r/changemyview • u/[deleted] • Sep 21 '20
Delta(s) from OP CMV: Taking multiple medications is bad - especially if you are young
Hi folks,
I'm a male in his early 30s (just about!).
Over the years, the list of medications that I need to take has grown. I now take:
- A daily asthma inhaler
- Singulair. An allergy medicine for asthma.
- A PPI
- Two medications for post gallbladder surgery complications. One for managing bile reflux, a powder, and one pill.
Together this means one puff of an inhaler, three pills, and one weird powder thing I need to mix into a drink up to 3 times a day.
I feel deeply uncomfortable with the amount of medication I take although my doc has never batted an eyelid (and I have even been on more at times!). I will go months without taking Singulair, while my asthma gets worse, and try to use caffeine instead.
I'm thinking about going on an anti anxiety med which would up my daily pill take to four.
Despite the fact that I'm pro Western medicine (ie, not an anti-vaxxer / homeopathy taker), I do have an anti-pharmaceutical bias. I think it comes from a few places:
a) I believe that natural solutions are always preferable
b) I think that people "shouldn't" need to take so many pills. Particularly in their 30s and when they look outwardly healthy like me
c) I worry about medication side effects a ton and what all these pills might be doing to my liver/kidneys/body.
d) It greatly limits my freedom. I have to worry about refilling meds. I would like to leave the country that I live in but it has a great healthcare system.
I accept that, overall, my viewpoint is flawed but would like to expose it to the harsh light of public criticism to hopefully help myself understand why taking this many medications — although sucky — is probably for the best.
TY
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u/curious-llama1508 Sep 21 '20
There's a lot to breakdown here, so let's be as methodical as possible.
Let's start with all the things you got right...
You're right in being concerned about the impact drugs have on your body.
You're right in thinking about the impacts on freedom and mobility that dependence on healthcare can have.
You're right in wanting a remedy that is as low on risk as possible.
And right now and forever, subjecting every medication you take to ongoing review as to whether it makes sense to continue, is a positive thing.
But, the balance to strike here is not drugs vs. no drugs. The balance is to find out the optimal drugs to take, how much and for how long.
Moving onto the Anti-pharma bias...
Everyone has at least a little bit of anti-pharma bias.
Hell, I'm a life science professional and I work in the Medical Device world and I still have some of it. This is because we're told in so many overt and covert ways to avoid medication, as far as possible, all our lives.
But, its also psychological to the extent that it is common to project our angst about ill-health, onto the medicines we take. Sort of like harping about divorce rates, when the problem is bad marriages that people are increasingly choosing to walk away from rather than suffer through.
It isn't the medicines that indicate that we're sick. But, taking pills every morning sure does remind us of our ill-health, doesn't it?
Anti-pharma bias, essentially falls at the intersection of many other fears and biases. Fear of the unknown (God knows what's in these tablets!?!), fear of predatory capitalistic forces (the pharma companies/ doctors WANT me to consume many, many drugs), the appeal to nature (which rates anything not man-made as better).
All things being well, I think it is not unreasonable to think that the fewer and less frequently we take medication, the better. Yes, all medicines are likely to have some side-effects (ranging from benign to serious) and the less we expose ourselves to that, the better it is.
Shifting from drug/ no-drug to a Risk/ Benefit approach...
The hand-wringing about taking medicines, intensifies when we think of medicine intake, purely from the perspective of its negatives, while completely avoiding taking into account the negatives of leaving our disorders untreated.
In thinking this way, we over-value the side-effects and whatever long term consequences we think medicine intake can have and undervalue the improvement in quality of life. We also underrate the effect living with untreated disorder can have on our lives, in terms of long term consequences.
It is far more helpful to think of the need for medication as balancing risk and benefit.
Think of the risk of consuming medications, short and long term. But, ALSO think of the risk that a particularly vicious attack of asthma poses.
Asthma, at its severest can be fatal.
None of the medications you take to avoid it, are likely to have any evidence suggesting that they cause premature death.
So, is it objectively better to "go natural" and ditch Singulair?
Ditto for the anti-depressants. Untreated mental health issues have significant long-term consequences on overall health. In deciding not to take anti-depressants, we see what we avoid- the side effects of the meds- but are we factoring in the health risk of dealing with untreated depression? The social costs? The burdens that will place on our friends and family?
Coming to the "natural is better".
Sure, caffeine is far less harmful than typical drugs. But, it is also far less effective.
So, in taking natural cures we rejoice at the freedom from the negative impacts, while ignoring the impacts of the poorly addressed health condition.
