Americans are taking more and more prescriptions drugs. How much more? Let's see the data!

Females still have a higher average rate of prescription drug usage than males. But males are closing the gap fast. Also, prescription drug usage has increased across all Age Groups.

We have some CDC data to breakdown and visualize. In fact, the data visualization dashboard for this post, Polypharmacy USA, is already online. The Githhub repo, likewise. As always, all graphs, code, and data tables produced by Data Humanist for American Exile are licensed under CC0 1.0 (Universal Public Domain). Open Source, Open Science. Transparency with both data and analysis.

But first, some context — some background notes about FDA Fast-Track Approval and about the Ubiquity of Antidepressants.

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Fast-Tracking Prescription Drug Approval
Over the past half century, Big Pharma has brought many more drugs to market — a large proportion of which are directed towards life style diseases and the aging population. In fact, since 1992, the FDA has offered a fast-track approval process to help Big Pharma get the products out the door and into the public. So call this progress — except when it is not.

The prestigious journal Nature (13 May 2022) reported on one of many controversies:

“Despite a nearly unanimous vote against the approval [of Aducanumab, marketed as Aduhelm] by an independent panel of experts, the agency fast-tracked the drug, which was developed by Biogen, a biotechnology company based in Cambridge, Massachusetts. Three advisory-panel members resigned in protest against the decision, and the approval is the subject of multiple investigations by federal regulators.”

The independent panel of experts voted “No,” but the FDA said “Yes.” The story does not end there. For the USA market, Biogen recently cut the price of Aduhelm in half. But on 20 April 2022, Biogen withdrew its application for marketing the drug in the European Union. Why?

Because the European Medicines Agency — the EU equivalent of the FDA — had “recommended refusing marketing authorisation in December 2021” for Aduhelm and Biogen appealed but lost the review (EMA: 225498).

So to Aduhelm, the FDA said “Yes,” but their independent panel of experts said “No” — and later, the EMA said “No.” Whom do you trust?

Antidepressants: Progress, right?
Aduhelm is just one dubious drug, but we have an entire class of dubious prescription medications widely used in the USA and elsewhere: antidepressants. Over the past three decades, antidepressant use has been increasing among American adults: as reported by both the CDC [1] and the National Center for Health Statistics [2].

So much so that the U.S. Geological Survey (USGS) documented in 2018 that antidepressants as pollutants were not only in stream waters but also in fish:

But let’s pretend the pollution of our environment by prescription drugs does not exist. So ignore also the recent report out of Florida International University (2 February 2022), “Pharmaceutical contaminants discovered in South Florida bonefish:

“Pharmaceutical contaminants originate most often from human wastewater and are not sufficiently removed by conventional water treatment. They remain active at low doses, can be released constantly, and exposure can affect all aspects of fish behavior, with negative consequences for their reproduction and survival.”

Let’s not talk about the fish. Why else might the increase in antidepressant usage be a problem and not just medical progress? Because except for transitory relief — very short term,  antidepressants do not work. Over time, you do NOT get better and you may well get worse. Really? Antidepressants stop working? Says who?

To cite the conclusion from the peer-reviewed study “Antidepressants and health-related quality of life (HRQoL) for patients with depression: Analysis of the medical expenditure panel survey from the United States” (20 April 2022):

The real-world effect of using antidepressant medications does not continue to improve patients’ HRQoL [health-related quality of life] over time. Future studies should not only focus on the short-term effect of pharmacotherapy, it should rather investigate the long-term impact of pharmacological and non-pharmacological interventions on these patients’ HRQoL.

See also the U.S. News coverage (20 April 2022). Even the MSM admits we might have a problem. So the “real-world effect of using antidepressant medications” over time is not beneficial. Could it be outright harmful? On 27 May 2022, fellow substacker A Midwestern Doctor at The Forgotten Side of Medicine argued:

Prior to the Covid vaccinations, psychiatric medications were the mass prescribed medication that had the worst risk to benefit ratio on the market.  In addition to rarely providing benefit to patients, there are a wide range of severe complications that commonly result from psychiatric medications.

The severe complications include an increased propensity to commit acts of self-harm and of violence. On 2 June 2022, A Midwestern Doctor followed up with “How the FDA Buried the Dangers of Anti-Depressants.” Both essays are long reads, but well worth the time and trouble.

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Polypharmacy and the Bigger Picture

At American Exile in another post, we discussed the trend lines for Obesity and Metabolic Syndrome, Diabetes and Pre-diabetes, and Hypertension and Heart Disease. All bad. Since the 1970s, drastic — almost unbelievable — increases in from lifestyle disease illnesses. Yet concurrent with this, we had another upward trend: polypharmacy, meaning “the use of multiple medications by a patient.”

So the trend is not that more Americans overall are using prescription drugs, although this is generally true. Rather, when we break it down on a per person basis, that person is now also more likely to be using multiple prescription drugs: that person is now a poly-pharmaceutical American.  

The following graph is based on the CDC data we analyze here. For the Age Group 65 and older, stratified by Sex, it shows the population percentage which has used “At least five” prescription drugs (that is, different prescriptions) in the past 30 days.

We might reasonably expect that senior citizens will use more prescriptions, and that since the first Year Range in this data, 1988-1994, to the last, 2015-2018, we might see a general increase. But did you expect the scale of increase as shown above?

