Amino Acids, Neurotransmitters and Pain Relief

Chronic pain is a complex condition that can change the way your body works. The natural chemicals (neurotransmitters) that your nervous system depends on to help manage pain and inflammation are in high demand, so making sure you have enough of them available is vital for proper relief.

Did you Know?

Amino acids and nutrients are the building blocks of  the neurotransmitters your nervous system uses to reduce the volume and frequency of pain and inflammatory signals. Addressing amino acid depletion with medical foods is a safe and easy way to restore the foundation of your nervous system’s health and an important part of any comprehensive pain management program.

Everyday Medications that Increase the Risk of Heart Attack

Data out of Stanford University suggest that Proton Pump Inhibitors (PPI’s) such as Prilosec, Prevacid, and Nexium are associated with a higher risk of heart attack.  Published in the journal PLOS One online, researchers looked over 2.9 million patients over a several year period to determine if patients who took PPI’s for gastro esophageal reflux had an increased risk for myocardial infarction than patients who did not.  Concern was raised when scientists discovered that PPI’s potentially reduced the antiplatelet effect of clopidogrel, a drug use to prevent clotting after a heart attack or stroke.  The clopidogrel is used after heart attack to prevent clotting which could lead another heart attack.  They were concerned that if heart attack was raised in this population, it could extend to lower risk patients.

The study showed that patients taking PPI’s had a 16% increased risk of heart attack.  H2 Blockers, such as Zantac and Pepcid were not associated with an increase risk.  Perhaps more importantly, the risk was not just associated with high risk categories such as having had a previous heart attack, the elderly or taking clopidogrel.  It was applicable to all ages and risk groups.

The study has several limitations including the attempt to look back at charts and determine what medications are being taken.  Often patients will take over the counter PPI’s and may not be accurately reporting it to their physician.  Also, retrospective analyses like this are subject to certain biases and are not as valuable as preplanned double-blind clinical trials.  However, the large number of patients reviewed does give the study significant credence.

PPI’s are one the most commonly used medications in the United States and around the world, with over 113 million prescriptions filled globally each year.  PPI’s are used to treat stomach and intestinal ulcers and heartburn, as well as to prevent gastrointestinal bleeding from NSAID’s in higher risk populations.  NSAID’s have been associated with a number of serious complications in addition to bleeding ulcers including kidney and liver issues, fluid retention with swelling in the legs, elevated blood pressure and possibly increasing the risk of heart attack.

Medications that are often used to treat or prevent the side effects of another medication create a potentially vicious cycle for patients who will ultimately end up taking more and more medications to manage an illness. The risk of adverse events increases with the number of medications prescribed, and the number of medications prescribed increases with age.

The avoidance of polypharmacy and therefore reducing the risk of dangerous medication side effects is crucial for patients and providers.  Alternative therapies, such as FDA regulated medical foods, which by definition must be on the FDA GRAS list (generally recognized as safe), may have similar efficacy to standard pharmaceuticals but without the side effects. Understanding the risks and benefits of medications is an important part of being a patient and a healthcare provider. Exploring the medication options that may be better tolerated is something every patient and physician should do.

 

Safer Options for Pain Management

Pain is complex and there are several treatment options to choose from depending on the type of pain you are experiencing including medications, therapies and mind-body techniques.  The most common treatment consists of analgesics:  narcotic (opioid) and non-narcotic (non-opioid) analgesics.

Narcotics vs NSAIDS
Primary Differences Between Narcotics and NSAIDs

Narcotic analgesics are derived from or related to opium.  Opioids bind to opioid receptors which are present in many regions of the nervous system and are involved in pain signaling and control.  Opioid analgesics relieve pain by acting directly on the central nervous system.  They block incoming pain signals but also work in other parts of the brain, modulating pain receptors in the nervous system, primarily located in the brain and the spinal cord.

Non-opioid analgesics or NSAIDs work by blocking the production of prostaglandins by inhibiting the cyclooxygenase enzyme and therefore decreasing the formation of pain mediators in the peripheral nervous system.   Non-opioids work more directly on injured or inflamed body tissue. In a basic sense, opioids decrease the brain’s awareness of the pain whereas the non-opioids affect some of the chemical changes that normally take place wherever body tissues are injured or inflamed.