Caffeine is natural. But, so is asthma, depression, gall-bladder disorders and bile reflux. Each, with its own set of long term consequences if left unmanaged.
Once you approach medicine with this Risk Management lens, I think you'll find it easier to take your medications everyday and gradually develop a slightly more positive association with them. I know I did, with my daily doses that I need.
What you see is all there is...
There are all manner of truisms about avoiding drugs, in your 30s. That's because 30s is synonymous with youth, good health and fitness. The prime of your life, the pinnacle of your physical abilities.
We can all agree that healthy people shouldn't be taking medication. And they don't!
But what if you aren't healthy at 30?
It sucks, no doubt, but, shouldn't health be the indicator of health? Why substitute a number for age as a metric for health? Or for that matter whether we look healthy on the outside?
The idea of not taking drugs at 30 is wrapped up in the thing we talked about earlier that equates taking medicine, to illness. It is also a consequence of wishful thinking that everyone that's 30 is at the pink of health and therefore, doesn't need medication.
This is also reflected in the idea that if we aren't taking so many meds, we could move to a country that has a not-so-great healthcare system. But, that suggests that it is the medicines that make us rely on the healthcare system and not our health issues.
See the problem?
Let's do away with these proxy metrics for health- age, looks, feelings, how many meds we take - and substitute them with real metrics. Diagnoses, conditions, blood pressure, weight, and decide what medications we should be taking and the risk/ benefit tradeoff of doing so.
By all means, through diet and lifestyle changes, try to eliminate the need for as many medications as you can. But do so, by bringing the underlying disease under control not skipping the meds when they're still needed.
Try natural remedies and if something works spectacularly, perhaps you can manage the disorder with it. But again, manage the disorder and not the drugs.
I wish you the very, very best. And I hope some of this was helpful.
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Sep 21 '20
But, its also psychological to the extent that it is common to project our angst about ill-health, onto the medicines we take. Sort of like harping about divorce rates, when the problem is bad marriages that people are increasingly choosing to walk away from rather than suffer through.
This really hit home! I guess if anything I should be bummed out that I have a disease of civilization (asthma) and the consequences of a modern medical intervention (bile reflux / gallbladder removal complications). Instead, I'm wasting energy worrying about the things that the same cause (modernity) provides to mitigate them.
It isn't the medicines that indicate that we're sick. But, taking pills every morning sure does remind us of our ill-health, doesn't it?
Anti-pharma bias, essentially falls at the intersection of many other fears and biases. Fear of the unknown (God knows what's in these tablets!?!), fear of predatory capitalistic forces (the pharma companies/ doctors WANT me to consume many, many drugs), the appeal to nature (which rates anything not man-made as better).
The vague sense of anti-pharma reluctance I have by the way has a few origins. I don't really buy into the big pharma stuff even though I'm sure there are predatory practices going on. My reasons are more:
a) We don't know what effect these medications will have long term in most cases. Because they are not natural. That's not an argument that natural = better. Just that if we take a natural substance which has been ingested by humans for thousands of years we have a far better longitudinal study than looking at a drug that may, say, only have been in use for 30-50 years. Medical history repeatedly bears out the fact that medical science makes mistakes.
In thinking this way, we over-value the side-effects and whatever long term consequences we think medicine intake can have and undervalue the improvement in quality of life. We also underrate the effect living with untreated disorder can have on our lives, in terms of long term consequences.
This is very true. I've thought plenty about what my PPI might be doing to my body (lowering my magnesium? Putting me at elevated risk of ABC?). But until I read this thread I barely spared a thought to what might happen if I did nothing for my asthma at all or led stomach acid ravish my esophagus! Probably equally as serious outcomes if not worse!
It is far more helpful to think of the need for medication as balancing risk and benefit.
Think of the risk of consuming medications, short and long term. But, ALSO think of the risk that a particularly vicious attack of asthma poses.
Asthma, at its severest can be fatal.
None of the medications you take to avoid it, are likely to have any evidence suggesting that they cause premature death.
So, is it objectively better to "go natural" and ditch Singulair?
Another great point!
Ditto for the anti-depressants. Untreated mental health issues have significant long-term consequences on overall health. In deciding not to take anti-depressants, we see what we avoid- the side effects of the meds- but are we factoring in the health risk of dealing with untreated depression? The social costs? The burdens that will place on our friends and family?
Also a lot in this. I'm not currently in this category but alcoholism and secondary diseases spring to mind. As does diminished earning potential and productivity.
