Prescription Drugs: How They Can Help, Hurt…or Even Kill!

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By Mike DuBose with Blake DuBose and Surb Guram, MD

America’s prosperity and access to a wide variety of healthcare options provide us with many benefits compared to the rest of the world. Our excellent living conditions have pushed the average American’s life expectancy to nearly 80 years (compared to just 54 years in 1914). Many of the diseases and conditions that killed so many in years past are now being successfully controlled or eliminated by modern medicine.

Prescription drugs have significantly contributed to this progress. I have studied many medications for the benefit of my own health and others’ as we worked with doctors to improve our well-being. To my surprise, I have found that many individuals do not fully understand the positives and negatives of the medications they are taking. Very few research the drugs or ask their doctors and pharmacists questions about how they work, what they do to the body, how they interact with other medications, and the potential side effects and dangers they present.

It takes work to find the balance between too few and too many prescriptions, to understand their proper usage, and to maximize prescription drug savings. But the benefits—feeling better, enjoying a long life, and preventing disease—make it worthwhile. Based on my research, experience, and interviews with pharmacists and medical doctors, the following are tips to help maintain good health and effectively manage prescription intake:

  • Listen to your body: Some illnesses or conditions don’t cause any outward signs, or the symptoms may mimic those of another disease. However, our bodies usually try to communicate with us if something is wrong, and it’s essential that we listen. If any aspect of your health, no matter how small, changes abruptly or causes you discomfort, note the details. If the patterns persist, contact your doctor for an exam and treatment.
  • Find good doctors before you need them: To stay at optimum health, you need a team of competent doctors and specialists helping you. Rather than simply going to a “doc in the box” or urgent care practice when you’re sick, try to build relationships with a set of professionals. Going to the same physicians over time means that they will get to know you and will pick up on irregularities in your health much faster. To find good medical professionals, ask friends and acquaintances for their recommendations. If you hear the same names coming up repeatedly, you know you are on the right track. Ideally, you want to seek a caring but knowledgeable physician who will take the time to listen to and examine you, and come to a reliable diagnosis and treatment plan. Internists have advanced training in diagnosing and treating medical problems. One great doctor can save your life! Although I was exhibiting no symptoms and appeared healthy, my internist, Dr. Surb Guram, noticed a hard-to-find aneurysm in my heart that required open heart surgery. If not for Dr. Guram’s thorough understanding of my health, my heart problems might have gone undetected!
  • Ensure that conversations with your doctor are friendly, honest two-way exchanges: According to the Mayo Clinic, it’s important to share all of your symptoms with your doctor. Keep a written record of all issues you have experienced, when they took place, and how long they persisted. Also note any major problems or stressors that coincided with the symptoms (such as depression, major life events, stress, anxiety, or hormonal changes), and be sure to let the doctor know of any medications you are taking. Many doctors are being pressured to limit the time they spend on each patient, so come prepared with this information and a list of any questions you have to really make the most out of your visit. Although typically very intelligent, doctors are still human beings, so the more accurate you are in your descriptions of your symptoms, the more likely it is that they will make a correct diagnosis.
  • Get annual physicals: Many major diseases have the potential to be detected early and even cured—if you’re aware of them in time. See your primary doctor at least once per year and allow him or her to perform any tests on you that he or she deems necessary. It was through an EKG that Dr. Guram detected a minor irregularity within my heart, leading him to order more tests, revealing a silent heart aneurysm that required major attention! (If your doctor recommends a CT scan, however, ask for alternatives such as an MRI, since CT scans expose you to a significant amount of radiation.)
  • Make a written list of your medications and update it regularly: List dosage and times per day you take each prescription, and include any supplements you take regularly as well (some supplements can affect other medications). Preferably, it should be in an electronic form such as a Word file that you can print out as needed. You can also keep a list in an e-mail that can be easily pulled up on your smartphone if you forget the hard copy. Although medical practices’ electronic records are evolving, it’s still your responsibility to ensure your doctor knows which medicines and supplements you are taking so they can give you the best possible treatment options.
  • Ask for hard copies along with any electronic prescriptions you are given: Sometimes, electronic prescriptions get lost or sent to the wrong place. To cover all of your bases, ask your doctor to word process you prescription and print a copy for you, or to write it legibly on a prescription pad.
  • Record the details: Albert Wu, M.D., M.P.H, of the Johns Hopkins Bloomberg School of Public Health, recommends, “Always ask your doctor how to take medication—how much…how frequently...what time of day…and with or without food.” It can be easy to forget this information between your doctor’s visit and when you arrive home, so bring a pad and paper to take notes. It’s also helpful to accompany older or forgetful relatives and record this information for them at their appointments.
  • Double check that you are given the correct medicine: Although electronic prescriptions have significantly decreased the likelihood of pharmacists misreading doctors’ handwriting, the potential for error is still there. Dr. Wu suggests having your doctor pronounce the name of the medication he or she is prescribing to you and then repeating it back. When you pick up the drug from the pharmacy, confirm with the pharmacist that it is the correct medication. The FDA requires medications to display different sizes, shapes, colors, and symbols to help indicate differences, but some still look similar, so examine them carefully.
