Some of us once flaunted our use of illegal drugs as a badge of rebellion and cheerfully ignored warnings of harm. Now we are encouraged to take drugs – to bring down the likes of cholesterol and blood pressure – in far greater quantities than even we ever did previously. Are they actually any safer, or even as good at doing what they purport to?
The drug anyone 55 and over is most likely to be prescribed is a cholesterol-lowering statin
If you are an average 50-something your daily drug consumption could soon be fairly impressive. About 50 per cent of people over 65 are on five or more drugs. It’s the medical version of five a day.
This is not difficult to achieve and happens because of the way prescribing guidelines work. Say you show up at the GP with raised blood pressure and raised cholesterol. The guidelines say you should be on statins plus one if not two blood pressure-lowering drugs.
If you also happen to have arthritis, guidelines recommend an anti-inflammatory such as aspirin or ibuprofen.
But that painkiller may cause bleeding in your stomach, and for that, guidelines advise a type of drug known as a PPI, which suppresses the acid in your stomach.
So there you are, not really ill at all, but you are already on five daily drugs. A total that is likely to steadily increase.
Here are a few of the drugs with issues you may not always be told about. Ask your doctor some tough questions to be sure you really need them.
Poor odds: aspirin for heart attack prevention
Aspirin is certainly effective and safe for pain relief in the short term, but you should challenge its use if you’re advised to take a low-dose version to cut the risk of heart attacks and stroke by reducing clotting. This is officially no longer recommended, since research has found that the number being protected was about the same as those who suffered serious internal bleeding: 350–400 to 1. Not exactly favourable odds.
Yet low-dose aspirin is still being widely prescribed; about 30 million prescriptions a year in England alone.
Part of the reason is that it is now being recommended as a way to cut your risk of colon cancer. It looks a promising approach but trials have not been completed and the risk remains the same.
Drugs that steal your vitamins
There is another even less well-recognised drawback to relying on regular dug use to stay healthy: they can seriously lower levels of essential vitamins and minerals, creating a whole new set of side effects.
The diabetes drug metformin, for example, brings down the amount of vitamin B12 (actions include nerve and brain health and DNA repair) that you can get from food.
Heartburn drugs, known as proton pump inhibitors or PPIs (names all end in ‘prazole’: esomeprazole, lansoprazole, omeprazole), have the same effect. They also make it harder for you to absorb a wide variety of other essential nutrients, such as magnesium and iron. These are the ones you may be given to protect your stomach against the aspirin-type drugs known as NSAIDS.
This problem can be reversed with supplements, but it may be difficult to persuade your doctor, as they are generally suspicious of them.
Statins have the best-known nutrient-blocking effect. They lower cholesterol but also cut production of a vital antioxidant called CoQ10 , which is needed for the power plants (mitochondria) in every cell to work efficiently. These slow down as we age anyway.
Point out to your doctor that in Canada packets of statins have to carry a warning that they deplete our CoQ10.
Benzodiazepines: dangerous but hard to give up
These are given for insomnia and anxiety, and are among the most widely prescribed drugs (20 million a year) even though the evidence is growing that they are dangerous, addictive and not very effective.
Officially, you shouldn’t be on them for more than eight weeks. But research shows that one in five patients taking them has been on them for years.
According to the All Party Parliamentary Group for Involuntary Tranquiliser Addiction, there are as many as one and a half million people addicted to these drugs. But addiction is not the only risk.
Benzodiazepines can increase your risk of developing Alzheimer’s, cancer and dying years earlier than someone who doesn’t take them.
If you’re over 65 you’ll have a 60 per cent increased risk of developing Alzheimer’s over the next 15 years. Like other many other drugs they affect absorption of various nutrients including vitamins B6, C and D.
“Three per cent of people over 75 will die in the next four years if they are not on benzodiazepines. That goes up to 14 per cent if you are,” says one academic, who claims regular use of benzodiazepines is as dangerous as smoking.
Statins: the drug experts lock horns over
The drug anyone 55 and over is most likely to be prescribed is a cholesterol-lowering statin to protect their heart; 60 million last years in England alone. That could double if the latest proposal by NICE on guidelines is accepted.
For years, doctors generally thought statins were safe, though there were always a few mavericks who disagreed. They pointed out that the rate of side-effects was a lot higher than generally recognised and, among healthy people, hundreds had to take them for just one to benefit.
Both sides agree that if you have had a heart attack, they do reduce this risk of a second one.
Recently the mavericks have come down from the hills and are now strongly challenging accepted wisdom. They point to the fact that the positive evidence all comes from trials run by drug companies – who have a record of being ready to fudge their data to make drugs look good.
It’s a fascinating and complicated saga, and infuriating if you just want a simple answer: is this drug worth it or not? Have a look at HealthInsightUK, which I edit, and then, now that you are better informed, talk to your doctor.
Have you been prescribed any of these drugs? Have they had a positive or negative result? Share your stories in the comments section below