Healthy Matters - with Dr. David Hilden

S01_E13 - Talking All Things Pharmacy with a Pharm D

May 29, 2022 Hennepin Healthcare Season 1 Episode 13
Healthy Matters - with Dr. David Hilden
S01_E13 - Talking All Things Pharmacy with a Pharm D
Show Notes Transcript

5/29/22
 
The Healthy Matters Podcast
 
Episode - 13 - Talking All Things Pharmacy with a Pharm D


What's with the expiration date on our drugs?  What is Noloxone?  Why are prescriptions so expensive in the U.S.?

Pharmacists are an essential piece of the healthcare puzzle, and frankly, we wouldn't really have much of a healthcare system without them.  Join us for Episode 13 of The Healthy Matters Podcast where we explore all things pharmacy with Dr. Laurie Willhite, a Pharmacy Doctor at Hennepin Healthcare.

How much does a pill weigh?  Well, not very much.   But Hennepin Healthcare pharmacies alone disposed of expired meds in the community equal to the weight of the entire starting lineup of the Minnesota Vikings - just last year!  Learn about the best practices for staying on top of your medications, when and how to dispose of them, as well as a role you can play to help with the opioid epidemic, on Episode 13 of The Healthy Matters Podcast!

Got a question for the doctor?  Or an idea for a show?  Contact us!

Email - healthymatters@hcmed.org

Call - 612-873-TALK (8255)

Twitter - @drdavidhilden

Find out more at www.healthymatters.org

Speaker 1:

Welcome to the healthy matters podcast with Dr . David Hilton , primary care physician and acute care hospitalist at Hennepin healthcare in downtown Minneapolis, where we cover the latest in health healthcare , and what matters to you. And now here's your host, Dr . David Hilton .

Speaker 2:

Hey everybody. It's Dr . David Hilton . Back with episode 13 of the healthy matters podcast. Today, I've invited Dr . A pharmacy, Lori Wil height to talk about medications and all things that a pharmacist would know. It's gonna be a great show. So let's get to it. Lori , welcome to the show and thanks for being here. Happy

Speaker 3:

To be here, Dr . Hilton . Thank you.

Speaker 2:

Tell me for a minute. You're a pharmacist, but pharmacists do a variety of things. I'm calling you a pharmacist at work. We often call you a phar D. That's what we refer to many people. Listening, probably know their pharmacist as the person that's in the store, or they go and they in a retail pharmacist. Mm-hmm <affirmative> so that's a lot of , that's kind of a wide range. Laurie , what is a phar D and how does a phar D fit into the staff of a

Speaker 3:

Hospital? A phar D is a doctor of pharmacy. We are pharmacists and we are the doctors of our profession. So we are the doctors of medication. Um, how we fit into the hospital is the, the backbone of really medication use in the hospital is what goes on in our inpatient pharmacy, all the IVs and all of the doses of medication that go out and all of the drug shortages that we deal with and try to mitigate our , all in the pharmacist realm. We have pharmacies up on the patient care units that Dr. Haldon , I'm sure you know, many of our,

Speaker 2:

I know them by name.

Speaker 3:

Yes. Yes. Um,

Speaker 2:

They've pulled my Fanny outta the fire more times.

Speaker 3:

<laugh> <laugh> yeah. And , um, those pharm DS are up in the units, you know, consulting , um, answering questions, making suggestions for perhaps appropriate antibiotic therapy or talking about a drug interaction, or we have some new , um , pharm DS up on the units that are trying to plan very carefully for patients that are going home from the hospital, what we call transitions of care. So making sure that when the medication leaves the hospital, that number one, you know, the patient can afford. It knows how to take it is set up with the pharmacy, has the follow up appointments in place. And that's been super beneficial. We have pharm D in our clinics that see patients and go through their medications and make sure that they're using 'em appropriately. Uh, and then we have PharmDs all over in our community pharmacies as well. So you might, if you go to wittier clinic or Brooklyn park or Richfield, we have , uh , pharmacists embedded there. And the providers in those clinics know those pharmacists by name, it

