1. Painkillers (Opioids & NSAIDs)

Pain relief is essential—but it comes with serious risks. Opioids are typically used short-term for severe pain, especially in hospitals. NSAIDs, on the other hand, are over-the-counter staples used for everything from headaches to arthritis.

Examples:

• Opioids: Oxycodone, hydrocodone, morphine

• NSAIDs: Ibuprofen, naproxen, diclofenac

Common Uses:

• Acute injuries, surgery, arthritis, chronic pain

Risks:

• Opioids: Sedation, respiratory depression, overdose, addiction

• NSAIDs: GI bleeding, kidney damage, increased heart risk with long-term use

Quick Tip: If you’re in the hospital on IV opioids, ask to trial an oral version before discharge. You’ll want to make sure it works before you’re sent home.

Risk Reduction:

• Use the lowest effective dose for the shortest possible time

• Avoid combining opioids with alcohol or other sedatives

• Consider non-drug options like physical therapy, mindfulness, or exercise

Did You Know? In 2021, more than 80,000 overdose deaths in the U.S. involved opioids—many of them prescription-related.

2. Antibiotics

Antibiotics are life-saving. But today, they’re often overprescribed, misused, and misunderstood. Taking them when they’re not needed—or stopping them too early—contributes to antibiotic resistance and harmful side effects.

Examples:

• Amoxicillin, azithromycin, ciprofloxacin

Common Uses:

• Ear, throat, skin, and urinary tract infections

Risks:

• Antibiotic resistance, making future infections harder to treat

• C. difficile infection (a serious GI illness), especially in older adults

• Allergic reactions, nausea, diarrhea

Risk Reduction:

• Only take antibiotics when truly necessary

• Always complete the full course—don’t save some for later

• Don’t pressure your provider for antibiotics for viral illnesses (colds, flu)

3. Benzodiazepines

This class of medication is incredibly effective—but also easy to misuse. Benzodiazepines can provide quick relief from anxiety and sleep problems, but they shouldn’t be long-term solutions.

Examples:

• Lorazepam, diazepam, clonazepam

Common Uses:

• Anxiety, insomnia, panic attacks, seizures

Risks:

• Drowsiness, falls, confusion

• Dependency and withdrawal symptoms

• Increased risk of dementia with long-term use

Note: Benzos are best used short-term, for 2–4 weeks max, unless under close supervision.

Risk Reduction:

• Explore non-drug alternatives like therapy, mindfulness, or CBT

• Avoid alcohol or other sedatives

• Taper slowly under medical guidance if stopping

4. Proton Pump Inhibitors (PPIs)

PPIs are among the most prescribed drugs for acid reflux and ulcers—but they’re often used longer than necessary, which can lead to serious side effects.

Examples:

• Omeprazole, pantoprazole, esomeprazole

Common Uses:

• GERD, acid reflux, stomach ulcer prevention (especially with NSAIDs)

Risks (especially long-term):

• Bone thinning, fractures

• Deficiencies in magnesium, B12

• Higher risk of pneumonia or C. difficile infection

Risk Reduction:

• Use short-term unless medically necessary

• Reassess need every 3–6 months

• Try lifestyle changes: smaller meals, weight loss, elevate head of bed

5. Antidepressants

Used widely for mental health and sometimes chronic pain, antidepressants can be essential—but side effects are common and often under-discussed.

Examples:

• SSRIs (sertraline, fluoxetine), SNRIs, tricyclics

Common Uses:

• Depression, anxiety, PTSD, neuropathic pain

Risks:

• Weight gain, sexual dysfunction

• Insomnia or agitation

• Increased suicidal thoughts in younger users, especially when first starting

• Withdrawal symptoms if stopped abruptly (dizziness, mood swings, brain zaps)

Risk Reduction:

• Start low and go slow, especially in older adults

• Don’t stop suddenly—taper under medical guidance

• Combine with therapy for best long-term outcomes

6. Corticosteroids

Steroids can be life-saving in conditions like asthma or autoimmune diseases, but they carry serious risks—especially when used long-term or stopped abruptly.

Examples:

• Prednisone, dexamethasone, methylprednisolone

Common Uses:

• Asthma, COPD, autoimmune conditions, inflammation

Risks:

• Bone loss, weight gain, mood changes

• Elevated blood sugar, even in non-diabetics

• Suppressed immune system and infection risk

Note: If you’re started on a high-dose steroid in the hospital, make sure you understand the tapering plan—suddenly stopping can be dangerous.

Risk Reduction:

• Use shortest course possible

• Monitor bone density and blood sugar

• Ask about inhaled or topical options that have fewer systemic effects

Key Takeaways

• Just because a drug is common doesn’t mean it’s harmless

• Always ask: Do I still need this?

• Prioritize lifestyle changes and non-drug treatments when appropriate

• Review your medications regularly—especially if you’re on five or more

Medication Safety Checklist

Before your next refill, ask your doctor or pharmacist:

• Do I still need this medication?

• Could the dose be lowered or the drug stopped?

• Are there safer or non-drug alternatives?

• What side effects should I watch for?

• When should this be reviewed again?

Final Thoughts

Managing medications doesn’t have to be overwhelming—but it does take awareness, communication, and regular reassessment. Whether you’re helping an aging parent, managing chronic illness, or just trying to be smarter about your own health, understanding your medications is one of the most important things you can do.

Next week, I’ll dive into natural and alternative strategies for anxiety and sleep issues—especially if you’re trying to cut back on medications like benzodiazepines. Stay tuned!