You may not remember much about the arrival of the year 2000 but along with welcoming in the new millennium there were numerous Y2K prophecies regarding the exponential rate at which medicine would be advancing.
Some predictions had us living in a sci-fi-like existence by 2025 where healthcare would resemble an episode of Star Trek. A world where injury or disease could be zapped away using a hand phaser.
In addition to forecasts about amazing advances in medical technology, millennial soothsayers believed dietary supplements based on folklore blends of vitamins, minerals, and herbal ingredients would surely be replaced by pharmaceuticals. However, if you have recently walked through a drugstore, nothing could be farther from the truth.
The sales of dietary supplements in 2022 is estimated to reach $50 billion-plus with revenues for 2028 expected to exceed $77 billion, so the dangers of self-medicating will likely continue to grow.
Alarming Habits Linked to Self-Medication
A recent behavioral health study reported that nearly 78% of respondents who had experienced health issues said they self-medicated in seeking relief from either physical or mental health issues (or both). Although many people attribute self-medicating with drug or alcohol abuse, there are millions of Americans who are simply fearful of Big Pharma and the latest medicines they are pushing.
If you are thinking that the majority of the people practicing the art of self-medicating in America are men and women who hadn’t seen a physician, you would be wrong.
The results of a recent survey indicated that fewer than 35% of those self-medicating had not seen a physician about his or her health problem. In addition, of the 65% who sought healthcare, a whopping 85% were prescribed medications but chose to self-medicate anyway. Of those who self-medicated, 70% took a prescription medication along with an OTC remedy, dietary supplement, or illegal drug. So seeing a doctor to get a diagnosis and treatment plan obviously does not prevent all the dangers of self-medicating.
Self-Medication: An Implicit Human Right
Whereas self-medication can involve anything from illegal drug abuse to drinking too much caffeine, this blog also addresses how self-medication today is related to a patient’s personal independence from established medicine.
In medical terms, self-medication is a recognized human behavior that has been well studied in the field of psychology with special emphasis on its connection to addictive mechanisms. On the other hand, the art of self-medication defines the self-administration of any substance following a self-diagnosis of one’s health problem based solely on perceived symptoms.
For almost fifty years, self-medication to treat common health issues at home has been protected as a human right. The Proxmire Amendment of 1976 became section 411 of the Federal Food, Drug, and Cosmetic Act and prohibits the Federal Drug Administration from establishing FDA standards to limit the strength of vitamins and minerals in dietary supplements or to regulate them as a drug based solely on their potency.
Although dietary supplements can only be regulated as a food and not as a drug, the FDA has warned that over-the-counter products have been found to contain regulated substances and are being falsely marketed as dietary food supplements. In recent years, competitive athletes and bodybuilders were surprised by a failed drug test related to a supplement they took during training that contained undisclosed ingredients. Unfortunately, the FDA is limited to post-market enforcement only.
Managing Dangers of Negative Health Outcomes
As a practicing physician, how much medicine your patient takes and when it is taken will be written on their prescriptions. But for anyone who is self-medicating, the problem often begins with not understanding how dangerous a supplement can be if dosing limits are exceeded. A landmark study conducted in the United States over a ten-year span estimates that 23,000 emergency room visits each year are directly linked to adverse effects of dietary supplements.
Discussed below are some of the noted culprits. Overconsumption of dietary supplements has been associated with increased risk for severe medical outcomes:
- Weight Loss – One fourth of ER visits related to dietary supplements are attributed to weight-loss products, especially those marketed as fat-burners to increase metabolism. Women were disproportionately affected and hospital admissions often resulted from combining prescription weight-loss medications with supplements that increased the dangers of self-medicating.
- Energy Boosters – Excessive amounts of caffeine and other stimulants used in dietary supplements can cause an unhealthy increase in heart rate, high blood pressure, and heighten stress levels. The most common symptoms treated in emergency rooms for overconsumption of dietary supplements for boosting energy levels included dehydration, insomnia, hypertension, and heart arrhythmias.
- Sports Performance – Pre-workout and sports performance supplements generally contain high amounts of caffeine and other stimulants. In addition, the FDA has found bodybuilding products that contained steroids or steroid-like substances associated with serious health risks, including life-threatening liver injury.
- Sexual Function – Once again, men were more likely to experience adverse effects from supplements marketed for sexual enhancement. NBA star Lamar Odom collapsed after taking a herbal replacement for the little blue pill that the FDA had already warned about potentially causing severe reactions due to a hidden ingredient.
- Cold & Flu Remedies – The most popular OTC drugs are those used to treat conditions that are easy to self-diagnose, such as cold, headache or allergies. However, incorrect self-diagnosis can result in negative effects on the cardiovascular system, brain, liver, or other serious damage. According to mayoclinic.org, they neither prevent or shorten the duration of a disease and thus should always be used sparingly.
Self-medication may offer some relief in the short-term but over time it can exacerbate the problem, lead to addiction, or cause a worsening of mood disorders. Moreover, dietary supplements can interact with prescription medications and have been linked to an increased risk for liver or kidney damage, stroke, and even death. In a study on dietary supplements linked to severe health events in young adults, researchers at Harvard’s T.H. Chan School of Public Health concluded that supplements sold for weight loss, muscle building, and increased energy have almost three times the risk for severe medical outcomes.
Safer Living with Medical Supervision
Can people live better without supplements? Definitely not. Your body needs vitamins and micronutrients in correct quantities to ensure optimum health, but people also need a balance of macronutrients like carbohydrates, fats and proteins. The biggest problems with dietary supplements happen when people take too much or try to rely on them instead of medications prescribed by his or her healthcare provider. Like medicines, dietary supplements can help people manage good health but both have risks and side effects. Most people believe natural means safer or better, but that is not always true.
Since medical science has not perfected the hand phaser for people to “live long and prosper,” physicians will likely need to take a bigger role in helping patients manage their use of dietary supplements. Certainly, there are already many positive changes in lab services like routine bloodwork that will help tomorrow’s primary healthcare provider as well as the patient’s medical specialists to provide better advice on maintaining a healthy balance of micronutrients and how to safely use OTC drugs. In addition, pharmacist can take a bigger role in helping the public understand “What is a safe approach for administering multifaceted self-care”.
Photo credit Ron Lash