  • Decide on the right dosage: According to Dr. Wu, most physicians will prescribe the average dose that is typically effective for most people. However, everyone is different, and factors such as weight, gender, and age may make your ideal dosage deviate from the average. It’s important to work with your doctor to get it right—in fact, the American Society of Consultant Pharmacists warns that medication-related problems are believed to be one of the top five killers of people age 65 or older, and 28% of senior hospitalizations are due to adverse drug reactions. Each year about 32,000 seniors suffer hip fractures due to falls caused by medication-related problems such as dizziness. If in doubt about your ideal dosage, start at the lowest dose and increase gradually with the supervision of a medical professional. To save money, talk to your doctor about possibly prescribing you a higher dosage, then splitting the pills or taking them less frequently so you can ingest the needed amount at the best cost. You may also want to ask for samples before ordering a full 30- or 90-day prescription so you can experiment and make sure the medication is right for you.  
  • When possible, limit the number of prescriptions you take: In our society, prescription drug use—warranted and unwarranted—has become increasingly common, particularly in older age groups. The American Society of Consultant Pharmacists notes that as your age increases, the number of medicines you’re prescribed probably will too. However, the higher the number of drugs you take, the more likely there will be an interaction, so you should only take those that are actually necessary for your health. If you have found a good, reliable team of doctors, you should be able to talk with them comfortably to decide which are right for you. Of course, for those prescriptions you actually do need, take them! Being stubborn and refusing to see a doctor or take necessary medicines will harm your quality of life and may even shorten it.
  • Research your medications: Enter your drug name and dosage into Google or the search functions on websites such as university medical school sites, WebMD.com, and Drugs.com. Many of these websites also have a handy tool that allows you to cross-reference the drugs you are taking and alert you to any potential interactions that could cause problems (sometimes, combining drugs may alter their chemical properties, which can be dangerous!). Some insurance companies will also send you notices if your health record indicates you have been prescribed drugs that may interact negatively with each other. For example, I received a letter warning that combining one of my antibiotics with my heart medication could cause an irregular heartbeat. Neither my doctor, pharmacist, nor cardiologist had informed me about this! Not all medical professionals are aware of all potential interactions, so conduct research on your own. I like to search reputable websites for information such as: when is the best time to take the drug, if it is more effective to take with or without food, if it is safe to take with other drugs, and which drugs or supplements to avoid when taking that medication. Grapefruit juice, for example, has been proven to diminish the effectiveness of some medications, and the popular supplement St. John’s Wort can cause problems when taken with prescription drugs. Don’t get alarmed by all the possible side effects listed, however. Speak to your doctor or pharmacist and weigh them logically against the potential benefits that taking a drug could offer.
  • Try alternatives until you find the best fit: If one drug’s side effects are too much for you to handle in comparison to its benefits, discuss your concerns with your physician about similar drugs that might work better for you. Certain medications can mimic serious illnesses such as dementia. A 2012 Wall Street Journal article notes that “Alzheimer’s symptoms such as confusion, memory loss, and personality changes also can be side effects from medication—even commonly used drugs...Cholesterol-reducing statins have also been linked to brain fog in some people.” Armon Neel, Jr., PharmD echoed similar concerns in a 2013 Bottom Line Health story.
  • Take advantage of technology for refills: If you visit different specialists, you’ll likely receive several prescriptions starting on various days of the month. This can be frustrating because you often can’t get them refilled at the same time, and it’s difficult to remember which needs to be replenished when! However, many pharmacies now offer convenient electronic systems that allow you to check in on what prescriptions you have filled with them, note when they are due for refills, and even set up automatic refills. Pharmacies will then automatically alert you by your choice of communications: telephone, e-mail, or text messaging. (Some controlled substances, like sleeping pills, may still have to be called in. Also, remember to bring your driver’s license or other form of ID if you will be picking up a controlled substance.) You can wait to pick them up until another prescription is ready, minimizing time spent on the task. To save even more time, you can complete privacy forms allowing family members to pick up each other’s prescriptions. As noted previously, always double check your prescriptions upon pickup to ensure they are the correct drugs, dosages, and prices. Sometimes, the automatic refill system picks up on prescriptions that are still active but that you don’t need.
  • Organize and store your medications wisely: Try to stockpile a week or two’s worth of your necessary prescriptions as a backup in case you will be traveling during a time when you would normally get a refill. Most insurance companies will fill a prescription roughly every 25 days, so if you refill on that schedule, you should be able to set aside some extras. (Some mail order pharmacies will also let you order three-month supplies.) Store your medications in a cool, dry place—I double bag in large plastic Ziplocs to keep out moisture. For convenience’s sake, you can place a month’s supply into two sets of four plastic containers each labeled with the days of the week (one color, like white, for daytime medications, and another, like blue, for nighttime). One seven-day set can stay out in a sealed 4” X 6” plastic bag, and the others go into another airtight plastic bag. If you follow this strategy, pay careful attention to the pills as you separate them into their containers. Accidentally dropping extra pills into one compartment could harm your health. (You also want to avoid dropping them on the floor, where a pet or child could find them and eat them.) Try to use all medications by their expiration dates. Research has found that they may still be potent past these dates, but their effectiveness declines over time.