Although non-opioids are often preferred for certain types of chronic pain, they have two serious drawbacks.  The first is the ceiling effect; Non-opioids have an upper limit of pain relief that can be achieved.  Once the upper limit is achieved; increasing the dosage will not provide any further pain relief but may exacerbate side effects.  Opioids on the other hand tend not to have a ceiling.  The more you take, the more pain relief you will get.  The second major drawback of non-opioids is the side effects profile.  The side effects of NSAIDS make it impossible for certain patient populations to use NSAIDs such as those with history of peptic ulcer disease, cardiovascular disease and the elderly. In 2014, the American Academy of Neurology determined that the risks of opioids outweigh the benefits for certain chronic pain conditions.

Treatment of pain with the use of medical foods gives patients a safer option for pain management by approaching pain from a new perspective.  Medical foods treat the nutritional deficiencies that are found in patients with acute and chronic pain.  By restoring an optimal balance between the chemicals in the body, substances called neurotransmitters, that are responsible for transmitting and dampening pain signals, one can better manage pain.

Research has found low levels of the amino acids gluatamate, tryptophan, arginine, serine, and histidine in patients with chronic and acute pain.  The perception of pain can be modified by providing amino acids and nutrient precursors to the key neurotransmitters involved in the pain process. Amino acids are able to cross the blood brain barrier and are necessary to produce the appropriate neurotransmitters needed to reduce pain signals and lower inflammation. Increasing the intake of amino acids and nutrients lead to an increase in neurotransmitter levels [1].

The theory that the body’s need for amino acids and nutrients are modified by a disease has been long recognized and is supported by studies that reflect changes in plasma, urinary and tissue levels of nutrients with modified intakes of these nutrients [2].   There are various reasons for depletion of nutrient levels including diet, metabolic demands and genetics.  The required amount for each patient varies depending on the duration and severity of pain. Addressing the increased demand for amino acids and nutrients is a key component for improving clinical outcomes.

Two double-blind clinical trials compared Theramine, a medical food specially designed to address the increased amino acid and nutrient requirements of pain syndromes, to low dose naproxen and ibuprofen.  In both studies, Theramine showed statistically greater pain relief than either naproxen or ibuprofen.  This was measured by patient report and a reduction in the inflammatory markers C-reactive protein (CRP) and interleukin-6 (IL-6) [3, 4].  Treatment with amino acid precursors was associated with substantial improvement in chronic back pain and a reduction in inflammation.

Pain Reduction with TheramineThe improvement in pain directly correlated with increased amino acid precursors to neurotransmitters in the blood.

Theramine is designed using Targeted Cellular Technology (TCT), which facilitates the uptake and utilization of the neurotransmitters precursors that are used in the modulation of pain.  TCT allows for the production of neurotransmitters from ingestion of smaller amounts of amino acids to elicit the same response as larger amounts, making daily dosing more feasible and reducing the potential for tolerance.

At least 100 million adult Americans suffers from chronic pain, a safe and effective treatment option such as medical foods that do not treat symptoms alone but addresses the distinctive nutritional needs of adults who have different or altered physiologic requirements due to pain is vitally needed.

To date, Theramine has been in clinical use for over 10 years with no report of GI bleed or adverse side effects and the clinical trials of Theramine clearly support the theory that the nutritional management of pain syndromes is a safe and effective treatment for pain.

The Dangers of NSAIDs

The most commonly prescribed drugs for pain are Non-Steroidal Anti-Inflammatory drugs (NSAIDs).  Approximately 98 million prescriptions for NSAIDs were filled in the United States in 2012 [IMS 2012] and this number does not include NSAIDs that are purchased over the counter.  Although effective in treating pain and inflammation, NSAIDs are linked to adverse side effects which make them inappropriate for use in many patient populations.  There are several serious side effects and toxicity related to use of traditional NSAIDs. Toxic side effects of traditional NSAIDs include:

  • Stomach ulceration and/or bleeding
  • Kidney damage
  • Easy bruising because of loss of platelet function
  • Exacerbation of cardiovascular conditions

Recent studies have also highlighted a higher risk of atrial fibrillation with NSAID use [1] and an increase risk of bleeding and events such as heart attack, stroke or cardiovascular death with the use of NSAIDs in conjunction with antithrombotic therapy [2].

