The latest report on the health of the nation released by the Centers for Disease Control and Prevention (CDC), Health, United States, 2004, features a special section on "Drugs."1 In this section, the CDC reveals the extent to which prescription drug use has affected Americans.
Most of the study compares data from a period ending in 1994 with data from a period ending in 2002. Assuming that these trends have continued, usage is probably substantially higher as of 2005.
All Prescription Drugs
The percentage of the U.S. population that reported taking at least one prescription drug in the previous month rose sharply between 1994 and 2000, from 39.1% to 44.3%. Leading this increase was the number of people taking three or more prescription drugs. This group increased from 11.8% to 16.5% (approximately one out of every six individuals). These increases were seen in all age groups. The number of children, those 18 years and under, taking three or more prescription drugs increased by more than 50% between 1994 and 2000. As of 2000, a shocking 3.7% of children were taking three or more prescription drugs.
Seniors, those 65 years and older, were the greatest users of prescription drugs. As of 2000, a whopping 83.9% of seniors took one or more prescription drugs, up more than 10 percentage points from 73.6% in 1994. Interestingly enough, the percentage of seniors taking 1-2 prescription drugs decreased slightly, while the percentage taking three or more drugs increased by more than one-third to 47.6%.
Medical doctors and hospital outpatient clinics did their part to increase the use of prescription drugs, especially for those taking multiple drugs. A total of 6.7% of office and outpatient visits resulted in five or more drug prescriptions. More than a threefold increase was seen in the percentage of children receiving prescriptions for five or more drugs from 1995-2002, up to 2.6% of the child population. Seniors also saw dramatic increases, with 20.3% (one in five) of those 75 years and older receiving prescriptions for five or more drugs by 2001-2002.
Antidepressants and Stimulants
The percentage of adults reporting antidepressant use in the previous month increased from 2.5% by 1994 to 7.0% in 2000, more than a 250% increase. Women led the way in this ignominious statistic, with 9.6% of U.S. adult women (approximately one in 10) reporting antidepressant drug use in the previous month by the year 2000.
The percentage of visits by children (ages 5-17) for antidepressants also increased, from 2.2% of visits in 1994-96 to 5.9% of visits in 2000-2002 - almost a threefold increase. Those ages 12-17 were the biggest users of antidepressants: 8.2% of boys' visits and 9.4% (almost one in 10) of girls' visits in 2000-2002 were for antidepressants.
Visits by children ages 5-17 for stimulants increased as well, from 5.1% in 1994-96 to 9.5% (nearly one in 10) in 2000-2002. Boys were the leaders in stimulant visits, with 14% (one in seven) of visits by 5-11-year-olds and 13% of visits by 12-17-year-olds. Visits by girls for stimulants doubled over that time period, from 2.4% to 5.3% (one in 19 visits).
Cholesterol-Lowering Statin Drugs and COX-2 NSAIDS
Cholesterol-lowering drugs became very popular between 1995 and 2002, especially for older adults, those 45 years and older. Only 11.8% of visits by older adults resulted in prescriptions for these drugs back in 1996. That number increased almost fourfold by 2002, to 39.8%. Visits by seniors for cholesterol-lowering drugs increased to 64.6% by 2002, more than a threefold increase over the 1996 level.
Use of COX-2 nonsteroidal anti-inflammatory drugs (NSAIDs) increased substantially between 1999 and 2002, with the percentage of adult visits resulting in a prescription increasing from 27.1% to 44.6%. Seniors again showed the highest levels, with 66.9% (more than two-thirds) of visits for those 65-74 years old and 67.5% of visits for those 75 years and older. These figures came out prior to the recent announcements about the potential for severe side-effects and even death for those taking COX-2 inhibitors. (Please see "A Prescription for Disaster" on page 3 of this issue.)
The above data make a few things abundantly clear:
- Most seniors are taking more than one prescription drug, with almost half taking three or more.
- Children are becoming major consumers of prescription drugs, in some cases on par with their parents, depending on their age.
- The policy of prescribing multiple drugs simultaneously has become standard practice for most medical doctors and hospitals.
Society's trend toward seeking health through drugs has been increasing for decades. Yet the sharpest increase and the tendency toward multiple simultaneous drug therapies are more recent. This approach to health, and its subsequent risks and complications, will continually confound the efforts of doctors of chiropractic to help their patients maintain wellness. DCs may ultimately want to be better informed of the drugs their patients are taking in order to understand the potential hazards their patients are facing and how to best apply care.
- Health, United States, 2004, With Chartbook on Trends in the Health of Americans. National Center for Health Statistics. Hyattsville, Maryland, 2004.