7 more overused drugs – a book review

Learn what meds you should avoid and why #MindOverMeds#DrWeil#IntegrativeMedicine#bookreview

When I wrote the post 7 overused drugs, I knew other doctors would agree with me, but I didn’t know that a well known doctor was publishing a book that agrees with it.

MIND OVER MEDS- book cover

Published this year by Little, Brown and Company, MIND OVER MEDS teaches you to know

“When Drugs Are Necessary,

When Alternatives Are Better-and When to

Let Your Body Heal on Its Own.”

Andrew Weil, M.D. wote MIND OVER MEDS as well as  Spontaneous Happiness, Spontaneous Healing and other books on physical and emotional health and healing, nutrition, and integrative healthcare. He is the director of the University of Arizona Center for Integrative Medicine.

After the introduction, each chapter stands alone if you want to explore a particular class of medication. The book can also be useful as a reference manual. For each chapter Dr. Weil also collaborated with colleagues with expertise in those areas.

Besides 4 of the 7 drugs that I discussed in my post, Dr. Weil discusses 7 other broad categories that I will briefly review.

 general principles about drug use

  • Don’t stop taking a prescription medication suddenly, unless instructed to by a physician.
  • Wean off medications gradually, supervised by a physician.
  • Don’t attempt to stop medication without first initiating other measures to manage the condition the medication was prescribed for. (paraphrased from the introduction)

Dr. Weil reviewed four medication groups that I discussed in this post- 7 overused drugs

  • Antibiotics
  • Sleep aids
  • Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
  • Opioids and the Treatment of Chronic Pain

six-facts-graphic

Neither of us reject these drugs completely; rather we urge caution,

  • don’t rush to use them without trying non-drug treatments first or concurrently,
  • use only when absolutely necessary, and
  • be aware of potential side effects and harms.

 7 other classes of overused medication

1.Statins- medication used to lower blood cholesterol and prevent heart disease

“Current emphasis on statin therapy should be

balanced by equal emphasis on lifestyle changes.”

diagram of the human heart
Heart diseases affect any and sometimes multiple parts of the heart- the atria, ventricles, the valves, the aorta, the pulmonary artery and veins, the walls and the coronary arteries (not shown in this diagram. )

2. Medication for GERD- gastroesophageal reflux disease, commonly referred to as reflux or heartburn

“Heartburn is a warning sign of disturbed GI function that should prompt us to identify and change the habits responsible for it.”

3. Antihistamines (allergy meds) and Medications for the Common Cold and Flu

These are in two separate chapters but I group them together since the same meds can be used to treat all three conditions.

“People with allergic rhinitis and others…would be wise not to rely on antihistamines, but to try natural remedies and lifestyle change …to control symptoms.”

“Most healthy people recover from both colds and flu on their own with no need for drugs, prescription or OTC (over the counter). “

I included antihistamines on my list of drugs that are underused. I was referring to people with severe uncontrolled allergy. Dr. Weil seems to concur with their use in this case.

4. Steroids- the steroids in the cortisone family, not the anabolic steroids

“Save these powerful drugs for serious conditions and try to slowly wean off them once improvement occurs.”

5. Psychiatric Medications for Adults, Children and Adolescents and for Attention Deficit Hyperactivity Disorder (ADHD)

Dr. Weil’s discussion of these medications takes up three chapters but I’m grouping them together.

These drugs are on my list of underused drugs. I said that because severe mental illness symptoms usually needs  medication for adequate control and those people should stay on medication indefinitely, until a physician recommends stopping. Otherwise, I agree with Dr. Weil that milder illness may not need medication.

“Antidepressant drugs are indicated for major depression, not for routine management of mild to moderate depression, for which more effective and safer treatment options exist.”

“Medication treatment should always be integrated with psychotherapy and other non-pharmacological approaches and should be discontinued as soon as possible” (the chapter on children)

“ADHD is highly overdiagnosed. Children with learning or behavioral difficulties should be carefully evaluated before being labeled with the disorder.”

6. Antihypertensive (hypertension or high blood pressure) Drugs and Medications for Diabetes

I’m grouping these together because these

two conditions frequently occur together, what we in medicine call comorbidity.        complications of high blood pressure

“In treating high blood pressure, it is extremely important to take individual uniqueness into account.”

“Our health care system and our society should encourage better lifestyle choices by making these…more accessible and more affordable…by changing diet, increasing physical activity ..many will be able to keep their use of medications to a minimum..”

7. Medications for Osteopenia (thin bones) and Other Preconditions

“Most people with osteopenia have …low fracture risk. They do not need drug therapy, since the risk outweighs the benefit.”

If you need to check if any of your medications fall into any of these categories, you can check at this link, or ask a question in the comments or here.

MedLine Plus- Drugs, Herbs, and Supplements 

Last words about medication overuse

Dr. Weil offers these last words(among several others) about using meds wisely.

To consumers-

Be informed. Do not take medications (of any kind) unless you know the reason, how they work, and the potential benefits versus the potential risks.

To pharmacists-

Be knowledgeable about the dietary supplements, herbal remedies, and other natural products that consumers are taking.

To physicians, nurses, and allied health care providers-

Be informed about alternatives to medications therapy for the health conditions you see.

