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America's Medicine Cabinet Is Full

Study finds many taking several medications, supplements

TUESDAY, Jan. 15, 2002 (HealthDayNews) -- What's in your medicine chest? The answer, if you're like most Americans, is quite a bit.

Eight in 10 of the nation's adults take at least one drug each week, and many are also taking unregulated dietary supplements or herbal remedies at the same time, a new survey says.

Drug use increases with age. But women over 65 take the most, with 23 percent on five or more prescription medications -- and 12 percent on 10 or more remedies -- each week, according to the study.

Over-the-counter painkillers, led by acetaminophen (the ingredient in Tylenol), ibuprofen (Advil and Motrin), and aspirin, make up the bulk of the weekly intake. Estrogen was the leading prescription drug, taken by 5.2 percent of the group, slightly more than half of whom were women. Among men, heart drugs and diuretics were the most common pills, says the study, which appears this week in the Journal of the American Medical Association.

The survey, conducted between 1998 and 1999, also found that 14 percent of people said they take unregulated dietary and herbal supplements. The percentage was slightly higher among those who reported using prescription drugs but varied widely depending on the medication. For example, more than a fifth of people who reported taking the antidepressant fluoxetine, or Prozac -- which at 1.1 percent was 38th on the list of most used drugs -- also said they take herbal cures, the highest rate of combination.

"What's clear from all these data is that there's been a considerable increase in the use of [alternative] products in the U.S. population" in recent years, says David Kaufman, associate director of the Slone Epidemiology Unit at Boston University's School of Public Health and lead author of the study.

Although the researchers didn't inquire about adverse reactions, "the possibility for interactions exists" between mainstream and alternative remedies. "It's also possible that people don't tell their physicians they're taking supplements" and other alternative therapies.

Kaufman and his colleagues surveyed 2,590 Americans, ages 18 and up, by phone about their weekly medication use. Just over 80 percent reported taking at least one compound a week, typically a painkiller.

Two-thirds of the drugs identified by the subjects in the survey were prescription-only compounds. Yet six of the top 10 most commonly used products -- and the entire top four -- were over-the-counter treatments, the researchers learned.

High blood pressure and headaches were the leading ailments for which people said they take drugs, the researchers say. Also frequently mentioned were allergies, diabetes, and high cholesterol.

The single biggest category of dietary supplements taken were multivitamins, which accounted for about a quarter of all products, the survey shows. Ginseng, ginko biloba, glucosamine and St. John's wort were among the most commonly used supplements.

Rebecca Burkholder, director of food and health policy for the National Consumers League, says more patients are now coming to understand that dietary supplements may interact with the prescription drugs they take. Yet many still ignore that prospect.

Part of the problem is that these products are often advertised as "natural," a term with heavy marketing influence but effectively no scientific meaning, Burkholder says. "People have this overall perception that natural is safe and it's what the body needs. They're going to think that it's good for them when it can be on a label and doesn't mean anything at all."

Indeed, the most common reason for people taking either vitamins or supplements was the rather diffuse notion that the products would be healthful and good for them, the survey shows.

Corinne Russell, a spokeswoman for the Consumer Healthcare Products Association, which represents supplement makers, says people are increasingly interested in information about potential conflicts between their prescription drugs and the supplements they take.

A 1999 survey by Prevention Magazine, for example, found that 71 percent of men and women who take supplements want to know how they'll interact with the other medications or products they're using. [The survey also showed that only 48 percent of people said their doctors always offer information about potential drug-supplement or drug-drug interactions.]

Many companies have voluntarily begun putting known interactions on their products' labeling, she says. Regardless of labeling, however, Russell says her group "always recommend[s] that consumers, if they have any questions about what to take or potential interactions, they should talk to a doctor or pharmacist or other health professional."

What To Do

But Maryann Napoli, assistant director for the Center for Medical Consumers, says that's poor advice.

"It makes people think that doctors know about herbal supplements or the interactions between them and drugs, and I don't think that they do," Napoli says. "I would advise people to educate themselves. If you take at least one prescription drug, I think you should have at least one drug handbook in your library."

To find out more about medications and how they're regulated, visit the U.S. Food and Drug Administration. For more on the supplement industry, try the Consumer Healthcare Products Association.

SOURCES: Interviews with David Kaufman, Sc.D., associate director, Sloan Epidemiology Unit, Boston University School of Public Health and professor of epidemiology and biostatistics, Boston University School of Public Health, and Maryann Napoli, associate director, Center for Medical Consumers, New York, Rebecca Burkholder, director, food and health policy, National Consumers League, Washington, D.C., and Corinne Russell, director, public affairs, Consumer Healthcare Products Association, Washington, D.C.; International Wellness & OTC Survey, Prevention Magazine; Jan. 16, 2002 Journal of the American Medical Association
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