Wednesday, January 22, 2014

Medications: The Easy Way to Avoid Real Change

Are we taking the easy way out?
Are we ignoring the real problem as long as we can shift the burden or consequence to someone else, or a later date?

I'm thinking of all the medications out there used to treat symptoms of poor life choices.
If the problems are due to smoking, drinking, unhealthy diet, lack of exercise, infidelity, overworking, etc... and a drug makes the symptoms better - are we just removing the pressure needed to make difficult personal changes?

Instead of using the fundamental solution: Changing our lifestyle; are we settling for the symptomatic solution of medication?

I understand the healthcare costs.  I know how much needle exchange has decreased disease and it's treatment in IV drug users.  I've seen people who work 80 hours a week function for years with the help of stimulants.  I have seen obese people saved from the catastrophic results of high blood pressure and diabetes.

These are good things.  But is good the enemy of great?  Are we sacrificing the crucible, the pressure needed to make us change our lifestyles?


David K said...

It is an interesting question. That pesky personal freedom is always getting in the way. Add long as it is easier to take statins, certain people will do that rather than exercise.

To add to the complexity, what about when it becomes a direct cost to the public? Smokers cost more in medical care. Smokers are also disproportionately represented on the MedicAid roles. Private insurance can charge smokers higher premiums to discourage use and defray costs. Does the public have a right to tell smokers to stop if they are footing the bill?

Nathan said...

I agree with David K. You can't force people to utilize healthcare. You can show the many ways people can live healthily and the benefits of living healthily, and support people in taking steps to make choices that are healthier for them. Harm reduction methods do much more good than judging people who are not interested or willing to make changes, and are better than coercion.

I don't know why you lump needle exchange with statin and stimulant use. Needles are not a pharmaceutical. Needle exchanges add no new risks to people (unlike stimulants and statins), just decrease health burdens. I think it is really unhelpful and wrongheaded to presume that if only folks who use injected drugs got more blood/skin infections, HIV,Hep B, and if millions of more used needles were not properly disposed of every year, then finally these people would stop using and everything would be great for them. What needle exchanges do are reduce often irreparable harm of behaviors with significant risk and reduce barriers to other helpful services (removing judgement, reducing cost, increasing stability, increasing interaction with caring/effective professionals, reducing isolation, increasing access and willingness to try other services or health seeking behaviors, no shaming for "relapse" etc.).