To all readers of his book

Contact your elected representatives to end direct-to-consumer advertising of prescription medications.

 

So what are the alternatives to using drugs for these and other conditions? I’ll tell you what Dr. Weil says, as well as other experts, in my next post. Or, you can get Dr. Weil’s book and find out now.

For your review:

7 overused medications

7 underused medications


What doctors want you to know about healthcare

To address a female physician as “Mrs.,” even if she is married, is to imply that despite all her professional accomplishments, her worth is reduced to her marital status. It ignores all the hard work that went into earning the title of “Doctor,” and denotes, whether intentional or not, that a female physician is somehow less deserving of the title than a male physician.”

Read KevinMD

If you want to know what doctors think, and more importantly, how they feel about their jobs, read KevinMD.

(This post has affiliate links.)

Founded by Dr. Kevin Pho in 2004, this blog features articles by thousands of doctors, representing multiple specialties, ages, genders, ethnicity and practice setting. They write on multiple topics related to health, the science, practice, business, and politics of medicine, the doctor-patient relationship, and anything else even remotely related to medicine and health care.

On KevinMD  you will not find detailed infographics, slick images, or cute printables.

You will find stories filled with raw emotion as physicians  candidly share the horrific struggles, the occasional remarkable successes, and the everyday grind  of providing healthcare to hurting, needy, sometimes demanding, occasionally grateful patients.

And you will hear from patients whose experiences with physicians and the healthcare system range from sublime to horrendous.

You may not like or agree with some of the things you read there-I often don’t and I’m a doctor myself.  That’s part of the point of this blog. We physicians are not homogeneous. We are individuals with different stories to tell from differing points of view, based on background, training,  and experience.

The blog is divided into sections based on broad categories of topics –

  • physician,
  • practice
  • policy,
  • finance
  • tech,
  • edu,
  • meds,
  • conditions.
  • patient
  • social

Some of the articles are directed to patients while others are physician oriented. I encourage you to read some of both, in addition to the ones I am sharing here.

Many of the physician authors write their own blogs, so it is a good place to explore and discover other health bloggers that you may enjoy.

How doctors feel about relationships with patients-

Dr. Jennifer Lycette , an oncologist who blogs at The Hopeful Cancer Doc, offered her take on a situation that I have encountered more than once myself.

Don’t call me “Mrs.” Call me “Doctor.”

“To address a female physician as “Mrs.,” even if she is married, is to imply that despite all her professional accomplishments, her worth is reduced to her marital status. It ignores all the hard work that went into earning the title of “Doctor,” and denotes, whether intentional or not, that a female physician is somehow less deserving of the title than a male physician.”

Dr. Oglesby nametag

How patients feel about communicating with doctors

Martine Ehrenclou is a patient advocate.

She is the author of Critical Conditions: The Essential Hospital Guide to Get Your Loved One Out Alive and The Take-Charge Patient.

She submitted an interesting piece on a controversial topic, that of patients recording their visits with doctors, either with or without permission.

“patients are in fact secretly recording conversations with their doctors without asking permission first.

Talk about a blow to the doctor-patient relationship.

I understand the hesitation to ask permission to record an office or hospital visit with a medical provider as I experienced it myself. But secretly recording is a violation of trust. Why would any patient surreptitiously tamper with the relationship with their doctor, something that is considered the cornerstone of quality care?’

Documenting information your doctor gives you is essential because it’s just too easy to misunderstand or forget the medical information conveyed. “

She offers these

Tips to remember what the doctor tells you.

How doctors think about treating illness

Dr. Eileen Sprys is a family physician who wants you to know

When you have a cold, why I’m not giving you an antibiotic

“I want you to know that as a physician, I feel a pang of insecurity, guilt, and sadness when a patient tells me they’re upset because I won’t write an antibiotic.  I don’t want you to be sick or miserable.

I understand how inconvenient and sometimes life altering a cold can be. I desperately, desperately wish that I had a cure for your cold, but none of us do.

I also want you to know that for every antibiotic I over-prescribe, that I run the unnecessary risk of making someone even more sick, even to the point of hospitalization or death. I went into medicine to help you and to relieve your suffering with integrity — and that by giving you antibiotics without indication, I am betraying my own purpose.”

six-facts-graphic

What doctors want you to know but don’t have time to tell you

a vision refractor
An ophthalmologist is a physician (doctor of medicine, MD, or doctor of osteopathy, DO) who specializes in the medical and surgical care of the eyes and visual system and in the prevention of eye disease and injury.

Dr. Brian C. Joondeph is an ophthalmologist and can be reached on Twitter @retinaldoctor. This article originally in the HealthZette reveals

8 things doctors secretly want to tell their patients

Number 8 is “I’m only human.”

 “We have our good days and bad days just like anyone else. We try to always have a smile on our faces, be upbeat and cheerful. But we, too, are affected by life’s challenges — work, family, finances, health, and so on. Don’t be too quick to judge and criticize!”

What doctors do away from their practice

KevinMD does have a few photos, and even some videos. I enjoyed this one by physician-comedian Brad Nieder, MD who blogs  at the The Healthy Humorist.

In this clip he explains how he learned to eat less.

sharing the HEART of health

Dr. Aletha