Podcast 45 - Medication Kills

Transcription

Dr. Chad Edwards: This is Dr. Chad Edwards and you’re listening to podcast number 45 of Against the Grain.
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Announcer: Welcome to Against the Grain podcast with Dr. Chad Edwards, where he challenges the status quo when it comes to medicine. We get into hot topics in the medical field with real stories from real patients to help you on your way to a healthy lifestyle. Get ready because we’re about to go Against the Grain.
Marshall Morris: What up? What up? This is Marshall Morris and today I’m joined with Dr. Chad Edwards. He is a former U.S. Army veteran, or I guess current veteran and former active duty member. Author, he’s a board-certified physician, Dr. Edwards, welcome to today’s episode Tulsa prolotherapy.
Dr. Edwards: Man, I am excited to be here. It’s Friday. It’s good. I’m ready to get rolling.
Marshall: Let’s get rolling. Let’s get into it. What are we talking about today? What is today’s hot topic?
Dr. Edwards: This is one of my favorite topics. Of course, I say that a lot, but this time I’m passionate about this topic. This is something that I think everybody needs to hear. This is an amazing and I think shocking topic for a lot of people. You remember that phrase, “Crack kills?” You heard that?
Marshall: Yes.
Dr. Edwards: The title of this podcast I think we should actually title this one “Medication kills.”
Marshall: Medication kills.
Dr. Edwards: Or “medications kill”, however you want.
Marshall: Okay.
Dr. Edwards: Wherever you put the “s”.
Marshall: That’s a pretty big statement right there. Why do you feel like that’s worth titling this particular podcast episode that medication kills?
Dr. Edwards: For one thing, I’m going to answer that question by going the long route. I’m going to lay the groundwork here. A lot of people that listen, they understand that if they listen to the podcasting — If all four people that listen to the podcast have listened to the previous episodes, they know that obviously we do things a little bit differently. My thought process, my concept, my paradigm for my approach to medicine is very different. But I used to do traditional medicine. I was, you mentioned, board-certified in family medicine. I did a traditional residency in the U.S. Army and got fantastic training. I learned how to take care of acute medicine very, very, very well; ran the ICU. It was really cool because in my residency program we were the only residency in-house and it was a large medical facility. We delivered 300 babies a month in our hospital. That’s 10 a day. Even though residency was extremely taxing, I mean it was not fun. We worked our butts off all the time and it was a very hands-on residency which I’m a hands-on kind of guy. I love procedures. It was a busy, busy, busy residency and so when you were on call for the family what we call FPIT, Family Practice Inpatient Team, we would go to the ER because the ER would call and say we have a patient that needs to be admitted.
We go down there, do all the paperwork, get him admitted and then you might get called upstairs for labor and delivery, and you have to deliver a baby. Then you get called to the ICU and have to intubate a patient — You’re just all over the place. But the traditional approach to medicine is when you go to your doctor – If you have high blood pressure, you go to your doctor and you say, “I have high blood pressure.” They say, “Okay, well you have high blood pressure, here is your pill.” One problem — one pill; Sometimes it is one problem — two pills or three pills. In fact, the Joint National Committee on hypertension says that your — It’s a group that puts together recommendations for how we treat and manage and evaluate hypertension. The JNC 7, I think we’re on eight or nine now, but the seventh committee said that it’s going to take the average patient with hypertension three medications to control their high blood pressure, to get them to goal. Three medications for one problem, so the old paradigm of ‘one problem — one pill’ it really is ‘one problem — five pills’ from the blanks Tulsa prolotherapy.
So it’s this concept of you have a problem, you go to your doctor, you get your pill, you get your medication. That is kind of standard medicine and I would have patients that would come in and they would say whatever. I would tell them all these things and, of course, we as physicians we know that lifestyle matters. We know that you know that you got the USDA food pyramid and all this crap that they tried to ram it down your throat on this is how you eat which is pure bull crap by the way. Not founded on any-
Marshall: We’re kicking over all the sacred cows today. We’re waging holy war.
Dr. Edwards: I do what I can. We’re declaring jihad on traditional medicine.
Marshall: Oh God.
