During visits to relatives or friends who are quite old or have been very ill, you may be alarmed by the sheer number of medicines they take. Is all of this really necessary? The answer may well be “No!” Can some drugs cause new problems instead of solving old ones? The answer is “Yes, absolutely!”

In a recent case, someone I know was trying to recover from two strokes, but had great difficulty in sleeping at night. She was given a drug called trazodone to help her sleep. Family members and friends soon noticed that she was often sad and weepy—not at all her normal self. They thought the strokes had caused the depression, and they feared it might be permanent. But after a reduction in trazodone dosage, the patient’s mood improved. Then the drug was stopped altogether, and she slept well at night without it. Recently, she has done better in therapy, too.

Sometimes a drug is a greater threat to a patient than the problem for which it is prescribed. Lay people often sense the danger of taking too many drugs, yet feel that they lack the technical knowledge and credentials to protest. But I am happy to say that help is on the way.

An excellent guide for patients and family members called “Too Many Meds?” can be found in the September 2017 issue of Consumer Reports. This is a collection of articles with much needed information and good advice.

Lead writer Teresa Carr stresses that med problems are magnified when someone receives prescriptions from two or more physicians and none of the doctors know about any other medication the patient is taking. She suggests “throwing all your pill bottles into a bag at least once a year and taking them to your doctor or pharmacist for a thorough drug checkup.” (Some doctors and pharmacists charge for these reviews; others do not.) Carr also suggests the possibility of switching to lower doses or using non-drug approaches “that might be safer.”

In an article on making lifestyle changes instead of using risky meds, Carr and co-writer Ginger Skinner say that sleeping pills can produce: “Dizziness, next-day drowsiness, impaired driving, dependence, and worsened sleeplessness when you try to stop.” They suggest that a better remedy for insomnia is to have someone teach you “good sleep habits,” and suggest “ways to change your behavior, such as cutting out naps or not using your laptop in bed.”  Carr and Skinner also suggest alternatives to risky drugs for back and joint pain, dementia, mild depression, heartburn, and other ills.

Some Americans, brought up in a culture where there seems to be a pill for every problem, are skeptical of an approach that discourages use of prescription drugs. But Teresa Carr says that “Americans take more pills today than at any other time in recent history . . . and far more than people in any other country.” While she concedes that much med use is “lifesaving or at least life-improving,” she adds that “a lot is not.”

The pharmaceutical companies, of course, are making enormous sums of money by selling drugs. They also spend enormous sums on advertising those drugs in newspapers and magazines and on television. One need not be very cynical to suggest that our media would do more reporting on bad and over-prescribed drugs if they didn’t make so much money by running drug ads.

Perhaps we should consider, also, the stress factors in contemporary American life that may push many people toward drug use, whether legal or illegal. One is ever-present noise, including music—or what passes for music—played at very high volume and so pervasive that it is hard to escape. Another is the lack of privacy, with cameras and microphones seemingly everywhere. Yet another is the rude-and-crude approach to life and other people that has transformed much of our culture over the past 50 years. Courtesy, which traditionally softened so many of our rough edges, is still in a long decline. The “social media”—which we really should call the “anti-social media”—spread gossip, hatred, and threats.  Our country, for all of its wealth and all of the trinkets that wealth can buy, is not a very happy place today.

Understanding the deep unhappiness the current culture has brought to so many people, and trying to reverse that culture’s worst trends, are two of the steps needed to reduce drug abuse.

In the short run, though, the September issue of Consumer Reports can help many people.

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