TL:DR - From my experience, there are too many people who just accept that they will have to be on a medication forever. The medical system and doctors are incentivized to prescribe. The best way to avoid falling into the endless loop of polypharmacy (taking anywhere from 3-10 medications at once) and specialist referrals, aim to become so healthy that you become "un-prescribable."

This week, I had another conversation about a client’s "lifetime medication," and I’m getting tired of it.

So I’m coining a new term—"Un-prescribable."

What it means to be Un-prescribable

I define un-prescribable as being so healthy that the mainstream medical system can find no probable cause to put you on a medication and has no idea what to do with you because you are in the minority of healthy individuals.

You want to tip-toe so stealthily around the healthcare system that you don’t trigger a button that says, "I meet a diagnostic criteria for a high risk of disease! Treat me!"

It is usually a symptom or screening lab test that triggers a cascade of more screening, referrals, and finding a reason to put you on a medication.

The game I recommend playing is that you do such a great job of maintaining your body and mind that the only reason to go to a hospital is for a life-threatening emergency.

The most common triggers for a lifetime medication are:

• Mental health (stress, anxiety, depression)

• Metabolic disease (like diabetes)

• Cardiovascular disease (high cholesterol and blood pressure)

• Cancer

• Chronic inflammation (from infections, diet, lifestyle, medications, stress, environment)

• Digestive issues

• Obesity

• Pain

From a naturopathic perspective, the risk factors for one are the same risk factors for all. So it does not make sense to treat every disease like a special snowflake that requires its own patented medication forever.

What is a lifetime medication?

It is a medication that is prescribed with the expectation that a patient will be on it for the remainder of their life. I’ve seen it too many times.

At first, I was much more understanding. If someone’s doctor had prescribed a medication, I assumed there was solid clinical reasoning to prescribe it.

I witnessed this firsthand as a volunteer health coach at a community clinic in San Francisco. I would work with patients with Type II Diabetes who were often on a cocktail of medications. My job was to coach them with my rudimentary understanding of nutrition and exercise, and I don’t remember hearing any emphasis otherwise towards a plan to de-prescribe medications.

Then I began to see it once I started my own practice as a Naturopathic Doctor.

One of my early patients had been on proton pump inhibitors (PPI’s like Prilosec) for more than a decade. PPI’s suppress stomach acid that is required to absorb Vitamin B12 and to maintain an acidic environment in the stomach to digest food and fight off harmful microbes. Plus, the insert itself says it is meant for short term use only.

Then I saw more cases of patients left on medications for years and decades, while their problem persisted.

• Antibiotics as prophylaxis (aka prevention) of chronic UTI’s (urinary tract infections).

• Steroids for inflammatory conditions.

• Antidepressants for depression (of course) but also for Irritable Bowel Syndrome. Does that even make sense?

• Gabapentin for chronic pain without trying to find the cause or providing alternatives.

• Statins for high cholesterol even if it caused muscle pain and increases risk for mitochondrial damage and dementia.

Literally, a pill for every ill, without any improvement in health.

Why do patients end up on medications forever?

First, I want to acknowledge that there are circumstances where long term medication use is necessary. This should be the exception, not the norm.

My frustration is there are far too many people who are stuck on a medication who would be able to otherwise discontinue their medication with intensive lifestyle, nutrition, natural, and movement therapies.

Pharmaceuticals have become a first-line therapy

Starting in 1910 with the Flexner Report, there was a shift in American health policy to move to a more disease-based model of medicine. The number of medical schools were decreased and medical training was centralized to a smaller number universities.

The goal was to standardize medicine with higher educational standards and science-backed therapies. This seems like a positive on the surface, but it also led to the elimination of other medical schools that taught alternatives like homeopathy, osteopathic medicine, and naturopathic medicine.

This more centralized system also paved the way for the biggest financial donors (like the oil titan John D. Rockefeller at the time) and lobbyists to influence how doctors were trained, what research was funded (or excluded), and what types of medicines were favored (profitable).

Long story short, the way medical schools educate doctors today is based on a "diagnose the disease and prescribe medication" paradigm of practice.

