More and more people in America seek relief from stressors by using artificial means, rather than developing the skills needed to cope with them naturally. Overdose mortality has now become a pressing public health problem. According to statistics released by the Centers for Disease Control, between 1999 and 2007 the rate of unintentional overdose in the United States has increased by 124%. Experts attribute this phenomenon to the exponential increase in prescription opioid overdoses. Some evidence suggests that the risk for drug-related adverse events is higher among individuals who are prescribed opioids at doses equal to 50 mg or more per day of pure morphine.
The abuse of opioid pharmaceuticals has been growing steadily for 10 years and has gotten to a point where it now overshadows all the other drug problems in the United States, certainly more so than heroin and cocaine. —Dr. John A. Renner, Associate Professor of Psychiatry at Boston School of Medicine in Massachusetts, Director of the Addiction Psychiatry Residency at the Boston VA.
According to a report by the IMS Institute for Healthcare Informatics, The Use of Medicines in the United States: Review of 2010, published April 2011, a prescription pain killer tops the list of the 10 most prescribed drugs in the U.S. In order of number of prescriptions written in 2010, the 10 most-prescribed drugs in the U.S. are:
- Hydrocodone (combined with acetaminophen) — 131.2 million prescriptions
- Generic Zocor (simvastatin), a cholesterol-lowering statin drug — 94.1 million prescriptions. It is a known fact that an increased ability to cope with stress positively correlates with “good” cholesterol levels.
- Lisinopril (brand names include Prinivil and Zestril), a blood pressure drug — 87.4 million prescriptions. While there is no direct proof that stress by itself causes long-term high blood pressure, other behaviors linked to stress — e.g., overeating, drinking alcohol and poor sleeping habits — do cause high blood pressure. The short-term stress-related spikes in blood pressure caused by chronic stress may put individuals at risk of developing long-term high blood pressure.
- Generic Synthroid (levothyroxine sodium), synthetic thyroid hormone — 70.5 million prescriptions
- Generic Norvasc (amlodipine besylate), an angina/blood pressure drug — 57.2 million prescriptions
- Generic Prilosec (omeprazole), an antacid drug — 53.4 million prescriptions (does not include over-the-counter sales). The relationship among stress, psychological traits associated with chronic anxiety, acid reflux parameters, and perceptions of reflux symptoms has been established in numerous studies published in the last ten years.
- Azithromycin (brand names include Z-Pak and Zithromax), an antibiotic — 52.6 million prescriptions
- Amoxicillin (various brand names), an antibiotic — 52.3 million prescriptions
- Generic Glucophage (metformin), a diabetes drug — 48.3 million prescriptions
- Hydrochlorothiazide (various brand names), a water pill used to lower blood pressure — 47.8 million prescriptions.
The most prescribed drugs, however, are not the ones generating the highest income for pharmaceutical companies. According to the IMS report, Americans spent a staggering $307 billion on prescription drugs in 2010. The 10 best selling drugs are:
- Lipitor, a cholesterol-lowering statin drug — $7.2 billion
- Nexium, an antacid drug — $6.3 billion
- Plavix, a blood thinner — $6.1 billion
- Advair Diskus, an asthma inhaler — $4.7 billion. A connection between the development of infantile asthma and environmental stress, and adult stress and anxiety has been long established. That psychogenic factors can contribute to the onset and severity of asthma has been known for decades.
- Abilify, an antipsychotic drug — $4.6 billion. Usage of this drug developed to treat serious mental illness such as schizophrenia has grown significantly, primarily for stress and anxiety reduction, uses which the FDA has not approved.
- Seroquel, an antipsychotic drug — $4.4 billion. This drug, also developed to treat serious mental illness, is increasingly popular since it has been “discovered” to be an effective sleeping aid, a use which the FDA has not approved.
- Singulair, an oral asthma drug — $4.1 billion
- Crestor, a cholesterol-lowering statin drug — $3.8 billion
- Actos, a diabetes drug — $3.5 billion
- Epogen, an injectable anemia drug — $3.3 billion
It is interesting, and quite frankly worrisome, to note that so many of the drugs on the most prescribed and the best-selling lists target symptoms such as hypertension, hypercholesterolemia, gastric acidity, asthma, sleeplessness, and psychogenic pain that are directly associated with psychological disorders. These include unipolar and bipolar depression, anxiety, and primary insomnia. The inability to cope with stressors that, in our modern society, are primarily psychological in nature is paving the way for an overmedicated nation where stress signals that should mobilize individuals to take effective action are simply shut off, smothered by mass-produced chemical compounds. There are much better stress relieving approaches that do not include medication and that can enable us to face our challenges with a clearer mind, no side effects and a fatter pocketbook.