One of the more depressing parts of being an awake physician in the medical system is reading the drug lists of the patients you see and realizing how many prescriptions they are on that do not benefit them, and in many cases harm them. Presently, 66 percent of U.S. adults are estimated to have at least one prescription and on average, they have nine prescriptions filled per year (which can include renewals of an existing one).
Since doctors are extremely reluctant to terminate existing prescriptions, this creates a scenario where people get placed on more and more drugs as they age (some of which are for treating the side effects of other drugs they are taking).
This situation is even worse for the elderly, who have more time to be put on an increasing number of medications, and due to their altered physiology, are also the most vulnerable to the harmful effects of those medications. For example, from 2009-2016, after two billion office visits were assessed, it was found that for adults over 65, 65.1% were on two or more drugs, 48.9% were on four or more, and 36.8% were on more than five (with the highest use occurring in the oldest Americans).
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One of the best illustrations of the problem came from a study that compared 119 disabled elderly adults living in nursing homes to 71 matching controls. These patients (on average, were on 7.09 medications) were screened for which of their medications clearly met the existing criteria for being discontinued (on average 2.8 per patient). After those medications were discontinued in the test group, when compared to the controls who remained on all of their existing prescriptions, it was found that:
•The death rate dropped by 53% (in one year, 45% of the control group died, whereas 21% of the test subjects died).
•The annual rate of hospital referrals dropped by 60.7% (30% of the controls vs. 11.8% of the study).
•Not surprisingly, there were also significant cost savings from withdrawing the unneeded medications.
In short, doing nothing except terminating some of the most egregious prescriptions for our elders (who often lack the autonomy to refuse their prescriptions) resulted in a 23% reduction in their death rate. When you consider that many of these drugs are approved for much smaller reductions of the death rate, and that they frequently have a variety of other concerning side effects (e.g., triggering dementia), the absurdity of this situation (e.g., that this pivotal study never changed how we practice medicine) becomes apparent.
For example, almost everyone is put on statins—especially as they get older. Yet in trials evaluating statins, for instance, their effect on 50-75 year old patients’ risk of heart disease, statins caused a 0.4% reduction in the annual risk of a major cardiovascular event (most of which are not fatal) and no benefit in the overall death rate. Likewise, according to the existing trials (which are almost certainly biased to favor the pharmaceutical companies funding them), it was found on average that taking a statin for five years would increase your expected lifespan by three to four days. In contrast, statins are notorious for causing adverse effects which affect at least 20% of recipients. These effects include cognitive impairment and dementia, personality changes, loss of sensation throughout the body, and significant muscle weakness or muscle aches.
This seems absurd until you also consider that statins are also one of the most profitable drug markets in existence.
Note: a more detailed summary of the great statin scam and the tragic adverse effects of statins can be found here.
The Worst Drugs on The Market
A frequent question I receive is what the most harmful medications in America are. Prior to the COVID-19 vaccines (which I feel have earned that distinction), there were two ways I interpreted that question.
- Which medications are frequently prescribed to everyone, often provide minimal benefit, and cause actual harm you frequently see in practice?
- Which medications are highly toxic and have more narrow uses, but are nonetheless frequently given to patients in many cases where the harms of doing so far exceed any possible benefit?
In regards to the first interpretation, almost every integrative physician I’ve ever asked for their top 5 has listed the following:
•Proton pump inhibitors (PPIs—the most potent acid blocker and focus of this article)
•SSRI antidepressants (e.g., Prozac)
•Statins
•NSAIDs (e.g., Ibuprofen)
Note: they’ve also argued birth control pills, Tylenol, benzodiazepines (e.g., valium), corticosteroids, and flu shots also belong on the above list. Likewise, opioids used to always be on it, but now that the government has gone in the opposite direction and curtailed their prescribing, so they are no longer widely distributed and hence no longer can be in the first category.
In regards to the second interpretation, there are many more answers, but some of the most common ones include:
•Anti-psychotic meditations (used for a wide variety of mood disorders)
•Accutane (used for acne)
•Ciprofloxacin and other fluoroquinolone antibiotics
•Finasteride (commonly used for hair loss)
•Gadolinium (this is used as a contrast agent for MRIs)
•Gardasil (the HPV vaccine)
•Lupron (which amongst other things is used as a puberty blocker)
Note: as the above links show, I’ve gradually been able to cover the key issues with each of these classes of drugs, but I still have a ways to go.
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In sales, a common practice is to start with a free or low cost item, and then from the pool of people who get it, use their investment to sell them a moderately priced item, and then from the pool of those buyers, sell a more expensive item and so forth. This business practice, in turn, is known as creating “sales funnels.”
Frequently, with the above drugs, I see a variety of sales funnels. For instance, adolescent girls are frequently put onto birth control pills by their pediatricians (e.g., this survey found 54% of women aged 15-19 had used the pill)—often for reasons unrelated to sex (e.g., painful periods or PMS in a twelve year old).
Birth control pills, in turn frequently cause significant mood swings and mood alterations (e.g., a large study detected a 130% increase in the rates of depression during the first two years of using the pill), which often leads to these new mood disorders being “treated” with an SSRI antidepressant (which now more than 10% of teenage girls are on). In turn, one of the more common side effects of SSRIs are other new psychiatric disorders (bipolar I is the most common) which are then treated with an antipsychotic (or another mood stabilizer).
As a result, I often meet young women who went through this sales funnel in their adolescent years and now are on damaging antipsychotics. Additionally, I’ve also spoken to a few people who had been on this pipeline and said the neuropsychiatric damage they developed from the HPV vaccine ultimately tipped them over the edge (which then required taking an antipsychotic which frequently caused even more chronic psychiatric and neurological issues for them).
As you might guess, I am not a fan of this business model, and one of my goals here is to gradually go through why each of these drugs can cause so many problems.
