How many prescriptions does the average American take?
Data suggests that among those who take prescription medications, the average number of medications taken is four. More than 131 million Americans take at least one prescription medication.
However, taking too many prescription medications can be risky. Taking more than five medications is called polypharmacy. The risk of harmful effects, drug interactions, and hospitalizations increases when you take more medications.
In fact, most physicians use the Rule of 10. This means that if you are on more than 10 medications, they will remove one before they put you on another.
How do I know if I'm on too many medications?
The more medications you are taking, the higher the risk of those drugs interacting dangerously with each other. Multiple medications can cause confusion, lightheadedness, and even internal bleeding — all dangerous and injurious conditions, according to Yale Medicine.
The use of multiple medications can lead to misdiagnoses, adverse effects, and trips to the emergency room. In fact, over 70% of seniors go to the ER because of medication interactions and side effects.
Adverse drug events, or unexpected medical problems that occur during treatment with a drug or other therapy, cause 1.3 million emergency department (ED) visits in the United States each year and about 350,000 hospitalizations, according to the Centers for Disease Control and Prevention (CDC).
These medical events are most common among older people—those over 65 are nearly seven times more likely than younger people to be admitted to the hospital after an ED visit, and most of the time that visit is due to a negative drug interaction. “It only takes one unnecessary medication or a negative drug combination to cause a serious problem,” says Karen Jubanyik, MD, an emergency medicine specialist.
In many cases, you may not need all the medications you’re taking, says Marcia Mecca, MD, a Yale geriatrician who directs a “de-prescribing” program at the Veterans Affairs (VA) Connecticut Healthcare System in West Haven. However, once on a medication, patients can’t just stop. This could lead to death. Only the prescribing physician can tell the patient how and when to stop taking a medication. Likewise, patients should never skip a medication dose as this can be extremely dangerous to the health and life of a patient.
See the Medication Safety Checklist to know how safe your medications really are.
Are doctors paid or get incentives to write medications?
Federal law forbids doctors from receiving a commission for prescribing a specific drug. However, years ago, the law permitted pharmaceutical companies to offer legal incentives to doctors if they prescribe that company's drugs.
This is no longer the case. Pharmaceutical companies cannot give incentives. The only thing they can do is bring lunch to the doctor's clinic and it must be enough to feed the whole staff. Everyone who partakes in the lunch while they are listening to the representative must sign in that they agreed to sit through the lunch. In some cases, they must also be willing to pay tax on the lunch on their tax return..
Are doctors compensated for writing prescriptions? No. They are paid for evaluating and diagnosing you and providing care to you. If prescriptions are indicated and appropriate, they write out the prescriptions and hand them to you.
Why do doctors prescribe so many meds?
How do I end up getting on so many meds?
Well, there are 3 logical reasons...
Almost 90% of older adults regularly take at least 1 prescription drug, almost 80% regularly take at least 2 prescription drugs, and 36% regularly take at least 5 different prescription drugs. (Merck Manual)
Again, 5 medications is called polypharmacy. This includes your over-the-counter medications as well as medications prescribed to you.
Reason #1: You need this medication. Your doctor has diagnosed you with a disease or disorder and the standard treatment is to prescribe a medication that will resolve the issue or manage the issue.
Reason #2: You go to more than one doctor. Since we all know medical records are always incomplete and wrong, one doctor does not know what the other doctor is doing. You might go to the dermatologist and get a cream, then to the eye doctor and get eye drops, and then to your primary for blood pressure medicine,
Reason #3: and then you go to the grocery store for fungal foot powder and a pain reliever/sleep aid like Tylenol PM. Now you are on 6 medications! Tylenol PM has 2 medications rolled into one pill!
So let’s ask a few questions here:
Are there side effects to each medication? Yes.
Is there an interaction between these medications? Yes, and it may also depend on how and when you take or absorb them.
Does the doctor know you are on 6 medications? No.
Does the pharmacist know you are on 6 medications? No.
Do these drugs have to be broken down, eliminated, or stored by your liver or kidneys? Yes.
Since only YOU know exactly what you are taking and when, is it any surprise that I saw so many seniors with drug interactions, side effects, liver failure, and kidney failure in the emergency room where I worked? No.
Is it any wonder that I had to admit my seniors to the hospital to stabilize their liver and kidney functions and call the hospital pharmacist to rearrange their medications into safer drugs? No.
Is it any wonder that pharmacists are refusing to fill prescriptions unless they know all the medications you’re on, including the over-the-counter ones? (About 30% of prescriptions will not be filled because your pharmacist does not have complete information.) Pharmacists are there to protect the public against themselves and their medical providers.
So, when we ask, “How many medications are safe?”
You must first ask,
“Do I know all the medications I take? Even those I take once in a while?
Do all my doctors know all my medications?
Do all my pharmacists know all my medications?
Do all my doctors and pharmacists know my liver and kidneys' health?
When you can answer YES to the above 4 questions, then your doctors and your pharmacists believe you to be safe, and maybe, just maybe, you are safe.