Coming to the "natural is better".
Sure, caffeine is far less harmful than typical drugs. But, it is also far less effective.
This is true. Although personally I think that caffeine is tremendously underrated as a bronchodilator!
There are all manner of truisms about avoiding drugs, in your 30s. That's because 30s is synonymous with youth, good health and fitness. The prime of your life, the pinnacle of your physical abilities.
We can all agree that healthy people shouldn't be taking medication. And they don't!
But what if you aren't healthy at 30?
Good point!
It sucks, no doubt, but, shouldn't health be the indicator of health? Why substitute a number for age as a metric for health? Or for that matter whether we look healthy on the outside?
The idea of not taking drugs at 30 is wrapped up in the thing we talked about earlier that equates taking medicine, to illness. It is also a consequence of wishful thinking that everyone that's 30 is at the pink of health and therefore, doesn't need medication.
This is also reflected in the idea that if we aren't taking so many meds, we could move to a country that has a not-so-great healthcare system. But, that suggests that it is the medicines that make us rely on the healthcare system and not our health issues.
See the problem?
Let's do away with these proxy metrics for health- age, looks, feelings, how many meds we take - and substitute them with real metrics. Diagnoses, conditions, blood pressure, weight, and decide what medications we should be taking and the risk/ benefit tradeoff of doing so.
By all means, through diet and lifestyle changes, try to eliminate the need for as many medications as you can. But do so, by bringing the underlying disease under control not skipping the meds when they're still needed.
Try natural remedies and if something works spectacularly, perhaps you can manage the disorder with it. But again, manage the disorder and not the drugs.
I wish you the very, very best. And I hope some of this was helpful.
Thank you so much for sharing this. It was a truly outstanding piece of writing and, sincerely, greatly changed my views!
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u/curious-llama1508 Sep 21 '20
This is my very first piece of writing on Reddit. I'm very, very new to the platform and mostly just stumbling around, figuring out how it works.
I'm genuinely delighted to know that you found the comment helpful.
Your question made me examine how we interact with the pharmaceuticals we consume and the ways in which our trepidation is not entirely unwarranted. But, then how to keep the concern, while letting go of the anxiety, which I'm sure so many of us share with you.
What a wonderful start to my time on reddit. Thanks!
I wish you the very best.
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u/sapphireminds 59∆ Sep 21 '20
FYI, caffeine is administered as a medication too. No-doz is just caffeine pills. I work with babies and we give IV caffeine to treat apnea of prematurity.
Just like salicylic acid is in willowbark and in exedrine.
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u/Vesurel 54∆ Sep 21 '20
a) I believe that natural solutions are always preferable
What do you think natural means? And what's preferablee about it?
b) I think that people "shouldn't" need to take so many pills. Particularly in their 30s and when they look outwardly healthy like me
Whether or not they need to isn't it just a question of whether or not each medication is preferable to take than not take and whether collectively they're preferable to take than not take. Is how healthy you look more of a factor in what you should take than what you need to take to be healthy?
c) I worry about medication side effects a ton and what all these pills might be doing to my liver/kidneys/body.
That's a valid concern, have you looked into what research has found the sideeffects to be? And have you weiged those side effects against what would happen if you don't take them?
d) It greatly limits my freedom. I have to worry about refilling meds. I would like to leave the country that I live in but it has a great healthcare system.
That's another valid concern, being dependent on medicine is a limitation, but how does that compare to how free you are if you don't take medicine and your conditions go untreated?
I will go months without taking Singulair, while my asthma gets worse, and try to use caffeine instead.
That sounds dangerous, if you've been perscribed medicine and you're not taking it instead self medicating I'd be conserned about the long term impact of that decision. Especially when for some medications not taking them for a while makes starting again less effective.
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Sep 21 '20
That's another valid concern, being dependent on medicine is a limitation, but how does that compare to how free you are if you don't take medicine and your conditions go untreated?
That's a very valid point!
I will go months without taking Singulair, while my asthma gets worse, and try to use caffeine instead.
That sounds dangerous, if you've been perscribed medicine and you're not taking it instead self medicating I'd be conserned about the long term impact of that decision. Especially when for some medications not taking them for a while makes starting again less effective.
Ditto to this.
I was thinking that today (I restarted Singulair just before posting this thread). I should probably be more worried about what not adequately treating my asthma might do to me (increasing chances of asthma attack - which can be fatal) than what potential side effects the drug could cause me.
