In his shifts in the emergency room of a Toronto hospital, Dr. Joel Lexchin sees prescription drugs misused on a daily basis. “In ER we see lots of examples of people not using medications properly in one way or another,” says Lexchin, who is also a professor at York University’s school of health policy and management. He says many people don’t take their drugs as prescribed, stop taking them prematurely because of minor side effects or take another family member’s prescription.
Others are unclear about just what they’re taking. “It’s quite frustrating when people come in and don’t have a list,” says Lexchin. “’[I’m taking] a little white pill’ doesn’t help us.”
Worse than frustrating, being careless with prescription drugs can be dangerous. According to a 2008 study in the Canadian Medical Journal quoted in the Canadian Pharmacists’ Journal, one in nine ER visits was due to a medication-related issue.
South of the border, 700,000 emergency-department visits and 120,000 hospitalizations each year are due to adverse drug events, according to the U.S. Centers for Disease Control’s Medication Safety Program. And people over 75 are most at risk of death due to such an adverse event, says the National Center for Biotechnology Information.
Often, people suffer from interactions between medications, remedies or supplements. This can lead to significant problems, says Lexchin. It can happen when a patient isn’t in close contact with a physician, fails to report other drugs being taken or visits numerous pharmacies, preventing the pharmacist from identifying medications that may interact. “There’s a potential for overlap there,” says Phil Hauser, a pharmacist in St. Catharines, Ont., and a member of the Ontario Pharmacists Association’s board of directors.
To prevent prescription medicine problems:
Be frank with your doctor. Report the medications you’re taking, along with over-the-counter drugs, supplements, vitamins, Chinese herbs and naturopathic remedies. If you’re undergoing chemotherapy, mention that as well.
Bring a list of what you’re taking when visiting a doctor, walk-in clinic or hospital. Give caregivers or family members a copy to carry as well. If you’re having a reaction or side effects to a medication, call your doctor or pharmacist. Report to Health Canada if you have a serious adverse reaction.
Ask your doctor if your prescription is off-label. According to Lexchin, 12% of medications are prescribed off-label, meaning they’re not officially approved to treat your health condition. To ensure you’re getting a drug that’s best for treating your specific problem, ask your doctor for one that’s approved.
Check how long a prescribed drug has been on the market. Before they hit the market, many medications are tested on middle-aged men and women in small, homogenous groups, says Lexchin, and more time is usually needed to see if serious reactions will occur. If your doctor prescribes a drug that’s been around for less than three years, ask if there are alternatives that have been around longer.
Make an appointment with your pharmacist to go over your medications. In 30 minutes, your pharmacist can flag potential interactions, adjust dosages and discuss long- and short-term side effects. “It’s saved quite a few lives,” says Hauser.
Keep an eye on those drugs
Storing your medications safely, guarding their potency and keeping them away from children and teens is also critical in ensuring you’re getting the maximum benefit from your drugs — and protecting your family at the same time.
- Store your medications in a dry, cool environment, and be aware of the expiry date. “Most expiry dates are very conservative,” says Lexchin, though he says certain medications such as nitroglycerin, which degrades in sunlight, have to be tossed out as soon as they expire. When drugs expire, bring them to a pharmacy for disposal, says Hauser. Flushing them down the toilet or putting them in the garbage is hazardous for the environment.
- Don’t store one medication in another medication’s packaging — it can lead someone to take the wrong drug, says Hauser.
- Store all medications — prescription as well as over-the-counter — high up and locked away if you have young children.
- Educate teens about drug safety, says Hauser. “Sit down with your preteen or teen and explain the perils of these medications.”
And don’t forget that if you have any questions about your medications, many pharmacies are now open 24 hours a day, says Hauser.
More tips for drug safety and effectiveness:
- Don’t take medications with grapefruit, lime or Seville orange juices — even several hours before a dose. They can seriously affect how you absorb a drug and can lead to a dangerous reaction.
- Read your medication insert. The side effects that you may think are serious could be temporary — allowing you to complete your course of medication.
- Stick with one pharmacy. This ensures your pharmacist has a clear picture of what you’re taking.