Every morning, I take six pills.
And what you don’t realize before you require six pills to function is that it’s actually a fuck ton of pills! It’s so many, in fact, that doctors have a special word to describe it — polypharmacy. It’s the regular use of five or more medications, and it’s associated with lots of negative health outcomes — drug interactions, medication non-adherence, prescribing cascades, and even hip-fractures. It also describes the treatment regimen of a third of U.S. adults over 60.
And it describes me. So why aren’t I in the literature?
When I first thought of what to write for this issue, I wasn’t thinking of writing about polypharmacy at all. Instead, I wanted to test hacks for remembering to take medication — something that I’ve been trying (and failing) to get better at. I mentioned polypharmacy once in an introductory sentence, and that throw away line led me down a rabbit hole of journal articles and reports that left me wondering, where are the young people?
Type ‘polypharmacy’ into Google and look at the results on the first page. The sites you find will be geared at geriatrics. Occasionally, they’ll include a line about “at-risk younger people,” only to leave them relatively unaddressed in the rest of the paper. This all would give you the impression that polypharmacy just doesn’t affect young people, and the ones it does affect aren’t impacted in a way that warrants mentioning.
But polypharmacy impacts 4% of Americans between the ages of 18 and 24. That’s 1.2 million people, a number that is likely to rise as chronic illness increases among the population. Three-fourths of 18-24 year olds with polypharmacy use psychotropic medications (drugs that treat mental health disorders), where drug interactions can be deadly and adverse reactions can cause increased suicidal ideation and cardiac arrests. Scarily, a report from the University of Pennsylvania found that these dangerous drug interactions may be happening in up to 26% of psychotropic drug users.
So polypharmacy is very much not just a problem of those 60 years and older, and the effects it has on young people aren’t dismissable as less dangerous. There should be more research on this.
There should be more public awareness of this.
My medication regimen has been polypharmaceutical for about a year and a half, and it’s changed a lot over that time. Twice now, a pharmacist has had to call my doctor and explain that the combination of medications they called in had serious interactions. Once, the pharmacist refused to fill the script on the grounds that the combination could kill me. A few weeks back, I learned that one of the medications I’m on decreases the effectiveness of another. I’ve been on that medication for at least eight months now. I don’t particularly mind (I just take two doses of my industrial grade vitamin D supplement now) but you would think I’d have been informed of this at some point!
I’m a big fan of pharmacy. I think, for most disorders, drugs provide the most effective treatment, and the current zeitgeist of skepticism towards medication is ill-informed and dangerous. (No, your sunscreen isn’t going to kill you, your birth control won’t give you cancer, and no, RFK Jr., Tylenol doesn’t give kids autism). I also can’t ignore that the US has a problem with doctors flippantly prescribing medication without doing their due diligence. And while the medical community has put a lot of effort into researching and defining solutions for this when it comes to old people, they’ve left the youths in the lurch.
Featured Image by Anna Shvets on Pexels