Dr. Edwards: [laughs] so you got this traditional paradigm and I had patients that would come in and they would say, “Whatever you do, don’t take away my Big Mac,” or whatever. They would say, “Doc, just give me my pills, so I can eat what I want.” Some people might say, “Okay. Well, if you’re controlling all the numbers, you’re managing the disease, what’s the problem with that?” So the topic here, why is this a hot topic is because traditional medicine says, “Here’s your problem, we manage this with medications.” All four listeners, they know that’s true. You go to your doctor, here’s your pill. That’s pretty much what they’re going to do almost across the board. The problem with that is what we’re going to talk about right here.
Marshall: Okay. I want to just clue into one of the words that you just used. You said, “I’m managing my disease.” Certainly there’re certain diseases that are incurable, right?
Dr. Edwards: True.
Marshall: At that point it really does become managing the disease or managing the symptoms of the disease, but are you saying that we oftentimes are trying to then solve the problem with medication, so that we don’t actually have to change how we’re living, which actually caused the disease in the first place?
Dr. Edwards: I would argue that a lot of disease processes occur because of that very thing. Our lifestyle puts us at higher risk for an illness or a disease process and instead of addressing the underlying cause we simply take a medication to manage the manifestations of that illness or disease Tulsa prolotherapy.
Marshall: Okay. Let’s get into the specifics of why this route of care is not — Certainly there’s a number of reasons why that’s probably not the appropriate route of care, but we’re getting into one specific one today, is that right?
Dr. Edwards: That’s correct.
Marshall: Okay. Get us into that.
Dr. Edwards: This topic is that your medications are killing you, period. Your medications are killing you and we’re going to bring this full circle. I’m going lay the foundation before the break. When we come back from the break we’ll talk about – We’ll bring that full circle and then just, Marshall, beat me over the head when we’ve got that break. Just beat me over the head. The problem with this is there was a study that was published in 1998 and this was published in the Journal of the American Medical Association. JAMA, major peer-reviewed medical journal, 1998, and they were looking at adverse drug reactions. They looked at a database or multiple databases from 1966 to 1996, 30 year time frame. They looked at combined adverse drug reactions from patients that were in the hospital, hospitalized patients, as well as adverse drug reactions that caused a patient to be admitted to the hospital, so whatever made the patient to go to the hospital or whatever was in the hospital. That was who they were looking for in this study. Adverse drug reactions are — You can think about drugs gone wrong. Like the old frying pan with the eggs and the thing “this is your brain, and this is your brain on drugs.” You could say, “This is your brain, and this is your brain on medications,” especially if it’s a statin. That’s another topic for another day.
They excluded from this study, so you think what an adverse drug reaction is, and there’re all kinds of problems that you can get from them, but in this study they excluded drug administration errors. The nurse was supposed to give drug A and she gave drug B, or she was supposed to give a hundred milligrams and she gave two hundred. They excluded anything like that. That was not included in this study or in these numbers. They excluded non-compliants, patients that weren’t taking their medications, or they weren’t taking it as prescribed. They took five of them instead of one or they didn’t, they took zero instead of two, whatever. They excluded overdose, patients that took too much of their medication. They excluded drug abuse, they excluded therapeutic failures, you’re prescribed a medication you didn’t get to go with the results and they excluded possible adverse drug reactions, so these reactions that were documented Tulsa prolotherapy.
We know that they were drug reactions. They excluded all of those things. Doesn’t sound like there’s much left. The reality is there’s a lot left. What we’re going to talk about in this study is what they defined as “serious adverse drug reactions” and so serious adverse drug reactions or ADRs were those adverse drug reactions that were so severe that they required hospitalization or they were permanently disabling, from that point on the patient was never the same, or they resulted in death. Hospitalized, permanently changed, dead; those are the three things that we are going to talk about when we come back from break on the numbers on this. Make sure you still tune in because the numbers on this will blow you away.
Marshall: Okay. We are going to take a quick break and when we come back, we’re getting into it.
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Marshall: Okay. We are back with Dr. Chad Edwards. We are talking about adverse drug reactions. Dr. Edwards is going to get us into the numbers. I’ve seen the numbers here in the show notes and it’s just a little bit startling, just a little bit.
Dr. Edwards: Right.
Marshall: Why don’t you get us into it for all the listeners out there?
