When Did This Become Acceptable?

This is the part I struggle with.

When did it become acceptable for somebody to be taking ten, twelve or even more medications, still be profoundly unwell, and for the answer to another symptom to simply be another prescription?

At some point, surely somebody has to stop.

Not for another five-minute conversation about the latest symptom. Not to add another tablet. But to sit down with the person, look at everything they are taking, why they are taking it, when each medication was started, what symptoms appeared afterwards and whether every prescription is still necessary.

Because when somebody is taking multiple medications and becoming progressively less well, continuing to add to that list without repeatedly reviewing the whole picture is not good enough.

It is unacceptable.

A Prescribing Cascade Should Be a Warning Sign

There is a recognised term for what can happen when a medication causes a side effect that is then interpreted as another illness: a prescribing cascade.

Think about what that actually means.

A person develops a symptom because of a treatment. The symptom isn't recognised as a possible adverse effect. Instead, it becomes another diagnosis and another drug is prescribed.

That drug can then create its own side effects.

And the patient can end up carrying an ever-growing list of diagnoses and prescriptions while becoming increasingly frightened, confused and disconnected from what originally went wrong.

Could something we're already giving this person be contributing to what we're now trying to treat?

That question should be fundamental.

We Have to Stop Normalising People Feeling Terrible

I also think we have become far too accepting of people living in a state of chronic ill health.

Exhaustion. Brain fog. Constipation. Dizziness. Poor sleep. Digestive problems. Pain. Weakness. Anxiety. Loss of independence.

People can begin to believe that this is simply their life now.

I don't accept that we should automatically dismiss these things as inevitable consequences of ageing, chronic illness or "just one of those things" without asking whether medications, interactions, nutritional deficiencies, diet, blood sugar, hormones, digestion, sleep or other underlying factors could be contributing.

A person is not a collection of separate symptoms requiring separate prescriptions.

They are one human being.

Who Is Actually Looking at the Whole Medication List?

This is another question that needs asking.

A person may have medication prescribed by their GP, a hospital consultant, a pain clinic, mental-health services. psychiatrists or another specialist. They may also be taking over-the-counter medicines.

Who is looking at the complete picture?

Who is asking whether one treatment is worsening another problem?

Who is checking whether several medicines have overlapping effects?

Who is asking whether the person still needs something prescribed five or ten years ago?

Who is investigating whether their nutritional status has changed?

And most importantly:

Who is asking the patient how they actually feel?

If someone is taking a bag full of medication but can barely function, we cannot simply point to a list of controlled diagnoses and call that successful healthcare.

We Need to Stop Accepting "More Medication" as the Only Progress

Medication can save lives and can be essential. But prescribing something is not the same thing as restoring health.

There is a difference between managing disease and building health.

Where appropriate, healthcare should also be helping people improve their nutrition, metabolic health, movement, sleep, digestion and understanding of their own bodies. It should investigate persistent symptoms rather than automatically suppressing each one as it appears.

And where medication is sometimes necessary, it should be regularly reviewed so that people are taking what they genuinely need, not simply accumulating prescriptions indefinitely.

For me, that is the issue at the heart of this.

I'm not angry that medication exists.

I'm angry when people are left profoundly unwell and frightened while the medication list gets longer and nobody appears to be going back to ask why.

That is the part I find totally unacceptable.

What if people were given better information when those first symptoms appeared?

A symptom is information. It is a sign that something in the body may need attention. Instead of only asking “How do we get rid of this symptom?”, we should also be asking:

“Why has this symptom appeared, and what is the body trying to tell us?”

Imagine if people were routinely taught to understand those early signs. If we looked at nutrition, deficiencies, blood sugar, digestion, hormones, thyroid function, sleep, stress, the nervous system, lifestyle and appropriate testing before a relatively small problem had the opportunity to become a much bigger one.

Sometimes that knowledge could potentially nip a problem in the bud.

Surely we should be doing everything we reasonably can to help people understand and support their health before they reach the point of long-term chronic illness and barely functioning, or, in some cases, being unable to function at all.

Because the consequences of reaching that point can be devastating.

Chronic illness can take away someone's ability to work, socialise, exercise, care for their children, maintain relationships or live independently. It can affect their finances, identity, confidence and hope for the future. For some people, the physical and psychological burden of severe long-term illness can become so overwhelming that they experience suicidal thoughts or even die by suicide.

We cannot treat that level of human suffering as an acceptable endpoint.

How different might some people's lives have been if, when their body first began signalling that something was wrong, somebody had given them the knowledge, time and support to understand those signals and act on them?

Perhaps instead of spending years managing an ever-growing collection of symptoms, diagnoses and prescriptions, some people could be living healthier, more independent lives and functioning far closer to their own optimal level.

That, for me, is why prevention and health education matter so much.

We shouldn't wait until somebody's health — and sometimes their entire life — has unravelled before we teach them how to understand and support their body.