Everything around you, everything that you can touch, is made of chemicals. You are made of chemicals. An interesting thing about chemicals is that they interact with each other. Some chemicals bond together to form new compounds, some decay into simpler compounds, and others do unexpected things. For example, if you read the itty, bitty print on the little document that comes with any prescription or over the counter medication, there is a section that warns you about drug interactions. Most of us, however, don’t read these warnings.
But we should. Some of the interactions they tell you about are quite literally deadly! I think we’re all a bit careful about mixing drugs, but… remember, everything is made of chemicals?… there’s a surprising number of “harmless” foods and household items that can cause interactions that are as dangerous as mixing prescription drugs.
70% of Americans take one or more prescription drugs. Luckily, prescription drugs must perform extensive testing to identify unexpected side-effects and drug interactions. But so many drugs are produced that it’s not possible to test all of the millions or billions of potential interactions that could occur.
Then there are over the counter medicines. Over the course of a year, the average American buys over the counter drugs 26 times every year. Think about the cold medicines, pain killers, decongestants, and antacids that we all use every year. In fact, many OTC medicines started out as prescription drugs but were later deregulated and sold without a prescription. Deregulation, however, does not mean that these drugs suddenly became harmless. They are still just a powerful, and the list of dangerous interactions remains just as long.
And what about “non-traditional” medicines and herbal treatments? In addition to prescription and over the counter drugs, another 30% of Americans use herbal cures. Most prescription medicines began as something natural… parts of a tree, an extract from a fruit, a type of leaf, etc. Before salicylic acid was synthesized in a laboratory and called Aspirin, people took the natural form, the ground bark of a White Willow tree. Once again, natural medicine is just the pre-pharmacy versions of prescription drugs and the cause of just as many serious drug interactions.
What about nutritional supplements? 68% of Americans take supplements. They’re just more chemicals. The same goes for food. Consider vitamin K. You get it from green leafy vegetables. Or from a multivitamin. However you get it, Vitamin K interferes with blood thinners. Millions of individuals with serious heart conditions take blood thinners.
Have you ever eaten bran cereal to lower your cholesterol? Good for you! But did you know that if you take Digoxins (to strengthen your heart) AND you eat a lot of bran, your medication becomes less effective and takes longer to work? St. Johns Wart, one of the most common herbal supplements, reduces the effectiveness of Digoxins by 25%. Milk can weaken or cancel the effects of anti-biotics.
Alcohol, of any kind, interacts with many drugs. It boosts the effectiveness of insulin and other diabetic medicines and can induce hypoglycemia causing a coma. Perhaps the most surprising interaction comes from… grapefruit. Yep, the sour puss of the citrus family! It is often considered a serious “health food”, yet it can make statins (Lipitor, Zocor, and Altoprev) far more toxic to your liver. Grapefruit can dangerously boost the effect of blood pressure and erectile medications, resulting in possibly fatal side-effects.
Polypharmacy. When a condition happens often enough to have a name, it’s probably happening too often. Polypharmacy is the technical term for, “You’re taking so many pills that you’re going to have a problem.” And it does happen… yep… too often. Especially when we get older, and take more medications. There is a direct correlation between our age and the number of medications and nutrients we take.
According to the Mayo Clinic, medications have been on the rise over the last decade and today 20% of Americans are on five or more prescriptions. If you’re over 65 years old, there is a 65% chance that you are taking 5 or more prescriptions. Women take even more prescriptions than men.
If you have 5 or more prescriptions, there is a 50% chance that you will have a drug interaction. If you are unfortunate enough to have 20 or more prescriptions, you have a nearly 100% chance of interactions. And that doesn’t even take into account the interactions of over the counter medications, supplements, etc.
The seriousness of Adverse Drug Reactions (ADR) is difficult to measure. If you’re older, and take a LOT of medications, you may get used to strange side effects and not report them. Not surprisingly, when someone very elderly (with multiple medical issues) passes away in their sleep, it is often just reported as “old age”. There is rarely a reason to go through the time and effort of an autopsy to determine the cause. However, if the individual is hospitalized, every death must be analyzed, if only for insurance and liability reasons. What are hospitals reporting?
Studies conducted on hospitalized patient populations have estimated that just under 7% of hospitalized patients have a serious adverse drug reaction. That means that ADRs are responsible for over 2.2 million serious drug interactions, and over 106,000 deaths. If these studies are correct, ADRs are the 4th leading cause of death. That’s more than pulmonary disease, diabetes, AIDS, pneumonia, and automobile deaths!
A hot topic today is the legalization of medical cannabis, which is often presented as a medical miracle. It reportedly helps to manage pain, nausea, depression, anxiety, eating disorders, glaucoma, epilepsy, and even cancer. Maybe. It’s too early to say how effective cannabis can be in addressing these issues. Still, we can expect to see a flood of cannabis-based medications for just about every medical issue.
One of the complicating issues with cannabis is that it is not just one medicine. It is a whole medicine full of new and unexplored drugs. Some want to break it down into individual cannabinoids (cannabis chemical compounds, and target specific afflictions with specific compounds. Others favor using the “whole-plant”, due the entourage effect, where individual cannabinoids work better when they are taken together. Who is right? It may depend on the individual case.
The reason I bring up cannabis is that these cannabinoids, either taken individually or together, all appear to be either completely non-toxic or ultra-low in toxicity. That doesn’t mean that the cannot be side-effects, but at any level of dosage, through any means (pills, injections, liquids, edibles or even smoked) no one has ever died of an overdose. However, the many pharmaceutically approved drugs that we take, even simple drugs like Tylenol, can be (and are) fatal. Technically, cannabis is a food and is less toxic than cabbage… at least if you just eat or smoke it.
Let’s consider someone who is very old, and not that healthy. The things that cannabis is best researched for… pain, depression, anxiety, eating disorders… are pretty common ailments for the elderly and the generally sick. Currently, these ailments are treated by some pretty deadly medications with horrible side-effects. If we just replaced the deadliest pharmaceuticals with safer cannabinoids, we could avoid thousands… possibly tens of thousands… of ADRs, every year.
We’re all going to get older. Many of us will go through a period of sickness before we are old. Every year, we all take more and more prescriptions. Anything that reduces the frequency and severity of polypharmacy directly impacts the lives of each and every American.
Have you spoken to your parents and grandparents? Have you looked at their prescriptions? How many of them are taking more than 5 prescriptions? If they are, there’s a pretty good chance that they are going to have a serious ADR. And that chance will rise as they get older and get more prescriptions.
What do you think? How important is this issue for you? Let us know what you think!