Page 48 - Fall2011

WHY OVERMEDICATION? I am expected to suggest an appetite stimulant,
Why do medical directors or physicians allow overmedication? antidepressant, or a synthetic form of multivita-
min with alcohol stimulant. If there is nausea, a
1. They are not aware the medication is causing side effects. In most nurs- medication is administered for it and the cause
ing homes, they visit and review their residents infrequently or not at of nausea is not addressed. If pain is the cause of
all. Their care is typically based on a signature to a previously defined weight loss, a pain medication is administered,
“protocol.” The rest of their care is typically responding to a nurse’s and the cause is not addressed.
request. Most often, the nurse does not understand potential side effects When I challenge this current treatment
and medicates the side effect, assuming it is a new disease process. paradigm, the staff is uncomfortable because I
2. They are hesitant to discontinue a medication another physician has have introduced a subject about which I am more
started out of respect to the physician. With many specialists, the list knowledgeable, and a modality with which they
of medications becomes extensive. are unfamiliar. I am not expected or asked to
3. They do not understand the contraindications and harmful side effects spend time on a discovery as presented below in
of medications. A physician receives his continued training from a the holistic model. No one is asking why in this
pharmaceutically sponsored class or meeting with a pharmaceutical setting, and consequently no one is getting well.
representative, whose ultimate goal is to sell drugs. As a holistic nutritionist I ask, “Why is this
4. They may have no training in geriatric medicine, nor does the pharma- person losing weight?” I review medications
ceutical representative. There are many drugs that are not well tolerated that may cause anorexia or fluid loss, as well
in the elderly or in an overmedicated resident with compromised liver as nutritional deficiencies (such as a common
and renal function. anticonvulsant-induced osteomalacia). I rule out
5. They protect their own interests. If the resident presents with an event pain (often a statin-induced myopathy). I confirm
such as stroke and the medication for that disease process has not been that a drug is not used which is contraindicated
prescribed or has been discontinued, the physician can be deemed li- for poor renal or liver function causing nausea.
able. Therefore they prescribe the medication, even though they may I rule out increased energy expenditure such
not consider the therapy beneficial or believe in it. as new diagnosis of cancer or lung disease or
6. They are trained only in pharmaceutical therapy or invasive procedures. increased healing needs. I evaluate balance of
When a disease presents, they want to do something to help, and phar- mind, body and spirit. I analyze adequate intake
maceutical intervention is all they understand. and utilization of minerals, which could result in
7. If they understand integrative healing therapies or suggest them, the depression, sleep disturbance or poor hormone
healthcare facility would not allow it. The Medicare-Medicaid Program utilization. I address the root of the weight loss,
does not pay for this. The facility or resident would incur the cost, which rarely simply calls for more food or supple-
something most are unwilling to do. ments. Additional pharmaceuticals or “natural
8. They do not believe or trust in the body’s ability to heal, and assumes medicines” may be suggested. There are many
the resident will rely on pharmaceutical therapy forever. natural medicines that prove clinically important,
which can replace or work in conjunction with
Why don't medical directors or physicians suggest healing and inte- pharmaceutical therapy. Most have little or no
grative therapy? They either do not understand it, or believe they will lose side effects (see Jelin JM, Gregory PJ and others.
income to a “competitive” therapeutic approach. Pharmacist’s Letter/Prescriber’s Letter. Natu-
ral Medicines Comprehensive Database. 12th
RESOLUTIONS FOR CHANGE edition. Stockton, CA: Therapeutic Research
When a disease process presents itself, we should ask why this has Faculty: 2009; pg 1- 2004).
occurred. Health care providers should attempt to resolve the root of the In my experience, chiropractors, acupunc-
disease with a healing therapy. At the same time, if a pharmaceutical turists, massage therapists, naturopathic doctors,
therapy to ease symptoms is implemented, this should always include plans energy workers, true nutritionists (not dietitians),
to reduce or eliminate it as the symptoms resolve. A drug should never be and so on, are trained this way. They work to sup-
used as a “cop out” in addressing the primary cause of the disease. port healing, not to drug or to conduct their work
For example, I have a nursing home resident who is losing too much in support of an industry. Today you will find
weight. As a dietitian, I am expected to order Ensure, or a pharmaceutically some physicians moving into this paradigm and
sponsored synthetic supplement, update food preferences, and add more away from the pharmaceutical model and some
fat (most often synthetic trans fat) to the food. If weight loss continues, medical schools are teaching these modalities.
48 Wise Traditions FALL 2011 FALL 2011 Wise Traditions

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