Seniors, too many drugs and now a scare that supplements are “lethal”…..

by Dr. Alan Kadish NMD

It’s almost fantasy land and one should be starting to question if the author of the Drug Discovery and Development Magazine article based on the March Journal of the American Medical Association article entitled ” Prescription and Over-the-Counter Medication and Dietary Supplement”   is intentionally screaming “fire” in a theater. The  JAMA article’s conclusion is that:  ” In this study, the use of prescription medications and dietary supplements, and concurrent use of interacting medications, has increased since 2005, with 15% of older adults potentially at risk for a major drug-drug interaction.” How did we go from this conclusion to supplements are “lethal” ? ( The DDD article is below my comments)

As an example in their publication they point out that, “For example, the use of clopidogrel in combination with the proton-pump inhibitor omeprazole, aspirin, or naproxen – all over-the-counter medications – is associated with an increased risk of heart attacks, bleeding complications, or death.”  I’m not seeing a supplement here……the real issues is the use of 4 or more RX’s call polypharmacy. This has been an increasing issues nationwide as the average senior is now taking more prescriptions than ever before. If your interested income facts and figures on the drug industry and what are the most popular drugs for 2014 see a chart on TheRubins website and note the income for the manufactures.

There is no question that the use of multiple prescriptions, over the counter medications and supplements inevitably is not a good idea…..unless your doing your homework. By that I mean that your taking the time to check the literature and make certain that indeed your not putting yourself at risk. Another option is to utilize the services of a competent physician or pharmacist  who will take the time to do the research and is not doing the superficial approach of taking unsubstanciated scare reviews as gospel. Another free method is to use the medication checkers online. WebMD offers one that is easy to use along with many others on the web. You might not be aware that many of your physicians electronic records software programs also integrated medication checking, as a prescription is being prescribed. At the Center we have been using an electronic records system that does this checking for years. 

Your probably wondering what got under my skin to be so forward. Two recent articles in the February, 2016 Vitamin Retailer detailing the misrepresentation of supplement use and their risks along with the article discussing the slanted PBS segment detailing a very one sided approach to supplements, with clear intent to mislead.

Let’s review the facts: 106,000 Americans died last year from prescription drug use. It’s the 6th most popular way to die…..at the hands of your health care provider.

Yet when we look at a recent publication the October 2015  issue of the New England Journal of Medicine regarding supplements, they estimated the number of ER admissions, at “only” 23,000 per year…….. if you include all products from herbs to some drugs and what they claimed was “snake oil”. It get’s better when you dive into the figures you find that the overwhelming majority were discharged the same day, without need for any intervention. Serious…. sure doesn’t sound that way to me.

Now for the best news….did you know that 166 million Americans use dietary supplements. Perhaps a simple math evaluation is in order. Where is the serious concern of lethality …..I’d say prescriptions hands down ! The articles never mention the fact that many prescriptions deplete your levels of vitamins and minerals, but let’s not get off track.

With that said I also want to be clear that I prescribe medications, when they are appropriate and will be the best option.  At the Center we use natural approaches which can be any combination of therapies from supplements to herbal products from acupuncture to lifestyle interventions, all based on the situation at hand and the patients desires.

After 30+ years of using combination approaches of prescriptions and supplements I have not had my patients experience the adverse events that are suggested in these fear mongering articles. We use common sense and keep up with the literature to avoid potential side effects. There will never be a guarantee eliminating adverse events however but using common sense, current literature, reasonable doses and the minimal amount of products needed you can reduce your risk. 

Keep your eye on the expanding and obviously threatening body of new findings for supplements. Their effectiveness with limited risks make them an obvious choice for a multitude of medical issues. 

Want an integrated approach to your medical care ? Call us at the Center 541.773.3191

 

 

Prescription Drugs and Supplements: Lethal Combination in American Seniors

Tue, 03/22/2016 – 10:38am
Seth Augenstein, Digital Reporter

Older Americans are living longer – and their medicine cabinets are more packed than ever before with drugs and supplements targeting different conditions.

That could mean danger, according to a new study by pharmacy experts at the University of Illinois at Chicago.

The percentage of older adults using five prescription medications rose from 30.6 percent in 2005 to 35.8 percent in 2011, according to a massive search of pharmacy records for patients between the ages of 62 and 85, and verified by in-home interviews.

The health-conscious seniors have also started using dietary supplements, showing an increase from 51.8 percent to 63.7 percent, they found. But some of the mixes between the prescription drugs and the well-intentioned supplements could have unforeseen, potentially fatal consequences, says the study, in the latest issue of the journal JAMA Internal Medicine.

“The risk seems to be growing, and public awareness is lacking,” said Dima Mazen Qato, assistant professor of pharmacy systems, outcomes and policy at the school, and lead author.

The scientists found 15 potentially life-threatening combinations among the most-common drugs and supplements used. And they found that those potentially fatal mixes doubled from 2005 to 2011, from eight percent to 15 percent of seniors using those mixes.

The vast majority of these combinations involved statins and anti-platelet medications, and most often omega-3 fish oil supplements, they said.

“Many older patients seeking to improve their cardiovascular are also regularly using interacting drug combination that may worsen cardiovascular risk,” said Qato. “For example, the use of clopidogrel in combination with the proton-pump inhibitor omeprazole, aspirin, or naproxen – all over-the-counter medications – is associated with an increased risk of heart attacks, bleeding complications, or death. However, about 1.8 percent – or 1 million – older adults regularly use clopidogrel in interacting combinations.”

The use of four or more prescription drugs is called “polypharmacy” in the industry. Its clinical consequences in the Baby Boomer generation were delineated in a 2014 study by Duquesne University doctors.

“Polypharmacy has been and always will be common among the elderly population due to the need to treat the various disease states that develop as a patient ages,” the doctors concluded. “Unfortunately with this increase in the use of multiple medications comes with an increased risk for negative health outcomes such as higher healthcare costs, ADEs, drug-interactions, medication non-adherence, decreased functional status and geriatric syndromes.”

Drug Discovery and Development Magazine

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Dr. Kadish is an unusual physician often referred to as a "doctor detective". His expertise is the evaluation and treatment of complex disorders, typically after other physicians have been stumped, is renowned. He provides care for all family members and has additional training in autistic spectrum disorders and chronic complex diseases.