Health-focused doctors have to go out of their way to educate themselves on nutrition, exercise, and natural therapies.

Doctors don’t believe the body can truly heal 

During my medical school education, I just kept hearing even in naturopathic medical school that Type II Diabetes was incurable. It was only up till recently that more doctors are recognizing that Type II Diabetes can be reversed.

The same goes for digestive issues like Irritable Bowel Syndrome, Cancer, Heart Disease, and Depression/Anxiety.

If a condition is thought to be incurable, then of course the only solution is management through medications and procedures.

You may not believe you can truly heal

It is not just doctors. We have been convinced by the constant stream of pharmaceutical ads that gradually brainwashed us to link a newly named syndrome or disease that can be cured by the latest and greatest drug. Of course, you see these pharmaceutical ads only after seeing the newest fast food value meal ad that plays during the commercials during your favorite sporting event timeout.

But don’t blame yourself. When you have dealt with a health issue for long enough, why would you believe it could change?

Insurance companies dictate incentives

I have never contracted with an insurance company because I do not want their reimbursement schedule to dictate how I practice.

There is a medical billing game where doctors have to constantly justify how they practice to a middleman who is not involved in someone’s care. Intentionally or not, the things I feel are most important—nutrition and lifestyle consulting—do not get reimbursed at a rate that would make practicing medicine financially viable.

Reimbursement rates are based on a formula based on time, complexity, and procedures. And if the insurance company doesn’t agree, then you or your billing team has to fight the insurance company for reimbursement. As a result, I could spend an hour consulting you on life-changing nutrition and lifestyle, and not get paid for that time. Clinics also have to spend time and energy with this administrative overhead instead of caring for you!

This creates an environment where the practice gets paid more the sicker you are. This also dis-incentivizes starting with the lowest risk therapy first or optimizing for the best clinical outcome because non-intervention doesn’t get reimbursed.

I have met great, caring doctors in the insurance-based system, but they are often working under the constraints of that system and are forced to play the game while juggling their duty to care for you.

Not addressing the root cause(s)

In the examples I mentioned above, I have seen and experienced clients getting off their medication.

Why? We changed the underlying conditions that were causing the symptoms. In naturopathic medicine, we call it removing the obstacle to cure.

There is always a reason for an illness, even a mysterious one. This is part of the fundamental belief that nature does not make mistakes and disease is the body’s response to a threat.

Robert Naviaux coined the term "Cell Danger Response." He proposes that all diseases are a cellular response to a perceived threat. This completely changes how we approach disease—remove the threat, and the symptoms and disease will resolve itself as long as irreversible damage has not been done.

How to become un-prescribable

First, do not accept that a pharmaceutical is always the only long-term therapy.

Always ask if there’s an alternative or what it will take to not need it anymore. There is no such thing as a 100% safe and effective therapy without side effects. Side effects should really be called known adverse effects. Be stubborn about it.

Your doctor should be as stubborn and determined as you to get off a medication or avoid it all together. If not, it’s time to find another doctor who is open to having an open discussion about it with you.

Second, know that most diseases start well before they become diagnosable.

You must start working on your health today.

Cancers can grow for years before reaching a detectable size. Pre-diabetes starts years before diabetes. No one gains weight overnight.

Start doing mini lifestyle experiments. Keep what works. Eliminate the rest.

Third, realize that you are either moving towards or away from health with every thought and action you take.

Therefore, your one objective in life is to remove anything that leads to declining health and stack as many healthy habits, thoughts, and behaviors for the rest of your life.

Becoming un-prescribable is as much as a mindset as it is the latest and greatest supplement or miracle drug.

If you are with me, I will be going into more specific strategies and tactics. But I wanted to at least start to define the objective to aim for—becoming un-prescribable.

P.S. Are you with me? Let me know if the comments below and share this with someone who might need to hear this message.

P.S. Do you want my help to become Un-prescribable? I work with my clients to use intensive, manageable lifestyle changes to get off their medications and minimize how many supplements they need.

Schedule a consult here https://l.bttr.to/uYxzi or reach out via email.