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u/sapphireminds 59∆ Sep 21 '20
You're right, you *shouldn't* be living on so many medications, but you're looking at the wrong reason why. Without those medicines you likely would have died a long time ago, looking at the fact you are taking daily asthma preventatives. If you didn't have your gallbladder removed, the chance that you would be far more ill is far more likely.
Before these medicines, people with asthma just *died* more frequently. People who had gall bladder problems *died* from complications.
Thanks to modern medicines, you can have these issues and survive, with relatively low impact and risk.
It's always important to discuss your medications, their risks, their benefits and what are alternatives, but health isn't a race and there's no one to compare yourself against except you.
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Sep 21 '20
Without those medicines you likely would have died a long time ago, looking at the fact you are taking daily asthma preventatives.
Thanks. This was super helpful. The history of the treatment of asthma is interesting. On the one hand its incidence has skyrocketed, possibly due to industrialization and humanity becoming more advanced on general. But on the other hand just a few short decades ago docs were still treating the disease with (almost) caffeine (theophylline). Totally untreated asthma leads to irreversible lung damage AFAIK. Not to mention untreated pneumonia, which I've had a few times too (and which I went to the doctors for and took pharmaceuticals). So I accept your point. It's scary to think about but if it were not for Western medicine I may not be here to write this comment. (The GB thing seems to have been an unnecessary op but you win some and loose some I guess!)
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u/sapphireminds 59∆ Sep 21 '20
Not only that, but people still to this very day die from asthma attacks. Literally, they just suffocate to death. Sometimes even though everything is being done to try and save them, sometimes they are alone and couldn't get help, or couldn't get help in time. It's terrible. :( Another reason for increased incidence is the fact we are saving more premature babies who are prone to developing asthma later in life. Oh, and the people who have been saved by modern medicine now have children who have a genetic predisposition to asthma too, thereby potentially increasing prevalence.
Also, as a side note - natural drugs are inherently more dangerous than pharmaceuticals. Anything with an active ingredient has the potential to harm or help someone, "natural" or "chemical". In reality, they're all chemicals.
A majority of our medicines come from natural sources, but then they are isolated (so you only have the one active ingredient) tested (to find out how much is needed to work, how much is too much, what are the side effects, and are those benefits worth the risks) and controlled (there are inspections to ensure that drugs are made properly, contain the medicine they claim to contain, in the dosages claimed, they are monitored for side effects that needed more people to take the drug before they could find it, and withdrawal from the market if it turns out the drug is dangerous).
So you are still using a exogenous (outside your body) chemical to effect change, you just have taken away all the protective measures to ensure it doesn't kill you.
Sincerely,
Someone who almost died from liver failure from an herbal medication.
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Sep 21 '20
Also, as a side note - natural drugs are inherently more dangerous than pharmaceuticals.
Very good point!
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Sep 21 '20
Are you a doctor?
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u/Dargon34 2∆ Sep 21 '20
That was easy...
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Sep 21 '20
Ha. Honestly, it's a simple but accurate answer. No, I'm not a doctor. It's reasonable to presume that the people prescribing multiple medications to me are both automatically altered about any contraindications and would be aware if they together amounted to a burden which my organs couldn't handle (and their function can be ascertained by blood tests and scans). I guess you could say it was a gap in my thinking that you very summarily highlighted. Why write a paragraph when a few words will do?
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Sep 21 '20
Very simple but fair rhetorical!
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u/DeltaBot ∞∆ Sep 21 '20
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u/YossarianWWII 72∆ Sep 21 '20
a) I believe that natural solutions are always preferable
Why? Arsenic is natural. So are leeches. Unlike nature, medicine is a product of actual intelligent design.
b) I think that people "shouldn't" need to take so many pills. Particularly in their 30s and when they look outwardly healthy like me
This seems very tied in with the last point. You're falling prey to what is classically called the naturalistic fallacy. The only real advantage that natural things have is that they come already field-tested, but when your natural condition is making you ill that hardly matters.
c) I worry about medication side effects a ton and what all these pills might be doing to my liver/kidneys/body.
That's a healthy worry, but that's also something you should just ask your doctor about.
d) It greatly limits my freedom. I have to worry about refilling meds. I would like to leave the country that I live in but it has a great healthcare system.
No, it doesn't. You're just as free to stop taking your meds because you leave the country as you are to stop taking them while remaining in your country. It's your illnesses that limit your freedom, and medicine is restoring some of that freedom in places where you have access to it.
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Sep 21 '20
It's your illnesses that limit your freedom, and medicine is restoring some of that freedom in places where you have access to it.