  • Take medicines at the right times and in the correct way: If you take multiple pills each day, examine all of your medications before swallowing them. If you use daily pill containers, it’s easy to drop an extra one in or miss a day when filling them. Some medications can cause acid reflux if not flushed from the esophagus, so  consider following your pills with water and a little bread or other food. Never chew any time-release medications or take too many doses at once, or you will put potentially harmful amounts into your bloodstream. You should also time your medications appropriately. For example, if taking medications in the morning upsets your stomach, try after lunch. Some drugs will indicate when to take them on the box or label. The antacid Prilosec, for example, should be taken in the morning at least 30 minutes before eating or drinking coffee to calm stomach acids. Doctors also recommend that some medicines (like antibiotics) only be taken for a specific amount of time. If taken incorrectly, even over-the-counter drugs can cause short- or long-term damage. Therefore, it’s very important to study your medicines and how they should be used. Be sure to take all your drugs as recommended and to complete the entire course, especially with antibiotics and antidepressants.
  • Be cautious with antibiotics: “Overuse of antibiotics, and prescribing broad-spectrum drugs when they aren’t needed, can cause a range of problems. It can make the drugs less effective against the bacteria they are intended to treat by fostering the growth of antibiotic-resistant infections. And it can wipe out the body’s good bacteria, which help digest food, produce vitamins, and protect from infections, among other functions,” according to a 2013 Wall Street Journal article by Sumathi Reddy. Yet the article cites two recent studies published in medical journals Pediatrics and the Journal of Antimicrobial Chemotherapy, which found that “about 25% of the time antibiotics were being prescribed for conditions in which they have no use, such as viral infections.” It can be difficult for some doctors to tell a bacterial infection (like a sinus infection), which could be treated by antibiotics, from a viral infection (like bronchitis), which cannot. When you are sick, work with your doctor to determine if an antibiotic is truly needed, and avoid taking them if they’re not.
  • Avoid addiction: Prescription drug abuse is a serious and often overlooked issue. Many users feel that they are somehow safer than “street” drugs, but the consequences can be just as deadly. According to a Psychology Today article by Harvard Medical School faculty member Wesley Boyd, M.D., Ph.D, “In 2009, 16 million Americans used prescription drugs for nonmedical purposes at least once in the previous year.” The Mayo Clinic reports that prescription abuse is a growing problem, especially among seniors, people who are in their teens and young twenties, and those with histories of addiction. Once a person is addicted, he or she often needs greater and greater amounts of the drug to achieve a “euphoric effect,” the CDC notes, which can cause the heart to slow down so much that breathing stops completely, resulting in a fatal overdose. The clinic especially warned against misuse of opioids (like hydrocodone and oxycodone), sedatives, anti-anxiety medications (like Xanax, Valium, and Ativan), and stimulants (like Adderall or Ritalin), which can cause increased risk of choking; memory problems, low blood pressure, and slow breathing; and high blood pressure and heart problems, respectively. Since some people actually need these medications and have legitimate prescriptions, it can be strikingly easy for abusers to get their hands on them. According to Boyd, “70% of those 12 years or older who abused prescription drugs obtained them from friends and/or family—often by simply raiding the family medicine cabinet.” To protect your family, keep all controlled substances in a safe place where children and teens cannot access them, and always take your prescriptions in a safe and correct way. If you feel you may be losing control or becoming addicted, speak to your doctor, who may wean you off of the medication and refer you to a counselor or other professional.
  • Use antidepressants safely: One out of every five Americans suffers from mental illness, according to a 2012 ABC News article by Mikaela Conley. With numbers like that, it’s no wonder that 1 in 10 Americans now takes antidepressant medication (for women in their forties and fifties, the number is 1 in 4), as reported by Roni Caryn Rabin of the New York Times. Drugs, however, are not a cure-all. In fact, most research indicates that the best way to treat mental illnesses incorporates not only medication, but also counseling or talk therapy. Mental illness is very complex, so if you suffer from it, seek help from not just prescription drugs, but also skilled psychiatrists, psychologists, or MSW counselors to work toward a healthier mindset.
  • Don’t go cold turkey: While we typically receive detailed instructions on how to start taking a drug, we’re rarely told how to safely stop taking it. Some drugs, such as headache medicines, can be taken off and on as needed; however, others can cause very serious side effects if quit abruptly and must be tapered off gradually. According to Jack Fincham in a March 2013 Bottom Line Health article, “The specific tapering schedule will depend on many factors, including how long you’ve taken the medication…the dose...your age...and other medications you are taking.” Depending on which medications you’ve stopped taking, sudden withdrawal can cause muscle pain, weight loss or gain, nervousness, insomnia, depression, hyperactivity, anxiety, seizures, hallucinations, or a shut down of the gastrological system. To prevent these negative reactions when you decide to stop taking a drug, research a regimented withdrawal plan and speak to your medical provider about the best way to implement it.

