More Americans are taking an unhealthy mix of drugs and supplements. Here’s how to cut back.

The number of American adults who are using multiple medications and supplements is rising, with potentially dangerous side effects.

Researchers from the University of Illinois and Johns Hopkins just published new data in JAMA on medicine use in the US over a five-year period, from 2005-'06 to 2010-'11. What they found were increases in nearly every category examined.

During that time, the prevalence of prescription medication use among older American adults (62 to 85 years old) shot up from 84 percent to 88 percent. That means nearly 90 percent of older folks in this country are on at least one drug.

More startling: The number of adults who use five or more prescription medications at one time increased from 31 percent to 36 percent, while dietary supplement use also expanded, from 52 percent to 64 percent. (In that category, omega-3 fish oils saw a major leap, from 5 to 19 percent.) The only category that saw a decline was over-the-counter medications, which dipped from 45 percent to 38 percent.

Using too many drugs at once increases the risk of dangerous interactions

The use of multiple medicines and supplements is so prevalent that drug interactions are becoming a more widespread problem, the researchers warned. "While concurrent use of prescription and nonprescription medications remains common, concurrent use of interacting medications among older adults has almost doubled since 2005-2006, with approximately 1 in 6 older adults in the United States potentially at risk for a major drug-drug interaction."

They also suggest that some of these pills may be unhelpful, putting patients at a great deal of unnecessary risk: "Despite no evidence of any clinical benefits, dietary supplement use is increasingly common among older adults, with almost a 50 percent increase in the use of multiple supplements."

Other studies have found that the trend toward higher rates of prescription drug use affects all Americans, not only the elderly. In November, research that was also published in JAMA looked at all US adults 20 years and older. They found that nearly 60 percent of those surveyed reported using prescription drugs in 2011-'12 — the highest amount ever.

These new findings square with a report published by the Centers for Disease Control and Prevention, which took a longer view. There, the researchers found the numbers of Americans who used prescription drugs in the past month has been steadily rising since the late 1980s, while the number who use no drugs has dropped:

CDC

Thoughtful tips for cutting back

To cut back, Richard Lehman at the BMJ shared nine handy rules that should make everybody think twice before popping pills:

1. Think what you could do instead of using a medicine.

2. Unless you have a special reason, avoid new medicines. Stick to those about which a lot is known from many sources and which have been used for over 10 years; bad news about a drug often takes years to emerge.

3. Before deciding to use a medicine be clear whether it is to relieve a symptom, to cure a disease, to remedy some deficiency, or to prevent something. It doesn’t make any sense at all to prevent something in the future if it’s going to cause you some problem now.

4. Ask a doctor or pharmacist you trust, someone who understands it a bit better than you do, how well the medicine works, what problems people have had with it, and what happened.

5. If you have to take medicines, get to know as much as you can about those that help you.

6. Everybody is different and you must learn how your own body reacts to medicines.

7. Keep a diary of your experiences with a medicine: why you took it, how much for how long, what happened and when, how well it worked, and anything you didn’t like.

8. If something bad happens that you suspect may have been caused by a medicine, report it on a yellow card; ask a doctor, pharmacist, or nurse to help you do that or to do it for you.

9. When you have a problem about an adverse reaction or something difficult to discuss with your doctor, take someone with you to the consultation, because four ears are better than two; there are too many things to think about and an independent opinion is well worth having.

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