Are parents active parts of a national drug epidemic?

When you reach for ibuprofen for your sore back or a pill to help you sleep, are you sending a bad message to your kid?

Yes, says Bryant Gumbel in his video commentary about the drug charges against ball player Alex Rodriguez. While he thinks that Rodriguez should be punished for being a liar and a cheat, he doesn’t think that people should be shocked by the fact that Rodriguez was taking drugs to improve his performance.  He says that the country is crazy for drugs, taking them for “any and everything, for problems real and imagined.”

He goes on to say, “When so many moms and dads are active parts of a national drug epidemic, let’s stop crying that ball players are setting a bad example for kids.”

He may have a point.

Now, don’t get me wrong. I am a big fan of medications. I’ve watched them cure infections and diseases and deliver people from pain. I’ve seen children who were failing in school start to succeed with medication — and be happy. I’ve known so many people who were able to put their lives and families back on track with the help of antidepressants. Medications improve and save lives.

But they aren’t always the answer, or the only answer, and we often forget that. Our society likes quick fixes, and too often we think of medications that way.

Not every ache needs a painkiller — a cool cloth, massage, a stretch or some rest often does the trick.  Not every kid who struggles at school needs medication — the right school program, some real investment of time by a parent, some tutoring and sometimes some counseling can do wonders for lots of kids. And if everyone exercised for 30 minutes a day and made some simple changes in their diet (like cutting out sweetened beverages, eating more vegetables or cutting back on portion sizes and fast foods), there’d be much less obesity, diabetes, hypertension, high cholesterol and so many other health problems … and less need for medications.

But we’d have to work at it. We’d have to rearrange our days and our lives. It might be inconvenient and uncomfortable. It also might feel less certain than taking a pill, and that can make people uneasy — even when the non-pill treatments have clear benefits.

“Our society likes quick fixes, and too often we think of medications that way.”

Again, I’m not dissing all medications — and I’m definitely not saying that you shouldn’t take things your doctor prescribes. But I am saying that when your doctor prescribes something, it’s always worth asking if there’s another way to approach the problem. If the answer is no, then you should take the medication. But the answer just might be yes. Or perhaps the answer is maybe, and you and your doctor can talk about trying something before using medications. We need to have more conversations like these.

Gumbel is right that parents set an important example for their children—and sometimes we don’t even realize the examples we are setting. Many parents need to take medications, and they should talk to their children about why. But many parents take medications that aren’t so necessary.  Ibuprofen might help a sore back, but so might yoga or just getting some regular exercise. Regular exercise can make sleeping pills less necessary too, as can cutting out that late afternoon Starbucks run or the second glass of wine at night.

I think that doctors would discuss these options more if they felt more hopeful that patients would try them. Most of the time, when we tell patients to do things like exercise, change their diet, meditate or lose weight, well, they just don’t

Trying things like these can absolutely make you healthier, whether or not you end up being able to skip the pill. And when you do these things instead of reaching for a pill, you not only teach your child that there are other options, you teach them habits that can help keep them healthy for a lifetime.

Which, you have to admit, is a pretty great thing to do.

Claire McCarthy is a primary care physician and the medical director of Boston Children’s Hospital’s Martha Eliot Health Center.  She blogs at Thriving, the Boston Children’s Hospital blog, Vector, the Boston Children’s Hospital science and clinical innovation blog.

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  • Anthony D

    Sure, I use to remember when parents and their teens use to freebase together in their garage in my neiborhood when I was growing up!

  • Peter Elias

    “I think that doctors would discuss these options more if they felt more hopeful that patients would try them. ”

    I don’t think this is the biggest part of the problem, though it definitely contributes. I think the bigger problem is time – or the lack of it – coupled with productivity pressure. It takes much longer to talk about stretching, pacing, balanced workouts, how often to replace running shoes than to prescribe ibuprofen. It takes much longer to teach about sleep hygiene and life style barriers to sleep than to write a prescription for zolpidem. It takes much longer to explain that medication is no better than placebo for dysphoria and mild depression and only minimally better for moderate depression and to do the sort of deeper social history and intrapersonal exploration necessary to help people with problems of living than it takes to prescribe citalopram.

    I, and the primary care colleagues I talk to most often, are more than willing to talk about these things – when we have the time.

    • azmd

      It would be so interesting if someone would do a study to determine the amount of time required to provide education that produced behavioral change in these areas–and then compared that against the amount of time that the average clinic director wants patients seen in….

      • Dr. Drake Ramoray

        I can’t find the study at the moment but I think there is a study out there about care becoming inferior for multiple medical problems when visits are less than 15 minutes. It was a general IM study and I can’t remember if it was patient outcome, patient satisfaction, or both. Here is an older paper on 16-30 minute visits back when the push was to 20 minute followups in the 90s

        One thing it does show is shorter visit times equals more prescriptions which supports the topic of the original post that it is faster and easier to just write a script.

        • azmd

          Along those same lines, it’s kind of ironic that there’s this national hue and cry about the overprescribing of opiate pain medications. I wonder what people expected would happen when we made pain “the fifth vital sign,” told docs they could face disciplinary action for undertreating it, limited the amount of time that docs could spend discussing their patients’ pain with them and then allowed insurance companies to refuse authorization for any type of pain treatment other than medications?

          Catch-22 anyone?

    • Jane Galt

      “…how often to replace running shoes”

      In whose world was it EVER a physician’s role to advise patients as to how often to replace running shoes?

      For heaven’s sake, why don’t you medical doctors stick to medical stuff and let the guys and gals at Foot Locker give people advice as to athletic shoes?

      No wonder America spends more on “health care” than any other civilized nation. We’ve got medical doctors being paid medical doctor rates to play Mom, Dad, Nanny and Gym Teacher.

  • drjoekosterich

    Children follow more what we do than what we say. Collectively we have taken pills for bad hair days and minor discomforts. Little wonder children copy.

    • Jane Galt

      A friend of mine calls her children’s chewable vitamins their “energy pills”.

      “Come here and take your energy pill!”

      She also gives them chewable cherry-flavored melatonin tablets before bed, their “sleepy-time pills”.

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