The Fatal Prescription Pad

It’s well known that the most expensive medical technology in America is a doctor’s ballpoint pen. Doctors call for hundreds of billions of dollars in unnecessary tests and procedures every year. This has become a major thrust in healthcare reform. But now we discover that the prescription pad can also be deadly.

A story in USA Today reports on a statistic from the Centers for Disease Control showing that deaths by drug overdose are now higher from prescription painkillers than from heroin and cocaine. Prescription drug overdoses more than tripled from 1999 to 2006, giving rise to 13,800 deaths that year; the overall total from both legal and illegal drugs is around 26,000 fatalities. An authority quoted in the USA Today story was certainly right when he said, “The biggest and fastest-growing part of America’s drug problem is prescription drug abuse. The statistics are undeniable.”
For decades it’s been slow going to convince Americans, especially older ones, to kick the prescription drug habit. This spreads far beyond painkillers. Effective prevention could radically cut into the seven prescription medications taken by the average person over seventy. Whole categories of disorders, such as obesity, type II diabetes, and heart attacks could be profoundly reduced. But instead of joining the wellness movement, as a nation we wait until we get sick, and then we turn to big pharma and the latest silver bullet, as billion-dollar drugs are promoted to be.
If 13,800 deaths by overdose seems small, consider that emergency rooms see a far larger number of patients who overdose and survive, about 120,000 a year from opiate painkillers like morphine and codeine. The abuse extends much further, to antibiotics, for example. Over-prescribed by the hundreds of millions, common antibiotics have been losing their efficacy for decades, and we may be losing the battle against so-called supergerms, which have developed strong immunity against a wide range of antibiotics.  The next super bug may outwit anything a doctor can fire at it.

The whole image of brave physicians warring against insidious germs began in the era of microbe hunters like Sir Alexander Fleming, the discoverer of penicillin. We are stuck with that image, even though prevention is based on a better idea: instead of trying to win a battle, don’t go to war. Human beings aren’t isolated life forms. Our evolution has been entwined with that of viruses and germs.  They adapt in response to us; we adapt in response to them.

In modern times, this mutual adaptation has begun to favor the germ side, because with high-speed air travel and mass refugeeism, viruses and germs can spread around the world in a matter of days and weeks —  in the past they moved much more slowly or not at all.  In the face of sped-up evolution, humans can’t evolve fast enough physically to keep pace. But we can evolve mentally. Developing new drugs is a form of mental evolution, since we use our brains to pursue research and devise new theories of disease formation.

Wellness is another kind of mental evolution, one that is far safer, less expensive, and much less traumatic on the body.  People tend to forget that all drugs have side effects and all drugs lose their efficacy when taken over a long enough period. Wellness has no side effects and never wears out.  With the latest research showing that diet, exercise, stress reduction, and meditation actually change the expression of our genes, the argument in favor of positive lifestyle changes is overwhelming.

Prevention waits to be used. The only missing ingredient is you and I, the people who can decide to be well or wait until a doctor begins to move his ballpoint pen across a prescription pad.

Published in the San Francisco Chronicle