Dr. Edwards: Right. First of all, these were properly prescribed medications. This patient was prescribed this medication, the prescription was appropriate, it was given appropriately. This is the way it’s supposed to happen, okay? Second thing, these are serious, serious problems. People died, permanently changed or had to be admitted to the hospital because of it. The third thing is this is from a study in JAMA, Journal of the American Medical Association, 1998.
Good, solid data over a 30 year period. When they looked at the data, they saw that there was on, statistically across that 30 year period, if you were to apply those numbers to 1994, there was a 6.7% severe or serious adverse drug reaction for all of the cases. That resulted in 2.2 million events. 2.2 million people that were prescribed the medications had reaction so severe that they had to be admitted to the hospital, they were permanently disabled or altered, or they died. It’s a 2.2 million people for properly prescribed medications, published in JAMA. I’m not making this stuff up Tulsa prolotherapy.
Now let’s take that a step further. Just the people that died, the people that died on an annual basis in 1994, it was 106,000 fail events. That made it the fourth leading cause of death in the United States in 1994, properly prescribed medications. Your doctor prescribed the right drug to the right patient at the right time for the right reason. 106,000 people died because on that in 1994. Now let’s compare that to the things that a lot of people get really scared about. I would argue that many women are very scared. There’s a lot of fear about breast cancer. How many people died in 1994 from breast cancer? 40,000 people.
Marshall: And 106,000 died from adverse drug reactions.
Dr. Edwards: Correct, properly prescribed medications. Okay, so car accidents, a lot of people scared when you think about. A lot of people die in car wrecks. 40,716 in 1994; Plane crashes — 462 people. Shark attacks — 38 people. Bee stings — 53 people. If you take adverse drug reactions — I’m sorry, if you take fatal adverse drug reactions for properly prescribed medications it outweighs or you are more likely to die to die from an adverse drug reaction than you are to get breast cancer, or get in a motor vehicle collision, or bee sting, or a shark attack, or a plane crash. If you take all of those causes of death and add them up, it is still less than properly prescribed medications.
Marshall: Kind of makes me not want to take any more medications.
Dr. Edwards: Medications are important. We have to have them. They are a blessing appropriately applied. When they are appropriately applied they can be a tremendous asset. My problem is that we will willly-nilly, just without regard for side effects — “Your cholesterol is too high, well let’s just give you a statin.” “But I’m 30 years old and I have no family history, and I’ve never had a problem” “No way. That doesn’t matter. You just need to take this statin because your numbers are too high.”
It’s crap. It’s just pure bull crap and the evidence does not support it. It does not support it. It hasn’t ever been there. It will never be there. It’s hog wash and yet we just willy-nilly throw this stuff out there. Then if you go to your doctor and you say, “Hey, I’m having a problem with this,” they’re going to get a lab, especially on a statin, they’re going to get a lab and they’ll say, “Well, your CK is not elevated, so it’s not your statin.” I have numerous patients. They will come back to me and say “I was on a statin, I starting having problems.” Muscle aches, fill in the blanks. “Then, I stopped taking it and it went away. I started it again and it came back again. I took, quit taking it and it happened again.”
It doesn’t take a rocket scientist to figure this out. It’s the drug. Then when you look at serious drugs, especially fatalities, we dismiss this stuff so readily. How can we possibly prescribe you something that would be harmful or even kill you? We don’t do that. We do it every day and we all like to just dismiss that’s what it is. Medications kill. They kill, they kill, and they kill. Now they can help when appropriately applied, but we want to minimize the risk of having one of these adverse drug reactions, which means you limit your exposure. You use them only when you absolutely need. You can listen to, I think it was podcast number 12, where we talk about antibiotics for a respiratory infection. I may have the number wrong. Those medications aren’t indicated for those issues. Then you have all kinds of potential complications Tulsa prolotherapy.
Statins for cholesterol and patients with, other than middle age men with the previous heart attack, there’s no evidence to support it. We can go on, and on, and on about the use of medications when they’re really not needed and could cause potential harm. If you have a life threatening infection, you absolutely need a lifesaving antibiotic. If you have off the charts, uncontrolled hypertension and you are doing everything you can, you absolutely need a medication. You need them in certain places and we just have to accept those risks. On many cases, we need to get off of some of these medications. The second thing, and we’re coming on the end here, I work in the emergency department. The other day I had a patient that came in on 27 medications.