In addition to all the health concerns, there are also financial issues to consider when taking prescription drugs. In fact, research shows that many individuals are taking prescriptions they just don’t need—and the financial costs are adding up. The September 2013 issue of Consumer Reports stated, “Many Americans, even those who have insurance coverage, spend more than they need to on prescription medications.” According to their 2012 Consumer Reports Best Buy Drugs annual poll, regular prescription drug takers spend an average of $758 per year on their medications. The average person who regularly takes prescription medications takes four, and 14% of respondents said they take seven or more. Many told Consumer Reports that they had to reduce other household expenses, like groceries, entertainment, and clothing, to help pay for the drugs. Seniors, who often live on a fixed income and are statistically more likely to take multiple medications, are particularly vulnerable to high drug costs. There are some strategies, however, that can help you save on prescriptions, including:

  • Ask your medical provider to prescribe you generic forms of the medications you take: Generics have the same molecular structure as their brand-name counterparts whose limited patents have expired. Often, both forms are made in the same plant, so why pay more for the name?
  • Ask your pharmacist if there is a difference in the cash price versus buying the medication through your insurance, Medicare, or supplemental insurance: Sometimes, the cash price might be cheaper.
  • Research discounts online: Many pharmaceutical companies offer great saving programs! Go to the official website of the drug you take and enroll in their discount program. You will have to fill out some forms with your basic information and consent to receive some information about the drug via mail or via e-mail, but then you will receive a discount card in the mail. Then, take the card to your pharmacist and have them register the RX, PCN, and BIN numbers in their system. Another option is to Google “discounted [drug name],” but be wary of ordering from online companies, as they may not be legitimate.
  • If available, try some cheaper over-the-counter (OTC) drugs that have the same ingredients as your prescriptions: Many of them were once prescription drugs, and they’re much cheaper. For example, generic omeprazole contains the same active ingredients as Prilosec.
  • Ask your pharmacist if they offer a discount or generic drug program: You may have to sign up for it annually and pay a small fee (usually, $20 or so), but the savings can make it worthwhile. While researching the topic, Consumer Reports found that they were able to purchase generic Prozac for $4 a month at Sam’s Club, Target, and Walmart through those stores’ programs, versus paying $31 per month through insurance.
  • Consider using your insurer’s mail order program: Typically, these services will send you three months’ worth of your prescriptions each time you refill. Costs are usually based on a tiered system depending on factors like whether the medication is generic or not. According to Consumer Reports, Medicare and some other insurance carriers offer substantial discounts through their mail order pharmacy programs. Check their prices against your regular pharmacy’s, though, to make sure you’re getting the best deal.
  • Shop around: Call or visit various pharmacies to inquire about prices for your medications. Surprisingly, some offer lower prices than others!
  • Research your insurer’s restrictions: Sometimes, they will only pay for limited quantities of a drug or medical supply that you need. Ask your doctor’s office to fax them an appeal, and they may make an exception for you.
  • Conduct an annual review of your medications with your doctor: At your yearly physical, ask if there are any drugs or supplements you could reduce or eliminate. If so, seek your doctor’s advice on how to stop taking them.
  • Change your lifestyle to limit the need for some drugs: It’s easier said than done, but practicing healthy habits is often the best medicine! For better health, try to maintain a reasonable weight, eat right, exercise, stop smoking, and drink alcohol and caffeine in moderation. In the August 2014 Harvard Health Letter, Dr. I-Min Lee, a Harvard Medical School professor who studies the role of exercise in health, said that she views exercise as medicine, “and even better, it’s medicine that’s free and has very few side effects.” According to the article, “physical activity can greatly reduce your risk of heart disease, stroke, type 2 diabetes, breast and colon cancer, depression, and falls. Physical activity improves sleep, endurance, and even sex.”

