Prescription drug use is at record highs, with about 19 prescriptions filled for every American in 2020, amounting to 6.3 billion prescriptions.1 Though the figure is staggering, it appears to be getting worse for the next generation. U.S. girls born in 2019 may spend 60% of their lives on prescription drugs, while boys may spend 48%.2
“The years that people can expect to spend taking prescription drugs are now higher than they might spend in their first marriage, getting an education or being in the labor force. It’s important to recognize the central role that prescription drug use has taken on in our lives,” study author Jessica Ho, associate professor of sociology and demography at Penn State, said in a news release.3
Americans Set to Spend Even More of Their Lives on Drugs
Antibiotics, which were among the earliest prescription drugs, were designed to be taken for short periods of time to treat infection. In modern medicine, drugs are designed to be taken for extended periods and, often, for the rest of a lifetime. High blood pressure medications are one such example, as are statins.
“Individuals with hypertension are expected to take antihypertensive medications for the rest of their lives,” the team explained. “Similarly, the United Kingdom’s National Health Service states, ‘You usually have to continue taking statins for life because if you stop taking them, your cholesterol will return to a high level within a few weeks.’”4
Using data from the 1996–2019 Medical Expenditure Panel Surveys, the Human Mortality Database and the National Center for Health Statistics, the researchers provided estimates of prescription drug use patterns over a lifetime. For those born in 2019, their results suggest women can expect to take prescription drugs for 47.54 years while men may take them for 36.84 years.5
Further, by the age of 40, most U.S. men take prescription drugs. For women, however, this occurs by age 15. Ho explains:6
“We see that women start taking prescription drugs earlier than men do, and some of that is related to birth control and hormonal contraceptives. But it is also related to greater use of psychotherapeutic drugs and painkillers among women. If we consider the difference between men and women, excluding contraceptives would only account for about a third of the difference.
The remaining two-thirds is primarily driven by the use of other hormone-related drugs, painkillers and psychotherapeutic drugs used to treat conditions such as depression, anxiety and ADHD.”
Statins, high blood pressure drugs and antidepressants were among the drugs commonly being taken for longer portions of a lifetime.7 Such long-term use of medications that were only developed 50 years ago is unprecedented, and the related side effects are completely unknown.8
Human Life Becoming Increasingly Medicalized
Prescription drugs are already “the most common therapeutic intervention” worldwide, quite an accomplishment when you consider that modern prescription medications didn’t emerge until about the mid-20th century. The Penn State study noted:9
“With few exceptions, most commonly used drugs today were developed after 1950. Beta-blockers were discovered in the mid-1960s, and statins and calcium channel blockers were not introduced until the late 1980s. Our most frequently prescribed drugs are relatively new medical innovations that have quickly become widespread over a short time period.”
Now, an estimated 85% of adults aged 60 and over take prescription drugs, as do 45.8% of all Americans. A number of factors are driving this high — and rising — rate of prescription drug use, according to the Penn State study, which was published in Demography:10
An aging population
Increased incidence of chronic disease
Medicalization, “when aspects of normal life become viewed as medical conditions to be treated by drugs and other therapies”
The ascendance of drugs to first-line treatment for an increasing number of medical conditions
Continued development of new drugs
Finding new uses for existing drugs
Institutional factors related to the health care and pharmaceutical industries
The trend toward medicalization has been “predominant” in the U.S., the team noted, with society expecting and demanding “a pill for every ill.” In its updated guidance on childhood obesity, the American Academy of Pediatrics, for instance, recommends weight loss drugs and surgery in children as young as 12 and 13. While drugs were once viewed as ancillary treatments, they now take center stage of many treatment plans:11
“Numerous aspects of daily life are increasingly regarded as conditions requiring medical diagnoses and treatment, especially using prescription drugs. Medicalized phenomena include obesity, substance use, hyperactivity, loneliness, childbirth, pain, and aging … Prescription drugs thus moved from the periphery to the core of medicine.
Drugs have become the go-to treatment, a shift reinforced by factors relating to the culture of medicine, changing institutional constraints in health care, and health policy. Increased prescribing is spurred by physicians’ curative orientation and factors that became increasingly salient during the managed care era, including increased time constraints, the tying of physician pay to patient satisfaction, and uncertainty in clinical practice.”
