#TimesUp; #NeverAgain; #Privacy; #OpioidCrisis; #BlackLivesMatter…. The last year has been a dramatic one for turning points in long-festering social issues. For decades, we turned our cultural cheek on problems we knew existed (misogyny and bias) or should have seen coming (opioids, mass killings and privacy). But in 2017 and into 2018 we are witnessing a tidal wave of resistance and public denunciations against the ugly side of American life. A collective enough is enough echoes across most every city and small town. We are exasperated, frustrated and increasingly skeptical of the marketing messages, the government oversight, and even the broader social order.
Multiple sentinel events preceded our awakening and the momentum grew with each societal failure exposed. Ironically, what many have seen as a “me first” political shift is colliding head-on with a cultural tilt toward broader societal ideals where safety supersedes freedom and equal rights trumps individual power (sorry, couldn’t resist).
Healthcare has felt the full force of impact this shift, with the opioid epidemic leading the headlines. And perhaps that crisis is revealing a crack in the industrial healthcare complex. In particular, the behavior of doctors and pharmaceutical companies over the last few decades is giving some of us considerable pause.
While the total number of prescriptions has been skyrocketing for some time now, much of the recent growth has been fueled by the so-called lifestyle drugs and medications for pre-disease states. For every legitimate and life-saving prescription written for major depression or paralyzing anxiety disorders, several more are being doled out for situational distress, poor coping, and/or general mood enhancement. From energy to erections, it is no longer necessary to be satisfied with an underperforming life. The promise of enhancing our lives with more focus when we need it, and more sleep when we can’t, is simply too tantalizing to avoid. With the long-term risk of this “life-hacking” unknown, we are diving head-first, throwing caution to the wind. And the entirety of healthcare has been complicit.
Yet, we are neither happier nor healthier for it. We ignored the negative feedback loops, receptor downregulation, and side effects we should have seen coming. With prolonged use our shortcuts to better sleep, better relationships, and better self predictably lost their effectiveness or upset the delicate neurohormonal balance that forms the foundation of homeostasis. Short-term fixes quickly gave rise to long-term struggles that has many of us, myself included, wondering what exactly we got ourselves into. We should have seen this coming.
But, with the ugly consequence of narcissism and hedonism on full display recently, a tremor of resistance and self-awareness just may be building. With each story of addiction, abuse, and failure, the relentless American pursuit of power and self-determination is humbled just a little bit. In fact, a new and growing movement is afoot to “unprescribe” America and refocus our priorities on addressing the bio-psycho-social roots of many of our health problems. Dubbed the “slow medicine” movement, these physicians are working to reverse the cultural belief that every symptom needs a drug, instead relying more on the body’s natural healing process (and time) to support recovery and well-being.
To improve the lives of our patients, we must reverse course on overprescribing and slowly chip away at the marketing messages that encourage a medication-first culture in this country. It won’t be easy or quick, but the path to a joyful and fulfilling life is never short and fast. Slow and steady wins this race.