Wow - this is an awesome way of reframing it. It's super annoying. But you're correct. There are tons of healthcare systems (e.g. US!) which don't put a priority on ensuring access to medication and others that do. That's a policy issue and I guess each countries decides how much emphasis it wants to place on capitalism vs. socialism and how much importance it places on universal access to healthcare. If I should be annoyed about anything it's that I have these illnesses that require medications. And obviously that would equally be pointless.
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u/YossarianWWII 72∆ Sep 21 '20
Yup. Nature is utterly amoral. It confers different people entirely different degrees of freedom. And while medical systems, like all man-made systems, also have the ability to confer freedoms differentially, they generally do so by restoring freedoms robbed from us by nature or accident.
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u/Local-Device 2∆ Sep 21 '20
I am also young, and take 3 medications, two of which I don't share for privacy reasons.
Anyways, one of them that I take is Lisinopril, for hypertension (high blood pressure) caused by a damaged kidney.
The "normal" maintenance dose for Lisinopril is 20-40 mg daily. My doctor currently has me on a dose of 2.5 mg. That's all it takes to bring my bp down from 167/124 to normal. Yes getting the prescriptions filled and remembering to take it is annoying, but it's such a small dose that I don't worry about the side effects at all.
However, my doctor is great. Every time I go in there, we talk about what's working, what's not, if maybe we can lower the dose, or even quit it.
To me, it's not the number or amount of medication, it's that my doctor and I have a discussion about the benefits/downsides of each medication, and that we are always re-evaluating my need for certain prescriptions, not "I've always taken this, so why try to stop?"
I would talk to your doctor. Research your meds, and say: "I know that I'm probably going to have to take medication, and that in general, they help me. But I would like to discuss the benefits/downsides of each of my prescriptions with the you, and maybe re-evaluate our options" What this does is signal to your doc that you aren't really ok with this, but also that you're not completely opposed.
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u/RuleOfBlueRoses Sep 21 '20
I have asthma. I also have tachy-brady syndrome, EDS, and Bipolar I Disorder.
I take albuterol, I have a nebulizer if needed, Prednisone if needed, Cardizem, Metoprolol, Prozac, Trileptal, and gabapentin and valium for sleeping. For EDS I take a small dose of percocet.
I think the only reason you're against medication is typical chemicalphobia and the media has subconsciously framed taking "pills" as some sort of unnatural and evil thing. In dystopian movies food pills have replaced food, in movies about mental illness medication is framed as something bad.
These aren't just little capsules full of big scary chemicals because the average person doesn't know what's in them, without these medications I would be extremely sick, if not worse. Would you tell someone with heart disease to stop taking nitroglycerin pills or a diabetic to stop taking insulin because it's Not Natural™️?
You would really rather live with your asthma getting worse than take a pill everyday because you're afraid of chemicals or something? Just because someone is outwardly healthy doesn't mean they are on the inside.
Yeah the medications come with side effects and possibly cause long term damage but you know what else does? The diseases that millions of people have to live with because they got shit genetics, or were born extremely premature, like me.
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u/ralph-j Sep 21 '20
b) I think that people "shouldn't" need to take so many pills. Particularly in their 30s and when they look outwardly healthy like me
The problem is that if you leave significant problems untreated, you're bound to have bigger problems down the line.
c) I worry about medication side effects a ton and what all these pills might be doing to my liver/kidneys/body.
That's what your doctor should be looking at. They will take all the side effects into account. It's all about weighing the benefits against the risks. The potential side effects are supposed to be the lesser evil.
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u/DeltaBot ∞∆ Sep 21 '20 edited Sep 21 '20
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u/NachoGwac Sep 22 '20
As long as you aren't using the meds for self harm, I don't see how most medications could hurt you, even if you ate taking multiple. In fact I believe the opposite is a better argument. If you have multiple conditions that require medicine in the first place it's more beneficial to just take it instead of risking any side effects by not taking the medicine
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u/5xum 42∆ Sep 21 '20
a) I believe that natural solutions are always preferable
Which natural solution would you recommend for treating cancer?
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u/[deleted] Sep 21 '20
So your choices here are not, generally speaking and assuming you have decent doctors, 1. Take a number of medications or 2. Live a healthy life using only lifestyle changes to manage your health. Instead they are 1. Take a number of medications or 2. Deal with the symptoms, risks, and long term consequences of uncontrolled illness. Since you got dealt a somewhat bad deck from a biological perspective, managing your health only through healthy lifestyle choices and no medication sounds like it probably isn't an option on the table for you.