NSAIDs work to reduce pain and inflammation by inhibiting cyclooxygenase, an enzyme.  The action of inhibiting cyclooxygenases, reduces pain and inflammation but is also responsible for many of the side effects of NSAIDs.  This inhibition is problematic because it also inhibits some important functions such as the repair and maintenance of the stomach lining.  This is why stomach ulceration and irritation is so common with the use of NSAIDs.

Inhibition of cyclooxygenase is also associated with reductions in prostaglandin synthesis and is associated with less sodium being excreted in urine and constriction of blood vessels.  This effect of NSAIDs on blood pressure may increase mean arterial pressure by as much as 5 to 6 mm Hg in hypertensive patients.   This consequence may be of particular relevance in patients with preexisting hypertension, edema or congestive heart failure.

One study noted the rate of new-onset hypertension developing in elderly patients for whom nonselective NSAIDs were prescribed was 27% [3]

The extremely high risk of side effects with such commonly used medication resulted in a quest for an analgesic/anti-inflammatory that could provide therapeutic efficacy equivalent to that of traditional NSAIDs but without the gastrotoxicity.

The use of medical foods to treat the dietary deficiencies associated with pain and inflammation has proven to be a safe and effective method for pain control.  Two double-blind, randomized,  trials, which compared Theramine to low dose naproxen and ibuprofen demonstrated statistically significantly reduction in inflammation as measured by inflammatory markers, CRP and IL-6 as well as improvement in low back pain.  Theramine was shown to be an effective pain medication but also an effective anti-inflammatory agent without the risk of gastrointestinal bleeding or other serious side effects.

All of the ingredients in Theramine are GRAS (generally recognized as safe) products and carries no risk of addiction or attenuation.  Theramine has been on the market for 10 years without report of GI bleed or serious adverse side effects.

There are several patient populations that should avoid NSAIDs due to the high risk of side effects.

  • Patients over 65 years of age
  • Previous GI history such as peptic ulcers or previous GI bleed
  • Patients with cardiovascular disease
  • Patients with liver disease
  • Patients with kidney disease
  • Patients on anti-coagulants or low dose aspirin

The cumulative evidence of the danger of NSAIDs is an important reminder that the while NSAIDs can be helpful and at times necessary medications for satisfactory quality of life, use of these medications, particularly among high risk patients must be carefully considered.

 

1.  Gang Liu, MD, PhD, Yu-Peng Yan, MD, Xin-Xin Zheng, MD, Phd, Yan-Lu Xu, MD, Phd, Jie Lu, MD, Ru-Tai Hui, MD, Phd, Xiao-Hong Huang, MD, Phd “Meta-Analysis of Nonsteroidal Anti-Inflammatory Drug Use and Risk of Atrial Fibrillation” The American Journal of Cardiology Nov. 15, 2014 Vol. 114, Iss. 10

2. Anne-Marie Schjerning Olsen, Gunnar H. Gislason, Patricia McGettigan, Emil Fosbøl, Rikke Sørensen, Morten Lock Hansen, Lars Køber, Christian Torp-Pedersen, Morten Lamberts. Association of NSAID Use With Risk of Bleeding and Cardiovascular Events in Patients Receiving Antithrombotic Therapy After Myocardial Infarction. JAMA, 2015; 313 (8): 805

3.  Solomon DH, Schneeweiss S, Levin R, Avorn J. “Relationship between COX-2 specific inhibitors and hypertension” Hypertension. 2004; 44: 140–145

Alternative Therapies for Pain Associated with Peripheral Neuropathy

Diabetic neuropathy can occur when people with diabetes develop nerve damage. Most commonly, the peripheral nerves of the feet are affected first, causing numbness, cramps, loss of balance, extreme sensitivity and pain starting in the toes and over time progressing up the legs. Diabetic neuropathy can affect nerves in hands and arms, as well as parts of the autonomic nervous system that are responsible for regulating heart rate, blood pressure and sleep cycles. Not everyone who has diabetes will develop neuropathy. (1)

