Prescription Drugs for Healthy Adults - Too Much of a Good Thing?

by Cynthia Pearson, Executive Director

Thank goodness for prescription drugs. Let me just say that right off the bat, before I give the wrong impression. Prescription drugs that have been proven to be safe and effective for a specific use have saved many, many lives. Maybe even mine. (I had a few pretty scary infections back when I was young and careless.)

But, what about all the prescription drugs that are now being marketed for healthy adults? Lately, I’ve become more and more concerned that too many people are being hurt because they are taking drugs that they might not have even needed. Of course, some prescription drugs can help an otherwise healthy adult look, or feel, better – think of the relief for people who sneeze like crazy with Spring allergies (again, me in my youth) or feel terribly self-conscious about hair loss or toe-nail fungus. These drugs may not be life-saving, but the people who take them gain some benefit from the medicines.

What’s starting to concern me is something different: the prescription drugs that perfectly healthy adults are encouraged to take in order to prevent illness. It’s so easy to believe that feeling good is the result of the new prescription. And, it’s often way too hard to convince your health care practitioner that feeling bad in some new way might be because you are experiencing a side effect of that very prescription. Menopause hormone therapy is a great example of this: drug company marketing made it very compelling to think that taking hormones made women feel smart, energetic, and sexy. How many women realize that the stroke they had — or their worsening incontinence — was caused by those same drugs? It took a big, long-term study to gather the evidence to show that hormone therapy has very few long-term benefits (other than helping to prevent bone fractures) and doesn’t, in general, help healthy women stay healthy.

Unfortunately, there aren’t enough of those big, long-term studies. Too often, the Food and Drug Administration (FDA) approves drugs for use in healthy adults based on studies that looked at the drug’s effect just on risk factors. For example, many cholesterol-lowering drugs have only been shown to lower a person’s cholesterol; they have not been shown to reduce a person’s risk of having an actual heart attack. Bisphosphonates are another example: these drugs have been approved based on their ability to reduce the risk of fractures so small they can only be seen on X-rays, and they have not been shown to have any effect on a menopausal woman’s comfort, health, or life.

Statins are being prescribed to prevent heart disease, and diabetes medicines to prevent diabetic onset, for people who only have risk factors, not clinical disease. Why am I so worried about using medicine in this way? Isn’t it better to lower risk factors, even if the ultimate disease prevention hasn’t (yet) been demonstrated? Not if the hoped-for benefit is outweighed by the risks of taking the drugs themselves. New risks of bisphosphonates have recently been identified, for example, and concerns about unwanted effects of statins are growing.

Check out the NWHN website for the latest information and, if you haven’t already, please join our e-advocacy list to help us change the way the FDA and the rest of the medical establishment make decisions about the use of prescription drugs for healthy women. Our health depends on it!