Speaker 2:

Strikes me , uh , um, for listeners, your healthcare team is more than the doctor you're seeing in front of you. Mm-hmm <affirmative>. And if , if you're at a place where it is just your doctor in front of you, that's not a very robust healthcare team. We have teams of other professionals, and I'm so thankful for our pharm D at Hennepin . I can't even tell you . So it's very kind. Yeah, it's a great team of care and , and that's not just at my organization. They have , um , pharm D all over. Yeah . So thanks for that. You also have an expertise in opioids, correct?

Speaker 3:

Yes. Um, I , uh, along with a physician partner, Dr. Resnikoff , who I know has been on the podcast with you as

Speaker 2:

Well. Yes . Oh, oh, that that's handy of you. Yeah. Yeah . For listeners go back to episode three, where we did an , an opioid episode with Dr. Charlie Resnikoff

Speaker 3:

That's right. Yes. Uh , for several years now, I've been involved in the pain clinic at Hennepin and working there and throughout the organization, just to, again, promote safe and effective use of , uh , opioid pain medication,

Speaker 2:

Medication safety. So, so first of all, a lot of people take medications. Mm-hmm <affirmative> I imagine that there's all kinds of ways in which they could be misused accidentally, intentionally , uh, uh, what kind of things do you , do you see

Speaker 3:

At home? You know, it's, it can be difficult sometimes to keep track of everything that you're taking, and it can be easy to leave things in the medicine cabinet, or maybe store away medications that your doctor stopped. And so it's just super important to, you know, store your medications properly so that perhaps when your grandkids come over, that they don't start rooting around in your purse for some Gama . And instead, you know, find your , uh , blood pressure medicine, which can be very scary. If a child even takes a single pill. I also, you know, really promote the use of pill boxes, because I think it's a great adherence tool. I use a pill box myself for the little handful of medicines that I take, and it really helps me remember to take my medication.

Speaker 2:

So I bet a lot of people listening are they could go to their medicine cabinet right now and see a hodgepodge mm-hmm <affirmative> , there might be some vitamins. They bought down at target 15 years ago, and some scuzzy old bottle, there might be some prescription drugs , some of which they take some of which they don't mm-hmm <affirmative>. And none of them have names that anybody really knows what they are. Mm-hmm , <affirmative> what they, what they , uh , were used for. I'm amazed anybody takes their medications correctly, and here's a deal I prescribe 'em <laugh>. And, and I think that , uh , if I had to take 'em , I think I'd struggle to take my pills correctly and to store 'em correctly. And right . When do you throw 'em out? And, and all of that stuff is really, really complicated. You mentioned pill boxes. How does , how does that help? What is a , what is a pill box , other than a hat that Jackie owns used to wear? <laugh> me what a pill box really is.

Speaker 3:

Yeah. So , um, you know, you can buy them on Amazon, you can buy 'em at your local pharmacy, your doctor's office might have some, and it's just a way to get your medication together and then just put in each one of those slots, the medication that you're supposed to take.

Speaker 2:

So, and they're marked with the days of the week

Speaker 3:

Or something exactly marked with the days of the week. And they might be, you know, marked , uh , morning, evening bedtime, honestly. Right. We're all so busy. It's, it's easy to kind of wake up in the morning and take your medication, but then, you know, sometimes people fall asleep and they wake back up again. They're like, did I take

Speaker 2:

My , did I take , I don't even know if I'd have to fall back asleep, I get up and I take one, and then you go brush your teeth, you get dressed, you read the paper, ands , like , dang, did I take my meds ?

Speaker 3:

That's what led me to get a pop box . Really?

