So here’s a very common question I receive from many of my patients on a regular basis: “my doctor prescribed a medication, how long should I take it for?”, or “I’ve been on a prescription medication for years, do I have to continue taking it forever?”. All too often, there’s a general assumption that once medicated for a health condition, taking it life long is the only option. As a licensed and regulated naturopathic doctor, I’m here to clarify that not only do prescriptions therapies not have to be taken life long, in many cases they shouldn’t.
And here’s why.
Asking
When your medical doctor, specialist, surgeon, or otherwise, prescribes a medication, drug, or compound to address an illness or health condition, all too often there’s an automatic refill of that prescription that simply repeats indefinitely. To complicate this issue further, most patients who are prescribed a drug simply assume that once started, there’s no option at any point to stop. This ever to common scenario is one that is not only very wrong in so many levels, but also potentially dangerous, and can ultimately work against the intention of trying to make you better. And this is exactly why, as a naturopathic doctor, it’s critical to communicate to patients that rather than you never really considering your drug schedule, it’s critical to know exactly what the drug is, what it does, and what sort of time line your prescribing doctor is looking at. So before ever starting a new drug (or any compound, natural or otherwise, for that matter), clarifying with your prescribing physician both the short and long term plan and timeline for the therapy really is crucial to your health success.
Underlying Health
People are prescribed a variety of drugs for a variety of reasons. From PPI’s for digestive issues, SSRI’s for anxiety and depression, to blood sugar and blood pressure medications for diabetes and high blood pressure or heart disease. The thing with being prescribed a medication is that the intent of any drug therapy is to either help correct an underlying illness or begin managing associated health symptoms. The problem however, is that once a medication improves the presentation of an illness or health concern, the clinical inclination is to keep someone on the therapy indefinitely, as without them, the illness or disease will return back to its original unhealthy state. This, however, could not be further from the truth.
Medical Algorithms
The common medical system (conventional as it’s called) works from an algorithmic basis. For example, if a patient presents with symptom ‘x’, the next medical steps to follow are ‘a’, ‘b’, or ‘c;. Then, once a, b, or c have been achieved, option or medical step ‘d’ , ‘e’ , or ‘f’ is to follow. This is a wonderful guiding foundation, however it does not consider individuality in health, nor does it generally help define how long a patient should be on a certain medication over the long term. Rather, once a patient achieves a certain standard or level of health (or absence of disease), it’s usually the therapy (or drug) that is recognized as the main intervention creating success. The problem here is that whereas both conventional and naturopathic medicine understand a persons physical, mental and emotional health sometimes requires support to achieve a stable level through therapy or prescription, it’s only naturopathic medicine that truly see’s that a person’s body has an innate ability to heal and maintain its own health. So once a patient is stable or reaches a predetermined level of clinical health, the therapy or prescription can and should be gradually reduced or taken away, as the body is in a state to better accept non prescriptive supports or therapies that better align with both short and long term health.
Chronic Disease
There are many pharmaceutical drugs that, without them, would create a relentless abundance of chronic illness, disease states and acute (emergency) situations that would otherwise end up much worse (such as when a person requires medications for surgery, analgesics for pain or a broken bone, blood thinners for heart attacks and so on). However, the majority of illness and disease in most cultures are based on chronic disease states (often lifestyle induced), not of an urgent life threatening stage (per se), and require long term care and support. Diabetes medications, for example, are a class of drugs which help people with diabetes (let’s use Type 2) better manage their blood and insulin levels over the short and long term. Once blood sugars are better monitored and managed, there is a real possibility that people can slowly begin weaning off these drugs in a relatively short period of time (1-3 months for example), at which point, very simple dietary and lifestyle factors can easily maintain blood sugar levels with no need for long term medication. This same example can be used for a huge array of many other conditions, such as thyroid disease, cardiovascular illness, high cholesterol, crohns/colitis, arthritis, osteoporosis, GERD, and the list goes on.
I should be clear that some drugs do need to be taken life long, or at least annually alongside a medical re-assessment (such as type 1 diabetes for example), however many of these diseases and illnesses I’m speaking of still require regular assessments from your doctor to confirm dosing of a drug alongside consideration of lowering or altering as needed.
Health versus drug follow ups
The major issue with patients being put on life long drug prescriptions is that there’s a general lack of health reassessment in medicine. Not only do drug doses need to be reviewed regularly, so to does the underlying health issue of the individual being prescribed a medication. With the addition of simple lifestyle and dietary guidelines and changes over time, I’ve seen many many instances where someone on a 20 year drug therapy plan could have ideally stopped taking the drug after only 3 months with success, but secondarily has worked with me (in agreement with his/her prescribing physician) to slowly wean off the medication to the point where he/she is now in better health than they have been over the 20 years prior.
Many pharmaceutical medications, although lifesaving in many cases, have a tendency to be prescribed as a lifelong drug therapy. Despite the fact that these drugs are often taken indefinitely without question, there is clear evidence and logic proving that before remitting to a life of taking more and more medications, the majority of prescriptions can be reconsidered within a very reasonable period of time.
The statements in this article are not intended to diagnose, treat, or manage a health condition or illness. Always refer to your prescribing physician before altering, stopping or beginning a new medical intervention or therapy.