America’s prosperity and access to great healthcare options provide us with many benefits. Our excellent living conditions have pushed the average American’s life expectancy to nearly 80 years (compared to 54 years in 1914). While the Covid pandemic shortened the length of our lifespans, many of the other diseases and conditions that were disabling or deadly in the past are now being successfully controlled, treated, or eliminated by modern medicine.
Prescription drugs have significantly contributed to this progress. While they can save lives and are invaluable tools for medical professionals in treating illness and disease, research indicates that medications are also known as “killers of many individuals 65 and over!” The National Institute on Aging reports “Medicines are intended to help us live longer and healthier, but taking medicines the wrong way or mixing certain drugs and supplements can be dangerous. Older adults often have several medical conditions which may require multiple medicines, putting them in danger of serious side effects.” WebMD.com also acknowledged that “The more prescriptive drugs you take, the chances increase of having a ‘serious’ drug-to-drug interaction which can put your heart at risk.” Some studies indicate that many people aged 65 and older were taking 15+ prescriptions daily and are over-medicated! When over-the-counter and dietary supplements are included, these numbers spike.
It takes experimental work to find the balance between too few and too many of the “right” prescriptions, understand their proper usage, and maximize savings. But the benefits—feeling better, enjoying longer lives, and preventing or treating illness and disease are worthwhile. Based on my research, personal 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 health condition. 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, like a tiny mole, changes abruptly or causes you discomfort, note the details when patterns surface.
Engage with excellent doctors before you need them: To maintain optimum health, it’s essential that you have a team of competent doctors and specialists helping you. While sometimes necessary, rather than simply going to a “doc-in-the-box” or the ER when you’re sick, build relationships with competent professionals. Going to the same physicians over time means that they will get to know you, have access to your medical records, and will likely notice irregularities in your health.
Ensure that conversations with your doctor are friendly, honest two-way exchanges, but to the point: According to the Mayo Clinic, it’s important to share all of your symptoms with health professionals. Keep written records of all issues you have experienced, when they occurred, 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 let the doctor know of any medications you are taking. Many medical professionals are forced to spend less time with each patient (some no more than 10 minutes!) which can limit their ability to accurately diagnose your problem versus treating symptoms. So, when you meet with your medical professionals, have your notes and research ready to go! While you want to be friendly, it’s not a time to chit-chat.
Schedule annual physicals: Many major diseases have the potential to be detected and even cured—if you’re aware of them in their early stages. See your primary doctors at least once per year and allow them to perform any tests they deem necessary.
Develop a written, updated medication chart: List dosage/times of prescriptions. Include supplements and vitamins you take since they can affect other medications. Preferably, it should be in an electronic form such as a Word file that you can adjust as medications change. You can also keep a list which can be easily retrieved on your smartphone if you forget the hard copy.
Double check that you’re given correct medicines: Although electronic prescriptions have significantly decreased the likelihood of pharmacists misreading doctors’ handwriting, the potential for error is still there. When you arrive home after picking up your meds, ensure that it’s your correct prescription. The FDA requires medications to display different sizes, shapes, colors, and symbols to help indicate differences, but some look similar, so examine them carefully. While pharmacists double-check prescriptions, some use technicians to initially fill patient orders.
Decide right dosages: Most physicians will prescribe average amounts that are effective for most people. However, everyone is different and factors that might impact the dosage include test outcomes, weight, gender, and age. If in doubt about your ideal dosage, ask if you can start at the lowest milligrams and increase gradually with the supervision of a medical professional. And watch carefully for any unusual symptoms after beginning the meds.
Research your medications: Many individuals visit different medical professionals who treat “specific” aspects of their health. For example, your cardiologist may prescribe blood pressure meds, while another physician might recommend drugs for unrelated symptoms. We trust our doctors and pharmacists to know what’s good for us. While they do their best, medical professionals don’t know how new prescriptions will interact with you or what will happen when combined with other medications. Many doctors are pressured to see as many patients in a day as possible due to minimal insurance and Medicare reimbursements. Likewise, pharmacy personnel appear to be racing to fill hundreds of daily medication orders.