Peripheral neuropathy, also known as distal symmetric neuropathy or sensorimotor neuropathy, is the most common type of diabetic neuropathy. Diabetic neuropathy affects 60-70% of diabetics. Certain risk factors increase the chances of developing diabetic neuropathy. These include age, the duration of the disease, and glucose levels in the blood. There are different factors that may lead to diabetic neuropathy. Additionally, certain neurovascular factors, autoimmune factors, mechanical injury to nerves, inherited traits that increase susceptibility to nerve disease, and lifestyle factors can increase the chances of developing diabetic neuropathy.

Preventing diabetic neuropathies is a challenge but is not impossible. Diabetic patients should keep glucose levels as close to the normal range as possible. Maintaining a normal blood glucose level can help protect nerve cells from unnecessary damage and even lesson symptoms associated with diabetic neuropathy.

There are many treatment options currently available to patients for pain relief associated with diabetic neuropathy. Two commonly used medications for pain relief associated with nerve pain are opioids and a class of medications known as anti-epileptics. Opioids were originally developed to help patients manage pain associated with cancer, but have since been incorporated in a number of pain management treatment protocols for non-cancer pain. This class of medications can be a useful for pain relief, but can also lead to addiction and other harmful side effects. Anti-epileptics like gabapentin are also commonly used to manage diabetic nerve pain. This class of medications was originally developed to treat epilepsy, but has since been approved by the FDA to treat nerve pain. Common side effects of gabapentin and other anti-epileptic medications include dizziness, dry mouth, blurred vision, headaches, diarrhea, fluid retention, and weight gain.(2)

Patients and providers have increasingly been looking to certain medical foods as a safe and effective alternative option to some of the more dangerous pharmaceuticals used for the management of pain and numbness associated with peripheral neuropathy. One example is Percura, a medical food that is specially formulated to provide the nervous system with the amino acids and nutrients required to effectively manage the unique nutritional needs of nerve cells. A recent open label study showed that patients with moderate to severe peripheral neuropathy showed improvement in pain after one month taking Percura. Side effects associated with Percura are mild and temporary and include, bloating and diarrhea. Percura and other medical foods may represent a valuable treatment option for patients with diabetic peripheral neuropathy, without the side effects associated with opioids or anti-epileptic medications.


[1] Dyck, Peter J., Feldman, Eva L., Vinik, Aaron I..  “Diabetic Neuropathies: The Nerve Damage of Diabetes”. National Diabetes Information Clearinghouse.  NIH Publication, February 2009. Web. November 26 2013. http://diabetes.niddk.nih.gov/dm/pubs/neuropathies/#what

[2]“What are the Real Risks of Antidepressants?”.  Harvard Health Publications.  Harvard Medical School, May 2005.  Web. http://www.health.harvard.edu/newsweek/What_are_the_real_risks_of_antidepressants.htm

Sneeze-Free Spring

Spring has finally arrived, but with those trees and blooming flowers comes the dreaded spring allergies.   Pollen becomes airborne and allergy sufferers begin sniffling and sneezing.  40 million Americans a year suffer from allergic rhinitis, also known as hay fever.

The main cause of spring allergies is pollen.  Trees, grasses, and weeds release pollen into the air which can be inhaled through the nose.  Most seasonal allergies occur when the immune system mistakes the pollen as a foreign invader and releases antibodies.  These antibodies are typically used in order to attack bacteria, viruses, and other illness-causing organisms.  When the antibodies attack these allergens, they release chemicals called histamines into the blood which can help stop itchy and running nose and eyes, sneezing, and coughing.

The higher the pollen count, the more likely allergies will flare up.  For an accurate pollen count in your area, click here.  On breezy days, allergy symptoms become more prominent due to the wind picking up pollen and carrying it through the air.  On rainy days, most allergens are washed away, reducing the number of allergy symptoms.

Many people turn to the help of both prescription and OTC medications to manage allergy symptoms.  As with all medications, there are risks because of the possible side effects.