Speaker 2:

Yeah . Cause , cause you're , and you're doubling up and you're missing dose . I heard, I don't know if this is true, but I heard that the , uh , there was a study some years ago that the, the one type of medication that the highest compliance or the people take the most accurately was of all things, birth control pills, because it came in a little round thing and you just took each day mm-hmm <affirmative> . But , and the patients, women who were taking them were very , um , motivated to have them work. Yes. Because they, it was so, and even that, even then with them all in a nicely labeled monthly format with all the days of the week, and even in a highly motivated patient still, it was only something like, I don't remember another number, but it was not a hundred percent accurate taking people only took them accurately 70 or 80% of the time. Wow. So , and that was for that very controlled and motivated group of patients. I can't imagine someone who's got a half a dozen medications in various bottles from the pharmacy. Right. How you would ever take them correctly.

Speaker 3:

Right? Yeah. It can be challenging for sure. So, you know, that kind of goes into the question of talking to your doctor on a regular basis to make sure that do I really need to be on these medications? Like, oh, my doctor might have prescribed Gabapentin for my back pain. Is it really helping, you know, talk to your doctor about that? It's, don't put your medications on autopilot, I suppose, is what I would say.

Speaker 2:

I love that point, Lori . And if we , I wanna delve into that a little bit more shift to that about discontinuing medications, cuz as a doctor, I prescribe many of the medications that my patients are, but they might see five or six or seven other doctors mm-hmm <affirmative> somebody else started something. I don't know what it's there for. So I let it go. Mm-hmm <affirmative> maybe it's lazy. I don't know. But, but it it's hard to know. Yeah . And patients aren't sure why they're taking them . They got 'em from a number of different places. Mm-hmm <affirmative> as a pharmacist. I'll bet you see that all the time because you also deal with patients. You you're not a retail pharmacist, you work in a hospital. Mm-hmm <affirmative> I think that that's a great tip for patients and for the people like me who prescribe the drugs to pay attention to, to them and ask really, if you don't know why you're taking it, maybe you should ask.

Speaker 3:

Yes, absolutely. The more that you know about your medications, the better, and then just make sure that your doctor and pharmacists are on the same page in terms of everything that you take, especially, you know, your primary care doctor

Speaker 2:

Mm-hmm <affirmative>. So we've had two good tips already. Number one, pill boxes and ways to manage the medications you might have at home. Mm-hmm <affirmative> number two, ask your doctor or whoever or your pharmacist mm-hmm <affirmative> of what your medications are and why you might need to be on them. Maybe you don't need to be on all of them. I was at a medical conference just three days ago in Washington and they, one of the slides they were showing, we were talking about advocacy and policy. And one of the things they were talking about was the most trusted professions in healthcare . Number one, nurses. Mm . Number two, it was pharmacists. Mm . And number three was the doctors. Now we were close. We were close. But uh , your , your profession , uh , um , out outrages us in being trusted. Now, when we're talking with Lori Willy , she is a pharm D a doctor of pharmacy, a pharmacist at Hennepin healthcare with me. When we come back from the break, we're gonna get into one of her specialty areas that is the opioid epidemic and things you need to know about that. So stay tuned and we'll be right back.

Speaker 1:

You're listening to the healthy matters podcast with Dr . David Hilton , have a question or a comment for the doctor become a part of our show by reaching out to us@healthymattersathcmed.org . Or give us a call at six one two eight seven three talk that's 6 1 2 8 7 3 8 2 5 5 . And now let's get back to more healthy conversation.