I was recently prescribed a medication thought to be safe by a specialist and filled by my pharmacist. However, afterwards, I received an urgent warning from my insurance company, that’s electronically connected to my pharmacy—"don’t take the drug because, when added to my other meds, it can cause dangerous irregular heartbeats which trigger strokes.” Another friend experienced the same scenario when she was prescribed the wrong drug which most likely led to her death based on post-mortem research. John Hopkins University reports that approximately 9,000 individuals die and thousands are hospitalized annually due to medication errors! According to a New York Times article, clinical pharmacist Timothy O’Shea, reported “Each year an estimated 4.5 million Americans visit physicians’ offices or emergency rooms because of prescription-related problems.” Chad Worz, PharmD, noted that older adults experience side effects more intensely as our bodies struggle to absorb or remove medications. As a result, blood pressure may be lowered, causing dizziness and falls. A study by the Lown Institute recently found that more than 40% of older Americans take at least 5 medicines and 20% take 10+ (excluding supplements and vitamins). Professor Sharon Lee, MD, with Mount Sinai Medical School, stated that some individuals take so many medications, they require “extra drugs” to offset the negative effects of other medicines. It’s alarming to see countless seniors in doctors’ offices with huge bags of prescription bottles! Even over-the-counter products, like Aspirin, can cause major problems!
So, thoroughly evaluate your meds by entering names/dosages into reputable websites and focus on “side effects.” Drugs.com contains excellent electronic tools where you enter prescriptions, vitamins, and supplements to cross-reference products you’re taking which may identify potential hazardous interactions. You can save your on-line file and update it as needs change. The resource lists individual drug reactions, but also reveals what happens when combined with other medications since they can produce new chemistry that creates threats!
Don’t become alarmed by the lengthy prescription problems listed on websites since they vary by individual. Studies show it takes two weeks for your body to adjust to new prescriptions. If you’re having serious symptoms, like heart palpitations, alert your doctor. Look for best times to take drugs with/without food and how other products interact with them. Grapefruit, for example, can diminish the effectiveness of some medications, and popular supplements can cause problems when taken with prescriptions. In some situations, you have to experiment and conduct your own research to examine each medication when concerns surface. For example, a friend suffered significant nausea for months. His doctor diagnosed his condition as reflux and prescribed medications to lower acids. The patient was instructed to sleep on elevated-wedge-like-pillows to reduce reflux. Not finding any relief, he consulted with a gastroenterologist who ordered medications for nausea that caused other side effects and conducted an endoscopic abdomen examination without results. But the nausea continued. I suggested that we examine his medicines for possible sources. Our research revealed nausea was a negative reaction from his blood thinner! He worked with his cardiologist, switched to the anticoagulant Eliquis, and his nausea disappeared!
Try alternatives until you find the best fit: If one drug’s reactions are excessive in comparison to its benefits, discuss concerns with your physician about similar medications that might work. Statins, while valuable in lowering you cholesterol, can cause joint and muscle pains. After testing different statins that caused significant problems, my doctor identified one that is tolerable for me. Ideally, you want to work with your medical team as “partners” to diagnose and treat you accurately.
Certain medications can mimic serious illnesses: A Wall Street Journal article noted that “Alzheimer’s symptoms such as confusion, memory loss, and personality changes can be complications from medications—even commonly-used prescriptions and over-the-counter drugs....Cholesterol-reducing statins have also been linked to brain fog in some people.” I was taking a popular statin and upon arrival at my home of 25 years, I couldn’t determine which key opened the front door—that was very scary!
Take advantage of technology: It’s frustrating you can’t pick up all medications together at the same time to avoid excessive trips! Many pharmacies offer on-line electronic systems that allow you to check prescription due dates, establish automatic refills, and alert you by text when your medications are ready. I added my renewal dates into my calendar as reminders. Double-check before leaving pharmacies to ensure your orders and prices are correct.
Save money: Consumer Reports determined “Many Americans, even with insurance, spend more than they should on medications ($1,300+ annually).” Studies show that families are experiencing skyrocketing inflation and some are reducing household expenses to pay for legal drugs. Conversely, many seniors, with limited income, are living dangerously by not taking all or part of their medications to cover essential bills.
Here are some cost-saving ideas. Ask medical providers to prescribe generics which have the same molecular structures as their brand-name counterparts and are often produced in the same factory! Many pharmaceutical companies offer great saving programs! Explore your drug’s official website to apply for electronic discount cards and have your pharmacist register RX, PCN, and BIN numbers into their systems. If available, try cheaper over-the-counter products that were once prescribed. Inquire with your pharmacist if they provide discounts or generic-drug-programs and are there benefits when paying with cash. Websites GoodRx, RxSaver, WebMDRx, and Singlecare compare different pharmacy prices. To reduce unnecessary trips and save time, request prescriptions for 90-day supplies. Medicare (www.cms.gov) furnishes medication discounts for lower-income-families called “Extra Help” ($1,843 monthly individual income limits and $2,485 for couples).
