Are you taking any medications for health issues? If you are, you are not alone. Most people do or will take some long-term medications throughout their lives and most will take several.
According to the results of the 1996–2019 Medical Expenditure Panel Surveys, the Human Mortality Database, and the National Center for Health Statistics, newborns born in 2019 will take some form of prescription medication for about half of their lives. The average female is expected to take medication for 47.54 years and the average male for 36.84 years of their lives (1).
The numbers are the highest for non-Hispanic whites and the lowest for Hispanics. Some of the most common medications used include statins and other antihyperlipidemic agents (for cholesterol), antihypertensives (for blood pressure), antidepressants, and analgesics (for pain). However, the list goes on for commonly used pharmaceuticals. In females, including teenagers, hormonal birth control and other hormonal medications are also common. Painkillers and psychotherapeutic drugs are also generally higher in females (1, 2, 3).
According to the Centers for Disease Control and Prevention, 48.6% of people take at least one prescription drug, 24% take three, and 12.8% of individuals take five or more medications (2). In individuals 65 or older take even more medications, up to 42% take five or more (3). This is eye-popping!
But it’s not just the US. In Canada, about 67% of Canadians reported taking prescription medication in the past 12 months, according to Statistics of Canada (4). The use of prescription medication is the highest for older adults at 86% and adult women at 73%, followed by adult men at 60% and young adults (ages 18 to 24) at 47%.
Depending on the country, medication use in individuals over 15 is generally between 50 and 70% (5). Iceland, Belgium, Croatia, Finland, and Portugal have the highest rates and Romania, Italy, Cyprus, and Turkey have the lowest ones. Women take more prescription medication than men in Europe as well. Medication use is high in Australia and New Zealand as well with 54.2% of males and 63.9% of females taking at least one medication (6).
We must also remember that medications are prescribed or recommended even more often than they are being used. Since the United States doesn’t offer universal health care and universal drug coverage, cost-related medication non-adherence is very high. On the other hand, Canada remains the only country with universal health care without universal coverage for prescription medications, thus cost-related medication non-adherence is also high compared to European countries (4).
Though cost-related medication non-adherence may be less of an issue in countries that cover prescription medications for free or at a low price, medication non-adherence can occur for other reasons. The amount of medications recommended and prescribed is even more alarming than the ones taken.
According to an IQVIA report, the use of prescription medication globally has grown by 14% over the past five years and we expect a 12% growth by 2028. The global spending on medication has also grown by 35% and is expected to grow by 38% by 2028 (7).
The Problem with Taking Too Many Prescriptions
So why is this a problem? Taking medication is sometimes necessary. Medications can save lives in many cases. There are certainly situations where life-long use of prescription medications is necessary.
However, there is a problem with overprescription and overuse. Medications don’t come without risks and side effects. Taking even one pharmaceutical has its risks that need to be weighed. The benefits can outweigh the risks and side effects, but not always.
Adverse reactions shouldn’t be taken lightly. Medication error is one of the most frequent yet avoidable harms in medicine (8). According to a 2023 study published in Therapeutic Innovation & Regulatory Science, adverse drug reactions are the fourth to sixth leading cause of death worldwide, right alongside heart disease, cancer, and stroke (9).
When it comes to adverse drug reactions, we have to take a lot of factors into consideration. According to a 2008 review published in the Saudi Pharmaceutical Journal, there are many factors that may play a role in adverse drug reactions, including drug-related factors, dosage, gender, race, pregnancy, breastfeeding, kidney problems, liver function, and more (10).
Moreover, taking multiple medications holds even more risks. Medications can adversely interact with or affect each other. Doctors commonly prescribe medication to counteract the side effects of another drug. But when this second medication also comes with side effects, you may be prescribed a third one to counteract those. This can lead to a prescribing cascade and ongoing risks.
Many medications can damage your body and cause issues over time. You may tolerate medication well at first, but it can lead to side effects later or may cause further health risks. For example, many medications can damage your liver long-term (11). Since your metabolism changes as you age, you may have increasing difficulty metabolizing certain medications as you get older. Thus your ability to metabolize a medication you’ve been taking for a long time may decrease, warranting other or more medications or leading to lower results.
Moreover, in modern medicine, reaching for pharmaceutical drugs seems to be the first course of treatment, instead of the last step. Certainly, there are situations where medication should be part of the first step. In case of life-saving surgery, anesthesia and other medications are necessary. If you have sepsis, antibiotics are an immediate must.
However, in many cases, especially lifestyle-related and chronic diseases, there is a lot more we can try. Dietary changes, improvements in lifestyle, supplementation, and other alternative, natural options may help to eliminate the need for medication, reduce the amount of prescriptions needed, or decrease the length of medication use. Proton pump inhibitors (PPIs), for example, may be prescribed for very legitimate reasons, but are often renewed for long periods of time when they don’t need to be, or shouldn’t be. They carry specific risks, from altering the microbiome to depleting key minerals while potentially leading to weak bones (osteoporosis). While it’s not always enough, we certainly must put a much higher emphasis on diet, lifestyle, and other natural options to support our bodies instead of overprescribing medications.
According to the Lown Institute, medication overload may be the cause of up to 4.6 million hospital visits this decade (9). Deprescribing or reducing our medication load seems warranted. However, it’s important to do this with the support of your doctor in a planned and supervised manner, as simply stopping a medication can be hard on your body and sometimes dangerous.
The Canadian Medication Appropriateness and Deprescribing Network is making efforts to raise awareness of the issue and offering support for the planned and supervised process to decrease or stop the use of medications (10). I aim to personally participate in program development on this topic for health professionals and work on a presentation for a medical conference.
