Tue | May 22, 2018

Popping prescribed pills

Published:Monday | September 15, 2014 | 12:00 AM
Garth Rattray

Nobody likes having to pop pills indefinitely. And, with the direct-to-consumer marketing strategies being utilised by some drug companies abroad, people get scared silly whenever the long list of possible side effects is read out.

What most people don't realise is that the list is of all the possible side effects and not of definite side effects. In fact, the vast majority of patients never experience any side effects at all.

I am always amazed whenever patients complain bitterly about having to take (perceived) 'dangerous' prescribed medications (they see them as unnatural, man-made chemicals), yet they swallow a handful of vitamins, minerals and concoctions of so-called natural products.

I try - usually in vain - to explain that any product, 'natural' or manufactured, that purports to do something for you, must first do something to you in order for it to work and therefore they may all have side effects. Furthermore, truly 'natural' products won't be found in pills, capsules or caplets. If they are prepared and altered for packaging, storage and distribution, they are no longer truly 'natural'.

limits to lifestyle changes

To be perfectly honest, I am not a fan of the term 'lifestyle diseases', because if that were truly the case, a proper lifestyle would ensure that nobody would ever get diabetes, hypertension, high cholesterol levels, and several other maladies. Even the word 'disease' is misused, because a 'disease' is a condition that causes the sufferer to be uneasy, to feel unwell. And, diabetes and hypertension are renowned for causing absolutely no symptoms most of the time. I would prefer the term 'lifestyle modifiable conditions'.

Several patients believe that they can stop their medications if they exercise regularly and change their diet. However, if the condition is way out of control, no amount of lifestyle change alone can bring the levels back into normal range. Lifestyle changes are extremely important but they have a limit. To get things within the range they need to be, medication is also needed a lot of the time.

When patients express their terror of the possible side effects of prescription drugs, I try to explain that, although the medication may give some people side effects, the conditions that need treatment will definitely give everyone very serious 'side effects'. It is far better to take the small risk of possible side effects from the medications than to guarantee serious harm from the untreated condition.

I try to use the analogy of someone needing to walk across a very busy, high-speed, interstate highway in the United States. No one of sound mind would take such a risk. But, if there is a pedestrian bridge spanning the highway, everyone would use it to get from one side to the other. Even if people were made aware that the bridge is man-made and therefore not 100 per cent safe - the risk encountered using the bridge is incalculably less then attempting to walk across the busy, interstate highway.

The busy highway traffic represents the untreated, life-threatening medical condition(s), and the bridge represents the prescribed medication(s). Using the bridge (medication) is much safer than encountering the busy highway traffic (the untreated medical condition).

Some people may reap so much benefit from lifestyle changes that they can avoid prescribed medications. But, they can only know where they stand if they adhere to medical supervision/monitoring.

I won't bash 'natural' products but, their use must be sanctioned by the attending physician and they must never be taken instead of prescribed medications. It must also be remembered that 'natural' products are not scrutinised or regulated as much as prescription products and their appropriate doses are often speculative.

If you need to pop one or even several prescribed pills each day in order to improve your quality of life or to extend your lifespan, it makes perfect sense to go right ahead and do so.

Garth A. Rattray is a medical doctor with a family practice. Email feedback to columns@gleanerjm.com and garthrattray@gmail.com.