Speaker 2:

And we're back talking with Lori Willy pharmacist at Hennepin healthcare opioids, the opioid epidemic, and , and listeners, if you missed it earlier, we do have an episode, episode three, where I talk about the opioid epidemic with Charlie Resnik coffin addiction. Doctor. I wanna talk to you specifically about your thoughts about a, how did we get here and B what ought we to be doing now about the opioid epidemic? So how did we get here? How is it that opioid overdoses are so common? Well,

Speaker 3:

Over and over again, we hear that. Um, I think a lot of us were really naive about the risk of opioids in the nineties. And we were, you know, very susceptible honestly, to some misinformation from some of the pharmaceutical companies about the addictive potential of opioids and when they should be used, but a big part of that, you know, a big part of the blame should be laid on. I feel like healthcare professionals for swallowing that right, we need to be more critical thinkers. Um, drug companies sell drugs. That's what they do. You know, we're the ones that should be looking out for patients. So definitely opioids, we're overprescribed. They were prescribed for chronic pain conditions where opioids aren't effective and a lot of people became dependent on them. Uh, and some of those people developed an addiction, unfortunately. So there was sort of another phase of the opioid epidemic when we were really trying to taper people off of their pain medicine, or maybe , um , some providers were stopping opioids, essentially things got a little bit more dangerous because people were still dependent or , and sometimes addicted, not always on these medications and began seeking medication on the streets. So , um , what's

Speaker 2:

The difference between being dependent and being addicted.

Speaker 3:

So our bodies respond to these medications. We become used to them, our bodies and our brains become used to them being around as part of the mix. And if you stop taking them suddenly you can have vomiting and feel sweaty and feel sick. And , um, so that's a , what we call withdrawal. So dependent just means your body has just become used to the medication. Um, addiction is when you maybe misuse the medication by taking too much, or you kind of get into circumstances where you're using it for something other than pain, maybe you're using it, you know , to treat , um , like an emotional issue or maybe you' bad. Things are happening in your life. You know, you're , um , maybe getting into trouble with your job or you're doing dangerous. Things like injecting. And , um, you're continuing to use, I guess, despite bad things happening. So

Speaker 2:

I, I hear you. I , I hear you and I , I concur with your earlier comments. Um, there's a lot of reasons we got here, I believe, but the healthcare community is, is , um, uh , part of that mm-hmm , <affirmative> maybe at the big part of that, patients simply were seeking relief for the pain. Right? And we were, I remember 20 years ago sitting in what, thankfully doesn't happen anymore, but we'd have drug representatives telling us if your patients have pain, they cannot become addicted. Use these medications mm-hmm <affirmative> and , and that's to their discredit that they were doing that. But it's to our healthcare communities , discredit that , like you said, we were , we didn't think critically enough about that. Mm-hmm <affirmative> and we , and we, I told, I remember telling patients, this is okay, you don't have cancer terminal illness . You don't have some or terminal illness . Mm-hmm <affirmative> , you don't have some horrible thing. Mm-hmm <affirmative> , uh , you , you hurt your back. And here's a opioid to help that, that in hindsight was not the right way to go. And patients, they, they listened to their doctors and , and they, they took the medications and we got to this point, mm-hmm <affirmative> now on , I'm gonna talk about what we do about it now. And I'm gonna frame it with this 20 minutes before coming in to meet you, to do this podcast. I'm driving down to Minneapolis street and there's a huge billboard. And it says, Naloxone reverses, opioid overdose, what is Naloxone? And what was that billboard about?

Speaker 3:

Yeah, Naloxone is a , is a magical drug that reverses the effects of an opioid overdose. It's very easy to administer. You can get a nasal spray from your pharmacist. There are a number of community organizations that have free Naloxone kits that you can carry. I carry Naloxone. I have, do

Speaker 2:

You carry one? Yeah,

Speaker 3:

I do. I have one in my medicine cabinet at home. Um, my kids have one. I, and whenever I have friends that are , um, graduating from high school, I give them a Narcan kit, send them down to send them to college with it just in case. Yeah.

