is critical that the physician be aware of all the patients’ medical issues and other medications they are taking. Certain psychiatric medications would be dangerous if prescribed to patients with certain medical problems. For example, some medications can worsen seizure disorders, cause abnormal heart rhythms, or worsen diabetes. Additionally, some psychiatric medications can have dangerous interactions with other medications.


4. Side effects. Psychiatrists must consider how a given medication’s side effects will impact a given patient. For example, a patient who drives heavy machinery for a living should probably not take a medication that causes drowsiness. On the other hand, sometimes physicians can “take advantage” of side effects. For example, if a patient is sleeping and eating poorly, the doctor might prescribe a medication with sleepiness and increased appetite as side effects.


5. History of response. If a patient or his or her family member has had a good response to a medication in the past, that might be a good reason to choose that medicine now.


6. Patient preferences. Finally, and most importantly, the physician must make sure that the patient is willing and able to take the medication being prescribed. If the patient feels that the side effects are intolerable, or simply cannot afford it, it doesn’t matter how reasonable the choice of medication might be since the patient will not take it. The physician should check with patient to ensure they are comfortable with the medication being prescribed. Likewise, patients should not hesitate to speak up if they have concerns about a medication being prescribed for them.

In summary, physicians consider a multitude of factors in choosing a psychiatric medication for a patient. Ultimately, the decision about a medication should be a collaborative one between the psychiatrist and the patient.

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Posted in: Claudia Reardon MD,depression,medication,psychiatrist,treatment

What’s the difference between all these medications?

By Sara Coffey, D.O.





This is a question I am often asked by my patients. Several times a day we see commercials for prescription pills to treat a variety of diseases from high cholesterol to heart disease and treatment for mental illness is no different. Today I would like to talk about one of the most common mental illnesses, Depression and its treatment.

Depression affects roughly 15 million Americans adults, and it is an illness that can be readily treated with antidepressant medications, talk therapy or a combination of medication and talk therapy. Antidepressants have been around for decades and include several classes of medications that work on different chemicals in the brain, but today the first line treatment for depression are medications called, SSRI’s or Selective Serotonin Reuptake Inhibitors. For the most part medications in this class are very similar; they work by increasing the amount of serotonin between nerve cells which is thought to play a role in depression. Unlike a pain pill that works right away, antidepressants can take up to 4 to 6 weeks to have an affect.



Which SSRI a doctor chooses will depend on each individual patient. Just like every other medication, antidepressants can have side effects and interact with the body or other medications in a way that may be dangerous or uncomfortable for patients. Some SSRI’s may be more likely to make a person tired or sedated, while others may have a tendency to give a patient more energy. Depending on an individual’s depressive symptoms, your doctor might prescribe a medicine that would be more likely to help you fall asleep or feel more alert and energetic. Furthermore, certain SSRI’s have been studied more in patients with a particular medical disease, like heart disease for instance and this might leave a physician to try a medication that has research data to show that the medication is safe for their patient. Certainly, some medications work better in some patients than others, and after a period of 4-6 weeks of adequate dosages if no improvement in symptoms occurs your doctor will likely recommend increasing your dose or switching to another antidepressant to treat your depression. In some instances a physician might recommend augmenting your medication by adding another medication that works in a different way to treat your Depression.



Even if the first anti-depressant doesn’t seem to work for you, there are still other options for treatment. Newer medications that work on norepinephrine and dopamine in the brain are also used quite frequently to treat depression, and older medications to treat depression, although they often have more side effects are still effective in treating depression and can be used in refractory cases.



As a patient it is important for your prescribing doctor to know about your symptoms, side effects, and other medical history and current medications that you are taking. And, as always if you have any questions about the medications you are being prescribed don’t hesitate to ask your doctor about your concerns.

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Posted in: depression,medication,Sara Coffey DO,treatment

Won’t they do other drugs?

By R. Scott Benson, M.D.



This is a question I get every time I talk with a family about medication treatment for their child with attention deficit hyperactivity disorder (ADHD). And the best answer has been “some will, some won’t”.



But at the APA meeting in New Orleans there was a report from the research group at the Mass General in Boston. They have been able to suggest answers to a lot of question about the outcome of children with ADHD. There is a higher rate of substance use problems in adolescents and adults who have a diagnosis of ADHD. But in this 10 year follow-up of children they asked “What are the predictors?”



Their data confirmed that a diagnosis of ADHD was associated with an increased incidence of drug and alcohol problems. But the finding of severe conduct problems in these children was even more highly associated with future substance use problems.



The take home message for me is that medication alone will not be sufficient to address the severe problems that many children with ADHD present. Parent training, especially for those with severely disruptive behaviors, is a necessary, integral part of their treatment.

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Posted in: ADHD,alcohol,drug abuse,medication,parenting,R Scott Benson MD,substance abuse,teens,treatment

Drugs Still Ending up in Water

It is not only prescription drug and over the counter (OTC) products that are polluting our water, but aspartame and sucralose too.

Water treatment is unable to remove metabolites of prescription drugs and many chemical including the poisons, aspartame and sucralose.

Certainly this creates a risk for everyone, and a topic I discussed many years ago while serving as a Health & Environment Commissioner.

Make sure when disposing of drugs and related substances that you take them to an approved location for incineration.  Do not throw them in the trash or flush down a toilet.

