Because I’m currently doing a series on positive psychology, when I was in the library the other day this book caught my eye: Happy At Last: The Thinking Person’s Guide to Finding Joy, by Richard O’Connor. He comes well credentialled, since not only is he a psychologist working with people with depression (his previous books include Undoing Depression), but he has struggled with depression himself. As anyone who’s experienced depression knows, that really focusses your attention on what makes you happy.
I’ll probably do a few posts on this book; it’s very good. Today, I want to look at a passing mention he makes which intrigued me. Out of the ten most prescribed medicines in the USA, eight deal with effects of stress.
The picture is the same in New Zealand, I found. Pharmac, the government drug-subsidy agency, in its annual review for 2008 lists the 20 most prescribed subsidized drugs in New Zealand. They are, with number of prescriptions and purpose (according to Pharmac – doctors may also be prescribing them for other things):
- paracetamol 1,760,000 – pain relief
- aspirin 1,280,000 – prevents heart attack and
stroke (cardiovascular risk)
- simvastatin (brand name LIPEX) 1,170,000 – impaired cholesterol
- omeprazole (brand name Losec or Omezol) 1,100,000 – heartburn, stomach ulcers
- amoxycillin 890,000 – bacterial infections
- metoprolol succinate 820,000 – raised blood pressure, heart
- amoxycillin clavulanate 800,000 – bacterial infections
- salbutamol 740,000 – asthma symptoms
- diclofenac sodium 530,000 – pain/arthritis
- cilazapril (brand name Inhibase) 510,000 – raised blood pressure
- zopiclone 470,000 – insomnia
- prednisone 450,000 – steroid treatment for asthma
attacks, arthritis etc
- frusemide 440,000 – heart failure
- bendrofluazide 430,000 – raised blood pressure
- quinapril 400,000 – raised blood pressure, heart
- fluticasone 410,313 – prevents asthma
- calcium carbonate 377,527 – osteoporosis
- flucloxacillin sodium 390,000 – bacterial infections
- thyroxine 380,000 – underactive thyroid gland
- felodipine 380,000 – raised blood pressure, heart
For perspective on the figures, the population of New Zealand is just over 4.2 million. Just these 20 drugs were prescribed 13.7 million times in one year, which is 3.3 prescriptions per head of population. The top four alone account for 5.3 million of these prescriptions, or almost 40%.
So let’s do a count. Out of these 20 (which were also the top 20 in 2007, though the order varied slightly), how many are for conditions which can also be improved by non-drug treatment and a healthy lifestyle?
Well, exercise reduces cardiovascular risk and (indirectly) diabetes risk, and improves blood pressure and sleep. Diet reduces cardiovascular risk, diabetes risk and osteoporosis (though that is a long-term proposition and you have to start early in life), and can improve blood pressure for some people. Relaxation and managing stress can reduce cardiovascular risk and blood pressure, improves sleep, and can be used in the treatment of asthma, pain, and even arthritis.
Stress also negatively affects the immune system, so managing stress can reduce the need for antibacterial drugs. There is also a stress link to many illnesses of the gastrointestinal system, as I’ve explored before. Finally, the most common cause of an underactive thyroid gland is Hashimoto’s thyroiditis, an autoimmune disease. Its underlying cause is unknown, but other immune disorders have been linked to stress.
So out of the 20, the number where exercise, diet and stress management could potentially make a difference is… 20. All of them. (Oh, all right, 19 – I don’t have any scientific evidence for the thyroid one, but it would surprise me if there wasn’t a stress link.)
Of course, I’m not for a moment suggesting that diet, exercise and stress management would remove all need for these drugs, even if somehow, miraculously, the whole population could be convinced to make use of them. All I’m suggesting is that improving diet, exercise and stress management could significantly reduce our reliance on drugs for health – drugs that, in some cases, have unpleasant side-effects which tend to get treated with, yes, more drugs.
- “Drug all older people” says British doctorAccording to the BBC, epidemiologist Professor Malcolm Law is advocating...
- Relaxation response reduces need for blood pressure drugsDr Herbert Benson, an associate professor at Harvard Medical School,...
- The Blue Prescription: “Relax”For over 10 years now, New Zealand general practitioners and...
- The two faces of alcohol: dangerous drug and health benefitTwo recent articles in TVNZ’s Health News highlight the two...
- World Heart Day: Assess your Heart Riskphoto credit: naama It’s World Heart Day (actually it was...