Speaker 2:

So tell me more about that. So you you're , you just, you and your family members carry a Naloxone mm-hmm <affirmative> and , and, and the , the idea being, if you are in a situation mm-hmm , <affirmative> where you are a loved one, or just someone you happen to see mm-hmm <affirmative> is overdosing. You'll have it

Speaker 3:

Exactly because minutes count opioids , um, and overdose stop breathing. And there's not a whole lot of time for first responders to get there. So , um, the more Naloxone out in the community, the better

Speaker 2:

Is it , uh, is there any way , uh, that it can be used unsafely? I mean, let let's say , uh, I've got a Naloxone or mm-hmm <affirmative> uh , and I see somebody who's not doesn't appear to be breathing has passed out, and I believe they've overdosed on opioids. Mm-hmm <affirmative> and I give it to them. What if I was wrong? And they were there , they had something else and yeah , it was it unsafe to give someone Naloxone, if they're not experiencing an overdose

Speaker 3:

That is a safe thing to do, cuz when right when someone's passed out and not breathing, you don't know what they took. Maybe they drank too much alcohol. Maybe they took an opioid. Maybe they took another drug. It's perfectly safe to give Naloxone. It's not gonna hurt the person. How,

Speaker 2:

How

Speaker 3:

Do you give it? Um, one of the easiest ways to give it is with this little, with the little nasal spray and that I think is super slick for people that aren't used to maybe drawing up medications from a vial and administering them , uh , in a syringe with a needle, like into the thigh. But you know, on the other hand, it's very teachable also to draw it up from a syringe and give it , uh , in the thigh intramuscularly . So I'm gonna put a little plugin for a organization I'm on the board of the Steve Rumer hope network. Uh , we distribute free Naloxone and training throughout the community, the whole state of Minnesota. So Google Steve Rumer hope network. And can you spell it? Yeah. Steve and then Rumer , R U M M L E R. Hope network.

Speaker 2:

Steve Rumer hope network. Yeah . I've heard of this and yeah , so I , I was gonna say, where do , where does one get this? Mm-hmm <affirmative> , let's say I have a loved one or a family member. I'm listening to the podcast now. And they are taking an opioid or maybe they have a , a substance use disorder and they, they are , um, they're using street drugs and I'm worried about them. Mm-hmm, <affirmative>, I'm worried about saving their life. If the need comes up, where do I get Naloxone? Do I, you know, it's not for me. I wanna have it on hand. Yeah . And in my glove compartment, because my loved one is at risk. Yes . Where do I get

Speaker 3:

It? Uh, there's a couple different ways to get it. One is you can actually call up your pharmacist, call Walgreens and say, Hey, could you get a Narcan, nasal spray prescription ready for me? And then

Speaker 2:

That's the name of it ? Narcan mm-hmm

Speaker 3:

<affirmative>. Yep . And they can even run it through your insurance. So it's covered like any other prescription drug. Some people would rather have like a free kit kind of off the books. And , um , for that I would Google Steve Rumer hope network and we can get you set up

Speaker 2:

Great tips there. The opioid , uh , epidemic is big. Mm-hmm <affirmative> I'm gonna shift gears. Let's talk about a couple other things around medications before we go to a few listener calls. So you , are you okay with a few listener calls? Sounds great. Okay. Before we do that prescription drugs, just in general, we're off opioids now. Mm-hmm <affirmative> some people take zero, some take one, some take 25. How many, how , how many prescriptions do people generally take

Speaker 3:

The average American adult takes for prescription medications

Speaker 2:

For , for mm-hmm <affirmative>. Wow. Um , I wonder what they are. I wonder if they're for their heart to , you know, I'm trying to think of what I prescribe the most. Let me guess, and I don't know if you know this, but I here's what I prescribe a ton of in primary care, tons of diabetes meds. Mm-hmm <affirmative> tons of blood pressure meds. Mm-hmm <affirmative> tons of cholesterol meds. Mm-hmm <affirmative> tons of antidepressants. Yep . Are they in there? What , what are the top, do you know? What are the top like groups of medications that people take?

Speaker 3:

Yes. Um, you know, antidepressants are not in the top 10. They're

Speaker 2:

Not. Oh , interesting. Okay.