The bottom line: In many cases, prescription drugs can literally be lifesavers. However, there are also many risks, side effects, and financial burdens that can be associated with their use. When you’re prescribed a medication, study it carefully through reputable research and websites, and seek the advice of your doctor and pharmacist on how to use it to help—not hinder—your health. The life you save may be your own!

About the Authors: Our corporate and personal purpose is to “create opportunities to improve lives” by sharing our knowledge, research, experiences, successes, and mistakes. You can e-mail us at [email protected].

Mike DuBose received his graduate degree from the University of South Carolina and is the author of The Art of Building a Great Business. He has been in business since 1981 and is the owner of Research Associates, The Evaluation Group, Columbia Conference Center, and DuBose Fitness Center. Visit his nonprofit website www.mikedubose.com for a free copy of his book and additional business, travel, and personal articles, as well as health articles written with Dr. Surb Guram, MD.

Blake DuBose graduated from Newberry College’s Schools of Business and Psychology and is president of DuBose Web Group (www.duboseweb.com).

Katie Beck serves as Director of Communications for the DuBose family of companies. She graduated from the USC School of Journalism and Honors College.

Dr. Surb Guram, MD is a board-certified internist and a graduate of the University of South Carolina School of Medicine. He is a partner with the SC Internal Medicine Associates in Irmo, SC and has practiced internal medicine in the Midlands for the past 30 years. See www.scinternalmedicine.com for more information on Dr. Guram and his practice.

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