Half the number of women living in England are taking at least one prescription drug a week. Almost as many men are doing the same. The volume of prescriptions issued by doctors has gone up by around a half in the last decade. This increasing dependence on medication has been described by an expert on public health as ‘worrying’. So are we becoming a nation of addicts? Or should we relax about the figures and keep popping the pills?
These statistics were among those published in the latest Health Survey for England. They showed that 50% of women and 43% of men are taking at least one prescription drug a week and that over 20% are taking three or more. Seventy per cent of those over the age of 75 take three or more. For men over 65, half are taking statins.
The most striking difference between men and women is the prescribing of anti-depressant drugs. Only 5.5% of men are on them but twice as many women.
Back in 2003 around 650 million prescriptions were issued during the year but by 2013 that figure had risen to nearly one billion, making the average number of prescriptions written every year 18.7 per person. The annual NHS drug bill is around £15bn.
Should we be worried by this apparently increasing addiction to prescription drugs? One obvious reason not to be is that the past decade has seen a considerable ageing of the population. More people living longer leads inevitably to greater overall use of prescription drugs since older people have more genuine need of medication. Indeed the increase in the availability of pills of one sort or another is at least in part responsible for our being able to live longer. Statins, for example, ward off life-threatening disease cause by high cholesterol.
Nonetheless, there are real grounds for concern. One is that the more pills we take, the more we risk encountering unforeseen consequences in how they react with each other. Responding to the new figures, Patricia McGettigan, a vice-president of the British Pharmacological Society, said: “The thing that hits me between the eyes when I read about a lot using more than one medicine is the potential for interaction between medicines. Patients taking medicines and doctors who prescribe them both need to be very aware of the potential for side effects and interactions and manage that carefully.” The BPS reported recently that there are about 8,000 patients in NHS beds who are suffering from adverse drug reactions.
The other concern is what the figures imply about our willingness to take responsibility for our own health and so avoid needing the drugs at all. Simon Capewell from the Faculty of Public Health said: “It is worrying because it reflects a big dependence on medicine rather than preventing the problem in the first place. The common medicines prescribed here are for high blood pressure, high cholesterol and heart disease – and all of those things are absolutely preventable and avoidable.”
What he is getting at is the cavalier way we treat our own bodies by smoking, drinking too much, eating junk food and taking too little exercise. The most obvious consequence of such behaviour has been the explosion in obesity rates: they have quadrupled in the last twenty-five years. Twenty-three per cent of adults in England are now technically obese and it seems certain there will be even more because of the increase in the number of obese children. In the age group from two to fifteen, 16% of boys and 15% of girls are already obese. Obesity is one of the chief causes of high cholesterol, heart disease, joint pain and depression. So there is a clear link between the rising incidence of obesity and our increasing dependence on pills.
The obvious conclusion is that we should start taking far more responsibility for our own health and then we would need to be less dependent on prescription drugs. In one sense the argument is incontrovertible. But in practical terms, is it that simple?
Some would say all the information people need to take care of their health is readily available, so it’s simply a matter of willpower. And some would go further and press the NHS to withhold treatment until patients had shown clear evidence of taking responsibility for their own health. An NHS Trust in Devon has recently decided (albeit for financial reasons rather than as a matter of principle) to withhold surgery from patients who are obese or whose condition is caused by smoking until they have taken steps to wean themselves off the cause of their complaints.
Others argue that we are not all equally cap[able of exercising willpower. It is a striking fact that children from families in the poorest fifth of income distribution are three times more likely to be obese than children from families in the richest fifth. In short, such children are far more likely to be pumped full of the junk food that sets them off into a life of obesity.
On this argument, personal willpower, though not unimportant, is far from being the obvious solution to the problem. Instead, governments need to act. They need to take on the providers of junk food, cheap alcohol and tobacco much more aggressively than they have been willing to do in order to make this toxic diet less available. They also need to act to arrest the growing income inequality that pushes poorer people into the arms of those who sell them cheap rubbish that makes them ill.
What’s your view? Do you think it matters that we are swallowing so many more prescription drugs than we used to do? And if so, what do you think we should do about it?