Speaker 3:

But they are commonly prescribed. Another one would be like a asthma inhalers, like albuterol .

Speaker 2:

Oh , I forgot about those. Yeah.

Speaker 3:

Mm-hmm <affirmative> number 10 is , um, a pain medication called hydrocodone and acetaminophen Vicodin. Right? Vicodin Norco. That's

Speaker 2:

In the top

Speaker 3:

10. Yep . That's number 10. Number 10.

Speaker 2:

Well , I , I don't write many of those Laurie . You'd be happy .

Speaker 3:

<laugh>

Speaker 2:

I used to not very much anymore .

Speaker 3:

It's appropriate sometimes. And then , um , Gabapentin is in there too. Is

Speaker 2:

It okay? That's another pain medication, although that was developed as a, as a seizure medicine didn't do anything for seizures. I

Speaker 3:

Don't think. Not too much. No.

Speaker 2:

Do you know what the number one drug is?

Speaker 3:

Atorvastatin.

Speaker 2:

It is a atorvastatin goes under the brand name. Lipitor. Yep . That one doesn't surprise me. Yeah. Let's talk about statins for a minute. Yeah . I , I do a lot with statins Uhhuh . <affirmative> I'll bet. Lots of listeners here have either are either taking a statin or have been told they're supposed to be so the statins. Yeah . How do they work? What do they do? And can you answer this question that I hear a lot from people. I don't wanna take a statin because they, they , um, have all these side effects. Mm-hmm <affirmative> can you, first of all , um , how do they work and are those side effects true? So

Speaker 3:

That's a class of medication that affects how cholesterol is formed metabolized. Um, they're very extremely effective medications. We know that many people can't control their cholesterol through just diet and exercise, including Mr. Wil height . <laugh> yeah .

Speaker 2:

He's someone in your family.

Speaker 3:

Yep . He's been on atorvastatin for a long time. Yeah. So they're , they're great drugs. They have prescribed to the right people. They have proven , uh , benefits in improving mortality. So very important side effects. The most common ones honestly, are probably upset stomach and then the muscle aches can happen, but

Speaker 2:

Yeah, they can, I've said it some it can.

Speaker 3:

Yeah . Yeah . Right. But , um, certainly I don't think it's a reason to avoid taking the medication or at least trying it. Yeah . So

Speaker 2:

Yeah. I , I tell that to people , um, you know, you could eat grass and pine nuts all day long and your cholesterol can still be high because you know, your liver's this manufacturing plant of cholesterol, it's not all what you eat. Mm-hmm <affirmative> and your risks of heart disease are astronomically much higher than any problems of statin. So I'm a I'm of that camp. Although I don't like to say you must take medications for things, right . This is one that people often, if it's, if you're, if you're in the risk groups, I generally do kind of recommend those as

Speaker 3:

Well. Yeah. Dr . Hilton , can I ask you a question? Yeah. So for those drugs, like statins and blood pressure medicines and Metformin, you know, there's some of the most important drugs that people should be taking every day , if they're appropriate. And they're also some of the least kind of glamorous ones and they don't right . They don't have that immediate mm-hmm <affirmative> , um, you know, benefit to them. Right. So how do you get patients motivated to take those

Speaker 2:

Photos ? That's a really good question, Laurie , cuz I say, okay, you can take this Metformin, which is the one for diabetes. I would imagine that's a fairly highly prescribed one mm-hmm <affirmative> because just about everybody with type two diabetes should be, at least tried on Metformin and you're right. You don't get any effect right away. Mm-hmm <affirmative> so I uh , for adults, I tell them about the, the , uh , the risk to their kidneys and their heart and their , uh, and the diabetes is the cause of blindness and kidney failure. Mm-hmm <affirmative> mm-hmm <affirmative> . And so probably the leading cause of leg amputations in this country. And it all starts with taking that Metformin mm-hmm <affirmative> but those are really distant goals. So I that's a good question. I , I do just tell people about the , uh , to I get it. Mm-hmm <affirmative> you're not gonna notice any benefit mm-hmm <affirmative> to your day to day life, but your long term life is, is gonna , is gonna benefit from this. It is a hard one though. Yeah. Motivational prescribing, I guess, is what you're talking about . That's that is kind of, that is kind of a hard one, right? What people do want, they want antibiotics a lot. Yes. And this is another thing we overdo don't we?