Anti-histamines can cause drowsiness throughout the day, increasing the risk of falls in the elderly as well as increasing the probability of a work or auto related accident.  Anti-histamines often lose their effectiveness over time.  Most OTC decongestants should only be used for 7-10 days.

Nasal decongestants are effective because they reduce blood flow to the nose, constricting blood vessels and decreasing inflammation.  If they are used for long periods of time they may cause rebound nasal congestion.  Nasal decongestants have been shown to cause high blood pressure and heart palpitations, putting older adults and people with cardiovascular disease particularly at risk.

The common side effects of the various OTC nasal decongestants and anti-histamines are often unappealing to people suffering from allergies, sinusitis, and nasal congestion, leading people to look for drug-free alternatives.  There are many benefits to choosing a drug-free alternative.  Drug-free alternatives are safer, have fewer side effects, and can last for longer periods.

When choosing a drug-free product for allergies and congestion, people should always look for the ingredients that are well known for their safety profile and anti-inflammatory properties.  Look for ingredients that have been carefully selected based on their history of safety and efficacy for supporting the natural processes that reduce inflammation, sinus congestion, and an overactive immune response.

Grape seed extract, for example, increases levels of antioxidants by destroying free radicals which are known to cause premature cell death.  Another ingredient to look out for is Choline Bitratrate.  Choline Bitartrate is the precursor to Acetylcholine (Ach), an essential neurotransmitter in your nervous system which can decrease levels of inflammation in the body.  Ach is the neurotransmitter that also controls mucous secretion, membrane constriction, and blood supply to nasal and sinus cavities.  L-Arginine is another safe and effective ingredient that promotes the production of Nitric Oxide, a neurotransmitter that causes the smooth muscle in  blood vessels to relax which helps to increase blood flow.

There are a few other precautions that a person can take in order to help avoid spring allergy triggers.  Getting an air filter can help circulate air around the house, as well as help trap and get rid of some of the larger particles of pollen.  Vacuuming twice a week can help get rid of dust mites that have been trapped in the carpet.  Washing your hair after going outside can help get rid of pollen that may have been caught in a person’s hair.  Clean air filters and book shelves in order to clear off dust mites that collect in the home.  When driving, keep windows closed because the car filter helps remove allergens from the air.  For more helpful solutions please click here.

The Cost of Pain

Pain and the treatment of pain affect every sector of our society with at least 100 million adult Americans reportedly suffering  from common chronic pain conditions, a conservative estimate because it does not include acute pain of children.[1]  The proliferation of pain in the United States has resulted in a sharp increase over the past decade in the overuse of narcotics. The prescribing of narcotics has become a popular option for the treatment of chronic pain associated with back injuries, headaches, arthritis, and fibromyalgia.

Chronic pain takes an enormous personal toll on millions of patients and their families, and leads to increased health care costs. Patients with chronic pain have more hospital admissions, longer hospital stays, and unnecessary trips to the emergency department. Such inefficient and even wasteful treatment for pain is contributing to the rapid rise in health care costs in the United States.

The prevalence of pain has a tremendous impact on business.  A recent report by the Institute of Medicine indicated that the annual value of lost productivity in 2010 dollars ranged between $297.4 billion to $335.5 billion. The value of lost productivity is based on three estimates: days of work missed (ranging from $11.6 to $12.7 billion); hours of work lost (from $95.2 to $96.5 billion); and lower wages (from $190.6 billion to $226.3 billion)[2]. This billion dollar annualized price tag will likely climb as the U.S. population ages.

The cost of pain also includes the cost of treating side effects. The most commonly prescribed drug for pain is Non-Steroidal Anti-Inflammatory Drugs (NSAIDs).  Approximately 98 million prescriptions for NSAIDs were filled in the United States in 2012 (IMS 2012).  Although effective in treating pain and inflammation, NSAIDs are linked to adverse side effects which make them inappropriate for use in many patient populations.  There are several serious side effects and toxicity related to use of traditional NSAIDs which can lead to costly hospitalizations or death.