Marshall: 27?
Dr. Edwards: 27. There is absolutely no way that we can appropriately evaluate the interactions that each one of these medications have, the way your body metabolizes one, the way it’s going to alter you physiology, the way they are going to cause toxic levels of one versus as the other. There’s just no way to do that. Where there’s too much biochemical individuality and there’s too many interactions with one medication to another, there’s just no way to appropriately manage 27 medications, especially when it’s the number four cause of death in the United States in 1994. It’s just ridiculous. They are appropriate under certain conditions. They absolutely have to be used in some places and I frequently prescribe medications, but we have to be very careful about how we do it because medications kill.
Marshall: Probably prolonged exposure to a medication likely is not the best course. Unfortunately, based on what you’ve told me, is that medications become the norm for a lot of people.
Dr. Edwards: It’s right.
Marshall: That’s because they don’t know any different to that. They don’t have any other evidence. That’s what their doctor’s telling them, “This is what your lifestyle will be like is taking this medication.”
Dr. Edwards: That’s right.
Marshall: Is that because they’re solving the symptoms rather than solving the underlying cause? Or what’s the deal there?
Dr. Edwards: I think when you look at medications, they can be very complex. We got biochemical names, and I hope I’m not getting off track with what you are asking, but just looking at this big picture scheme. I remember the TV show ER back in the early ‘90s and there was a patient I remember, one of the early episodes, this just kind of stuck in my head. This patient comes in and has epileptic seizures, young kid. Mom, I think she was Vietnamese in the show. She comes in and she’s giving the kid her medications. She’s not an idiot, but English isn’t her first language. She was prescribed a medication called Dilantin or the kid was, and then also taking a medication called Phenytoin. It’s the same medication by two different names; ones a brand name, one’s a generic. Mom was overdosing her kid. TV show, but this stuff happens, overdosing her kid thinking that she’s doing the right thing because there’re two different names. That’s just one example of the many ways that this can be a major, major problem. I don’t know if I completely took a rabbit trail on what you were saying.
Marshall: No. The core point here is that medications need to be used for what their intended for rather than masking a symptom or an issue without getting to the core of what it really is.
Dr. Edwards: Absolutely. I read a report, this was in the American Family Physician, it’s a journal published by the American Academy of Family Practice. It’s a good journal. There was an article written on how to properly prescribe medications. There was an eight-step process on how you’re supposed to evaluate the patient and evaluate the medication – we’re talking one medication – in order to appropriately prescribe that medication. Ask the average patient or let’s poll all our four listeners and ask them, “How long do you think you have with your doctor?” When we’re under the constraints of the Obama-care, and Affordable Care Act, and insurance, and all these kinds of things, I would argue that the average physician has like five minutes with a patient of actually interacting with that patient. And I’m supposed to apply eight rules? Evaluate an eight-step process for each medication, and they’re on 27 medications, and I’ve got five minutes with them? It’s impossible. It can’t happen. This kind of system is killing people and not making them better.
Marshall: For all the listeners out there that you’ve inspired them to take action, what can they do?
Dr. Edwards: First of all, find a physician that will actually spend some time with you. Secondly, if you have a disease process that requires medication, absolutely take that medication, but be very careful and evaluate the risks and benefits of those medications. The third thing is focus on health. If there’s anything that you can do that might maybe not reverse the need for medication, but might lower the need for — Lower the dose. If you can get by on a lower dose, you’re one step down the road. So focus on health instead of focus on disease. Look for physicians that will work with you, spend some time with you. If you have some of these complex issues, you need the time. You have to have the time. It can’t be done in five minutes.
Marshall: For any listener that has more questions, they can go visit revolutionhealth.org. Dr. Edwards, any closing thoughts?
Dr. Edwards: Again, this is one of my passions. This is one of my topics. This stuff, it just — We just have to be much more careful and focused on our patients.
Marshall: Boom. Dr. Edwards, thank you so much.
Dr. Edwards: Have a great day.
Announcer: Thanks for listening to this week’s podcast with Dr. Chad Edwards. Tune in next week where we’ll be going Against the Grain.
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