Speaker 3:

Yes, we do overdo antibiotics. And uh, you know , I think there's a lot of factors in that. I think we, as patients sometimes kind of expect if we go and see our doctor and we have, you know, a stuffy nose or our eyes look red and we think we might have pink eye or we have a sore throat. And that unfortunately has led to a lot of over prescribing, a lot of , um, bacteria in our environment that have become resistant to antibiotics. So,

Speaker 2:

But it takes five minutes to tell a patient why you don't need an antibiotic for your runny nose. Mm-hmm <affirmative> and that's the right thing to do. Mm-hmm <affirmative> and that's what we should be doing, but it takes 20 seconds to write a prescription for amoxicone. Right. And fortunately, I think there is a little bit more knowledge out there. Mm-hmm <affirmative> do you know what the , the way I can get people to not want an antibiotic? Cuz I tell 'em they're gonna have C diff oh, you know , so , so C diff is a , is a , is a clotty O difficile is a bacteria that lives in the intestines of many of us. And if you take antibiotics unnecessarily, it can kill off the good bacteria, only leaving C diff and you get the worst diarrhea you've ever had. So I tell people you don't wanna get that. Right. So no antibiotics for you. You don't wanna get C diff

Speaker 3:

That's a good, that's a good motivator. Well,

Speaker 2:

We've had a great conversation with Lori will height a pharmacist at Heon healthcare . We've talked about a few issues. I hope you've learned some tips in there. What I'd like to do if it's okay with you, Lori , we have some listeners who have sent in some questions and maybe we can get to those now. Yeah.

Speaker 1:

Okay. Our first question is from Dave in Minneapolis, what's the main concern with expiration dates on prescriptions and what's the best way to dispose of them. Once they're passed.

Speaker 3:

I advise everyone to get rid of , uh , any expired medication in , in the house. Do yeah .

Speaker 2:

Do they break down? Do they become, is it dangerous or are they just less effective? Do you think

Speaker 3:

It's more of a potency issue? And um, so for that reason, I, I recommend getting rid of them and by getting rid of them, what I mean , um, you know, we try to keep all of this excess medication out of the environment.

Speaker 2:

So flushing 'em down the toilets, a Nono,

Speaker 3:

It's not optimal. It

Speaker 2:

Goes into the Mississippi river here, you know ? Right . You know , I don't know where it goes in the rest of the world, but right. Goes back into the environment. Yeah.

Speaker 3:

It's, it's best to just gather things up in a plastic bag. And most pharmacies, these days in the community, Walgreen, CVS and our own Hennepin healthcare pharmacies have a kiosk. It kind of looks like one of those bear proof , garbage cans that you'll see at camp ground , then it gets actually taken to a processing site and

Speaker 2:

It's safely disposed of somehow.

Speaker 3:

Would you like to know how many pounds of medication we disposed of at our Hennepin healthcare pharmacy

Speaker 2:

Year ? No . Okay. I have no idea

Speaker 3:

How <laugh>

Speaker 2:

Pounds we're into pounds.

Speaker 3:

Yes. Uh , it's equal to how much the starting lineup of the Minnesota Vikings ways . <laugh> <laugh>

Speaker 2:

So if you put the whole starting lineup on a scale, that's how many pills ?

Speaker 3:

Yep , yep . Um, 3000 pounds.

Speaker 2:

Oh my gosh.

Speaker 3:

Yeah. Yeah. So

Speaker 2:

That's, that's a, that's a mountain of pills.