Prepare for Travel: Plan ahead to ensure you have enough medicine for vacations and take your meds with you—not in checked luggage that could be lost or misplaced. Insurance companies generally allow 25-day renewals so you can build up some extras. Prior to leaving, double check your prescriptions which may have expired and need updates from doctors. If still active, and you’re running low, you can contact your insurance company to request “Vacation-Early-Refills.”
Organize medications: Place 30-day supplies into plastic reminder containers with week-day-labels (white containers for day-meds and nighttime blue/green). Pay careful attention when inserting them into slots since extra pills or an omission in one daily compartment could harm your health. (Avoid dropping pills on floors where pets or children could find them.) Use by expiration dates since effectiveness declines over time.
Take medicine as prescribed: If you ingest multiple pills daily, view them in your palm to ensure all are accounted for before swallowing. Some pharmaceuticals cause acid reflux and nausea if not flushed from the esophagus, so consume most meds with plenty of water and food. If you experience morning side effects, try after lunch since timing is important. Taking medications at night might cause insomnia so switching to morning hours may be helpful. Likewise, others that cause drowsiness during the day might be taken at night to help with sleep.
Be cautious with antibiotics: Overuse can make them less effective against bacteria by promoting growth of antibiotic-resistant infections. Excessive consumption over time can reduce or eliminate the body’s good bacteria, which helps digest food, produces vitamins, and protects from infections. Even when feeling better, take all your antibiotics.
Change lifestyles: It’s easier said than done, but practicing healthy habits is often the best life-strategy (reasonable weight, eat right, exercise, stop smoking, reduce stress, and drink alcohol or caffeine in moderation). Harvard Medical School documented that “exercise is good medicine, and even better, it’s free with few side effects. Physical activity can greatly reduce risks of heart disease, stroke, diabetes, breast and colon cancers, depression, and falls, while improving sleep, endurance, and mental health.” Brisk walking in malls or outdoors is an excellent source of exercise and socialization.
Avoid addiction: Mayo Clinic reports prescription abuse is growing, especially amongst seniors. Once individuals are innocently hooked, they often need greater amounts to achieve pain-relief or “euphoric effect.” As a result, the FDA notes that the heart could slow down so much that breathing stops completely, resulting in fatal overdoses. Since many families have legitimate medications, it’s easy for abusers to steal them. According to research, 70 % of children aged 12 years or older, who abused legal drugs, secured them from friends and/or family—often from medicine cabinets.
Don’t go cold turkey: While we typically receive detailed instructions on how to begin meds, we’re rarely told how to safely stop taking them. Most over-the-counter medicines can be taken as needed; however, others cause serious side effects if stopped abruptly and must be gradually reduced. According to Bottom-Line Health, “The specific tapering schedule will depend on many factors, including how long you’ve taken medications, dosage, age, and other drugs.” Sudden withdrawal can cause muscle pains, weight loss/gain, anxiety, insomnia, and gastrological shutdowns.
Use antidepressants safely: The CDC reports 20% of Americans suffer from mental-health challenges and 13% take antidepressants (20% amongst women aged 40-59 and one-in-four 60 years and older). Prescriptions aren’t cure-alls and some are recommended by doctors who aren’t trained to prescribe, monitor, and treat patients with psychotropic drugs. In fact, most research indicates that the best ways to treat mental health issues may incorporate a combination of: (1) medications administered by competent psychiatrists such as Josh Fowler, MD; (2) one-on-one counseling and support groups; (3) stress-reduction, and (4) exercise. Prayer is essential for believers. While it’s important to employ medical professionals as treatment partners, if God created the universe, He can help you!
The Bottom Line: In many cases, prescriptions can literally be lifesavers. However, there are also many risks, side effects, and financial burdens that are associated with use. What’s in your medicine cabinet? You don’t want to become “a statistic” when needlessly consuming too many or the wrong medications which could lead to sickness, disability, and even death!
The DuBose family’s purpose is to “Create Opportunities to Improve Lives.” Mike is a staff member with USC’s graduate school. In 1987, he founded his family of companies and eventually wrote the book “The Art of Building Great Businesses.” Visit his nonprofit website www.mikedubose.com for free access to his books and 100+ published articles, including business, travel, and personal topics, in addition to health research with Surb Guram, MD.