The plotted data above summarized in the chart below:

Women (adult biological females) went from 15.6% to 41.9% — so now 2.69 times greater, with a population percentage increase of 26.3%. Men (adult biological males) went from 11.3% to 42% — so now 3.72 times greater, with a population percentage increase of 30.7%. If only this Age Group were now 2.69 to 3.73 times healthier., instead of 2.69 to 3.73 times more poly-pharmaceutical.

One major issue with polypharmacy: interaction effects.  In the words of Jonathon Sullivan, MD, of Grey Steel, the various prescriptions “can work antagonistically or synergistically in unwholesome ways.” Even the NIH (24 August 2021) has expressed concerns:

Inappropriate polypharmacy — the use of excessive or unnecessary medications — increases the risk of adverse drug effects, including falls and cognitive impairment, harmful drug interactions, and drug-disease interactions, in which a medication prescribed to treat one condition worsens another or causes a new one.

When we break down American polypharmacy further by biological sex and age range, we find some truly disturbing patterns in prescription drug usage.

Disturbing why? Because Americans are NOT getting healthier despite all this medication. In our CDC data set, the Age Group 18 to 44 years old shows proportionally the strong increases in polypharmacy. Younger people are using more prescriptions more often. The prime marketing demographic captured.

So let’s have a quick look at Age Group 18-44 for “At least three prescriptions used in the past 30 days”:

Women (adult biological females) went from 7.6% to 11.9% — so now 1.57 times greater. Men (adult biological males) went from 3.6% to 8.2% — so now 2.28 times greater. (Below, the chart for the above graph).

Strange. It’s almost as if Big Pharma and Big Corporate Healthcare are profiting from perpetuating unhealthy lifestyles, from sustaining not preventing chronic illnesses. It’s almost as if Big Pharma along with Big Government were promoting legalized drug-dependency as the answer to everything. Even to the exclusion of eating clean, staying active and exercising, and taking personal responsibility for one’s health.

Like Covid, for example, when you were told to lock yourself up for a year and wait for the vaccine. The vaccine which would ensure that you would never get sick from — let alone die from — Covid. President Joseph Biden told us that — and did so even as late as July 2021. But otherwise, there was nothing you personally could do for your own health. Just trust in and rely upon Big Pharma, Big Government, and the MSM.

By the way, let’s also momentarily stop pretending that prescription drugs contaminating in our water supply does not present environmental and health problems.  Way back in 2011, Circle of Blue reported on “Unprescribed: Legislation to Keep Drugs Out of Water Thwarted by U.S. Pharmaceutical Lobbying.” Big Pharma is still winning that battle. (Infographic below courtesy of Kelly Shea @ Circle of Blue):

We have a clear-trade off. Eating clean and living healthy results in less need for prescription drugs and so also eventually cleaner water and better food supplies. But SAD — the standard American diet — and sitting on your ass too much results in more usage of prescription drugs and greater contamination of the environment. Upward spiral or downward spiral. Your call: which direction is our nation is going?

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Data Time!

Our data set, which contains the most recent data the CDC makes publicly available: “Table 39. Prescription drug use in the past 30 days, by sex, race and Hispanic origin, and age: United States, selected years 1988–1994 through 2015–2018.”  To download the CDC source:  [Excel | PDF].

The “selected years” or Year Ranges are 1988–1994, 1999–2002, 2001–2004, 2003–2006, 2005–2008, 2007–2010, 2009–2012, 2011–2014, 2013–2016, 2015–2018. (Yes, we have a gap in the original data set). For each Year Range, the data set reports on

• Percent of persons using at least one prescription drug in the past 30 days

• Percent of persons using three or more prescription drugs in the past 30 days

• Percent of persons using five or more prescription drugs in the past 30 days

We will simplify this to At least one, At least three, and At least five. Below, a quick comparison for the first and last Year Ranges in our data set, 1988-1994 versus 2015-2018, stratified by Sex:

The above graph —and the chart below — report on all four of the Age Groups in the data set: Under 18, 18-44, 45-64, and 65 & older. We see a strong prevalence towards polypharmacy. Females have a higher rate of prescription drug usage than Males. But since 1988, Males have made the more significant gains in prescription drug usage.

In the the chart below, the column Delta reports the population percentage increase or decrease (all increases here); the column Ratio compares the most recent Year Range, 2015-2018, to our starting Year Range, 1988-1994. The Male ratios are consistently higher than the Female ratios.

These results break down even further. The data — as we saw earlier — can be stratified by Age Group: Under 18 years, 18–44 years, 45–64 years, and 65 years and over. The dashboard Polypharmacy USA, created for this post, does exactly that. If you wish to dig deeper into the details, please pay it a visit.

Bottom line: since the 1990s (but starting earlier), we have sharp upward trends in Obesity and Metabolic Syndrome, Diabetes and Pre-diabetes, Hypertension, and also Polypharmacy. Americans use more and more prescription drugs, at earlier ages in life, but are not getting healthier. Good for Big Pharma — in terms of profit, power, and influence. But good neither for your individual health nor our shared environment.

What does work? For personal health, Dr. Suneel Dhand, MD, offers some no-nonsense advice that we at American Exile highly endorse as a starting place.

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