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Over Dose

Memphian April Houser takes four medications each day — a sleep aid, two antidepressants, and birth control pills — but since her boyfriend’s 10 prescriptions fill the medicine cabinet, she has to store her own pills on the nightstand.

Her boyfriend, who asked to remain anonymous, takes several allergy medications, anti-depressants, prescription vitamins, and pills for chronic fatigue syndrome.

“In the morning, it takes him about 15 minutes [to take all his medications],” said Houser. “Then he has to do it all over again each night.”

It may sound out of the ordinary, but according to a new study, Tennesseans lead the nation in prescription-drug use. The study, done by Blue Cross Blue Shield of Tennessee (BCBS), found that the average state resident filled 17.3 prescriptions in 2005. The U.S. average was 11.3 prescriptions.

“We’ve been number one for several years,” said Bill Cecil, director of health policy research for BCBS.

With such a high rate of prescription use, Tennesseans should also rank high in terms of overall health. But according to the United Health Foundation, which ranks states’ health status each year, Tennessee ranked 47th in 2006.

“Tennessee has issues with obesity, and the number of related diseases is pretty high in terms of diabetes and hypertension,” said Lawrence Brown, a professor at the University of Tennessee’s College of Pharmacy.

Generous TennCare benefits may also play a role in the study’s findings. Before 2005, TennCare enrollees had unlimited access to prescriptions. But after recognizing a high prescription rate among enrollees, the agency instituted a limit of five prescriptions per month.

“We’ve already gone from an average of 32 prescriptions [per enrollee per year] to about 10,” said Marilyn Wilson, a spokesperson for TennCare.

There’s a financial issue too, aside from the cost of purchasing the medicine. As a result of Tennesseans’ use of prescription drugs, insurance rates have skyrocketed in recent years.

“That’s been the truth for the increases in the past six to eight years,” said Cecil. Side effects of using too many prescription drugs, such as accidental poisonings and resulting hospitalizations, affect insurance rates as well.

But does the high rate mean that Tennesseans are abusing prescription drugs or does it mean that the state population is plagued with illnesses?

“Right now, we really don’t know,” said Brown, who’s researching the issue at UT. “We’re looking at health status, education level, socioeconomic status, and insurance to determine if any of those factors are what’s leading to the higher utilization in Tennessee.”