Sleeping pills and the nation of pill poppers, young and old (Providence Journal)

Posted on June 20, 2012
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America a nation of pill poppers

Providence Journal, Sunday


There is an advertising-fueled medicine myth in America that a little pill can cure you.

In light of the lobbying efforts by Big Pharma, one must wonder just what medications are really necessary and why. Sleeping pills, used by some 55 million to 60 million people in the U.S., are under scrutiny. And across the nation legislators and consumers are voicing concern about the medicating of America and teen abuse.

The recent BMJ Open (British Medical Journal Online) triggered sleepless nights after reporting on the association with some common sleeping pills to a four-fold increased risk of death, even for those taking small doses. Researchers also associated an increased cancer risk for those taking high doses.

But many physicians are questioning the study. Carl W. Bazil, M.D. a professor of clinical neurology at Columbia University’s College of Physicians and Surgeons, said: “There is an association there, but that does not prove that the pills themselves cause the problem. There may be other related contributing factors.”

His biggest concern with the report? “It did not prove any cause to the problems seen, only an association. For example, the increased risks seen with sleeping medication may actually be due to the insomnia that led to the prescription in the first place. If that is true, failing to treat the insomnia may actually lead to even worse outcomes.”

Sleep is so important that even losing an hour or two a night can interfere with a person’s judgment. With interrupted sleep, what can eventually happen is “an involuntary pattern of poor relaxation and sleep interference with associated depression and poor functioning levels,” added Bazil. He says that the sleepless cycle can be broken by medication, but believes that “behavioral techniques such as meditation are also very helpful.”

Different pills provide varying durations of help with sleep. But Bazil pointed out that “for someone who only has a problem falling asleep — and has no problem staying asleep — a very short-acting pill can be best.”

Currently the business of prescription-drug use is disconcerting. The National Conference of State Legislators in May noted: “Every day, about 75 people die and 2,000 people are treated in an emergency department due to unintentional poisoning. About 96 percent of these poisoning deaths result from drug abuse or misuse.”

Big Pharma may be part of the problem. In April,  , a blog by the Center for Responsive Politics, said: “The pharmaceutical industry as a whole spent $69.6 million on lobbying in the first three months alone” — the biggest spender of the top three spenders. (Agribusiness and utilities were the other two.)

In 2010, the Consumer Reports National Research Center surveyed 1,115 adults and learned that patients think that doctors are too cozy with Big Pharma and objected to “payments and rewards pharmaceutical companies routinely dole out to doctors because they feel these are negatively influencing how they treat patients.”

Additionally, pharmaceutical companies spend more than $4 billion a year on television ads; the Annals of Family Medicine called for a ban several years ago.

But there may be an upside to advertising in that it alerts patients to conditions that they may not be aware they had. However, Bazil said, “I think one of the biggest problems with drug advertising is that it is almost invariably aimed at the newer, most expensive drugs and not necessarily the ones that are the most useful.”

Despite concerns about sleeping pills, today opioids pose a bigger problem. The American Journal of Preventive Medicine in May 2010 reported a 65 percent increase in U.S. hospitalizations for poisoning by prescription opioids, sedatives and tranquilizers between 1999 and 2006 with data analyzed in 2009. This was based on 8 million hospitalizations from the Nationwide Inpatient Sample.

As early as 2005, the Centers for Disease Control and Prevention (CDC) warned about the over-medication of America. By 2010, CDC and the Substance Abuse and Mental Health Services Administration reported further escalated use and an increase in emergency-department visits, with the highest numbers for those between 21 and 29 years of age.

Today, prescription-drug abuse seems to be trickling down to teens raiding their parents’ medicine cabinets. Leftover pills that adults save “just in case” are ending up in fishbowls at teenagers’ pharming parties. They put a few pills in. Take a few pills out. And the next generation of pill poppers is off and running.

Rita Watson (  ) is a regular contributor here and a columnist for The Journal’s All About You section.

Copyright 2012 Rita Watson/ All Rights Reserved

©2012, Published by The Providence Journal Co. This material may not be published, broadcast, rewritten or commercially redistributed.

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