Speaker 3:

It sure is. That's a lot. And it's just great to get all of that out of people's medicine cabinets.

Speaker 2:

You know, what's really interesting about that is people think, well, who cares? I've got four pills, you know, who cares what I do with them, but in aggregate, we all have all that. It ends up to be 3000 pounds. Take 'em to the kiosk at your pharmacy. That's the best in

Speaker 3:

Advice . Yeah . Yep . Exactly.

Speaker 1:

Thanks for that. And this one is on everybody's mind, but Amber and Winona wondered why are meds so expensive in the United States in your opinion?

Speaker 2:

Is it because pharmacists get all the , get all the money for 'em

Speaker 3:

<laugh> no,

Speaker 2:

I'm gonna tell you right now. It is not the , it is not your clinic. It is not your pharmacist. It's not me. We're not the ones that are are driving.

Speaker 3:

Um, you know, honestly the reason why prescription drugs are so expensive in the United States is capitalism.

Speaker 2:

Yeah. Yeah . It's a market driven system.

Speaker 3:

It is. It is. Um, due to our lack of regulation, I suppose. Um, we are kind of ripe for exploitation when it comes to what we're being charged for prescription medications, there probably isn't enough competition and there's been a lot of consolidation in the drug industry with different companies buying each other up .

Speaker 2:

So, and I know it's a political conversation, but I belong to a physician organization that has an opinion on this. So, you know, it's our, you know , Medicare, probably the largest buyer of medications in the country. I don't know if it's the largest one must be mm-hmm <affirmative> cannot is prohibited from negotiating drug prices. Mm-hmm <affirmative> and so we simply must pay what the pharmaceutical companies want to charge. So , you know , it is a , it's a market driven system. Yeah . Well thank you. That was , uh , uh , everybody's probably got opinions about why medications are so expensive.

Speaker 3:

Yeah . But yeah, it's a , it is a cynical answer, but it's, I think it's true

Speaker 2:

Related to that, you know? Okay. So people have out of pocket expenses, Lori , for , for their meds. I wonder how much people have to spend

Speaker 3:

Statistics say that for the average individual, their prescription drugs cost $1,200 a year. That's not necessarily out of pocket cost in terms of what patients are paying. I think it varies widely mm-hmm <affirmative> where you live. Minnesota, I think is one of the better places to live in terms of getting coverage for prescription drugs. And then too, obviously like if you're employed or not and what kind of insurance your employer offers. And so, yeah, really, really variable. It's,

Speaker 2:

It's truly an issue in our, in our healthcare , uh , our system

Speaker 3:

Definitely.

Speaker 2:

So we've been talking to Dr . Laurie Willy . She is a doctor of pharmacy at Tenpin healthcare , a colleague of mine. Thank you for being on the show today.

Speaker 3:

Thank you, Dr . Helton . I

Speaker 2:

Enjoy that . It's been great having you on and I hope we can get you on a future show. I'd love that. I want to thank you all for tuning into this episode and be sure to browse the archives for previous shows, including the one on opioids, which is episode three with Dr. Charlie Resnikoff. And I hope you'll tune in for our next episode and in the meantime, be healthy and be well.

Speaker 1:

Thanks for listening to the healthy matters podcast with Dr . David Hilton , to keep up to date with the latest in healthcare and your health, visit our website@healthymatters.org . And if you have a question or comment for the doctor, email us@healthymattersathcmed.org , or give us a call at six one two eight seven three . Talk if you enjoyed this podcast and would like to support us, please leave us a review and share the healthy matters podcast with your friends and family. The healthy matters podcast is made possible by Hennepin healthcare in Minneapolis, Minnesota, and engineered by John Lucas at highball executive producers are Jonathan Camuto and Christine Hill . Please remember we can only give general medical advice during this program. And every case is unique . We urge you to consult with your personal physician. If you have more serious or pressing health concerns until next time, be healthy and be well.