A study on the effects of NSAID induced side effects in the elderly reflected the average direct costs of GI side effects per patient-day on NSAIDs were 3.5 times higher than those of a patient-day not on NSAIDs. Seventy percent of the cost was attributed to GI events resulting from NSAID treatment. [3]

NSAIDs Image

Treatment of GI problems alone caused by the use of NSAIDs is estimated to add over 40% to the cost of arthritis care[4]

From the perspective of the healthcare system, minor GI side-effects and prophylactic gastroprotection against NSAID-related side-effects may consume even more healthcare resources than severe events because of their high prevalence.

Opioid use has resulted in increased hospitalizations, increased spending on opioid addiction and increased workplace costs.  The cost of the average lost time claim with long acting opioids is 900% higher than those without the use of opioids. U.S. emergency room visits have also increased.  The number of cases in which an opioid other than heroin was cited as a reason for an emergency room treatment in  2004 was 299,498 and in 2011 was 885,348, an almost 300% increase.[5]

While many assume that increase spending and use of pharmaceuticals for pain has had a positive effect on the overall mitigation of pain, there is little scientific data on the relationship between spending on pharmaceutical agents and pain resolution.  Simply treating the symptoms of pain have not proven to be effective nor cost saving in the long run. However, it is increasingly clear that there may be a positive relationship between the use of non-pharmaceutical interventions with or without the use of pharmaceutical and the resolution of pain.

#medicalfoods #NSAIDs #opiods #sideeffects


[1] IMS Health Data, California Workers’ Compensation Institute

[2] Institute of Medicine of the National Academies Report. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research, 2011. The National Academies Press, Washington DC

[3] Br J Clin Pharmacol. 2001 August; 52(2): 185–192. Cost of prescribed NSAID-related gastrointestinal adverse events in elderly patients

[4] Bloom, BS. Direct medical costs of disease and gastrointestinal side effects during treatment for arthritis. Am J Med. 1988; 84(2A): 20-24

[5] IMS Health Data, California Workers’ Compensation Institute

Pain Management without Harmful Side Effects

The reduction and management of pain can involve many approaches: prescription medicines, over the counter medicines, medical foods, cognitive behavioral therapy, physical exercise, surgery, nutritional modification, pain education, massage, biofeedback, music, guided imagery, laughter, distraction, acupuncture, and nerve stimulation.  Two or more approaches combined can have a synergistic or additive effect that is greater than the sum of the parts.  One approach, medical foods, has medicinal value that is just beginning to be understood and can be used as a stand-alone therapy or adjacent treatment for chronic pain.

Due to its’ additive effect and low side-effect profile, Theramine®, a medical foods, can be used with high-risk patients over the age of 65 as an alternative to NSAIDs or narcotics.  Adding Theramine to a pain treatment protocol can lead to a reduction in previously prescribed narcotics and minimize the use of NSAIDs or both.  The ingredients in Theramine are Generally Recognized As Safe (GRAS) by the FDA, have no risk of addiction or adverse GI or cardiovascular side effects.  Reducing the burden of adverse side effects while improving clinical outcomes is critical for the overall patient care and a return to activities of daily living.

Two studies comparing Theramine to a low dose NSAIDs in adults 18 years of age and above found Theramine to be more effective than either naproxen or ibuprofen alone for inflammatory pain.  When Theramine was given in combination with the low dose of either product the results were even more beneficial.  Incorporating the use of Theramine into a clinical pain management protocol, allows physicians the flexibility to use less of a narcotic or NSAID pain reliever and potentially eliminate their use all together.

The two studies comparing the medical food Theramine and a non-steroidal anti-inflammatory medication, Theramine was shown to be more effective than low dose NSAIDs in treating low back pain.  Clinical data indicates significant reduction in back pain with the administration of Theramine alone, and as an adjunct therapy to a low dose NSAID, while administration of a low dose NSAID had no appreciable effect on pain. The use of Theramine as either a standalone or adjunct therapy can significantly improve pain perception.

Theramine is encapsulated with a patented technology that promotes the rapid cellular uptake and conversion of milligram amounts of amino acids and nutrients into the specific neurotransmitters responsible for modulating pain and inflammation.  This patented technology allows Theramine to be effective without losing efficacy over time.