By CLARKE CANFIELD, Associated Press Writer 
Sun Feb 7, 2010

PORTLAND, Maine – The federal government advises throwing most unused or expired medications into the trash instead of down the drain, but they can end up in the water anyway, a study from Maine suggests.
Tiny amounts of discarded drugs have been found in water at three landfills in the state, confirming suspicions that pharmaceuticals thrown into household trash are ending up in water that drains through waste, according to a survey by the state's environmental agency that's one of only a handful to have looked at the presence of drugs in landfills.
That landfill water — known as leachate — eventually ends up in rivers. Most of Maine doesn't draw its drinking water from rivers where the leachate ends up, but in other states that do, water supplies that come from rivers could potentially be contaminated.
The results of the survey are being made known as lawmakers in Maine consider a bill, among the first of its kind in the nation, that would require drug manufacturers to develop and pay for a program to collect unused prescription and over-the-counter drugs from residents and dispose of them.
Scientists and environmentalists have long known of the common presence of minute concentrations of pharmaceuticals in drinking water, either through human excretion flushed into sewers or leftover medicine thrown down the drain. Research shows that pharmaceuticals sometimes harm fish and other aquatic species, and that human cells can fail to grow normally in the laboratory when exposed to trace concentrations of certain drugs.
The Maine Department of Environmental Protection found tiny amounts — measured in parts per trillion — of medications ranging from antidepressants and birth control pills to blood pressure and cholesterol prescriptions. The most prevalent drugs were over-the-counter pain relievers, including ibuprofen and acetaminophen.
"People need a way to properly dispose of their drugs, and they're not getting it right now," said Mark Hyland, director of the state Department of Environmental Quality's Bureau of Remediation and Waste Management.
The bill is one of many "take-back" programs under consideration in more than half a dozen states and would be the first of its kind if enacted; it has won committee support and awaits further action.
The bill is opposed by the Pharmaceutical Research and Manufacturers of America, a Washington-based organization that represents pharmaceutical and biotechnology companies and has partnered with other groups to pay for advertising against the proposal.
The lobby acknowledges that previous testing shows trace levels of pharmaceuticals can be found in water supplies and landfills, but says the levels are so small that they pose little risk.
"The amounts of pharmaceuticals (in the environment) are infinitesimally small," said Marjorie Powell, senior assistant general counsel. "We're talking about two drops in an Olympic-size swimming pool. Those two drops are much lower than any doses that would have an effect on humans."
The state last October tested leachate at landfills in Augusta, Brunswick and Bath. Hyland ordered up the study after members of the pharmaceutical industry expressed skepticism about the presence of pharmaceuticals in landfill water.
Leachate at Maine landfills typically is piped or trucked to municipal wastewater treatment plants. Those plants are not equipped to remove drugs from the water before it is discharged into rivers and the ocean.
The pharmaceuticals found in the landfills don't pose a direct threat to drinking water, Hyland said. The landfills are lined to protect groundwater supplies, and in Maine there aren't any wastewater plants that treat leachate and discharge into rivers that ultimately supply drinking water.
But the leachate — in high enough concentrations — can pose a threat to fish and shellfish. Research suggests that hormonal drugs, such as birth control pills, tend to feminize fish. If the trend continues, Hyland said, there could be too few male fish to continue reproduction.
"What you find are greater concentrations of females downstream from where they've seen a dose of hormones, so you find a feminization of the fish population where there are fewer males around," he said.
Hyland said he has questions about the effect on commercial seafood — one of Maine's biggest industries — in ocean waters downstream from the rivers, particularly bivalves such as clams or mussels, which filter water constantly and live near the shore.
"But obviously we need to know a lot more before we can draw a lot of conclusions," Hyland said.
Although landfill leachate doesn't get into drinking water supplies in Maine, it probably does elsewhere, said Andy Tolman, a geologist with the Maine Center for Disease Control and Prevention. And some scientists urge caution about the dangers of drinking such water over several decades.
"Many larger states have big rivers that are used for both waste disposal and drinking water supplies, places like Ohio and Pennsylvania," Tolman said. "The same river gets used a number of times, and they're very concerned about treatment of sewage and leachate."
Powell, from the pharmaceutical lobby, argued that people can properly dispose of their drugs in their household trash. In Maine, much of the trash is burned, she said, and pollution control experts agree that incinerating unwanted drugs is the safest solution.
She argued that if the bill does pass, it will only make drugs more expensive, she said.
Concerns have grown in recent years over pharmaceuticals reaching drinking water supplies. An Associated Press investigation in 2008 reported that the drinking water of at least 51 million Americans contains minute concentrations of a multitude of drugs.
It's commonly believed that the vast majority of drugs that get into water supplies come from human and animal excretion and that smaller amounts come from flushing them down the toilet or drain, a practice the Food and Drug Administration says is not recommended for most medications.
Federal guidelines recommend using community drug take-back programs to dispose of medications. If those aren't available, people should mix their unwanted drugs with cat litter or some other undesirable substance, put them into a sealed container and put it in the trash, according to the Office of National Drug Control Policy.
http://news.yahoo.com/s/ap/20100207/ap_on_sc/us_pharmawater_landfills/print

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Posted in: medication,pollution,water

Eight Questions Parents Should Ask About Psychiatric Medications

By R. Scott Benson, M.D.



As a child and adolescent psychiatrist I talk to many parents about treatment options for their children. Whether it be talk therapy or medication, any recommendation for treatment should be based on a thoughtful evaluation.



If medication is recommended, parents find the following questions help in navigating this process. This dialogue with your child's doctor is a first step in forming a team effort for your child's treatment.

1. How will the medication help my child? How long before I see improvement?


2. What are the side effects which commonly occur with this medication?


3. Is this medication addictive? Can it be abused?


4. Are there any tests which need to be done before my child begins taking the medication? Will any tests need to be done while my child is taking the medication?


5. How will my child's response to medication be monitored? How often?


6. Are there any other medications or foods to avoid?


7. How long will my child need to take this medication?


8. What do I do if a problem develops (e.g. if my child becomes ill, doses are missed, or side effects develop)?

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Posted in: children,medication,treatment