Insurance Companies, Big Pharma Contributed to the Shift
Big Pharma’s role in increased prescription drug use comes as no surprise as the industry with the most to gain financially. From 1997 to 2016, medical marketing rose to $ 29.9 billion, up from $ 17.7 billion, with prescription drug advertising the driving force behind the increase.
For instance, television advertisements for prescription drugs are illegal in most countries — but not in the U.S., where 80 such ads air, on average, every hour on Americans’ televisions.12
Prior to the 1980s, these types of direct-to-consumer (DTC) ads were unheard of,13 even in the U.S., but within a few decades they became among the most common public health messages seen by Americans — and they work to increase drug sales.
DeepIntent, a health care advertising technology company “built to influence patient health and business outcomes,”14 conducted research on consumer behaviors and ad-supported content. Their findings revealed that 30% of people said pharmaceutical ads provide helpful information to someone in their household, and 27% spoke to their doctor about a medical treatment after they learned about it from an ad.15
The findings support earlier data from the company, which found that “pharmaceutical ads can empower patients to take a more active role in researching treatments” and “advertising influences patients’ decision to follow through in taking drugs prescribed by their doctors.”16
The most common action that people take after viewing a drug ad is to conduct research, and this research becomes the most important factor in medication adherence — even more than the person’s own previous experience taking the drug. They intend to use targeted ads to increase drug sales even more. DeepIntent CEO Chris Paquette said in a news release, “We have evidence that more relevant advertising drives real results for our clients.”17
Big Pharma also encourages prescription drug use by making payments to physicians and sponsoring medical conferences and academic seminars. Insurance companies, meanwhile, often require patients to try prescription drugs for a treatment first, or provide better coverage for drugs than nondrug interventions.
“For example,” the study explains, “insurers had more generous coverage of opioids and fewer or no requirements for approval relative to non-opioid painkillers for pain-related conditions.”18
Polypharmacy Is on the Rise
Polypharmacy, or the use of multiple prescription drugs at once, is also increasing among both children and adults. Among adults aged 65 and over, 42% were taking five or more prescription drugs in 2012, according to the Demography study, while 54% take four or more.19
Adverse effects from polypharmacy are common and may drive patients to seek out even more drugs to treat the side effects caused by their unsafe drug regimen. It’s a vicious cycle, one that’s perpetuated by a broken health care system that revolves around pharmaceutical-driven, fragmented care.
The featured study found the number of years people can expect to take five or more drugs has increased significantly as well,20 and compared to the 1990s, when most people taking medications took only one at a time, today people are equally as likely to be taking five or more drugs.21
When medications are prescribed in excess, including to treat the side effects of other drugs, the patient’s health suffers. “The use of numerous medications may result in medication-related problems such as inappropriate indications, therapeutic duplication, adverse effects, drug interactions, unnecessary medications, poor adherence, and a strain on health care resources,” according to a featured article in The Journal for Nurse Practitioners.22
How Much Is Too Much?
While the Penn State team said the study isn’t meant to dictate whether prescription drugs are good or bad, there’s reason for increasing concerns about “how much is too much,” and whether more drugs translate to better health. Ho said:23
“There’s a large body of research that shows Americans are less healthy and live shorter lives than our counterparts in other high-income countries. The prescription drug piece is part and parcel of that reality. What we find is, even above and beyond what we might expect to be seeing, the rates of prescription drug use in the United States are extraordinarily high.”
Deprescribing efforts, which are meant to cut a patient’s use of unnecessary medications, could help and research is underway to determine the best way to do it. The U.S. Deprescribing Research Network (USDeN), which is focused particularly on deprescribing for older adults,24 states:25
“Deprescribing refers to the thoughtful and systematic process of identifying problematic medications and either reducing the dose or stopping these medications in a manner that is safe, effective, and helps people maximize their wellness and goals of care.”
If you’re interested in weaning off of unnecessary prescription medications, work with a knowledgeable holistic health care practitioner who can help you do so safely, as not all drugs can be safely stopped cold turkey. Meanwhile, focus on leading a healthy lifestyle so you stay well and can avoid prescription drugs in the first place.
While the Penn State study paints a dire picture of drug usage now and in the future, it’s not set in stone — and you don’t have to be one of the statistics. By building a health plan that addresses diet, exercise, sleep, emotional wellness and toxic exposures, along with only targeted and truly necessary medications and/or supplements, you can reach and sustain optimal health for a lifetime.