Two multicenter double blind trials have established the safety and efficacy of Theramine in the treatment of chronic back pain. Pain fell by 63% with administration of Theramine and an NSAID as measured by the Roland- Morris Index (Figure 1), and by 62% as measured by The Oswestry Disability Index.

Pain Scale Graph

Traditional pain medication will always have its place in therapeutic treatment and, if used properly, is very effective.  However, physicians, insurance companies, employers and patients are requesting safer, more effective alternatives to treat pain without harmful and costly side effects. The rapidly increasing population of patients 65 years of age and older is a major concern for both physicians and insurance companies as the pain-related costs to overall U.S. health care expenses are likely to rise proportionally as well. The economic impact of pain is certain, as are the physical, emotional, and social impact for millions of people. Reducing the burden of treating chronic pain is a societal necessity, a medical challenge, and an economic requirement.

#medicalfoods #NSAIDs #theramine

The Rising Healthcare Costs of Pharmaceuticals

Prescription drug use and abuse in the United States, continues to rise at an alarming rate as consumers continue to rely on pharmaceuticals for managing disease symptoms. A recent Mayo Clinic study reports that nearly 70% of all Americans have used at least one prescription drug and more than half receive at least two prescriptions, a percentage that has grown over the last decade. A startling 13% of Americans are on painkilling opiods. Increased prescription writing for pharmaceuticals unfortunately results in more side effects, polypharmacy, fatal overdoses and frequent abuse. According the Centers for Disease Control and Prevention (CDC) The overall impact on healthcare expenditures on prescription drugs reached $259 billion in 2010, and accounted for 12 percent of the total personal health care expenditures and is expected to double over the next decade.

This dramatic increase in prescription drug use can be attributed to a number of factors. For example,  as the average lifespan of people increases so to does the incidence of chronic disease, many of which are conditions requiring more treatments and drugs for longer periods of time; patients expect that they will always receive a prescription when they go to a physician’s office which encourages doctors to overprescribe; hospitals and emergency rooms with little time for alternative treatments, want to help patients by giving them prescriptions to treat them expediently for pain, sleep and other issues; and since women on average visit a doctor more frequently than men do, women are often prescribed a narcotic or anti-anxiety drug more often than most men.

generic pills and bottleIncreased prescribing of drugs unfortunately results in more side effects and even fatal overdoses. According to the CDC, from 1999 to 2010, the number of fatal overdoses has increased fivefold among women and tripled among men. When abuse of prescriptions is considered, the problem can be described as epidemic.  Data from the National Survey on Drug Use and Health (NSDUH) show that nearly one-third of people aged 12 and over whom used drugs for the first time in 2009 began by using a prescription drug non-medically.

These escalations continue to put stress on America’s health care system.  Many studies point to the economic impact associated with the increased use of pharmaceuticals. In a recent study released by the Worker’s Compensation Research Institute, the average cost of treating an injured worker without an opiate is $13,000, compared to an average cost of $117,000 for a patient prescribed a long-acting opiate like OxyContin.  According to the Express Scripts 2012 Workers’ Compensation Drug Trend Report for each dollar spent on abused drugs, an additional $41 is used for associated medical treatment.

It’s no secret that more Americans want medical alternatives without the harmful side effects associated with certain pharmaceuticals.  Consumer demands have shifted away from traditional pharmaceuticals to natural alternatives such as plant based pharmaceuticals and more recently medical foods.  In fact, seventy-one percent of sleep-deprived Americans would rather use other means than pharmaceutical drugs to help them sleep, according to a 2013 Harris interactive Rx Sleep Survey.

In one pharmacoeconomic analysis published in the Journal of Pharmacy Research, it was determined that the actual cost of using the non-opiate pain medication, Theramine®, a prescription medical food with minimal side effects is considerably lower when compared to the total impact of NSAIDs.  Medical foods, once a novelty, are becoming mainstream for a variety of diseases. Since drugs and medical foods work along different pathways in the body, medical foods are often recommended as a complementary or adjunct medication to a reduced dosage of a drug, thereby minimizing the potential of harmful side effects associated with traditional, high dose medications. Medical foods offer an important alternative to traditional pharmaceuticals ultimately improving patient outcomes and reducing healthcare care costs.