What Can You Do to Reduce Your Medication Load?
Now that you understand the problems with taking multiple medications, you may be interested in reducing your medication load. It’s important that you do this in collaboration with your healthcare professional. But what can you do? Here are the steps I recommend to reduce your medication load:
Ask for a Prescription Check-Up
If you are interested in reducing your medication load, start with your doctor. It’s important that you work with a trusted doctor, so don’t hesitate to switch healthcare providers if needed or ask for a second opinion if necessary.
Instead of waiting until the end of your short doctor’s visit, make a dedicated appointment to discuss your medication use and how to reduce your medication load. It is possible that not all your prescriptions were recommended by the same doctors. Some doctors are not comfortable managing or reducing pharmaceuticals prescribed by others. In such situations, a pharmacist may be able to help by reviewing all your medications and offering suggestions. In other cases, you may have to coordinate some things and allow time for your various doctors to communicate.
Consider Your Issues Related to Your Medications
Do you experience any side effects or new symptoms? It is important that you note these and discuss them with your doctor. While new symptoms can be a sign of a new or pre-existing health issue, they can be side effects of your medication.
Insomnia, fatigue, restlessness, swelling, rashes, incontinence, weight gain, and other issues are common side effects of many medications. New symptoms and health issues can also be related to medication use, especially long-term use.
It’s important to address all your symptoms, potential side effects, and concerns with your doctor. Understanding these issues can help your doctor decide on what medications to decrease or change, at one pace, or in what order. It is not unusual to see some symptoms decrease or disappear when reducing medication load.
Patience Is Key: Remember, It Takes time
Reducing your medication load can take time and patience. While certain pharmaceutical drugs can be stopped abruptly and completely, many take time. You need to slowly reduce your medication load and taper off to decrease the risk of withdrawal symptoms or even life-threatening health issues.
In most cases, progressively lowering the dosage is the safest bet, especially when it comes to medications for depression, anxiety, and insomnia. In some cases, addiction to prescription medication should also be considered.
Benzodiazepine is a class of sedatives that are commonly prescribed for anxiety, insomnia, muscle spasms, seizures, stress, and sedation. Benzos are unfortunately highly addictive and addictions and misuse are common (11). Not to mention that taken long-term, they can be quite harmful, increasing the risk of cognitive issues and hip fractures (12). Opioids for pain can be similarly addictive and difficult to stop.
Stopping these medications can be incredibly difficult and should be done, supervised, and gradually. Breathwork, meditation, counseling, and attending support groups can help with withdrawal and ending the use of the medication successfully.
Be in Charge of Your Medication List
If you are seeing many doctors and healthcare facilities, it is easy to lose track of all your prescriptions. Your doctors are not always connected. Even in the best-connected healthcare systems with the best doctors, unless you share this information with them, they can’t know about all the over-the-counter drugs and supplements you are taking.
It is important that you keep track of everything, not just prescription medications, but herbs, supplements, CBD products, and if applicable, recreational drugs you may be using. Share this list with your doctor, as it can provide very important information to uncover the reasons behind your issues, reduce your medication load appropriately, and develop the right treatment protocol.
Work with a Functional Medicine Professional
Reducing your medication load or stopping all your medication is not enough. You need to the right treatment plan to support your body, lower your symptoms, and reduce your health risks.
As I mentioned earlier, diet, lifestyle strategies, supplementation, and natural, alternative strategies can go a long way. But you have to be strategic about this instead of taking and trying everything randomly without a plan.
You don’t want to overdo supplementations either, but take the ones that your body actually needs. You want to choose the diet and lifestyle protocol that actually supports your body instead of jumping around the trendy recommendations you see online. Certain things, like eating whole foods, sleeping enough, moving our bodies regularly, and lowering stress, are beneficial for all of us. I call these the fundamentals, not to be supplanted by drugs or supplements. However, we all have unique needs depending on our symptoms, health issues, family history, genetics, age, sex, lifestyle, and other factors.
Working with a functional medicine or integrative medicine practitioner who understands how to identify underlying issues behind your health problems, connect the dots in a holistic manner, use dietary and lifestyle strategies for better, and utilize vitamins, minerals, herbs, other supplements, and various complementary strategies to support and improve your health without or with less medication can be beneficial.
Ideally, you want to choose someone who is a trained medical doctor with an active medical license but approaches your situation from a functional medicine perspective. Healthcare practitioners like this understand modern medicine but also emphasize the importance of figuring out the root cause of your issues and supporting your body naturally, instead of only placing a bandaid on your symptoms. I’m among these practitioners and would love to assist your journey to reducing your medication load and improving your health. In fact, it’s one of the commonly cited reasons by patients wanting to begin partnering with me for their medical care.
Next Steps
If you are taking a variety of medications and want to reduce them, working with your doctor is critical. Working with a functional medicine professional can help you reduce your medication load and improve your health with better nutrition, improved lifestyle choices, and the right supplementation without relying only on pharmaceuticals. I recommend that you make a consultation here and together, we can figure out the right protocol and treatment strategy for you to support your health with less medication.
If you are dealing with any chronic health issues and need advice on how to improve your nutrition and health, I welcome you to start a functional medicine consultation with me for further personalized guidance. You may book your consultation here.
Check out my Histamine Intolerance Course here. Learn on your own time, from anywhere. Get an inside look at the most helpful functional medicine tests for pinpointing imbalances, ways to identify and manage the most common (and sometimes surprising) mast cell triggers, and learn what to eat, what to avoid, and why.
